bluuebunny/crossref_metadata_2025_split huggingface dataset:
Leishmaniasis of the lip in a patient with Down's syndrome
Authors: Ferreli C , Atzori L , Zucca M , Pistis P , Aste N 
Published: August 2004

ABSTRACTCutaneous leishmaniasis is an endemic protozoan infection in Sardinia, one of the major islands of the Mediterranean Basin. The main causative strain in this country is Leishmania infantum, which rarely involves mucocutaneous areas, but has the potential to cause visceral leishmaniasis. An atypical leishmaniasis involving the inferior lip of a 57‐year‐old female with Down's syndrome was observed at the Dermatology Department of Cagliari (italy). The diagnosis was mainly based upon histopathological examination, revealing intra‐ and extra‐cellular leishmania amastigotes. The leishmania infantum zymodeme MON‐111 was identified by isoenzymatic characterization. Laboratory investigations revealed a normal complete blood count and biochemistry profile, except for an inverted CD4/CD8 ratio. Treatment with meglumine antimoniate 60 mg/kg/day (Glucantime®) intramuscularly for 15 days, followed by intralesional administration 1 ml weekly for 4 weeks led to complete recovery. No relapses were observed at 6‐month follow‐up. The unusual localization is likely to be a reflection of the uncommon site of inoculation of the protozoa, transmitted by bites from flying vectors. Nevertheless, the presence of Down's syndrome in our patient may have contributed to the atypical presentation by traumatic exacerbation of the lesion, due to repeated auto‐induced microtraumas of the inferior lip accompanied by subclinical immunodeficiency. In fact, the specific immune response to Leishmania infection depends on a host‐cell‐mediated immune response, reported as defective in Down's syndrome patients. Differential diagnosis and early detection of the infection are necessary in order to start effective treatment and prevent more serious complications.
Multiple perforating and non perforating pilomatricomas in a patient with Churg–Strauss syndrome and Rubinstein−Taybi syndrome
Authors: Bayle P , Bazex J , Lamant L , Lauque D , Durieu C , Albes B 
Published: August 2004

SUMMARYWe report an unusual association of multiple perforating and non‐perforating pilomatricomas with Churg–Strauss syndrome, and a dysmorphic syndrome evocative of Rubinstein‐Taybi syndrome. These syndromes may be independent, but these rare diseases and genetic abnormalities may be linked together.
Awareness, knowledge and attitudes to basal cell carcinoma and actinic keratoses among the general public within Europe
Authors: MacKie RM 
Published: August 2004

ABSTRACTObjective  As the incidence of non‐melanoma skin cancer (NMSC) is reported to be increasing in Europe, the objective of this survey was to establish the general population's awareness and knowledge of basal cell carcinoma (BCC) and actinic keratoses (AK) within five European countries.Methods  A total of 1500 individuals from the United Kingdom, France, Italy, Germany and Spain were randomly selected to participate in the study. In a 10‐minute structured telephone interview respondents answered questions on skin cancer and BCC and AK.Results  Overall, 46% of respondents were concerned about skin cancer. Even though the majority of respondents believed there was a correlation between skin cancer and the sun or overexposure to sunlight, nearly a third of the surveyed population rarely or never used sunscreen when outdoors. In general there was a low level of awareness about BCC and AK, with only 22% and 6% of respondents, respectively, being aware of the conditions.Conclusion  There is a need to increase the awareness of skin cancer and safe sun practices among the European population.
Increased endothelemia as an indirect marker of changes in the blood vessel endothelium in psoriasis
Authors: Sochorova R , Svecova D , Sinka L , Rybarova L 
Published: August 2004

