A genital mass due to herpes simplex virus in a renal transplant recipient.

Infection with herpes simplex virus in immunocompromised patients may be atypical in appearance. Large, hypertrophic lesions in the anogenital region suggestive of malignancy have been rarely described, primarily in patients with HIV. We report a case of a large genital mass due to herpes simplex virus in a renal transplant recipient.

The diagnosis and treatment of human papillomavirus-mediated genital lesions.

Genital warts (condyloma acuminatum, venereal warts) are common highly contagious benign epithelial lesions occurring on the genitals, perianal area, and inguinal folds, and are caused by human papillomavirus (HPV). Diagnosis is based largely on the clinical appearance of lesions. New home-based treatments, including podofilox and imiquimod, have revolutionized the therapeutic management of genital warts, empowering patients to participate in their own treatment with products that primarily have local side effects.

High throughput analysis of red wine and grape phenolics-adaptation and validation of methyl cellulose precipitable tannin assay and modified Somers color assay to a rapid 96 well plate format.

The methyl cellulose precipitable (MCP) tannin assay and a modified version of the Somers and Evans color assay were adapted to high-throughput (HTP) analysis. To improve efficiency of the MCP tannin assay, a miniaturized 1 mL format and a HTP format using 96 well plates were developed. The Somers color assay was modified to allow the standardization of pH and ethanol concentrations of wine samples in a simple one-step dilution with a buffer solution, thus removing inconsistencies between wine matrices prior to analysis and allowing for its adaptation to a HTP format.

Yellow nail syndrome in three siblings: a randomized double-blind trial of topical vitamin E.

Yellow nail syndrome is an uncommon disorder characterized by dystrophic nails, lymphedema, and respiratory disease. It has rarely been reported in children and this is the first report of congenital yellow nails in siblings. The purpose of this study was to determine whether topical vitamin E applied to the nail plates and periungual skin would affect the growth rate or appearance of the fingernails in patients with congenital yellow nail syndrome.

Filtering activity of Spongia officinalis var. adriatica (Schmidt) (Porifera, Demospongiae) on bacterioplankton: implications for bioremediation of polluted seawater.

A study on the filtering activity has been carried out on reared specimens of the demosponge Spongia officinalis var. adriatica coming from an off-shore farm displaced off the Apulian coast (Ionian Sea). The experience was carried out under laboratory conditions, by using natural seawater collected from the sponge environment.

Parental authority, patient's best interest and refusal of resuscitation at borderline gestational age.

Potential conflict exists when parents refuse a medical intervention for their child that the physician feels obligated to provide. For the anticipated delivery of a preterm newborn, this conflict might exist if the parents refuse resuscitation. At borderline viability, most neonatologists are likely to respect the parents' wishes.

The Conscientious Practice Policy: a futility policy for acute care hospitals.

Much attention has been paid in recent years to the conflict that may occur when patients or their families insist on a therapy that the physician feels would be futile. In 1999 the Council on Ethical and Judicial Affairs of the American Medical Association recommended that all health-care institutions adopt a policy on medical futility that follows a fair process. Development of such a policy has proved problematic for many hospitals.

Physicians' refusal to resuscitate at borderline gestational age.

Most neonatologists believe there is a minimal gestational age, below which it is appropriate to refuse to provide resuscitation or intensive care. Determination of this threshold should involve knowledge of the outcome data, but also an understanding of the potential for misuse of these data. In particular, there is a risk of deception, of the parents and of ourselves, due to the uncertainty of the true gestational age, and the "self-fulfilling prophecy" that may occur when a center refuses to try below a certain gestational age because they have had no survivors below that age.

Self-healing juvenile cutaneous mucinosis.

Self-healing juvenile cutaneous mucinosis is an extremely uncommon disorder characterized by the acute eruption of multiple papules and subcutaneous nodules. In this report, we describe one of the youngest patients reported to date with self-healing juvenile cutaneous mucinosis and further define several of the histologic and clinical characteristics unique to the disorder. Awareness of this disease is important because, despite an ominous presentation, all reported cases have resolved spontaneously.

Deciding for neonates: whose authority, whose interests?

