bluuebunny/crossref_metadata_2025_split huggingface dataset:
Removal and prevention of dental plaque with d‐tagatose
Authors: Lu Y. , Levin G. V. 
Published: March 2003

SynopsisDental plaque develops when early bacterial colonizers adhere to the acquired pellicle (saliva‐derived proteinous coating on the tooth surface) followed by adhesion of late interspecies colonizers to form this type of biofilm (coaggregation). In developing a d‐tagatose‐based toothpaste, we examined 15 oral isolates, including both early colonizers (Streptococcus and Actinomyces) and late colonizers (Fusobacterium, Porphyromonas, Prevotella, Veillonella, Capnocytophaga, and Actinobacillus), and tested them for their ability to coaggregate with each other. We then tested the ability of d‐tagatose to reverse any such coaggregations. Coaggregation was examined visually and scored by using a system ranging from 0, for no visible coaggregation to 4, for maximum coaggregation. d‐Tagatose, at a concentration of less than 750 mm, completely reversed the coaggregation of 17 (60%) of 28 strongly coaggregating pairs (coaggregation score = 2 or higher) tested. In contrast, d‐sorbitol had little reversal effect. d‐Tagatose‐sensitive coaggregations were d‐galactose‐reversible as well. d‐Tagatose acted on both early and late colonizers; both groups, especially the late colonizers, were frequently involved in periodontal diseases. Thus, d‐tagatose has the potential for preventing and removing plaque development and for altering the subgingival microbiota. These effective qualities offer conservative control of gingival and periodontal disease.
Insulin resistance and associated metabolic abnormalities in muscle: effects of exercise
Authors: Pérez‐Martin A. , Raynaud E. , Mercier J. 
Published: March 2003

SummarySkeletal muscle is a major site of insulin resistance. In addition to glucose transport, oxidative disposal and storage defects, insulin resistant muscle exhibit many other metabolic abnormalities. After a brief review of insulin resistance determinants, we will focus on muscular abnormalities in obesity and type 2 diabetes. Glucose and lipid metabolism defects will be analysed and their interactions discussed. Exercise can improve many of these muscular abnormalities and the mechanisms underlying exercise‐induced benefits have been clarified during the past decades. Therefore, exercise training has proved to be useful in the management of insulin resistant states, i.e. mainly obesity, especially in its truncal distribution, and type 2 diabetes. However, exercise prescription remains poorly codified, and results on glycaemic control are sometimes conflicting. In the last part of this review, we will emphazise the pathophysiological basis for an individualized exercise prescription in insulin resistant subjects.
Self‐help in the long‐term treatment of obesity
Authors: Latner J. D. 
Published: March 2003

SummaryDespite the short‐term success of professional behavioural techniques for obesity, weight losses are typically regained following treatment. The long‐term maintenance of treatment effects will probably require ongoing, continuing care. Continuing care may be economically feasible when administered through self‐help treatment modalities. Self‐help confers a number of psychological benefits, such as self‐reliance and an increased sense of empowerment. The effectiveness and cost‐effectiveness of various modalities of self‐help are reviewed, including purely self‐prompted help, self‐administered manuals, computer‐assisted therapy, professionally assisted correspondence courses, and non‐profit and commercial self‐help groups. Stepped‐care models suggest using a combination of these approaches when appropriate. However, logistical difficulties present themselves in stepped‐care approaches with obesity, such as the complicating effects of severity and comorbidity on stepped‐care status. Self‐help groups are a promising venue for the provision of continuing care and as an adjunct to more intensive, specialty therapies.
Combined therapy with saquinavir, ritonavir and stavudine in moderately to severely immunosuppressed HIV‐infected protease inhibitor‐naive patients
Authors: Battegay M , Vernazza Pl , Bernasconi E , Flepp M , Sendi P , Erb P , Malinverni R , Jaccard C , Morgenthaler S , Bedoucha V , Hirschel B ,   for the Swiss HIV Cohort Study
Published: March 2003

1

Basel Centre for HIV Research, Outpatient Department of Internal Medicine, University Hospital Basel,

2

Department of Internal Medicine, Cantonal Hospital St Gallen,

3

Department of Internal Medicine, Regional Hospital Lugano,

4

Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich,

5

Basel Centre for HIV Research, Institute for Medical Microbiology, University Basel,

