bluuebunny/crossref_metadata_2025_split huggingface dataset:
Outbreak of cutaneous larva migrans in a group of travellers
Authors: Tremblay A. , MacLean J. D. , Gyorkos T. , MacPherson D. W. 
Published: March 2003

Summary introduction  We describe an outbreak of cutaneous larva migrans (CLM) in a group of 140 holidaymakers to a resort in Barbados and the index case.methods  A two‐page questionnaire was mailed to holidaymakers and 90% responded.results  25.4% of respondents developed a rash consistent with CLM. Risk factors for developing the illness were younger age and less frequent use of protective footwear while walking to the beach. Patients had difficulty in obtaining a correct diagnosis during their initial medical consultation and in obtaining medication from pharmacies. Efficacious treatments were oral and topical thiabendazole.conclusions  CLM can occur in a large proportion of people exposed to contaminated soil or sand. Protective footwear is effective in reducing infection. Thiabendazole is an efficacious treatment.
ELISA and Western Blotting tests in the detection of IgG antibodies to Taenia solium metacestodes in serum samples in human neurocysticercosis
Authors: Shiguekawa Kely Yoshiko Martins , Mineo José Roberto , de Moura Leandro Pajuaba , Costa‐Cruz Julia Maria 
Published: March 2003

Summary A comparative study of total saline extract (SE) and cyst vesicular fluid (VF) of Taenia solium metacestodes by ELISA and Western blotting assay (WB) tests was conducted to detect IgG in sera for diagnosis of human cysticercosis. Sera were obtained and analysed by ELISA in 1 : 20 and 1 : 100 dilutions from 208 individuals: 22 confirmed neurocysticercosis (NC) (group 1), 101 suspected NC (group 2), 55 with various intestinal parasitosis (group 3) and 30 healthy individuals (group 4). The WB test was carried out on SE and VF extracts with and without reducing agent, 2‐β‐mercaptoethanol (2‐ME) in 20 sera of each group. WB using extracts without 2‐ME and ELISA at 1 : 100 dilution were compared in 20 sera from each group; sensitivity and specificity were calculated using samples from groups 1, 3 and 4. By ELISA, in the 1 : 100 sera dilution reactivity was reduced for both antigens without changes in the sensitivity of the test. By WB, antigens treated with 2‐ME demonstrated low specificity. For SE and VF antigens, the proteins of 24, 39–42, 47–52, 56, 64–68, 126–155 kDa and 18, 24, 26–28, 32–36, 47–52, 75 kDa, respectively, were considered immunodominant markers, with high indices of specificity, suggesting a profile for NC patients. However, as the sensitivity was found to be low, it might still not be a definitive test for NC when used alone. These data suggest WB as an indicative test to determine exposure to T. solium. ELISA and WB together may supply reliable results for the diagnosis of human cysticercosis, since appropriate purified antigens are not available yet.
Are there simple measures to reduce the risk of HIV infection through blood transfusion in a Zambian district hospital?
Authors: van Hoogstraten M. J. , Consten E. C. J. , Henny Ch P. , Heij H. A. , van Lanschot J. J. B. 
Published: March 2003

Summary objective  To quantify the potential impact of simple measures to reduce the risk of iatrogenic HIV infection through blood transfusion in a Zambian district hospital. methods  Three studies were conducted at St. Francis' Hospital, Katete, Zambia: (1) From 1991 to 1995 HIV seroprevalence among all listed blood donors and the impact of proper subgroup selection were studied retrospectively; (2) the sensitivity of locally used rapid antibody assays (HIV‐spot/Wellcozyme HIV 1 & 2) for the detection of HIV in donor blood and the influence of the expiration date of the tests on this sensitivity were determined prospectively from June 1993 until March 1994 by screening all consecutive surgical patients and blood donors; (3) the number of unnecessary blood transfusions was determined retrospectively from January 1995 through January 1996 and prospectively from February 1996 through March 1996, and possibilities to reduce the total number of blood transfusions were considered. results  (1) Excluding prisoners, who have an HIV seroprevalence of 19–25%, from the donor population significantly reduces the overall HIV seroprevalence from 13–16% to 8–9% (P < 0.01). (2) Under local circumstances the sensitivity of the used rapid antibody assays was 6.8–17.9% lower than claimed by the manufacturer. Usage of non‐expired tests increased the sensitivity significantly from 88.2% to 91.7% (P < 0.05). (3) None of the 294 studied blood transfusions can be classified as inappropriate according to international standards. conclusions  Simple measures such as proper subgroup selection among blood donors and correct use of non‐expired tests may decrease the risk of iatrogenic HIV transmission. Stricter indications for blood transfusions will not substantially reduce the number of transfusions.
Feasibility of an ultrasound service on district health care level in Botswana
Authors: Bussmann Hermann , Koen Emy , Arhin‐Tenkorang Dyna , Munyadzwe Grace , Troeger Jochen 
Published: March 2003