Two principles are commonly perceived as being central to decision-making for critically ill newborns: the patient's best interest standard, and the authority of the parents to speak for the newborn as the surrogate decision-makers. In this essay, these 2 principles are examined in the context of a particular setting, that of a critically ill newborn with a mother in early adolescence. Alternatives to the patient's best interest standard are explored, including consideration of other interests in addition to those of the patient, such as the interests of the young mother and other family members.

An open case series of patients with basal cell carcinoma treated with topical 5% imiquimod cream.

In an open-label study we assessed the response rate and posttreatment follow-up of topical imiquimod 5% cream in 5 patients with basal cell carcinoma (BCC) who were not treated with surgical excision after topical immunotherapy. All patients received imiquimod 5% cream 3 times a week for up to 16 weeks, at which time treatment was stopped. Patients were examined at regular intervals for signs of recurrence.

Treatment of human papilloma virus in a 6-month-old infant with imiquimod 5% cream.

A healthy female infant was diagnosed with genital warts at six months of age. She was the product of an uncomplicated vaginal delivery to a mother who was diagnosed with genital warts during the pregnancy, but did not undergo any treatment. The infant's warts were clinically resolved following a three week course of 5% imiquimod cream, an immunomodulating agent that has been demonstrated to be a potent inducer of several cytokines promoting an antiviral cell-mediated immune response.

Hirsutism: diagnosis and management.

The majority of women with hirsutism have the idiopathic variety characterized by normal circulating androgens. An index of suspicion should, however, be maintained for that subset of women whose hirsutism is indicative of a systemic hormonal aberration. The psychological consequences of this highly visible condition that can seriously impact quality of life substantiate the need for safer and more effective management options.

Gender and dermatology.

Women are the primary focus of dermatologic care in the United States. The awareness of differences in cutaneous biology between the sexes is vital to appropriate diagnosis and treatment of patients. Although research directed at women's health has become a greater priority in recent years, there has been very little gender-specific research in dermatology.

Androgen physiology and the cutaneous pilosebaceous unit.

Hormones play an important role in cutaneous physiology. The androgen hormones are of particular relevance in modulating hair growth and sebum production in the pilosebaceous unit, which is comprised of the hair follicle and sebaceous gland. Testosterone arising from the circulation is converted peripherally to its more potent, reduced form, dihydrotestosterone, by the enzyme 5 alpha-reductase.

Tinea capitis: fluconazole in Trichophyton tonsurans infection.

Tinea capitis is the most common dermatophyte infection in children. Trichophyton tonsurans is the most common etiologic agent in the United States, and for more than four decades the standard therapy has been griseofulvin. The availability of newer, and often more effective, antifungal drugs creates the opportunity for choice and the ability to optimally tailor treatment for a particular patient.

Porphyria cutanea tarda, hepatitis C, and HFE gene mutations in North America.

In some, but not all countries, porphyria cutanea tarda (PCT) has been associated with chronic infection with the hepatitis C virus (HCV). Recently, PCT has also been associated with mutations in the HFE gene that are associated with HLA-linked hereditary hemochromatosis. Until now, few studies of these associations have been reported from North America.

Aspects of sleep in centenarians.

Sleeping habits of 48 Calabrian centenarians (12 males, 36 females) were evaluated. Their average age was 102 +/- 1.87 years (range 100-107 years).

Multidimensional evaluation in a group of centenarians.

A group of 40 Calabrian centenarians (12 males, 28 females) was studied from June 1 to December 31, 1993. Their age was ranging from 100 to 107 years (mean age: 102.3 +/- 1.

Hypertension in a group of centenarians.

The aim of the present study was to evaluate the frequency of hypertension in a group of extremely old persons: 73 centenarians resident in Calabria were studied, aged 100-110 years, (mean age 102.95 +/- 2.0), 54 women (73.

Cutaneous photosensitivity diseases induced by exogenous agents.

Cutaneous photosensitivity diseases may be idiopathic, produced by endogenous photosensitizers, or associated with exogenous photosensitizers. Those caused by exogenous agents include phototoxicity, photoallergy, and the exacerbation or induction of systemic disorders in which photosensitivity is a prominent clinical manifestation. Phototoxic disorders have a high incidence, whereas photoallergic reactions are much less frequent.