6

Division of Infectious Diseases, University Hospital Bern,

7

Division of Infectious Diseases, University Hospital Lausanne,

8

Roche Pharma AG, Reinach, and

9

Division of Infectious Diseases, University Hospital Geneva, Switzerland
Objective  To assess the short‐term and long‐term effect of a combination of saquinavir, ritonavir and stavudine in moderately to severely immunosuppressed protease inhibitor‐naive patients.Design  Prospective open‐label multicentre study.Patients and Methods  A total of 64 protease inhibitor‐naive and stavudine‐naive HIV‐infected patients with a CD4 count of < 250 cells/μL and > 10 000 HIV‐1 RNA copies/mL received saquinavir hard‐gelatin capsules, ritonavir and stavudine. Full (drop in viraemia of > 2 log10 and/or < 500 copies/mL) and partial responders (drop to between 500 and 5000 viraemia copies/mL) at week 9 (end of phase I) entered the second phase (additional 12‐month period).Results  Fifty‐six patients completed phase I, 45 (70%) full responders and nine (14%) partial responders by intent‐to‐treat analysis. Thirty‐nine patients completed phase II, 33 (52%) full responders and two (3%) partial responders. Six patients had < 50 HIV‐1 RNA copies/mL at week 9, and 20 (31%) patients at month 12 of phase II. Mean CD4 cell counts increased significantly in the 56 patients from 89 to 184 cells/μL after 9 weeks and from 100 to 292 cells/μL in the 39 patients treated for another 12 months. Higher baseline viraemia and lower baseline CD4 cell counts were not associated with an unfavourable virological response at week 9 and month 12 of phase II. HIV DNA in peripheral blood monocytes decreased substantially (− 1.5 log10) but was detectable in all except one patient at the end of phase II.Conclusion  In protease‐ and stavudine‐naive HIV‐infected patients with moderate to severe immunosuppression, saquinavir in combination with ritonavir and stavudine caused a substantial long‐term decrease in plasma viral load in approximately half the participants and a substantial increase in CD4 cell counts.
Switch studies: a review
Authors: Murphy RL , Smith WJ 
Published: March 2003

Many physicians and patients wish to switch from successful protease inhibitor (PI)‐based regimens to alternative regimens, usually composed of a nonnucleoside reverse transcriptase inhibitor (NNRTI) or abacavir plus two nucleoside reverse transcriptase inhibitors (NRTIs). This reflects a desire to avoid or reverse the metabolic changes observed during long‐term PI‐based antiretroviral therapy; to alleviate PI‐associated adverse effects; and to improve adherence by simplifying the regimen. Data from a number of randomized and cohort PI switch studies are reviewed.Overall, the results of these studies are mixed, perhaps because of limitations in study design, patient number and duration of follow‐up. In most studies, the frequency of virological failure is reduced by switching to a NNRTI regimen. Switching to an abacavir‐based regimen is associated with two‐fold higher risk of virological failure if mutations in the reverse transcriptase gene pre‐exist. Improvements in metabolic and lipid abnormalities have not been uniform but favourable lipid changes have been reported, particularly after switching to nevirapine. Resolution of lipodystrophy symptoms has not been demonstrated objectively, perhaps because of insufficient follow‐up and/or the role of NRTIs in this syndrome.
The relationship between ritonavir plasma trough concentration and virological and immunological response in HIV‐infected children
Authors: Gatti G , Pontali E , Boni S , De Pascalis CR , Bassetti M , Bassetti D 
Published: March 2003