OBJECTIVE To assess the clinical benefit and financial feasibility of an ultrasound service in a district hospital in Botswana. METHOD An ultrasound service was established in the study hospital. Clinical and ultrasound‐aided diagnoses were compared in patients who met eligibility criteria laid down in an indication list. RESULTS We enrolled 2309 patients over 18 months. The most frequent indications for ultrasound were pregnancy‐related diagnoses followed by gynaecological and hepato‐biliary disorders. Ultrasound assistance improved case management in 696 cases (30%) and led to an immediate change in management in 151 patients. Ultrasound diagnosis was used as gold standard to assess the accuracy of the clinical diagnosis of incomplete abortion (sensitivity 24%; positive predictive value, PPV 66%), pelvic mass (sensitivity 53%; PPV 69%), ectopic pregnancy (sensitivity 75%; PPV 28%), and gall bladder stones (sensitivity 30%; PPV 32%). CONCLUSIONS Ultrasound improved case management for a wide diversity of clinical problems encountered on district health care level. The service proved to be affordable for the Botswana health care system.
Lower levels of the circulating neuropeptide somatostatin in Schistosoma mansoni infected patients may have pathological significance
Authors: Chatterjee Shyama , Mbaye Amadou , Van Marck Eric 
Published: March 2003

SummaryIn recent years, cases of severe morbidity (fibrosis, haematemesis, hepatosplenomegaly, ascites) caused to Schistosoma mansoni infections are on the rise in Northern Senegal. The neuropeptide somatostatin is reported to decrease portal pressure, control variceal bleeding and fibrosis, and reduce Schistosoma‐caused clinical morbidity in the rodent model. The aim of this study was to delineate the role of somatostatin in S. mansoni‐caused pathogenesis, by studying host levels of somatostatin in the peripheral blood of uninfected and S. mansoni‐infected individuals. Subjects from the district dispensary at Richard Toll, in the Medical Region of Saint‐Louis, Senegal, infected with S. mansoni and suffering from severe morbidity were selected. A separate group consisted of individuals resident in the same region but uninfected at the time of the study. Significantly lower somatostatin levels were detected in severe morbidity patients, compared with the exposed but uninfected subjects. In patients with schistosomiasis physiological levels of somatostatin may determine disposition of particular individuals towards severe morbidity, as opposed to others. Host pathology can thus be alleviated by the therapeutic ability of somatostatin to treat bleeding oesophageal varices, reduce portal pressure and prevent progression to severe fibrosis.
The impact of adjustment for parity and mid‐upper‐arm circumference on sensitivity of symphysis‐fundus height measurements to predict SGA foetuses in Mozambique
Authors: Challis Kenneth , Osman Nafissa Bique , Nordahl Gunnar , Bergström Staffan 
Published: March 2003

Summarybackground With a new symphysis‐fundus height (SFH) growth chart, based on Mozambican women with ultrasound‐dated singleton pregnancies, the aim was to examine the possibility to enhance sensitivity of predicting small for gestational age (SGA) newborns by attempts to adjust the chart for parity and for mid‐upper‐arm circumference (MUAC).methods  Two antenatal clinics were chosen in the suburban area of Maputo City. A cohort of 904 consecutively recruited antenatal clients was followed until birth. Gestational age was determined by ultrasound at enrolment. The growth of the SFH was measured every 2–3 weeks. Women with multiple pregnancy or with gestational age >21 weeks at enrolment were excluded. Attempts were made to adjust SFH measurements for parity and MUAC by developing a mathematical model to increase sensitivity of the SFH method to predict a foetus being SGA.results  Parous women had on average 0.5–1 cm higher SFH readings than nulliparous women. Women with a body mass index (BMI) <19 and women with BMI >27 had approximately 1 cm lower and 1 cm higher readings, respectively, compared with women of normal BMI. There was a significant correlation between BMI and MUAC (r = 0.621; P < 0.001). The usefulness of SFH measurements to predict SGA newborns was analysed. The sensitivity was 49%, the specificity was 66%, the positive predictive value was 14% and the negative predictive value, 93%. By using the correlation between BMI and MUAC we tried to find a simple and useful method to improve the sensitivity of SFH to detect SGA foetuses. By reducing the SFH measurement by 1 cm for women with MUAC >29 and by 1 cm for multiparous women the sensitivity raised to 65% at the expense of reducing the specificity to 51%. Using a linear function of BMI, MUAC and parity to adjust the SFH measurement for each individual woman, it was possible to get a sensitivity of 70% with a corresponding specificity of 56%.conclusion  By using BMI, MUAC and parity, it might be possible to improve the sensitivity of the SFH growth chart in predicting newborn being SGA but mostly at the expense of specificity.
A semiquantitative cytological evaluation of normal and pathological samples from the external ear canal of dogs and cats
Authors: Ginel Pedro J. , Lucena Rosario , Rodriguez Juan C. , Ortega Joaquin 
Published: March 2003

