bluuebunny/crossref_metadata_2025_split huggingface dataset:
Features and severity of occupational asthma upon diagnosis: an Italian multicentric case review
Authors: Moscato G. , Dellabianca A. , Maestrelli P. , Paggiaro P. , Romano C. , De Zotti R. , Marabini A. , Voltolini S. , Crippa M. , Previdi M. , Bramé B. , Benzon R. , Siracusa A. 
Published: March 2003

Background. The severity of occupational asthma (OA) at the time of diagnosis is not known. In this study we aimed to evaluate some features of the disease at the time of diagnosis, particularly looking at severity and treatment before diagnosis. Methods: Medical records of subjects (n = 197) who had received a diagnosis of OA in six specialized centres of Northern and Central Italy in the period 1992–97 were reviewed. The severity of the disease at the time of diagnosis was determined on the basis of symptoms, peak expiratory flow (PEF, percentage predicted), forced expiratory volume in one second (FEV1, percentage predicted), and PEF variability, following the criteria of the National Institutes of Health and World Health Organizaton (NIH/WHO) guidelines on asthma. Medications used in the month before diagnosis were recorded. Results: The most common etiological agents were isocyanates (41.6%), flours (19.8%), woods (9.7%) and natural rubber latex (7.6%). The level of asthma severity (AS) was mild intermittent in 23.9% patients, mild persistent in 28.9%, moderate in 41.6%, and severe in 5.6%. Asthma severity was positively associated with current or previous smoking (P < 0.05), and was not related to atopy and current exposure. A relationship with bronchial reactivity to methacholine was shown in subjects at work. Treatment before diagnosis was consistent with the NIH/WHO guidelines in only 13.2% patients, whereas 75.6% were undertreated and 11.2% were overtreated. Conclusions: In this study we found that the majority of patients had mild asthma at the time of diagnosis and that cigarette smoking was associated with a greater severity. Moreover, the majority of patients were undertreated before etiological diagnosis.
Occupational rhinoconjunctivitis and asthma in a wool worker caused by Dermestidae spp.
Authors: Brito F. Feo , Mur P. , Barber D. , Lombardero M. , Galindo P. A. , Gómez E. , Borja J. 
Published: March 2003

Background: The family Dermestidae belongs to the order Coleoptera. Occupational allergy has been described in museum personnel. A 31‐year‐old male wool worker presenting rhinoconjunctivitis and asthma episodes probably linked to exposure to Dermestidae‐infected wool was investigated.Methods: Extracts prepared either from insect bodies or from dust from parasitized wool were used for skin prick testing (SPT), conjunctival and bronchial provocation tests and in vitro determinations.Results: SPT and provocation tests were positive to both extracts. PEFR measurement demonstrated the association between the patient's symptoms and occupational exposure to Dermestidae. Specific IgE to both extracts was detected and immunoblotting revealed several protein bands from 5 to 200 kDa that were reactive to IgE from the patient's serum.Conclusions: Dermestidae exposure in wool workers when handling parasitized wool can be a cause of IgE‐mediated rhinoconjunctivitis and asthma.
Circulating Interleukin 16 (IL‐16) in children with atopic/eczema dermatitis syndrome (AEDS): a novel serological marker of disease activity
Authors: Frezzolini A. , Paradisi M. , Zaffiro A. , Provini A. , Cadoni S. , Ruffelli M. , De Pità O. 
Published: March 2003

Background: Chemokines play a central role in atopic eczema/dermatitis syndrome (AEDS). Interleukin 16 (IL‐16) has been described as a main cytokine involved in CD4+ cell recruitment during inflammation. Recently the influx of CD4+ lymphocytes has been related to the up‐regulation of IL‐16 in AEDS skin lesions. Circulating β‐chemokines (Eotaxin and RANTES) and IL‐16 were investigated in children with AEDS to correlate their presence with the severity of the disease. We also measured serum levels of soluble CD30 (sCD30), a marker of Th2 immune responses related to AEDS disease activity.Methods: Serum levels of eotaxin, RANTES, IL‐16 and sCD30 were measured by immunoenzymatic assay in paediatric patients with pure AEDS (pAEDS, n = 39); the severity of the disease was graded by SCORAD. Fifteen children with AEDS in presence of respiratory allergy (AEDS+A), 15 with allergic asthma (A) and 20 age‐matched healthy donors were investigated as control groups.Results: When compared to normals, high amounts of Eotaxin and IL‐16 were detected in sera of pAEDS (P = 0.002; P < 0.0001), AEDS+A (P = 0.02; P = 0.01) and A patients (P = 0.004; P = 0.03) with respect to normals. Serum levels of RANTES were also elevated in pAEDS patients, significantly higher than normals (P = 0.009), whereas no statistically significant differences could be detected between pAEDS and AEDS+A or A groups. IL‐16 was progressively increased in the different stages of pAEDS, with a positive correlation between IL‐16 and both SCORAD and sCD30 (P < 0.0001).Conclusion: We suggest that IL‐16 could serve as a useful marker of disease activity in childhood pAEDS.
In allergic asthma experimental exposure to allergens is associated with depletion of blood eosinophils overexpressing LFA‐1
Authors: Lantero S. , Spallarossa D. , Silvestri M. , Sabatini F. , Scarso L. , Crimi E. , Rossi G. A. 
Published: March 2003

