Miracle-dz/UniFAR-FTUs huggingface dataset:
Predictive Factors for Successful Outcome of Pulsed Radiofrequency Treatment in Patients with Intractable Lumbosacral Radicular Pain.

BACKGROUND In a previous prospective study on pulsed radiofrequency (PRF) treatment adjacent to the lumbar dorsal root ganglion (DRG) for patients with chronic lumbosacral radicular pain, we reported success in 55.4% of the patients at 6 months. Identification of predictors for success after PRF may improve outcome. We assessed the predictors of PRF in patients with chronic intractable lumbosacral radicular pain. METHODS Patients with monosegmental chronic lumbosacral radicular pain of L5 or S1 first received a selective nerve root block at the corresponding level. Independent of the result of this block a PRF treatment at the same level was performed. At 6 weeks, 3 months, and 6 months after the procedure the outcome was evaluated. RESULTS A positive diagnostic nerve root block and age ≥ 55 were predictive factors for successful outcome at 6 months, while disability was a negative predictor.The use of failed back surgery syndrome, gender, duration of pain, Numerical Rating Scale, level and side of treatment, DN4, and RAND-36 as predictors for success was not supported. CONCLUSIONS Successful outcome after PRF adjacent to the DRG, in patients with intractable chronic lumbosacral radicular pain, is more likely in patients ≥ 55 years, with limited disability and after a positive diagnostic nerve root block. A combination of all these factors creates a fair predictive value (AUC: 0.73).
Does Pain in the Neonatal Period Influence Motor and Sensory Functions in a Similar Way for Males and Females During Post-Natal Development in Rats?

OBJECTIVE : Early pain experiences can lead to disruption in the long-term responses to pain and in abnormal development and behavior in rodents. We evaluated the sensory and motor development of Wistar rats after exposure to painful stimulation (repetitive needle prickling) immediately after birth. METHODS : Male and female rats were followed up to 6 months of life, and sensory and motor functions were investigated by testing paw withdrawal with von Frey filaments, calibrated forceps (CF), and grip strength (GS) tests. RESULTS : Body weight increased with age and tended to be smaller in pain groups compared with their controls of the same sex. GS values also increased with age in controls but were stable and even decreased in pain groups from 120 up to 180 days. The von Frey filaments test showed higher values on the nonstimulated paws in male and female pain groups, with no differences between sides on the controls. The CF test showed smaller values on the stimulated paws in the pain group, with no differences between sides on the controls. CONCLUSIONS : Pain in the neonatal period influences sensory and motor functions negatively during development in male and female rats, even long term after the painful stimulus is ceased. The neonatal injury-induced hypersensitivity is persistent, and male and female rats respond similarly to the stimulus.
High plasma levels of the soluble receptor for advanced glycation endproducts in patients with symptomatic carotid atherosclerosis

Background Advanced glycation endproducts (AGEs), particularly carboxymethyl(lysine)‐adducts (CML), exert part of their cellular effects by binding to a receptor, named receptor for AGEs (RAGE). The soluble form of this receptor (sRAGE) has been shown to have an athero‐protective role. We hypothesized the existence of a relationship between the AGE–RAGE axis and the occurrence of symptoms related to carotid atherosclerosis in nondiabetic conditions.
Chronic Pain Types Differ in Their Reported Prevalence of Post -Traumatic Stress Disorder (PTSD) and There Is Consistent Evidence That Chronic Pain Is Associated with PTSD: An Evidence-Based Structured Systematic Review

Objectives The hypotheses of this systematic review were the following: 1) Prevalence of post-traumatic stress disorder (PTSD) will differ between various types of chronic pain (CP), and 2) there will be consistent evidence that CP is associated with PTSD. Methods Of 477 studies, 40 fulfilled the inclusion/exclusion criteria of this review and were grouped according to the type of CP. The reported prevalence of PTSD for each grouping was determined by aggregating all the patients in all the studies in that group. Additionally all patients in all groupings were combined. Percentage of studies that had found an association between CP and PTSD was determined. The consistency of the evidence represented by the percentage of studies finding an association was rated according to the Agency for Health Care Policy and Research guidelines. Results Grouping PTSD prevalence differed ranging from a low of 0.69% for chronic low back pain to a high of 50.1% in veterans. Prevalence in the general population with CP was 9.8%. Of 19 studies, 16 had found an association between CP and PTSD (84.2%) generating an A consistency rating (consistent multiple studies). Three of the groupings had an A or B (generally consistent) rating. The veterans grouping received a C (finding inconsistent) rating. Conclusion The results of this systematic review confirmed the hypotheses of this review.
Impact of Patients’ Knowledge, Attitude and Practices on Hypertension on Compliance with Antihypertensive Drugs in a Resource-poor Setting -