Abstract  Numbers of desquamated epithelial cells, yeast cells and bacterial organisms were counted in samples collected from the external ear canal of 37 normal dogs and 16 normal cats, and from 24 dogs and 22 cats with otitis externa. The aims of the study were to establish quantitative reference ranges and to correlate these data with the clinical status of the dogs and cats. Numbers of yeast cells and bacterial organisms were significantly increased in dogs (P = 0.05; P = 0.0001) and cats (P = 0.0001; P = 0.0001) with otitis externa, and in most cases high counts were correlated with clinical signs. Mean Malassezia counts per high‐power dry field of ≥ 5 in the dog and ≥ 12 in the cat were considered abnormal. Mean bacterial counts per high‐power dry field of ≥ 25 in the dog and ≥ 15 in the cat were considered abnormal. When used to differentiate normal from inflamed external ear canals, these figures provided a low sensitivity but a specificity of ≥ 95%.
Characterization of a monoclonal antibody against desmoplakin 1 for use in dogs
Authors: Nakamura Yuka , Nakashima Ko , Kano Rui , Watanabe Shinichi , Hasegawa Atsuhiko 
Published: March 2003

Abstract Skin biopsy specimens from face, axilla, abdomen and thigh, mucocutaneous tissues from anus and vagina, and oral mucosa from six healthy Beagle dogs were examined for desmoplakin (Dsp) immunoreactivity using immunoblotting and immunohistochemical analysis. With immunoblotting using mouse antihuman Dsp 1 monoclonal antibody (DP2.17), a band was detected at 250 kDa in all the extracts as in normal human skin samples, although no band was detected at 210 kDa, suggesting that monoclonal antibody DP2.17 recognizes canine Dsp 1 but not Dsp 2. Moreover, the desmosome regions of all specimens were stained with DP2.17 using immunohistochemical analysis. From these results, DP2.17, developed for the examination of human skin, might be suitable for the investigation of Dsp‐related skin disorders in dogs.
Adherence of Staphylococcus intermedius to canine corneocytes in vitro
Authors: Saijonmaa‐Koulumies Leena E. , Lloyd David H. 
Published: March 2003

Abstract This study investigated the in vitro adherence of Staphylococcus intermedius to canine corneocytes, collected from a healthy dog using double‐sided adhesive tape. Adherence was shown to depend on duration (P < 0.001) and temperature of incubation (P < 0.001) and the concentration of bacteria (P < 0.001). Isolates of S. intermedius from lesions of pyoderma were not generally more adherent to healthy canine skin than were isolates from healthy dogs. Significant differences in adherence were demonstrated between individual isolates within both groups (P < 0.001). The study suggests that among S. intermedius there is no correlation between virulence and adherence to canine corneocytes in vitro. The finding may be important for the potential use of avirulent variants of S. intermedius as antagonistic strains against canine pyoderma. However, more studies are needed to compare the adherence of the isolates to skin cells obtained from dogs with diseases predisposed to pyoderma.
Crusted scabies of the scalp in dermatomyositis patients: three cases treated with oral ivermectin
Authors: Dourmishev MD, PhD, DSc Assen L. , Serafimova MD Dimitrina K. , Dourmishev MD Lyubomir A. , Mualla MD, PhD Mohamed A. , Papaharalambous MD Velitchka , Malchevsky MD Tichomir 
Published: March 2003