ABSTRACTBackground  Endothelial cells have a pivotal role in the initiation and development of inflammation. The dermal microvasculature undergoes distinctive morphological changes. Central to the angiogenetic process are endothelial cell division and migration controlled by local expression of the mitogenic factor. There is considerable evidence for the development of angiogenesis in psoriatic skin. Quantitative assessment of the endothelium in psoriasis demonstrated a fourfold increase in surface area of the superficial vascular plexus in lesional skin. The rate of vascular proliferation in active psoriasis is similar to that in other angiogenic pathologies. To identify vasoproliferation in the skin adds a useful tool in the assessment of psoriasis activity in future studies of its pathogenesis. The basal level of endothelemia reflects a continuous replacement of cells. The hyperproliferation in psoriasis stimulates physiological cell replacement. The higher replacement of blood vessel endothelial cells causes an increase in circulating cell levels in the bloodstream. Endothelemia might serve as an indicator of changes in the blood vessel endothelium in psoriatics.Objective  The aim of the present study was to assess the changes in the amount of endothelial cells in the blood of psoriatic patients by comparing them with healthy controls.Material and methods  Fifty‐six patients suffering from psoriasis (PASI score 35.05 ± 5.61) and 20 healthy subjects were estimated for quantitative endothelemia using the counting of endothelial cells in Burker's chamber after their isolation together with platelets and the removal of the latter by addition of adenosine diphosphate. The cells were confirmed as endothelial in origin by positive staining for von Willebrand factor. The significance of the differences was estimated by Student's t‐test.Results  There were 2.02 ± 0.21 (female) and 2.3 ± 0.25 (male) endothelial cells in the control group and 4.6 ± 0.59 (female) and 5.15 ± 0.67 (male) in the psoriatic patients. The difference was statistically significant (P < 0.001).Conclusion  Expansion of the dermal microvasculature is a prominent feature in psoriasis. Endothelemia might be an indirect marker of changes in the blood vessel endothelium in psoriatic patients. No differences were found in endothelemia in psoriatics according to the gender.
Dermoscopic observation of Bowen's disease
Authors: Bugatti L , Filosa G , De Angelis R 
Published: August 2004

ABSTRACTBackground  In the literature no specific dermoscopic criteria have been described for the diagnosis of Bowen's disease (BD).Objective/aim  To assess the morphological findings of BD seen under dermoscopic observation.Methods  Clinical and dermoscopic images of 14 patients affected by BD with various amount of pigmentation were obtained by means of Heine Dermaphot. Dermoscopic images were analysed by experienced observers applying the modified pattern analysis.Results  The most frequently occurring dermoscopic features were found to be: multicomponent pattern (100%); atypical vascular structures (86.6%); absence of pigmented network (64.3%) or presence of pseudo‐network (35.7%); irregular diffuse pigmentation or blotches of pigment (64.2%); irregularly distributed dots and globules (64.2%); focal/multifocal hypopigmentation (78.5%), scaly surface (64.2%) and haemorrages (26.6%).Conclusions  Dermoscopically, BD is mainly characterized by a multicomponent global pattern associated with a prominent vascular pattern (mainly dotted vessels) and a scaly surface. Although no specific dermoscopic criteria can be given for BD, epiluminescence can be a valuable aid in the diagnosis of such a mimicker lesion.
Nickel allergy and orthodontic treatment
Authors: Kalimo K , Mattila L , Kautiainen H 
Published: August 2004

ABSTRACTObjectives  Tolerance induction to prevent development of nickel allergy has been suggested with permanent dental braces. We wanted to find out which effect orthodontic treatments had had on the development of nickel allergy in university students.Study design  We examined and patch tested 153 students, of whom 113 had a history of pierced skin, and 70 a history of orthodontic treatment roughly 10 years earlier.Results  All except one student with pierced skin were females. Development of nickel allergy was significantly associated with skin piercing (54% compared with 12%). At the time of the study, there was a slight but non‐significant difference in the prevalence of nickel allergy between students who had been subjects for orthodontic treatment (49%) compared with non‐treated ones (58%) if they had pierced skin. There were no significant differences in the development of nickel allergy among students who had had permanent dental braces before (50%) or after skin piercing (48%). However, from 40 students without skin piercing four of 11 (three males) with a history of permanent braces had developed nickel allergy, as compared with none of 22 (P = 0.008) without orthodontic treatment suggesting possibility of sensitization through dental devices.Conclusions  Orthodontic treatment may not lead to tolerance induction on all occasions, and sensitization through permanent devices seems to be possible.
Superficial white onychomycosis revisited
Authors: Baran R , Hay R , Perrin C 
Published: August 2004

