bluuebunny/crossref_metadata_2025_split huggingface dataset:
Persistent skin colonization with Staphylococcus aureus in atopic dermatitis: relationship to clinical and immunological parameters
Authors: Guzik T. J. , Bzowska M. , Kasprowicz A. , Czerniawska‐Mysik G. , Wójcik K. , Szmyd D. , Adamek‐Guzik T. , Pryjma J. 
Published: April 2005

SummaryBackground
Staphylococcus aureus has important implications for the pathogenesis of atopic dermatitis (AD). In some patients S. aureus can be eradicated from the skin during anti‐inflammatory treatment, while in others bacterial colonization is persistent. Potential mechanisms and features of these two distinct groups of patients are not known.Objective
Accordingly, we studied relationships between the ability to eliminate S. aureus during an anti‐inflammatory treatment and selected clinical and immunological features.Methods
Quantitative assessment of S. aureus on the skin, in nasal vestibule and throat, serum IgE levels, CD4/CD8 T‐cell ratio, lymphocyte proliferation and phagocyte oxidative burst were determined during the exacerbation and after 4 and 12 weeks of the treatment using topical steroid and oral antihistamine in 34 patients with AD.Results
S. aureus was found on the skin of all 34 patients during exacerbation. Disease severity scoring of atopic dermatitis (SCORAD) correlated with the density of bacteria. Treatment with oral antihistamine and topical steroid resulted in a significant alleviation of symptoms, which correlated with the elimination of S. aureus from the skin in 70% of patients. In the remaining 30% of patients, dense (more than 1010/cm2) S. aureus skin colonization, persisted despite the treatment. Patients with persistent S. aureus presented with higher serum IgE levels, lower lymphocyte proliferation in response to staphylococcal enterotoxin B, phytohaemagluttinin and anti‐CD3. Persistence of S. aureus was more common in men.Conclusions
Patients with AD differ in the ability to clear S. aureus from the skin during anti‐inflammatory treatment, which appears to be related to the abnormalities in immunological parameters. Local antibiotic therapy should be considered only in patients with persistent S. aureus colonization.
Early‐ and late‐phase bronchoconstriction, airway hyper‐reactivity and cell influx into the lungs, after 5′‐adenosine monophosphate inhalation: comparison with ovalbumin
Authors: Smith N. , Johnson F. J. 
Published: April 2005

SummaryBackground
Antigen inhalation in atopic asthmatic patients results in an early asthmatic response (EAR), accompanied by a late asthmatic response (LAR) in 60% of patients. Inhaled 5′‐adenosine monophosphate (5′‐AMP) causes immediate bronchoconstriction in asthmatics but not in normal subjects.Objectives
The aims of this study were to investigate whether 5′‐AMP can produce a LAR, airway hyper‐reactivity (AHR) and cell influx to the lungs, in a sensitized guinea‐pig model of asthma, and to compare with the profile of activity after ovalbumin (OVA) inhalation.Methods
Airway responses to inhaled OVA (10 μg/mL) and 5′‐AMP (3 and 300 mm) of actively sensitized, conscious guinea‐pigs were determined by whole body plethysmography as the change in specific airway conductance (sGaw). Inhaled histamine (1 mm) was used to investigate AHR, and cell influx was determined by bronchoalveolar lavage (BAL).Results
Exposure to OVA revealed an EAR, and LAR at 6 h post‐challenge. AHR to histamine occurred 24 h after challenge together with a significant increase in total and differential (eosinophils and macrophages) cell counts. Low dose 5′‐AMP (3 mm) produced an EAR, LAR at 6 h after challenge, and AHR to histamine 12 h post‐challenge. No AHR occurred 24 h after inhalation. Total and macrophage cell counts were increased significantly 6, 12 and 24 h after exposure. Bronchodilatation followed high dose 5′‐AMP (300 mm), followed by a LAR at 6 h. AHR to histamine occurred 12 h after challenge, but not at 24 h. A significant increase in total and differential (eosinophils and macrophages) cell counts occurred 6, 12 and 24 h post‐exposure. No changes were observed in non‐sensitized guinea‐pigs.Conclusion
OVA challenge revealed an EAR, LAR, cell influx and AHR in a guinea‐pig model of asthma. This study demonstrated for the first time that a LAR and AHR to histamine can be revealed following 5′‐AMP inhalation, in sensitized but not unsensitized guinea‐pigs. Cell influx at 6, 12 and 24 h post‐challenge suggests that it may be associated with the LAR and AHR.
Temperature measurement: comparison of non‐invasive methods used in adult critical care
Authors: Farnell Sarah , Maxwell Lorraine , Tan Seok , Rhodes Andrew , Philips Barbara 
Published: April 2005