AIM: The study objective was to assess the knowledge, attitudes and practices on hypertension of 240 adult Nigerian Africans with hypertension and their impact on compliance with antihypertensive drugs METHOD: It was a descriptive survey of 240 consented consecutive adult patients with hypertension who attended the Cardiology Clinic of the Federal Medical Centre, Ido-Ekiti, Nigeria, between April 2008 and March 2009. The hospital is rural health institution in south west Nigeria RESULTS: One hundred and fourteen patients (47.5%) were men and 126 (52.5%) were women. Mean age was 48.8±13.2 years. Mean systolic and diastolic BP were 156.8±25.1 mmHg and 98.4±18.7 mmHg respectively. Only less than half (47.1%) showed good knowledge of their hypertension. However, 141 (58.8%) possessed good knowledge of their antihypertensive drugs. Knowledge of hypertension was better in women than in men (59.3% vs 40.7%, p=0.014). Compliance to medications was good in only 77 (32.1%) of the patients. The reasons attributed to included: poor knowledge of the disease and ignorance of the need for long-term treatment (95, 32.6%); high cost of medications (63, 21.7%); religious practices and cultural beliefs (37, 12.5%); adverse drug reactions (19, 6.5%); inadequate access to medical care (18, 6.2%); and use of complimentary medications (60, 20.5%). CONCLUSION: The majority of our hypertensive patients still have a poor knowledge of their disease with a significant negative impact on compliance with medications. No doubt, there is a need to invent more effective education strategies directed towards the public in general and the patients in particular.
Association of xenobiotic metabolizing gene polymorphisms and chronic obstructive pulmonary disease in Indian population

Background and Aim: Genetic susceptibility to the development of chronic obstructive pulmonary disease might depend on variation in the activities of enzymes that detoxify cigarette smoke products. We studied the relationship of GSTP1, GSTM1, and GSTT1 gene polymorphisms with COPD risk in a case- control study of Indian patients and controls. Material and methods: A total of 186 patients with COPD and 160 healthy controls were included in the study. The Frequencies of GSTP1, GSTM1 alleles was determined by using conventional Multiplex PCR and GSTP1 by polymerase chain reaction and restriction fragment length polymorphisms technique. Results: A significant case –control difference was observed for the presence of null GSTM1, (61.8% Vs 55.0 %, P= 0.04). No difference was observed in the frequency of GSTT1 Null genotype and COPD susceptibility. (54.8% vs 50.6% OR: 1.26; CI: 0.87- 1.84; P value = 0.82) For GSTP1 polymorphism we found that Subjects homozygous variants Val/ Val were at increased risk of developing COPD (OR: 2.58; CI: 1.2- 4.8) as compared to heterozygote variants Ile/ Val (OR: 1.28 CI: 0.7-2.14) Also, the mutant allele frequency (Val) was significantly higher in patients as compared to controls and the difference was found to be statistically significant. (OR: 1.8 CI: 1.4- 4.2; P Value =0.001) Conclusion: We propose that subjects with GSTM1 null allele and GST P1 homozygous isoleucine genotypes are at higher risk of COPD and are significant indicators of susceptibility to chronic obstructive pulmonary disease in Indian population. Keywords: Chronic Obstructive Pulmonary Disease, Polymerase chain reaction, Gluthathione S- transferase.
Is pregnancy associated with biochemical and haematological changes in HIV-infected Nigerian women?