Background: In atopic individuals, exposure to allergens is followed by recruitment of blood eosinophils in the target tissue. We investigated whether allergen inhalation challenge could result in depletion of blood eosinophils overexpressing adhesion molecules involved in eosinophil migration.Methods: Blood eosinophils were isolated from seven atopic asthmatic patients and seven control subjects and the “at baseline” expression of lymphocyte function‐associated antigen‐1 (LFA‐1), macrophage antigen‐1 (Mac‐1) and very late antigen‐4 (VLA‐4) was assessed by monoclonal antibody staining and flow cytometry analysis. Asthmatic patients underwent allergen challenge and the expression of LFA‐1, Mac‐1 and VLA‐4 by blood eosinophils was again evaluated 3 h and 24 h after allergen challenge.Results: As compared to controls, eosinophils from atopics showed at baseline enhanced LFA‐1 expression (P=0.0012), but similar Mac‐1 or VLA‐4 expression (P > 0.1, each comparison). In atopics, the percentage and absolute number of blood eosinophils were significantly decreased 3 h after allergen challenge (P=0.001 and P=0.022, respectively) but returned to similar values to prechallenge values after an additional 21 h (P > 0.1). Allergen challenge was also followed by a significant decrease in LFA‐1 expression by eosinophils, at 3 h (P=0.002) and at 24 h (P=0.038), while no changes in Mac‐1 and VLA‐4 were observed. A significant correlation between postchallenge decrease in LFA‐1 expression and in blood eosinophilia, both expressed as percentage (r=0.88; P < 0.01) or absolute number (r=0.87; P < 0.01) was demonstrated at 3 h (r=0.88; P < 0.01) but not at 24 h (r=0.64, P > 0.05 and r=0.11; P > 0.05, respectively).Conclusion: In allergic asthma, an early recruitment of blood eosinophils overexpressing LFA‐1 occurs in the first hours after allergen challenge.
Dustborne and airborne fungal propagules represent a different spectrum of fungi with differing relations to home characteristics
Authors: Chew G. L. , Rogers C. , Burge H. A. , Muilenberg M. L. , Gold D. R. 
Published: March 2003

Background: Exposure to fungi is often assessed by culturing floor dust or air samples. Our objective was to evaluate the relationships between dustborne and airborne fungi and to identify factors that modify these relationships.Methods: From November 1994 to September 1996 sequential duplicate 45‐l air samples were collected in bedrooms of 496 homes in the Boston area, using a Burkard culture plate sampler. After air sampling, bedroom floors were sampled with a vacuum cleaner that was modified to collect dust in a cellulose extraction thimble. Dust was sieved, and the fine dust was dilution‐plated onto DG‐18 media.Results: Concentrations of total culturable fungi per gram of bedroom‐floor dust were correlated weakly, but significantly, with those of indoor air (r = 0.13, P < 0.05). Concentrations of some individual taxa in the dust and indoor air were also weakly associated. Adjusting for the concentrations of fungi in outdoor air, dustborne fungal concentrations were positively associated with those in indoor air for the taxa Cladosporium and Penicillium, but not for total fungi. The indoor air fungal levels were often predicted by different covariates to those predicting fungal levels in dust. The type of housing (house or apartment) and the presence of carpeting were often predictive factors for dust fungi. In contrast, outdoor fungal levels were often predictive of the indoor air fungal levels.Conclusions: Because our data do not indicate a strong overall relationship between culturable fungi in dust and indoor air, the results from these two methods (dust and air sampling) likely represent different types of potential fungal exposures to residents. It may be essential to collect both air and dust samples, as well as information on housing characteristics, as indicators for fungal exposure.
Beef allergy: a review of 12 cases
Authors: Orhan F. , Sekerel B. E. 
Published: March 2003