Aims and objectives.  To assess accuracy and reliability of two non‐invasive methods, the chemical (Tempa.DOTTM) and tympanic thermometer (GeniusTM First Temp M3000A), against the gold standard pulmonary artery catheter, and to determine the clinical significance of any temperature discrepancy using an expert panel.Background.  There is continued debate surrounding the use of tympanic thermometry in clinical practice.Design.  Prospective study.Methods.  A total of 160 temperature sets were obtained from 25 adult intensive care patients over a 6‐month period.Results.  About 75.2% (n = 115) of chemical and 50.9% (n = 78) of tympanic readings were within a ±0.0–0.4 °C range of the pulmonary artery catheter. Both the chemical and tympanic thermometers were significantly correlated with temperatures derived from the pulmonary artery catheter (r = 0.81, P < 0.0001 and r = 0.59, P < 0.0001) and limits of agreement were −0.5–0.9 °C and −1.2–1.2 °C respectively. The chemical thermometer was associated with a mean temperature difference of 0.2 °C, which increased 0.4 °C when used in conjunction with a warming blanket. With regard to clinical significance 15.3% (n = 26) of chemical and 21.1% (n = 35) of tympanic readings might have resulted in patients receiving delayed interventions. Conversely 28.8% (n = 44) of chemical and 37.8% (n = 58) of tympanic readings might have resulted in patients receiving unnecessary interventions.Conclusions.  The chemical thermometer was more accurate, reliable and associated with fewer clinically significant temperature differences compared with the tympanic thermometer. However, compared with the pulmonary artery catheter both methods were associated with erroneous readings. In the light of these findings and previous research evidence, it is becoming increasingly difficult to defend the continued use of tympanic thermometry in clinical practice. However, as chemical thermometers are not without their limitations, further research needs to be undertaken to evaluate the accuracy and reliability of other non‐invasive methods.Relevance to clinical practice.  Chemical and tympanic thermometers are used in both adults and children in a wide variety of settings ranging from community to intensive care. As such these findings have significant implications for patients, users and budget holders.
Music and its effect on the physiological responses and anxiety levels of patients receiving mechanical ventilation: a pilot study
Authors: Lee On Kei Angela , Chung Yuet Foon Loretta , Chan Moon Fai , Chan Wai Ming 
Published: April 2005

Aims and objectives.  The aim of this study was to investigate the effects of music on the anxiety of patients on mechanical ventilation, as assessed by objective parameters and a subjective validated anxiety scale.Background.  Mechanical ventilation, although sometimes lifesaving, is often associated with levels of anxiety requiring sedatives, which has inevitable implications on costs and complications.Design.  A randomized controlled trial design.Methods.  A total of 64 subjects was randomly assigned to undergo either 30 minutes of music intervention or a rest period. The subjects were asked to answer the Chinese State Trait Anxiety Inventory scale before and after the study period and physiological indices and resting behaviours were recorded before and after the study period in both groups. The subjects’ satisfaction with music was also obtained after music intervention.Results.  The findings indicate that patients on mechanical ventilation that listened to a single 30‐minute session of music appeared to show greater relaxation as manifested by a decrease in physiological indices and an increase in comfortable resting behaviours.Conclusion.  Music can provide an effective method of reducing potentially harmful physiological responses arising from anxiety in mechanically ventilated patients.Relevance to clinical practice.  As indicated by the results of this study, music therapy can act as a simple and safe nursing intervention to allay anxiety and promote patient comfort. Interest and comments on music therapy provided as a relaxation technique should be elicited from both nurses and patients.
Lack of evidence for local immune activity in oral hairy leukoplakia and oral wart lesions
Authors: Lilly E. A. , Cameron J. E. , Shetty K. V. , Leigh J. E. , Hager S. , McNulty K. M. , Cheeks C. , Hagensee M. E. , Fidel P. L. 
Published: April 2005