BackgroundCutaneous features in the scalp area among adult patients are rarely considered as a manifestation of scabies. MethodsThree patients with clinical and laboratory data of dermatomyositis with scalp involvement (fulfill three or four of Bohan and Peter’s criteria), of 4 years, 8 months, and 3 years duration, were seen at our department between 1995 and 1996. For relapses of ordinary scabies, they were treated repeatedly with local scabicide with temporary effect. After a symptom‐free period during the treatment of dermatomyositis with corticosteroids and azathioprine, they developed diffuse redness with scales and crusts on the scalp areas. Light microscopy examination of material taken from these crusts showed an abundance of live mites. ResultsAll patients were successfully cured of scabies with a twice oral dose of 200 μg/kg ivermectin within 8 days. ConclusionsOur patients with crusted scabies of the scalp and dermatomyositis prompted us to change our standard diagnostic and therapeutic regimens. Fascinating features included mimicry of scabies in patients with dermatomyositis, location of parasites on the scalp, suppressed cell‐mediated immunity and successful cure of mange by ivermectin.
Erythema multiforme, Stevens–Johnson syndrome and toxic epidermal necrolysis in northeastern Malaysia
Authors: Kamaliah M. D. , Drcog . , Zainal D. , Mbbs . , Mokhtar N. , Nazmi N. 
Published: March 2003

Abstract Background Previous studies have reported that drugs and infections are common causes of erythema multiforme (EM) and Stevens–Johnson syndrome (SJS). Toxic epidermal necrolysis (TEN) is mainly related to drugs. No study has been conducted in Kelantan, the northeastern state of Malaysia, to assess these cutaneous reactions. Methods A retrospective study of all hospitalized cases of EM, SJS, and TEN was conducted covering an 8‐year period from 1987 to 1994. Results There were four cases (13.8%) of EM, 22 cases (75.9%) of SJS, and three cases (10.3%) of TEN. Drugs as a definitive cause was observed in one case (25%) of EM, 12 cases (54.5%) of SJS, and two cases (66.7%) of TEN. Drugs as a probable cause was observed in seven cases (31.8%) of SJS and one case (33.3%) of TEN. The male to female ratio was equal in EM and SJS. Antiepileptics were the commonest culprits, followed by antibiotics. One patient died of SJS and one patient died of TEN, giving mortality rates of 4.5% and 33.5% respectively. Fever was noted in 18 patients (62.1%). Leukocytosis was noted in 10 patients (34.5%), and nine patients (31.0%) had elevated liver transaminase enzymes. No significant correlation was noted between these biochemical changes and cutaneous eruption. Secondary infections were observed in 11 patients (37.9%): Staphylococcus aureus was the commonest isolated organism. Conclusions This study shows that drugs remain the commonest culprit in SJS and TEN. Despite adequate treatment, the mortality rate remains high, especially in TEN. These findings are similar to those of other reported studies.
Correspondence
Authors: Goihman‐Yahr Mauricio 
Published: March 2003

Periorbital necrotizing cellulitisA 49‐year‐old Japanese woman with uncontrolled diabetes and alcohol abuse noticed a slight red discoloration above the right upper eyelid on the day after she had got very drunk. In spite of the treatment with antibiotics given by local physicians, her right upper and lower eyelids gradually became edematous so that she could not open her right eye. She was referred to us 7 days after the onset of the disease. Physical examination revealed marked erythema and swelling on the right eyelid with yellow, partially black necrotic tissues ( Fig. 1). A thick purulent discharge was drained from the right lateral canthus. The eyeground examination was unremarkable, and ocular movements were intact. Computed tomographic scans of the orbits showed neither orbital nor sinus involvement. The peripheral white blood cell count was 11,550/mm3. A culture of pus yielded β‐hemolytic, group A, Streptococcus pyogenes. The periorbital edema resolved after surgical debridement and systemic administration of imipenem/cilastatin and cefazolin for 3 weeks; however, facial nerve palsy of the right temporal branches still remains after 2 months (
Fig. 2).Marked edema and erythema on the right eyelidimageFacial nerve palsy after healing of the wound. Note lack of furrows on right half of foreheadimage
Primary squamous syringometaplasia with no underlying malignancy
Authors: Jerasutus Suthep , Laohabhan Kulakarn , Suvanprakorn Pichit 
Published: March 2003