Background: Although beef allergy has long been considered a rare condition, the number of studies regarding the nature, epidemiology, and symptoms of beef allergy has been increasing. We aimed to describe the results of allergy work‐up of 12 patients who have a convincing history of acute allergic symptoms following beef ingestion.Methods: Detailed histories of 10 children and two adult relatives were obtained and patients underwent skin prick tests with commercial beef extract, raw beef and cooked beef. Serum total and beef‐specific IgE were measured. Labial, and in selected cases, open food challenges were undertaken.Results: Interestingly, the rate of family history of beef allergy was 67% (8/12). Three patients (two with commercial extract, and one with cooked beef) had positive skin test responses to beef. Ten (83%) patients had elevated serum IgE concentrations (median 316.5 kU/l, range 9–1321 kU/l) and the beef‐specific IgE was positive in all patients (median 6.23 kUA/l, range 0.83–36.6 kUA/l). Labial food challenge was positive in four (30%) patients. Of the five patients who underwent open food challenges, three were positive and two tolerated the beef administered.Conclusions: We conclude that skin prick tests do not accurately diagnose IgE‐mediated sensitization to beef. Thus, patients with suspected beef allergy should be screened additionally for beef‐specific IgE antibodies, and in selected cases oral food challenge should be carried out to verify the diagnosis.
Facial clefting in an Arab town in Israel
Authors: Jaber L , Nahmani A , Halpern GJ , Shohat M 
Published: March 2003

To study the prevalence of cleft palate and cleft lip with or without cleft palate in an Israeli Arab town, questionnaires were sent to the parents of 1375 pupils in grades 1 and 2 in all seven primary schools in the town of Taibe, and 1281 responded. The information requested included data about siblings and members of the parental generation to give a total of 16 174, and the presence of consanguinity and history of exposure to medication, radiation, smoking or alcohol during pregnancy.There were four affected individuals among the index cases, of whom two had cleft palate only and two cleft lip with cleft palate, giving prevalence rates for each of these of 1.56/1000. Adding to these the number of affected siblings gave a total of 10 affected individuals; two with cleft palate only (0.39/1000) and eight with cleft lip with or without cleft palate (1.56/1000). Among the parental generation, of 16 reported affected individuals, two had cleft palate only (0.18/1000) and 14 cleft lip with or without cleft palate (1.26/1000). The overall prevalence rate for all 26 affected individuals was 1.6/1000; four of these had cleft palate only (0.24/1000) and 22 had cleft lip with or without cleft palate (1.36/1000). There were no cases whose mothers had been exposed to medication, radiation, smoking or alcohol during pregnancy. The effect of consanguinity was not significant (P < 0.92). This study shows that the prevalence of facial clefting in an Israeli Arab community is consistent with that in the general population worldwide.
Internal hernia of the small bowel around infrarenal arterial conduits after liver transplantation
Authors: Nishida Seigo , Pinna Antonio G , Nery Jose R , Levi David , Kato Tomoaki , Madariaga Juan , Tzakis Andreas G 
Published: March 2003

Nishida S, Pinna AG, Nery JR, Levi D, Kato T, Madariaga J, Tzakis AG. Internal hernia of the small bowel around infrarenal arterial conduits after liver transplantation. Clin Transplant 2002: 16: 334–338. © Blackwell Munksgaard, 2002Internal hernia of the small bowel is an uncommon but fatal complication of liver transplantation. The placement of infrarenal arterial conduits for arterial revascularization is an important technique for arterial reconstruction after liver transplantation. We report three cases of internal hernia with volvulus of the small bowel caused by the use of infrarenal arterial conduits. We reviewed the records of 1066 consecutive patients who underwent orthotopic liver transplantation between June 1994 and April 2000 at the University of Miami. In 271 of these patients, grafts were revascularized by anastomosing the donor iliac artery to the infrarenal aorta (an infrarenal arterial conduit).Two patients died after the surgery. One patient died of multiple organ failure because of sepsis 1 month after the surgery that involved reduction of the internal hernia and biliary reconstruction. Another patient died of multiple organ failure because of sepsis 8 days after the surgery that involved reduction of the internal hernia and adhesiolysis. One patient survived after the surgery that involved thrombectomy of the arterial graft and reduction of the internal hernia. Although there was ischemic damage to the liver after the surgery, the patient recovered. However, he died of liver failure because of recurrent infection with the hepatitis C virus 18 months after the surgery.Transplant surgeons should be aware that this complication causes not only bowel obstruction but also hepatic arterial thrombosis and ischemic liver damage. In order to prevent this complication, the arterial conduit should be retroperitonealized at the time of transplantation.
Onset of action of antipsychotics in the treatment of mania
Authors: Tohen Mauricio , Jacobs Thomas G , Feldman Peter D 
Published: March 2003