BackgroundWe studied a number of factors, including ritonavir plasma levels, and their capability of predicting response to therapy with ritonavir (RTV).MethodsEleven HIV‐positive children, nucleoside reverse transcriptase inhibitor (NRTI)‐experienced, protease inhibitor (PI) naive, receiving RTV in combination with two NRTIs were enrolled in the study. Demographic parameters were: median age (range) 10 (2–13) years, weight 26 (10–38) kg, body surface area (BSA) 0.93 (0.47–1.21) m2. Baseline values of CD4, percent CD4 and viral load were 137 (2–1390) cells/µL, 9.5 (0.4–32.4)%, and 5.15 (4.30–6.18) log10 copies/mL, respectively. The dose of RTV was 318 (266–409) mg/m2 twice daily. Peak (3.5 h after administration) and trough (predose) plasma concentrations of RTV were determined on one occasion at steady‐state after a morning dose. Virological response to treatment was quantified as the difference between the baseline value of viral load and the value observed at 6 months of therapy (Δ6).ResultsThe relationship between Δ6 and demographic parameters (age, weight, BSA, and baseline CD4, percent CD4, and viral load) and plasma concentrations of RTV was studied by linear regression. Median (range) Δ6 was 0.88 (0.77–2.62) log10 copies/mL. Peak and trough of RTV were 14.9 (3.2–31.4) and 5.0 (0.1–15.6) mg/L, respectively. Trough concentration of RTV was the best predictor of Δ6, although the relationship between these two variables was not statistically significant (r = 0.56, P= 0.075).ConclusionOur observation of a trend for a greater decrease in viral load in patients with higher trough concentration of RTV warrants further pharmacodynamic studies of PI in paediatric patients.
Naively changing HAART
Authors: Mandalia S , Parmar D , Fisher M , Pozniak A , Tang A , Youle M , Gazzard B , Beck EJ ,   on behalf of the NPMS‐HHC Steering Group
Published: March 2003

BackgroundFew UK studies have systematically investigated which antiretroviral therapy (ART) combinations HIV‐infected people are commenced on, when they start and reasons for stopping or changing their regimens.ObjectiveTo describe when HIV‐infected ART‐naive patients started first‐, second‐ or third‐line triple ART, classes of drugs prescribed and whether stopping ART was associated with virological, immunological or clinical indicators of treatment failure.DesignA multicentre prospective open cohort study, employing the National Prospective Monitoring System on the use, cost and outcome of HIV service provision in UK hospitals‐HIV Health‐economics Collaboration (NPMS‐HHC).SettingFive hundred and eighty‐five ART‐naive patients seen in one London and two non‐London HIV clinics between 1 January 1998 and 31 December 1999.ResultsOf 4044 HIV‐infected individuals seen, 585 (15%) were ART naive. Median time interval (interquartile range, IQR) between HIV diagnosis and starting triple ART was 800 (63–2094) days. Median CD4 count when first diagnosed with HIV infection was 278 (IQR 127–481) cells/µL which dropped to 190 (IQR 86–297) cells/µL when starting triple ART. Of these 585 patients, 162 started second‐line and 46 third‐line ART during the study period. Of those patients who stopped ART, 51% did not have evidence of virological, immunological or clinical indicators of therapy failure.ConclusionsReasons for the delay between diagnosis of HIV infection and starting ART are varied. The large proportion of individuals who stopped ART for reasons other than virological, immunological or clinical indicators of therapy failure, are most likely due to drug‐associated toxicity. Both of these findings need to be elucidated in greater detail through prospective studies.
Assessing limiting factors to the acceptance of antiretroviral therapy in a large cohort of injecting drug users
Authors: Clarke S , Delamere S , McCullough L , Hopkins S , Bergin C , Mulcahy F 
Published: March 2003

ObjectiveA comprehensive questionnaire was designed to assess the knowledge and understanding of injecting drug users (IDUs) regarding their HIV disease, and to determine any factors that may increase the acceptance of antiretroviral therapy (ART) by this group.ResultsTwenty percent of the total IDU cohort attending the GUIDE (GenitoUrinary Medicine and Infectious Diseases) clinic participated in the study. Fifty‐two percent had been homeless in the past 5 years and 84% are unemployed. Seventy‐two percent of patients did not complete second level education and 10% were illiterate. Fifty‐one percent had siblings or parents with a history of injection drug misuse, and 25% had at least one sibling also HIV positive. Forty‐seven percent started using drugs before the age of 13 years, and the most common initial drug was heroin (44%). Ninety‐five percent had attended for methadone maintenance therapy (MMT), with 39% currently attending for daily therapy. The majority of patients were unable to simply explain or interpret CD4 cell counts (54%) and ‘viral loads’ (65%). Fifty‐seven percent of patients were receiving highly active antiretroviral therapy (HAART). There was a statistically significant association between patients receiving HAART and both attendance at a primary care physician for methadone maintenance therapy (P = 0.005), and weekly take‐outs of methadone (P = 0.005). There was also an association between adherence to HAART and attendance at a methadone maintenance clinic (P = 0.04).ConclusionsThis study highlights the chaotic lifestyle and complex social background of the IDU. Such factors were not, however, associated with acceptance of HAART. The primary factor associated with both the acceptance of and adherence to HAART was regular and stable attendance for methadone therapy.
Findings from the first national clinical audit of treatment for people with HIV
Authors: Curtis H , Sabin CA , Johnson MA ,   the British HIV Association Clinical Audit Committee
Published: March 2003

