Allergic contact dermatitis due to benzalkonium chloride in plaster of Paris.

Plaster of Paris (POP) bandages are extensively used for splinting and casting injured or surgically repaired body parts. Allergic contact dermatitis caused by POP has been reported only rarely in the medical literature. An 81-year-old woman developed multiple large, tense, haemorrhagic bullae on the palm, and an acute vesicular eczematous eruption on the forearm, after the application of a POP splint.

Adjusting the balance in health-care quality.

In an increasingly informed society there has been a growing interest by consumers in evaluating the quality-of-care provided by their practitioners. This task is complicated by an asymmetry in the technical knowledge required to assess health-care quality between consumers and health providers. Recently attempts have been made to incorporate patient views into the assessment of quality to try and address this asymmetry.

Improving stroke outcome: the benefits of increasing availability of technology.

Introduction: A decision analysis was performed to explore the potential benefits of interventions to improve the outcome of patients admitted to hospital with a stroke, in the context of the technology available in different parts of the world.

Methods: The outcome of death or dependency was used with a six-month end-point.

Results: Four settings were identified that would depend on the resources available.

One year in Antarctica: mucosal immunity at three Australian stations.

The effect of a year's isolation in Antarctica on the human mucosal immune system was assessed during the winter of 1992 at three Australian Antarctic stations: Casey, Davis and Mawson. Saliva samples were collected from each expeditioner prior to their departure from Australia and during each month in Antarctica. The concentrations of salivary immunoglobulins IgA and IgG were significantly different between the three stations, but there were no differences for salivary IgM and albumin.

Special feature for the Olympics: effects of exercise on the immune system: exercise effects on mucosal immunity.

The present review examines the effects of exercise on mucosal immunity in recreational and elite athletes and the role of mucosal immunity in respiratory illness. Habitual exercise at an intense level can cause suppression of mucosal immune parameters, while moderate exercise may have positive effects. Saliva is the most commonly used secretion for measurement of secretory antibodies in the assessment of mucosal immune status.

Special feature for the Olympics: effects of exercise on the immune system. Overview: exercise immunology.

The review articles in this special feature reflect the current status of knowledge in the field of exercise immunology, with a focus on how exercise affects the human immune system and the health implications for resistance to infections and neoplastic diseases. In an Olympic year, the emphasis of exercise immunology research tends to be on elite athletes and the prevention of infections in the quest for optimum performance. However, research presented in this issue also covers recreational athletes, as well as highlighting the benefits of exercise for our ageing population.

The measurement of IgA and IgG transglutaminase antibodies in celiac disease: a comparison with current diagnostic methods.

Celiac disease (CD) is an inflammatory disorder of the small intestine induced by cereal prolamins. The demonstration of IgA endomysial antibodies (EMA) is currently the most reliable serological screen for CD. The antigenic target is transglutaminase.

Transient reactive papulotranslucent acrokeratoderma associated with cystic fibrosis.

A 20-year-old female with cystic fibrosis presented with a white marginal palmar eruption after exposure to water. There was no family history of keratoderma. A biopsy showed hyperkeratosis around dilated eccrine ostia.

Regional musculoskeletal pain. The neck.

Tumours, infections, aneurysms and metabolic and inflammatory diseases are rare causes of neck pain. Most cases involve neck pain of unknown origin or a whiplash-associated disorder. Neck pain is common in the general community and more common in certain occupations.

Biomechanics of the cervical spine. I: Normal kinematics.

Unlabelled: This review constitutes the first of four reviews that systematically address contemporary knowledge about the mechanical behavior of the cervical vertebrae and the soft-tissues of the cervical spine, under normal conditions and under conditions that result in minor or major injuries. This first review considers the normal kinematics of the cervical spine, which predicates the appreciation of the biomechanics of cervical spine injury. It summarizes the cardinal anatomical features of the cervical spine that determine how the cervical vertebrae and their joints behave.

Mucosal immune responses and risk of respiratory illness in elite athletes.

This review focuses on studies of mucosal immunity in elite athletes and specifically addresses the role of mucosal immunity in respiratory illness and associations with the intensity, volume, and duration of exercise. Habitual exercise at an intense level can cause suppression of mucosal immune parameters. Salivary IgA and IgM concentrations decline immediately after a bout of intense exercise and usually recover within 24 hours.

Mucosal immunity and respiratory illness in elite athletes.

This review focuses on studies of immunity in elite athletes and specifically addresses the role of mucosal immunity in respiratory illness and associations with the intensity, volume and duration of exercise. Investigations of mucosal immunity have mostly studied the response of salivary immunoglobulins to exercise, although nasopharyngeal secretions and breast milk have also been examined. Habitual exercise at an intense level can cause suppression of mucosal immune parameters.

Mortality after acute myocardial infarction is lower in metropolitan regions than in non-metropolitan regions.

Study Objectives: To compare in-hospital mortality for acute myocardial infarction (AMI) between metropolitan and non-metropolitan hospitals after adjustment for patients' severity; to examine the role of the use of effective cardiac medications in the possible mortality difference between these types of hospital.