Introduction:

An important consideration in treating acute mania is the promptness with which a chosen therapy can bring symptom amelioration. This article reviews the available published data from controlled, blinded studies regarding the latency of responses to antipsychotics in patients with acute mania.

Methods: Articles for this review were obtained from a search of the Medline database (1966–1999), using the following keywords and phrases: antipsychotic, atypical, bipolar disorder, mania, neuroleptic, typical. The bibliographic sections of articles gleaned from this search were used to direct further inquiries.

Results: Although information regarding the onset of action of antipsychotics is limited, we discovered data for four typical and three atypical antipsychotics. Drugs with the fastest onsets include haloperidol, risperidone, and olanzapine, with onsets appearing in 2–6 days. Chlorpromazine and thiothixene were at the slowest end of the continuum, with onsets of 2 weeks or longer. Data regarding pimozide are mixed, with some studies showing an onset equivalent to that of the ‘fast’ compounds and others showing one similar to that of the ‘slow’ compounds.

Conclusions: Choice of therapy should consider not only efficacy and safety, but also onset speed. Atypical antipsychotics appear to offer safer, faster, and more effective therapies.
Impact of axis II comorbidity on the course of bipolar illness in men: a retrospective chart review
Authors: Kay Joanne H , Altshuler Lori L , Ventura Joseph , Mintz Jim 
Published: March 2003

Objectives:
The purpose of this study was to investigate whether the presence of comorbid personality disorder influences the course of bipolar illness.
Methods:
Fifty‐two euthymic male bipolar I out‐patients were assessed using the Structured Clinical Interview for DSM‐III‐R Personality Disorders (SCID II). Bipolar patients with an axis II diagnosis were compared with those without an axis II diagnosis on retrospectively obtained demographic, clinical and course of illness variables.
Results:
Thirty‐eight percent of the bipolar patients met criteria for an axis II diagnosis. Two (4%) met criteria for (only) a Cluster A disorder, four (8%) for (only) a Cluster B, and six (12%) for (only) a Cluster C disorder. One (2%) bipolar patient met criteria a disorder in both Clusters A and B, and one (2%) for a disorder in Clusters B and C. Five (10%) met criteria for at least one disorder in Clusters A and C, and one met criteria for disorders in Clusters A, B, and C. The presence of a personality disorder was significantly associated with a lower rate of current employment, a higher number of currently prescribed psychiatric medications, and a higher incidence of a history of both alcohol and substance use disorders compared with the bipolar patients without axis II pathology.
Conclusions:
Our results extend previous findings of an association between comorbid personality disorder in bipolar I patients and factors that suggest a more difficult course of bipolar illness.
Pramipexole in treatment‐resistant depression: a 16‐week naturalistic study
Authors: Lattanzi Lorenzo , Dell'Osso Liliana , Cassano Paolo , Pini Stefano , Rucci Paola , Houck Patricia R , Gemignani Alfredo , Battistini Giulia , Bassi Annalisa , Abelli Marianna , Cassano Giovanni B 
Published: March 2003