Background:  Oral warts, caused by human papillomavirus (HPV), and oral hairy leukoplakia (OHL) caused by Epstein‐Barr virus (EBV), are common oral manifestations in HIV‐infected persons. Although both conditions occur most often with reduced blood CD4+ T‐cell numbers, oral warts and OHL rarely occur simultaneously, suggesting that dysfunctions in other secondary local immune parameters are also involved. The present study evaluated tissue‐associated proinflammatory and T‐helper cytokine and chemokine mRNA expression and the presence of T cells in each lesion.Methods:  Biopsies were taken from lesion‐positive and adjacent lesion‐negative sites of HIV+ persons with oral warts or OHL and lesion‐negative sites from HIV+ persons who were oral HPV or EBV DNA‐positive (matched controls). Cytokine/chemokine mRNA expression was quantified by real‐time polymerase chain reaction. CD3, CD4, and CD8 cells were identified by immunohistochemistry.Results:  No differences were detected in tissue‐associated cytokine/chemokine mRNA expression in warts or OHL when compared to lesion‐negative sites. Immunohistochemical analysis of T cells showed CD8+ cells exclusively, but few cells were present in either lesion. No differences were detected between lesion‐positive and ‐negative control sites of each pathologic condition.Conclusion:  Little evidence was found for local immune reactivity to either oral warts and OHL, suggesting that CD4+ T cells are a primary host defense against both oral warts and OHL, but with nonimmune factors potentially responsible for the divergent prevalence of each.
An ex‐vivo multiplexed antibacterial test on oral microflora
Authors: Yang Y. , Sreenivasan P. K. 
Published: April 2005

Background/aims:  Characterized clinical strains of oral bacteria are utilized to examine the antimicrobial efficacy of oral care formulations. A demonstration of antimicrobial effects of formulations on microbial samples obtained from the human mouth offers advantages, i.e. incorporates the considerable microbial diversity of this environment with bacteria harvested from naturally occurring biofilms to form the focus of this investigation.Materials and methods:  Samples of oral flora from each adult subject were briefly treated (2 min) with test and control formulations and plated on appropriate agar for multiplexed antimicrobial effects on functional groups of oral bacteria associated with specific conditions.Results:  Ex‐vivo treatments of oral samples with the triclosan/copolymer dentifrice demonstrated significant dose‐dependent antimicrobial effects compared with a control formulation on anaerobic and facultative oral bacteria from a group of 16 volunteers (P < 0.05) with reproducible effects observed in three separate trials (P < 0.05). Similarly, significant dose‐dependent effects were noted with chlorhexidine mouthrinses (P < 0.05). A simultaneous assessment of the effects of these formulations on several functional classes of oral bacteria associated with specific oral conditions such as dental caries and oral malodor demonstrated multiplexed antimicrobial activity (P < 0.05).Conclusions:  A rapid procedure using small volumes of human oral samples and well‐known formulations demonstrates ex‐vivo multiplexed antimicrobial effects on functional groups of bacteria with both dentifrices and mouthrinses. Modifications of this approach may include antibacterial effects over time with formulations at clinically relevant concentrations, effects of novel agents or samples from subjects stratified on the basis of their clinical status.
Requirement for βB1‐crystallin promoter of Xenopus laevis in embryonic lens development and lens regeneration
Authors: Mizuno Nobuhiko , Ueda Yoko , Kondoh Hisato 
Published: April 2005

Regulation of the lens‐specific βB1‐crystallin promoter in Xenopus laevis was investigated using transgenic larvae and tadpoles. Comparison of the promoter sequence with that of chicken βB1‐crystallin gene indicates significant sequence similarity over a span of several hundred base pairs starting from the transcriptional start site. Remarkably, PL‐1 and PL‐2 sequences identified in the chicken promoter as essential binding sites of MAF, Pax6 and Prox1 transcription factors were conserved. Mutations of X (Xenopus) PL‐1 and XPL‐2 sequences eliminated the promoter activity, indicating a conserved mechanism regulating βB1‐crystallin promoter among vertebrate species. A stepwise deletion of the promoter sequence starting from 2800 bp indicated that the proximal 260 bp directly upstream of the transcription initiation site is sufficient for eliciting lens‐specific expression, but the 150 bp promoter sequence is inactive despite it containing the XPL‐1 and XPL‐2 sequences, suggesting the presence of an additional and essential regulatory sequence located between −150 and −260 bp. Activity of the βB1‐crystallin promoter during lens regeneration from cornea was examined using transgenic tadpoles and found to have the same dependence on promoter regions as in embryonic lens development, indicating that gene regulation is largely shared by the two lens‐generating processes.
IS SURVEILLANCE NECESSARY FOR INVERTED PAPILLOMA IN THE URINARY BLADDER AND URETHRA?
Authors: Cheng Chi Wai , Chan Lung Wai , Chan Chi Kwok , Ng Chi Fai , Cheung Ho Yuen , Chan Shu Yin Eddie , Wong Wai Sang , To Ka Fai 
Published: April 2005