ObjectivesWe reviewed the impact of and assessed adherence to British HIV Association (BHIVA) guidelines in routine clinical practice. Feedback has been provided to clinical centres to facilitate any necessary change.MethodsWe used a questionnaire to gauge clinicians' views on the guidelines and availability of antiretroviral therapy (ART) drugs and specialized tests. A case note review of 2044 patients was conducted to assess adherence to guideline recommendations plus patterns of use of HIV resistance testing.ResultsMost clinicians (74.1%) report that BHIVA guidelines have influenced care at their centres. A significant minority report problems with access to specialized tests. Most patients who started ART did so at CD4 counts lower than guidelines recommend but in most cases this reflected the CD4 count at diagnosis of HIV. Of patients on ART, an overwhelming majority (97.6%) were receiving three or more drugs. Of those on three or more drugs, 58.9% had latest viral load (VL) below 50 HIV‐1 RNA copies/mL and a further 18.1% below 500 copies/mL. Only 19.3% of patients had been tested for HIV resistance, of whom more than half showed resistance to more than one class of drugs.ConclusionsThis clinical audit provides encouraging evidence of the quality of care offered to people with diagnosed HIV in the UK. However late diagnosis means most people start ART at a more advanced stage than guidelines recommend.
One‐year treatment of chronic urticaria with mizolastine: efficacy and safety
Authors: Lorette G , Giannetti A , Pereira Rs , Leynadier F , Murrieta‐Aguttes M ,   the URTOL study group
Published: March 2003

Abstract Aim To assess the long‐term safety and efficacy of the H1‐receptor antagonist mizolastine in the symptomatic treatment of chronic urticaria (CU). Background Mizolastine is a novel second generation antihistamine with additional anti‐inflammatory properties which has been shown to be effective in this condition as well as in allergic rhinitis. As the drug is used for chronic treatment, a detailed study of its efficacy and safety over a prolonged period was warranted. Methods This open label multicentre trial recruited 211 patients suffering from CU (67% female; mean age 40 ± 13 years), with ≥ 1 episode/week if untreated. After a 7‐day placebo run‐in period, patients received mizolastine (10 or 15 mg) for 12 months. Efficacy was assessed by the patient using daily diary cards and overall condition evaluation at study visits. Clinicians also assessed the same parameters at each visit, and gave a global assessment at study termination. Safety was assessed by monitoring adverse events and laboratory parameters. Cardiac safety was monitored every 4 months using 12‐lead ECGs, with particular attention to QT intervals. Results The trial was completed by 127 patients. Mizolastine reduced overall discomfort from the second week of therapy, and reduced itching and the number and size of wheals, as assessed by the patients. The clinician’s assessment of the proportion of patients with > 10 wheals decreased from 42% to 28% after 2 months. Clinical assessment also indicated that itch intensity and angioedema were improved by mizolastine, and the improvement was sustained throughout the trial. The investigators estimated that 70% of patients benefited from therapy. There were no drug‐related serious adverse events during the study. The cardiac repolarization assessed according to the QTc intervals was not modified during prolonged administration. Conclusion Mizolastine improves CU symptoms, and these improvements are sustained over 12 months with no loss of drug sensitivity. No specific side‐effects are associated with its long‐term use in the current study.
Patient attitudes to topical antipsoriatic treatment with calcipotriol and dithranol
Authors: Poyner Tf , Menday Ap , Williams Zv 
Published: March 2003

AbstractObjective Assessment of patient preference for antipsoriatic treatment with calcipotriol ointment or short‐contact dithranol cream.Methods Two hundred and fifty‐eight psoriatic patients treated with calcipotriol (n = 138) or dithranol (n = 120) for up to 3 months, assessed the acceptability of treatment, overall satisfaction with treatment, their treatment preference using the ‘willingness to pay’ principle and selected their treatment of choice.Results Overall satisfaction with calcipotriol was significantly better (72.7%, dithranol 60.3%; odds ratio 1.75, 95% CI 1.03, 2.99: P = 0.04). Patients considered calcipotriol a more acceptable treatment than dithranol in its appearance, smell, non‐irritancy, method and ease of application and lack of staining. Dithranol was considered less sticky than calcipotriol. Patients were ‘willing to pay’ a mean of £12.16 monthly for calcipotriol and £10.66 monthly for dithranol. ‘Willingness to pay’ did not correlate well with overall treatment satisfaction and was not correlated with household income. Calcipotriol was the preferred treatment of choice (calcipotriol 63%, dithranol 24%).Conclusion Patients with psoriasis prefer treatment with calcipotriol ointment over short‐contact dithranol cream.
Polypoid clear cell acanthoma: case report
Authors: Inalöz Hs , Patel G , Knight Ag 
Published: March 2003