Lattanzi L, Dell'Osso L, Cassano P, Pini S, Rucci P, Houck PR, Gemignani A, Battistini G, Bassi A, Abelli M, Cassano GB. Pramipexole in treatment‐resistant depression: a 16‐week naturalistic study. Bipolar Disord 2002: 4: 307–314. © Blackwell Munksgaard 2002
Objective: To assess the antidepressant efficacy and tolerability of adjunctive pramipexole, a D2–D3 dopamine agonist, in patients with drug‐resistant depression.
Methods:
The study sample consisted of in‐patients with major depressive episode, according to the DSM‐IV, and drug resistance. Pramipexole was added to antidepressant treatment with TCA or SSRI, at increasing doses from 0.375 to 1.0 mg/day. Two independent response criteria were adopted: a >50% reduction of the Montgomery–Asberg Depressive Rating Scale (MADRS) total score and a score of 1 or 2 on the Clinical Global Impression scale (CGI‐I) at endpoint. Side‐effects were assessed by the Dosage Record Treatment Emergent Symptom Scale (DOTES).
Results:
Thirty‐seven patients were enrolled. Of these, 16 had unipolar depression and 21 had bipolar depression. Six patients dropped out in the first week. Of the 31 patients included in the analyses, 19 completed the 16‐week follow‐up. Mean maximal dose of pramipexole was 0.95 mg/day. Mean scores on MADRS decreased from 33.3 ± 8.4 at baseline to 13.9 ± 11.5 at endpoint (p < 0.001) and the CGI‐S decreased from 4.6 ± 0.8 at baseline to 2.8 ± 1.3 at endpoint (p < 0.001). At endpoint, 67.7% (21/31) of patients were responders on MADRS and 74.2% on CGI‐I. Of the 37 patients enrolled, 10 discontinued pramipexole because of adverse events.
Conclusions:
These preliminary data suggest that pramipexole adjunction to antidepressant treatment may be effective and well tolerated in patients with resistant major depression.
A pilot study of loading versus titration of valproate in the treatment of acute mania
Authors: Oluboka OJ , Bird DC , Kutcher S , Kusumakar V 
Published: March 2003

Objective:  This double‐blind pilot study compares the effectiveness and incidence of adverse effects of oral loading versus titration schedules of valproate in acute mania.Method:  Consecutive new admissions for an acute manic episode were prescribed either an oral loading dose (20 mg/kg/day; n=5; mean age=33.4) or slower titration dose (10 mg/kg/day; n=6, mean age=30.6) of valproate for 7 days without other psychotropic agents, with the exception of benzodiazepines. Daily outcome measures included: serum valproic acid levels, the Young Mania Rating Scale (YMRS), the Brief Psychiatry Rating Scale (BPRS), the Clinical Global Impression Scale (CGI) and the Adverse Effect Rating Scale.Results:  The mean serum valproic acid levels were significantly higher in the loading group when compared with the titration group after 1 and 2 days following the initiation of treatment (p < 0.05). After 3 days of treatment there was a trend for the group that received the loading regimen to have slightly more improvement in YMRS scores compared with the titration group. Side‐effects were minor for both treatments, however, a higher incidence of side‐effects was reported in the titration group, with 50% of patients reporting sedation most likely because of increased use of benzodiazepines.Conclusion:  This suggests that a loading dose of valproate is likely safe and may provide an earlier onset of antimanic effects in patients with bipolar disorder. Future studies with larger sample sizes are indicated.
The impact of response to previous mood stabilizer therapy on response to olanzapine versus placebo for acute mania
Authors: Baker Robert W , Goldberg Joseph F , Tohen Maurico , Milton Denái R , Stauffer Virginia L , Schuh Leslie M 
Published: March 2003

Objectives:
A clinically important question for any new treatment for bipolar disorder is whether its efficacy extends to patients who have both responded and failed to respond to other mood stabilizers. In this secondary analysis of a placebo‐controlled trial demonstrating olanzapine's efficacy for acute mania, we explore whether its usefulness extends to those patients with a history of poor response to other mood stabilizers.

Methods: This 4‐week, double‐blind, placebo‐controlled trial studied olanzapine monotherapy 5–20 mg/day for hospitalized patients in acute manic or mixed bipolar episodes. The primary outcome variable was beginning to endpoint change in the Young‐Mania Rating Scale (Y‐MRS) total score. We investigated whether prospectively identified history of recent failure to respond to other mood stabilizers predicted response to olanzapine.

Results: As previously reported, olanzapine‐treated patients experienced significantly greater improvement in Y‐MRS total score and higher remission rates relative to placebo‐treated patients. The current analysis compared these outcome parameters in patients with known poor prior response to lithium and/or valproate with all other patients and found no significant group by treatment interactions, i.e., treatment effects were not significantly diminished in non‐responders to older mood stabilizing agents.

Conclusions: Olanzapine has been shown to be superior to placebo for the treatment of mania. This secondary analysis suggests that olanzapine monotherapy is similarly effective for patients whether or not they previously have failed to respond to another mood stabilizer for mania. A study limitation is that response to lithium or valproate was determined retrospectively.