Background:  A case series of inverted papilloma of the urinary bladder and urethra is presented, together with a review of the literature with respect to multiplicity, recurrence rate and association with transitional cell carcinoma, and a discussion on surveillance of the lesion.Methods:  Cases of inverted papilloma of the lower urinary tract in a single centre were reviewed. Patient and tumour characteristics, recurrence and associated transitional cell carcinoma are reported.Results:  Twenty patients were included (18 male, two female). The mean age was 60.8 years (range 35−78 years). All had solitary tumours ranging from 3 mm to 30 mm in size. Median cystoscopic follow up was 30 months (range 2−140 months). There was no recurrence. One patient was associated with subsequent transitional cell carcinoma 44 and 76 months later. Together with the present 20 cases, review of the English literature with respect to inverted papilloma of the lower urinary tract identified a total of 322 cases reported, with a recurrence rate of 3.85%. Moreover, 1.55%, 5.90% and 1.54% were associated with previous, simultaneous and subsequent transitional cell carcinoma, respectively.Conclusions:  Recurrence is not uncommon and risk of subsequent transitional cell carcinoma is not rare, such that non‐invasive surveillance with flexible cystoscopy is recommended for inverted papilloma of the lower urinary tract.
AMBULATORY CIRCULAR STAPLED HAEMORRHOIDECTOMY UNDER LOCAL ANAESTHESIA VERSUS CIRCULAR STAPLED HAEMORRHOIDECTOMY UNDER REGIONAL ANAESTHESIA
Authors: Ong Chin Hu , Chee Boon Foo Edward , Keng Victor 
Published: April 2005

Background:  The usage of circular stapled haemorrhoidectomy (CSH) has increased dramatically in recent years. Hitherto this has been performed using regional or general anaesthesia. The present study assesses the feasibility of performing CSH under local anaesthesia on an ambulatory basis and its acceptance by patients.Methods:  Sixty patients with symptomatic third or fourth degree haemorrhoids were randomized into two groups. Group A patients had CSH under regional anaesthesia (i.e spinal anaesthesia) and were discharged the next day and group B patients had CSH under local anaesthesia and were discharged on the same admission day. Both groups were assessed by visual analogue pain score. In addition, group B patients were asked questions regarding their satisfaction with the procedure.Results:  No significant differences in pain score and analgesic requirement were found between the two groups of patients. All patients in group B except for one, reported that they were satisfied to highly satisfied with their procedure.Conclusions:  Circular stapled haemorrhoidectomy can be performed safely under local anaesthesia in an ambulatory care setting. The potential cost savings that may accrue would offset the cost of the stapler.
BACK TO BASICS: MANAGING GUNSHOT INJURIES IN EAST TIMOR
Authors: Guest Glenn Douglas , Soldanha Saturnino , Walbheim Taco 
Published: April 2005

Background:  The management of patients following severe trauma requires a combination of skills. Among these are accurate clinical assessment, basic resuscitation measures, basic general surgical skills and techniques, good decision making and team leadership. More technically advanced imaging and investigations are often useful and can enhance clinical assessment but should not replace the basic elements. In situations where more advanced investigations are not available good outcomes can be achieved by application of the basic principles in trauma management and surgery. This article describes a mass casualty situation of gunshot wounds managed with limited resources and the outcomes.Methods:  A series of gunshot wounds managed in a single day at Dili National Hospital, Dili, East Timor is described. The presentation of the patients, initial assessment of injuries and haemodynamic stability are detailed in addition to the subsequent surgical treatment, complications and outcomes. The information was obtained from hospital records and personal recollection of the treating doctors. All injuries were documented with digital photography. All patients were managed by two surgeons who also supervised their postoperative course and reported on their outcomes. Surgical procedures on all of the patients were performed by the named two consultant surgeons and one basic surgical trainee.Results:  Fourteen patients were treated for gunshot injuries. All were single bullet injuries. Six trajectories involved the thoracic or abdominal cavity (one trajectory traversed both). Eight injuries were to limbs or soft tissue of the pelvis and included four compound fractures. Surgical intervention was needed for all patients ranging from emergency laparotomy for haemodynamic instability through to wound debridements. Thirteen patients survived and were discharged from hospital within 3 weeks. One patient died of uncontrolled haemorrhage.Conclusions:  In the present series of gunshot injuries managed with limited resources a good outcome was achieved with the application of basic principles. The present series emphasizes the importance of basic trauma management as outlined in courses such as Emergency Management of Severe Trauma and the use of basic surgical techniques as taught during the Advanced Surgical training program.
Clinical assessment of the laryngeal tube in pediatric anesthesia
Authors: RICHEBÉ PHILIPPE , SEMJEN FRANÇOIS , CROS ANNE‐MARIE , MAURETTE PIERRE 
Published: April 2005