Background. While there is evidence that HIV affects the course and outcome of pregnancy, reports on the effects of pregnancy on HIV infection remain conflicting, especially in low-resource settings. Methodology. A prospective study of two demographically similar cohorts of HIV-seropositive women, 154 pregnant and 151 non-pregnant, was conducted in a hospital setting in Nigeria. Results. Cases and controls were matched for age, but parity in controls was significantly higher than in cases (p<0.0001). The time between diagnosis and treatment commencement was greater in controls compared with cases (p<0.0001). Electrolyte, urea and creatinine levels were within normal limits, with mean serum urea and potassium higher in controls compared with cases (p=0.002 and p=0.023). Aspartate aminotransferase (AAT)/serum glutamic oxaloacetic acid transaminase (SGOT), alanine aminotransferase (ALT)/serum glutamic-pyruvic transaminase (SGPT) and amylase levels were higher in controls compared with cases (p=0.001, p=0.0001 and p=0.05), but the mean CD4 count was higher in cases compared with controls (p=0.001). The haematological parameters were within normal limits and comparable in cases and controls. A comparison of CD4 count, total white blood cell count and packed cell volume across the three trimesters in the cases did not reveal any statistically significant differences in these parameters. Conclusion. Pregnancy did not affect biochemical and haematological parameters in HIV-infected Nigerian women.
Multigene mutation analysis of mediastinal and hilar lymph nodes sampled by endobronchial unltrasound-guided needle aspiration

Background: The presence of an Epidermal Growth Factor Receptor (EGFR) activating mutation guide treatment selection in advanced Non-Small Cell Lung Cancer (NSCLC), whereas (BRAF) mutations play a role in metastatic melanoma. We aimed to determine the feasibility of routine multigene mutation analysis for EGFR, KRAS, BRAF and PI3KCA in EndoBronchial UltraSound-guided (EBUS) TransBronchial Needle Aspiration (TBNA) in patients with NSCLC and melanoma. Methods: Data was prospectively collected from patients undergoing EBUS-TBNA from March 2011 until September 2012. Smears were studied after using Papanicolaou and May-Grunwald Giemsa stains. Genetic mutations were analyzed in metastatic lymph nodes diagnosed by EBUS TBNA in 40 patients with NSCLC and 1 melanoma patient. PCR and direct sequencing of EGFR exons 18 to 21, KRAS exon 2, BRAF exon 15 and PI3KCA exons 9 and 20 were performed. Results : Multigene mutation analysis was completed for samples from 40 patients (97,6%). Mutations were detected in 11 patients (26,8%) : 3 (7,3%) EGFR exon 19 deletion, 6 (14,6%) KRAS mutation, 1 (2,4%) BRAF, and 1 (2,4%) PI3KCA mutation. Only one sample could not be processed for the detection of KRAS mutation. All the samples were adequate for the other mutations detection. Molecular biology analyses were performed both on cytological samples and biopsy samples in 7 patients (17,1%), with a perfect correlation between these. Conclusions: Mutations of the EGFR, KRAS, BRAF and PI3KCA genes can be detected in cytological samples routinely obtained with EBUS TBNA.
Transfusion‐related acute lung injury following intravenous anti‐D administration in an adolescent

Transfusion‐related acute lung injury (TRALI) is associated with administration of all plasma containing blood products. We present a 14‐year‐old adolescent diagnosed with idiopathic thrombocytopenic purpura who developed acute respiratory insufficiency compatible with TRALI within 5 hr following intravenous anti‐D. Full blown noncardiogenic pulmonary edema was noted after 9 hr. Mechanical ventilation was not required and the patient made a full recovery after 36 hr. Analysis of the anti‐D preparation revealed reactivity against the neutrophil FcγRIIIb. A postinfusion serum sample contained antibodies against class I human HLA‐A11 antigen. Clinicians should consider TRALI in patients developing unexplained dyspnea after receiving intravenous anti‐D. Am. J. Hematol. 2008. © 2008 Wiley‐Liss, Inc.
Disease Mutations in the Human Mitochondrial DNA Polymerase Thumb Subdomain Impart Severe Defects in Mitochondrial DNA Replication*