Design: Retrospective cohort study.

Setting: 47 acute public hospitals in metropolitan and non-metropolitan areas of New South Wales, Australia, taking part in the Acute Cardiac Care Project based on medical record review.

Immune status and respiratory illness for elite swimmers during a 12-week training cycle.

The impact of a 12-week training program by elite swimmers on systemic and mucosal immunity was studied prospectively to examine the relationship between changes in immune parameters and the incidence of respiratory illness. Saliva was collected before and after selected training sessions at 2 weekly intervals. There were significant decreases in salivary IgA (p=0.

Human immunodeficiency virus-related primary cutaneous aspergillosis.

A 31-year-old Caucasian man with AIDS developed a crusted violaceous plaque under adhesive tape near a central venous catheter insertion site. Histological examination demonstrated a ruptured hair follicle containing collections of fungal hyphae typical of Aspergillus spp. A culture of the biopsy material grew Aspergillus fumigatus.

Benign melanocytic proliferative nodule within a congenital naevus.

A neonate presented with a deeply pigmented papule within a medium-sized congenital naevus. Histologically, this proved to be a benign proliferative nodule in a congenital naevus. This case is presented to highlight the occurrence of this lesion, the main differential of which is the rare entity of true congenital melanoma.

Studies on the IgA-independent immunological responses in mice to influenza virus challenge after oral vaccination with irradiated whole virus and an erythrocyte complex.

Previous studies have described an oral influenza vaccine comprising whole irradiated virus and an erythrocyte complex (IV-EC), which gave broad-based protection against influenza virus challenge in mice. The present study examined the immune responses generated after live virus challenge of vaccinated mice, particularly to determine whether mice vaccinated with IV-EC had enhanced CTL activity to compensate for the previously reported diminution in lung IgA response. Oral vaccine groups examined were IV-EC, live virus alone (LV) or live virus-erythrocyte complex (LV-EC), compared with irradiated virus and erythrocyte alone controls.

Cytoplasmic interactions between decay-accelerating factor and intercellular adhesion molecule-1 are not required for coxsackievirus A21 cell infection.

Coxsackievirus A21 (CAV-21) employs a cell receptor complex of decay-accelerating factor (DAF) and intercellular adhesion molecule-1 (ICAM-1) for cell infectivity. In this study, the nature of potential extra- and/or intracellular interactions between DAF and ICAM-1 involved in picornaviral cell entry was investigated. Firstly, it was shown that intracellular interplay between DAF and ICAM-1 is not required for CAV-21 infection, as CAV-21 lytic infection mediated via the DAF/ICAM-1 receptor complex is not inhibited by replacement of the transmembrane and cytoplasmic domains of ICAM-1 with those from an unrelated cell surface molecule, CD36.

Morphology of lymphatic malformations: a pictorial review.

A pictorial review of the many clinical manifestations of lymphatic malformations is presented, changes to the terminology of lymphatic malformations are reviewed and the 'pros and cons' of relevant investigative techniques are discussed.

Influence of admission body temperature on stroke mortality.

Background And Purpose: The influence of body temperature on stroke outcome remains uncertain. The aim of this study was to investigate the prognostic role of admission body temperature on short-term and long-term mortality in a retrospective cohort study of patients with acute stroke.

Methods: A retrospective cohort of 509 patients with acute stroke, admitted to a tertiary hospital between July 1, 1995, and June 30, 1997, was studied.

Survival analysis for recurrent event data: an application to childhood infectious diseases.

Many extensions of survival models based on the Cox proportional hazards approach have been proposed to handle clustered or multiple event data. Of particular note are five Cox-based models for recurrent event data: Andersen and Gill (AG); Wei, Lin and Weissfeld (WLW); Prentice, Williams and Peterson, total time (PWP-CP) and gap time (PWP-GT); and Lee, Wei and Amato (LWA). Some authors have compared these models by observing differences that arise from fitting the models to real and simulated data.

Is there a role for a mucosal influenza vaccine in the elderly?

Influenza infection is an acute respiratory disease with a high morbidity and significant mortality, particularly among the elderly and individuals with chronic diseases. The majority of countries now recommend annual influenza vaccination for all people aged 65 years or older, and for those with high risk conditions. Most commercially available influenza vaccines are administered systemically and while these are effective in children and young adults, efficacy levels in elderly individuals have been reported to be much lower.

Expression of a clone specific DNA sequence from Staphylococcus aureus in Escherichia coli.

Staphylococcus aureus produces a large number of factors thought to contribute to virulence, although the precise role of some of these individual factors is not clearly defined. To investigate whether specific virulence factors might be responsible for the selection and dominance of certain genotypes of methicillin- and multiply resistant S. aureus (MRSA), the method of subtractive hybridisation was used to identify conserved DNA sequences associated with the clinical, clonal populations of S.

Association of Helicobacter pylori infection with gastric carcinoma: a meta-analysis.

Objective: As conflicting studies have recently been published, we aimed to determine if Helicobacter pylori (H. pylori) infection is associated with gastric adenocarcinoma.

Methods: This was a meta-analysis of observational epidemiological studies.