ABSTRACTBackground  Superficial white onychomycosis (SWO) is a distinct pattern of fungal nail invasion, which is usually treated with topical antifungals.Objective  This paper presents a case of SWO with deep penetration and records other similar cases.Methods  The clues to deep invasion of the nail plate are twofold: an inability to clear the discoloration by scraping the nail and a clinical involvement of the nail plate in the proximal nailfold area. Histology of the nail keratin will confirm deep penetration beyond the superficial layers of the nail plate.Results  In the light of this finding the authors propose a further subdivision of SWO to reflect previously unrecognized variants with therapeutic implications into: (i) the classical SWO type; (ii) the dual invasion of the nail plate, superficial and ventral; and (iii) the pseudo‐SWO with deep fungal invasion of the nail plate.Conclusions  This subdivision of SWO allows the clinician to treat the patient appropriately using topical antifungals when the disease is restricted to the dorsum of the nail. Systemic drugs either in isolation or in combination with topical treatment are mandatory when deep penetration or ventral fungal invasion are observed.
A case of porokeratotic eccrine ostial and dermal duct naevus of late onset
Authors: Birol A , Erkek E , Bozdoðan Ö , Koçak M , Atasoy P 
Published: August 2004

ABSTRACTWe describe the case of a 21‐year‐old man with an 8‐year history of porokeratotic eccrine ostial and dermal duct naevus (PEODDN) of late onset. The patient had pruritic, keratotic papules on the dorsal surface of his left hand, bilaterally on his palms and multiple yellowish lesions on the plantar surface of his feet. On histopathological examination cornoid lamella‐like parakeratotic columns above eccrine sweat ducts were observed. The acrosyringium was also dilated. The lesions were refractory to treatment with salicylic acid in petrolatum and acitretin for 2 months. This entity should be taken into consideration in the differential diagnosis of linear keratotic cutaneous eruptions.
Skin abnormalities in the National Portrait Gallery
Authors: Strauss RM , Marzo‐Ortega H , Goulden V 
Published: August 2004

ABSTRACTPathological changes in the human body have long been recognised in painting. To assess the frequency of potential physical abnormalities reflected in paintings, we reviewed portraits on display at one visit in the National Portrait Gallery in London. We identified a number of possible abnormalities, most of them dermatological, with the commonest finding being small facial papular lesions, most likely representing either common warts or dermal naevi. This exercise however, reflects a subjective interpretation of the different artists's perceptions of their models’ physical appearances.
Spontaneous regression of keratoacanthoma can be promoted by topical treatment with imiquimod cream
Authors: Di Lernia V , Ricci C , Albertini G 
Published: August 2004

ABSTRACTImiquimod, the first member of a new class of immune response modifiers, is approved for the treatment of external genital and perianal warts. Recently, many clinical trials highlighted the potential of imiquimod as a treatment for other viral infections and cutaneous neoplasms. We report two cases of facial keratoacanthomas (KA) treated with topical 5% imiquimod cream. Patients were successfully cleared of KAs after treatment for 8 weeks. No recurrence occurred after a 1‐year follow‐up. Despite the fact that KAs are characterized by the potential for spontaneous regression, it is possible that a faster activation of CD4+ lymphocytes, via interferon release and cytokine secretion takes place after imiquimod application leading to KA regression.
Oral lichen planus: an unusual cause of facial and abducens nerve paralysis associated with conjunctival and oesophageal involvement
Authors: Tunca A , Çalikoǧlu E , Aktaş D , Şafak N , Üstün H 
Published: August 2004

ABSTRACTLichen planus (LP) is a T‐cell‐mediated disorder that may involve the skin, nails and mucosal surfaces. Conjunctival, laryngeal and oesophageal involvement were reported to be extremely rare manifestations of the disease. In this report, we present an oral LP case who complained of severe burning pain on his tongue and oral mucosa caused by ulcerative lesions and associated with conjunctival, laryngeal and oesophageal involvement. In addition, neurological examination revealed facial and abducens nerve palsy. To the best of our knowledge, we are presenting the first case of erosive oral LP associated with facial and abducens nerve paralysis. Although this association may be coincidental, according to an immunological concept proposed to explain the pathogenesis of Bell's palsy, degranulation of mast cells activated by complement or specific allergens with the release of histamine and other substances were to be presented responsible from nerve oedema, ischaemia and paralysis. As mast cell mediators are likely to be involved in the immunopathogenesis of OLP, we think that the cause of facial and bilateral abducens nerve palsy could be explained by the same mechanism. This case is a good example of the need for team work in lichen planus patients undergoing interdisciplinary consultations.
Book Reviews
Authors: BYRES TERENCE J. , PHIMISTER IAN , FARRER JAMES , FIELD DONALD R. , CLENDENNING GREG 
Published: August 2004