A 26‐year‐old Thai man was first seen in our department for the evaluation of an intermittent, pruritic, papular eruption that had appeared over the previous 2 months. He noticed that the lesions usually arose following exposure to heat or excessive sweating. The patient was otherwise in good health and did not take any medication. His family history did not reveal any similar disease.On examination, there were multiple 2–3 mm, clustered, erythematous papules widely distributed on the chest, abdomen, buttock, and thighs ( Fig. 1). They were purpuric and blanched slightly when palpated. All lesions appeared to be at the same stage of development. Some papules had coalesced to give edematous plaques with satellite margins. Healing lesions showed striking reticulated hyperpigmentation. The clinical differential diagnosis included allergic contact dermatitis and herpes simplex. Histology of a punch biopsy from the back revealed squamous metaplasia of the eccrine ductal epithelium of the epidermis and the upper dermis. The metaplastic ducts were lined by large polygonal epithelial cells. Focal necrosis of the ductal epithelium, obliteration of the lumen, and parakeratosis were also observed. A slight perivascular infiltrate of lymphocytes with some neutrophils and eosinophils was noted in the upper dermis. The coils in the deeper dermis were not involved. A diagnosis of primary squamous syringometaplasia was made. Routine laboratory tests were normal.Multiple groups of 2–3 mm erythematous papules on the trunk and abdomen. Some lesions are confluentimage
PUVA treatment of vitiligo: a retrospective study of Turkish patients
Authors: Sahin Sedef , Hindioglu Ugur , Karaduman Ayşen 
Published: March 2003

Abstract Background Psoralen plus ultraviolet A (PUVA) is considered to be the treatment of choice for subtotal vitiligo; however, it is time consuming and carries certain health risks for both patients and physicians. This study attempts to evaluate the efficacy of the treatment in Turkish vitiligo patients. Methods We have performed a retrospective study of 33 patients with vitiligo who received systemic PUVA therapy during the period 1985 to 1997, and have evaluated their response to treatment. Results Overall, 28 patients (84%) showed some improvement; 12 patients experienced a repigmentation of 51–75% and six patients achieved greater than 75% repigmentation. Face and trunk lesions showed better repigmentation than other areas, whereas hands, feet, perioral, and periorbital areas were generally refractory to treatment. The age of the patient, age at onset of the disease, sex, disease duration, and degree of depigmentation prior to initiation of therapy had no influence on PUVA‐induced repigmentation. Conclusions The distribution of vitiliginous skin must be taken into consideration before the initiation of PUVA therapy, as the response to treatment varies greatly with different body sites; hands, feet, perioral, and periorbital regions are particularly treatment resistant.
Epidemiology and prognosis of plantar melanoma in 62 Japanese patients over a 28‐year period
Authors: Kato Taizo , Suetake T. , Tabata N. , Takahashi K. , Tagami H. 
Published: March 2003

Abstract Background The plantar surface is one of the commonest sites of malignant melanoma in the Japanese; however, the biological behavior is not sufficiently clarified, because of the paucity of long‐term studies. We attempted an epidemiologic survey of the cases of plantar melanoma treated in our institute to study the survival rate in the recent period. Methods Of the 207 cases of malignant melanoma observed over the past 28 years, 62 patients were diagnosed as having plantar melanoma. The proportion of plantar melanoma to all melanomas, the sex and age of the patients, and the histologic type, stage, and prognosis were evaluated by comparing those registered in the first half (1969–1982) and the second half (1983–1996) of the period. Results The proportions of plantar melanoma in the first and second half periods were 31% (28 out of 90) and 29% (34 out of 117), respectively. No sex difference in the patients was observed. The mean age of the patients was 67 years. Fifty‐one lesions were histologically proven to be acral lentiginous melanoma (ALM), two were superficial spreading melanoma (SSM), and nine were nodular melanoma (NM). Of the nine NMs, eight were registered in the second half period. The heel was affected in 33 (53%), the metatarsal regions in nine (14%), the toes in six (10%), and the arch areas in 14 (23%). The proportion of the weight‐bearing areas, including the heel, metatarsal areas, and toes, decreased in the second half period.A comparison of the stages of plantar melanoma showed that, in the first half period, there were 18% of patients with stage IV disease in contrast to none in the second half period. Conversely, the proportion of stage I and II disease was 50% in the second half period, whereas it was only 39% in the first half period. The 5‐year survival rates in the first and second half periods were 56% and 71%, respectively. Conclusions The prognosis of plantar melanoma has improved recently at our institute. The possible explanation for a trend to better survival in the second half period may be related to a decrease in stage IV disease as well as to an increase in the frequency of diagnosis of early stage disease.