AbstractClear cell acanthoma of Degos is a rare benign tumour of epidermal origin with distinct histological features. Clinically, clear cell acanthoma is characterized by a ‘stuck on’ appearance of a nodule or dome‐shaped plaque that usually occurs on the legs of middle‐aged or elderly persons. We observed an unusual case of polypoid clear cell acanthoma on the right thigh of a 58‐year‐old male.
Atypical familial Papillon–Lefèvre syndrome
Authors: Inalöz H Serhat , Harman M , Akdeniz S , Inalöz SS , Isik A Gulden 
Published: March 2003

AbstractThe Papillon–Lefèvre syndrome is a rare autosomal recessive disorder. Consanguinity seems a notable prerequisite. Papillon–Lefèvre syndrome manifests in the first 6 months of life with rapidly progressive periodontitis and severe alveolar bone destruction leading to early loss of both the deciduous and permanent teeth in association with palmo‐plantar hyperkeratosis. We present two unusual cases of familial Papillon–Lefèvre syndrome, one of whom has only late onset of mild skin lesions and the other has severe skin lesions and relatively mild periodontal disease. A number of other cases recently described have also had atypical features.
Examination of mycosis fungoides for the presence of Epstein–Barr virus and human herpesvirus‐6 by polymerase chain reaction
Authors: Erkek E , Sahin S , Atakan N , Kocagöz T , Olut AI , Gököz A 
Published: March 2003

AbstractBackgroundThe aetiology of cutaneous T‐cell lymphoma (CTCL) remains unknown despite numerous investigations. In recent years, retroviruses and human herpesviruses have been implicated to play a causal part in CTCL.ObjectiveThe aim of this study was to elucidate the possible aetiopathogenetic role of human herpesviruses (HHV) in mycosis fungoides (MF).MethodsPolymerase chain reaction was used to study formalin‐fixed, paraffin‐embedded lesional skin biopsies from 92 subjects with MF to evidence possible presence of Epstein–Barr virus (EBV) and HHV‐6.ResultsBiopsy specimens from nine subjects (9.8%) evidenced EBV DNA, whereas all except one of the subjects (1.1%) lacked HHV‐6 DNA.ConclusionsAlthough these findings do not support a primary aetiological role for EBV and HHV‐6 in classical CTCL, the possibility remains that both viruses, particularly EBV, may act as potential cofactors in the development of CTCL.
Five cases of livedo‐like dermatitis (Nicolau’s syndrome) due to bismuth salts and various other non‐steroidal anti‐inflammatory drugs
Authors: Corazza M , Capozzi O , Virgili A 
Published: March 2003

AbstractThe authors report five cases of Nicolau’s syndrome observed over a period of about 25 years. The disease had occurred after intramuscular injections of different drugs (bismuth, diclofenac and ibuprofen). In all the described cases the clinical aspect was characterized by a livedoid pattern followed by a slow necrotizing evolution with scar formation; in some cases surgical debridement and plastic reconstructive surgery were performed. In the past Nicolau’s syndrome was described after intramuscular injections of bismuth salts for the treatment of syphilis; now, although still rare, it is described after injections of various aqueous drug solutions. The pathogenesis of Nicolau’s dermatitis appears to be more complex than the previous hypothesized embolism caused by oleous drugs.
Treatment of chronic radiation ulcers with recombinant platelet‐derived growth factor and a hydrophilic copolymer membrane
Authors: Wollina U , Liebold K , Konrad H 
Published: March 2003

AbstractWe report on a 59‐year‐old woman suffering from cutaneous T‐cell lymphoma of the mycosis fungoides type, who developed chronic ulcerating radiation dermatitis after total body electron beam irradiation with a cumulative dose of 36 Gy. The painful and easily bleeding ulcers could be markedly improved using a combined approach with topical platelet‐derived growth factor gel and hydrophilic copolymer membranes.