Book ReviewsNeil Davidson, Discovering the Scottish Revolution 1692–1746.Benno Teschke, The Myth of 1648. Class, Politics and the Making of Modern International Relations.Amanda Hammar, Zimbabwe's Unfinished Business: Rethinking Land, State and Nation in the Context of Crisis.Yunxiang Yan, Private Life Under Socialism: Love, Intimacy and Family Change in a Chinese Village, 1949–1999.A. E. Luloff and R. S. Krannich (eds), Persistence and Change in Rural Communities: A 50 Year Follow Up to Six Classic Studies.
Defining endometrial growth during the menstrual cycle with three‐dimensional ultrasound
Authors: Raine‐Fenning Nicholas J. , Campbell Bruce K. , Clewes Jeanette S. , Kendall Nigel R. , Johnson Ian R. 
Published: August 2004

Objective  To define the changes in endometrial morphometry that occur during the normal menstrual cycle and to examine the discriminatory power of volumetric analysis over conventional two‐dimensional measurements in quantifying the effect of compounding factors on endometrial growth.Design  The design was that of a longitudinal observational study. Subjects were seen on an alternate‐day basis until ovulation and then every four days until the next menstrual period.Setting  A University teaching hospital.Population  Thirty women with regular cycles and acceptable ‘normal’, menstrual patterns.Methods  Three‐dimensional ultrasound data were acquired and subsequently analysed by a single observer.Main outcome measures  Endometrial thickness and volume.Results  Both endometrial volume and thickness increased significantly during the follicular phase (P < 0.001), reaching a plateau around the time of ovulation and remaining relatively stable throughout the luteal phase. These changes in endometrial thickness and volume were highly correlated (R2= 0.767; P < 0.001). Parity was associated with a significantly greater endometrial volume than nulliparity (4.159 vs 2.234 cm3; P < 0.05).Conclusions  This study has defined the relative and absolute changes in endometrial growth, both in terms of thickness and volume, throughout the normal menstrual cycle. These data provide a reference for future three‐dimensional studies investigating menstrual disorders, pathophysiological change and subfertility.
Spontaneous delivery or manual removal of the placenta during caesarean section: a randomised controlled trial
Authors: Morales Michel , Ceysens Gilles , Jastrow Nicole , Viardot Caroline , Faron Gilles , Vial Yvan , Kirkpatrick Christine , Irion Olivier , Boulvain Michel 
Published: August 2004

Objective  To compare blood loss with spontaneous delivery and manual removal of the placenta during caesarean section.Design  A randomised controlled trial.Setting  Four university hospitals between September 1999 and June 2002.Population  A total of 472 women delivering by caesarean section at term were randomised to spontaneous placental delivery (n= 235) or manual removal (n= 237).Methods  The allocation was made by opening the next available of a series of sealed opaque envelopes and derived from a computer‐generated list of numbers.Main outcome measures  Significant blood loss, defined as either a drop in haemoglobin of greater than 2.5 g/dL, or the need for blood transfusion.Results  The mean interval between delivery of the newborn and the placenta was longer in the spontaneous delivery group (3.4 vs 1.9 minutes), but the mean duration of the operation was similar. Significant blood loss occurred in 30 women (13%) in the spontaneous delivery group and 49 women (21%) in the manual removal one (RR 0.62; 95% CI 0.41–0.94). Post‐operative fever affected 6 and 5 cases, respectively, and antibiotics were used in 14 and 12 cases, respectively.Conclusions  Allowing spontaneous delivery of the placenta reduces significant blood loss without increasing operating time.
Obstetric risk factors and persistent increases in brain parenchymal echogenicity in preterm infants
Authors: Spinillo Arsenio , Chiara Alberto , Bergante Carola , Biancheri Danila , Fabiana DePaoli , Fazzi Elisa 
Published: August 2004