SummaryBackground : The aim of this study was to evaluate a new device for airway management in children: the laryngeal tube (LTTM).Methods : The LTTM is available in sizes S0–S3 for pediatric anesthesia. This prospective open study included 70 children ASA 1. The local Ethics Committee approval and parental consent were collected. The primary criterion was the success rate for insertion and ventilation. Secondary criteria were additional maneuvers and incidents elicited from LT use.Results : Seventy children were included: S0 = 5, S1 = 8, S2 = 36, and S3 = 21. Insertion was successful: at the first attempt in 78.6%, second in 17.1%, and third or more in 4.3%. In 12% of cases it was not possible to successfully insert the LT and proceed to adequate ventilation. Failures were explained by: inability to obtain satisfying ventilation (n = 4), hypoxemia (n = 1), gastric insufflation (n = 6), cough (n = 1), and laryngospasm or stridor (n = 2), some with the same child. Minimal additional maneuvers for adequate ventilation were necessary in 35% of cases (all groups), but <20% when considering only sizes 2 and 3. Moreover, after five cases, the anesthesiologists became more proficient at inserting the LTTM (respectively 73.3% failure before five cases vs 13% afterwards). Gastric insufflation occurred in eight cases (11.4%). Controlled ventilation was used in 30 children and peak inspiratory pressure was 19.2 ± 4 cmH2O.Conclusions : The LTTM is not recommended for children <10 kg. Over 10 kg, it provides a clear airway in most children, with a low rate of minimal additional maneuvers for sizes 2 and 3. The failure rate also decreases with the operator's training.
Dimensions of the neonatal cricothyroid membrane – how feasible is a surgical cricothyroidotomy?
Authors: NAVSA N. , TOSSEL G. , BOON J.M. 
Published: April 2005

SummaryBackground : Airway management of the neonate remains a cornerstone in neonatal resuscitation which in most cases involves tracheal intubation. However, difficult intubations do occur. Cricothyroidotomy is recognized as an entry point below the vocal cords. This procedure becomes increasingly difficult in young children and is not recommended in children under the age of 5 years. Little is known about the anatomy of the neonatal airway, especially the size of the cricothyroid membrane. The aim of the study was to determine the dimensions of the cricothyroid membrane in neonates.Methods : Twenty‐seven neonatal cadavers (mean height of 44.89 cm and a mean weight of 2.05 kg) were carefully dissected and the dimensions of the cricothyroid membrane recorded with a digital caliper (accuracy 0.01 mm) by two independent observers.Results : The cricothyroid membrane has a mean height of 2.61 mm (sd: 0.71) and width of 3.03 mm (sd: 0.63).Conclusions : Results of this study indicate that the dimensions of the cricothyroid membrane are too small for passing a tracheal tube as the dimensions of the tube exceeds that of the cricothyroid membrane. This could fracture the cartilages of the larynx. The performance of a surgical cricothyroidotomy with passing of a tracheal tube is therefore strongly discouraged in neonatal patients.
Induction of anesthesia in a combative child; management and issues
Authors: CHRISTIANSEN ELAINE , CHAMBERS NEIL 
Published: April 2005

SummaryA developmentally delayed, 13‐year old autistic boy required management of multifocal cerebral and pulmonary tumors, involving several anesthetics over a 4‐month period. At each anesthetic he refused premedication, displayed increasing anxiety and became more combative. With parental guidance and involvement, a variety of anesthetists tried a range of techniques to achieve induction, each ultimately resorting to the use of physical restraint. Principles essential to the care of such a child include early recognition, parental support, multi‐disciplinary planning of procedures requiring general anesthesia, continuity of anesthesia care, and clear guidelines about the perioperative management of uncooperative children, including the ethical use of restraint.