Forty-five different point mutations in POLG, the gene encoding the catalytic subunit of the human mitochondrial DNA polymerase (pol γ), cause the early onset mitochondrial DNA depletion disorder, Alpers syndrome. Sequence analysis of the C-terminal polymerase region of pol γ revealed a cluster of four Alpers mutations at highly conserved residues in the thumb subdomain (G848S, c.2542g→a; T851A, c.2551a→g; R852C, c.2554c→t; R853Q, c.2558g→a) and two Alpers mutations at less conserved positions in the adjacent palm subdomain (Q879H, c.2637g→t and T885S, c.2653a→t). Biochemical characterization of purified, recombinant forms of pol γ revealed that Alpers mutations in the thumb subdomain reduced polymerase activity more than 99% relative to the wild-type enzyme, whereas the palm subdomain mutations retained 50–70% wild-type polymerase activity. All six mutant enzymes retained physical and functional interaction with the pol γ accessory subunit (p55), and none of the six mutants exhibited defects in misinsertion fidelity in vitro. However, differential DNA binding by these mutants suggests a possible orientation of the DNA with respect to the polymerase during catalysis. To our knowledge this study represents the first structure-function analysis of the thumb subdomain in pol γ and examines the consequences of mitochondrial disease mutations in this region.
chronic heart failure, low T3 syndrome, systolic blood pressure, diastolic blood pressure and PR interval.

BACKGROUND: Thyroid abnormalities are common in Type 2 diabetes mellitus, severity of thyroid abnormalities accelerate coronary heart disease by several fold in patients with thyroid dysfunction. OBJECTIVES: The purpose of this prospective study is to determine the correlation between low T3 syndrome and Type 2 diabetes mellitus. METHODS: In this descriptive, prospective cross sectional study, all patients who presented to the Department of Medicine with Type 2 diabetes mellitus >5 years during this study period were included. Included clinical evidence of sepsis or cachexia or Concomitant presence of any predominant severe systemic disease including severe anaemia Hb% <5g%. Other major surgical procedures performed before or within 6 months after the time of thyroid sampling. RESULTS: Mean age of Type 2 diabetes mellitus patients was [60.50±6.15(SD) years], Fatigue and generalized weakness, dyspnoea on exertion, swelling of feet, cold intolerance, hair loss, hoarse voice and decrease libido were common symptoms of low T3 patients, Alcoholism was seen in (80%), Cardiomyopathy was see in most patients (42%) and was common in the age group of 55-60 years (38%) in present study, Mean pulse rate was [104±6.9 (SD) beats/min]. Systolic blood pressure was [131±20.8 (SD) mm of Hg], diastolic blood pressure was [84.6±12.4 (SD) mm of Hg]. Mean blood urea level was [74.2±18.9 (SD) mg/dl], mean serum creatinine levels was [2.3±0.5 (SD) mg/dl], the estimated creatinine clearance was [25.8±8.5 (SD) ml/min]. Mean serum LDL was [104.4±3.7 (SD) mg/dl], Mean PR interval is was [0.21±0.023 (SD) sec, Systolic dysfunction on 2D Echo was (20%), Diastolic dysfunction on 2D Echo was (30%), Pericardial effusion was seen in 10%. Global hypokinesia was seen in 30%. Segmental hypokinesia was seen in 3%. Mean ejection fraction was [36.78±5.08 (SD) %]. The high pulmonary artery systolic pressure was seen 70% of patients. CONCLUSION: There is significant percentage of Type 2 diabetes mellitus patients having low T3 alone as biochemical parameter. It is important to recognize this condition in patients with Type 2 diabetes mellitus as it is associated with increased severity of heart failure, increased in evidence of renal failure which may need additional support of thyroid hormone administration to have a better outcome in patients with chronic heart failure.
International MDS risk analysis workshop (IMRAW)/IPSS reanalyzed: Impact of cytopenias on clinical outcomes in myelodysplastic syndromes