Objective  To assess the risk of persistent (>7 days) increases in brain parenchymal echogenicity in preterm infants and their association with known obstetric risk factors.Design  Case–control study of prospectively collected data.Setting  A University hospital in Northern Italy.Population  Eighty‐five singleton infants between 24 and 34 weeks of gestation with a cranial ultrasonographic diagnosis of persistently increased parenchymal echogenicity without development of cystic degeneration, and 170 control infants with negative cranial ultrasonographic findings.Methods  A comparison of the prevalence of selected obstetric risk factors between infants with persistent echo‐dense lesions and negative controls.Main outcome measures  Odds ratios of persistent echo‐dense lesions including first‐degree interactions between variables.Results  After adjusting for birthweight, logistic regression analysis showed that the only factor associated with an increased risk of persistent brain echo‐dense lesions in infants was multiple courses of antenatal steroids (OR = 2.14, 95% CI = 1.11–4.15, P= 0.024). In this group, the risk of persistent echo‐dense lesions was particularly high in: (i) mothers receiving dexamethasone rather than betamethasone (P value for interaction = 0.015) and (ii) after expectant management of pre‐eclampsia or intrauterine growth retardation (P value for interaction = 0.03).Conclusions  Multiple doses of antenatal steroids, especially dexamethasone, could influence the prevalence of persistent increases in brain parenchymal echogenicity in preterm infants.
The safety of ondansetron for nausea and vomiting of pregnancy: a prospective comparative study
Authors: Einarson Adrienne , Maltepe Caroline , Navioz Yvette , Kennedy Deborah , Tan Michael Paul , Koren Gideon 
Published: August 2004

Objective  Ondansetron (Zofran) is a drug used for the treatment of nausea and vomiting caused by cancer chemotherapy. Despite the fact that it is not indicated, women are being prescribed this drug for the treatment of nausea and vomiting of pregnancy (NVP). There is a paucity of information on fetal safety for this indication. The objective of this study is to determine whether this drug increases the baseline rate of major malformations.Design  A prospective comparative observational study.Setting  Teratogen Information Services (TIS).Population  Pregnant women.Methods  Our three groups included women who were exposed to ondansetron and women exposed to (1) other anti‐emetics and (2) non‐teratogen exposures. All of the women called either our NVP Helpline or TIS at The Motherisk Program in Toronto, Canada, or The Mothersafe Program in Sydney, Australia.Main outcome measure  Rates of major malformation.Results  We have completed 176 pregnancy outcomes in each group. In the ondansetron cohort, there were 169 live births, 5 miscarriages, 2 therapeutic abortions, 6 (3.6%) major malformations and the mean birthweight was 3362 g [SD 525]. There were no statistical differences in any of the study endpoints between the ondansetron and the comparison groups.Conclusions  This drug does not appear (although the sample size is limited) to be associated with an increased risk for major malformations above baseline.
State of the Science of Translational Research: From Demonstration Projects to Intervention Testing
Authors: Kirchhoff Karin T. 
Published: August 2004

ABSTRACTAn overview of the effort of nursing in translation research begins with studies in research utilization. Delineation of issues in the uptake of evidence using guidelines and systematic reviews is discussed next. The federal initiatives in translation research are described with a focus on the Translating Research Into Practice (TRIP) studies. The article closes with future directions.
Qualitative Perspectives in Translational Research
Authors: Tripp‐Reimer Toni , Doebbeling Bradley 
Published: August 2004

ABSTRACTThe rapid uptake of qualitative approaches in translational research can be best understood in the context of recent innovations in health services research, as well as an overarching concern with improving the quality of health care. Qualitative approaches highlight the human dimension in health care by foregrounding the perceptions, experiences, and behaviors of both consumers and providers of care. As such, these methods are particularly useful for addressing the complex issues related to improving health care quality and implementing system change. This overview traces a brief history of the factors contributing to the recent and rapid growth of qualitative methods in health research in general and translational research in particular; describes the varieties of qualitative approaches employed in this research; and illustrates the utility of these approaches for variable identification, instrument development, description/explanation of patient/provider perceptions and behaviors, individual/organizational change, and theory refinement.