The International Prognostic Scoring System (IPSS) was created for evaluating clinical outcomes of patients with myelodysplastic syndromes (MDS). We evaluated the depth of cytopenias to determine whether this parameter could further refine the prognostic ability of the IPSS. Correlation was determined between the depth of cytopenias in 816 patients from the International MDS Risk Analysis Workshop database and patients' clinical features. Univariate analyses of hemoglobin (Hb), absolute neutrophil count, and platelet depth levels were assessed relative to the IPSS risk groups, refined French‐American‐British categories, cytogenetic groups, bone marrow blast percentage (%), age groups, overall survival (OS), and time to evolution of acute myeloid leukemia (AML). Multivariate analysis of different cytopenic levels was performed to determine whether depth of cytopenias was prognostically additive to the IPSS. All cytopenic categories had statistically significant rank correlations with IPSS, bone marrow blast %, and refined French‐American‐British categories. In multivariate analysis, Hb levels had additive prognostic value to the IPSS for evaluation of OS, but not time to AML, with greatest prognostic value in Intermediate‐1 and Intermediate‐2 categories. In contrast, platelet or absolute neutrophil count levels alone or in combination lacked additive prognostic value to the IPSS regarding OS or time to AML evolution. The depth of Hb level per se at the time of diagnosis has additive predictive value to the IPSS for OS in the intermediate‐risk groups. This information should prove useful for aiding therapeutic decision‐making, prognostic classification, and designing clinical trials for patients with MDS. Am. J. Hematol. , 2008. © 2008 Wiley‐Liss, Inc.
Ocorrência do uso de plantas medicinais por moradores de um bairro do município de Marília-SP

Medicinal herbs continue to occupy an important place in the therapeutic arsenal and frequently are the only available resource for some communities and ethnic groups. The objective of this study was to evaluate the use of medicinal herbs in the population of Marilia (Sao Paulo State, Brazil). The occupants of 150 houses in a popular residential district (Jardim Lavinia) were interviewed between March and July 2006, with the aid of semi-structured questionnaires. The results showed that 19.34% of the households had medicinal herbs; of these, 41.37% had Melissa officinalis, 31.03% Matricaria chamomilla, 13.79% Camellia sinensis, Mentha piperita and Foeniculum vulgare, 6.89% Valeriana officinalis, Baccharis triptera and Peumus boldus and 27.52% had others. Their use was recommended in 55.17% of cases by friends? family, 13.79% by TV? radio, 13.79% by received culture or belief, only 10.34% by medical prescription and 6.89% did not answer. 31.25% of the herbs found were used in ways contrary to their recommended use. 41.37% of the interviewees were more than 46 years old and 31.03% had completed university courses. It can be concluded from these data that, although medicinal herbs are widely consumed in Brazil, there is still a shortage of information about them, even among people with higher education, which can lead to incorrect use. The media is no longer the big promoter of herbal medication; popular culture enables indicated treatments to spread from person to person, also reaching the more advantaged population
Familial myeloma and monoclonal gammopathy: A report of eight African American families

Previous descriptions of familial myeloma have been mainly of Caucasian families. We report here eight African American families with familial multiple myeloma and monoclonal gammopathy identified over a 30 year period. Six patients with multiple myeloma (MM) and two with monoclonal gammopathy of unknown significance (MGUS) reported a family history of MM or had family members with MGUS found on screening. A pedigree compiled for each family included a history of other cancers. In the eight families, 21 of 58 first degree relatives had a plasma cell dyscrasia including 12 MM, eight MGUS, and one amyloidosis patient(s). The age of the MM patients ranged from 50 to 78 years (median 61 years). Four families had two members with MM, including one mother–son and three sibling pairs. Two MM families each had two additional first degree relatives with MGUS, with three generations involved in one family. Anticipation was suggested in two families with parent–child pairs with monoclonal gammopathy. The eight pedigrees had 66 members, 21 of whom had a diagnosis of cancer, including non‐Hodgkin lymphoma and Hodgkin disease, or a clonal myeloproliferative disorder other than MM. Although the mode of genetic transmission and anticipation cannot be confirmed due to the small sample size, the increased number of MM and MGUS family members suggests underlying genetic susceptibility factors for plasma cell dyscrasias and possibly for other cancers in these families. Am. J. Hematol. , 2009. © 2008 Wiley‐Liss, Inc.
Pirenzepine Promotes the Dimerization of Muscarinic M1 Receptors through a Three-step Binding Process*

Ligand binding to G protein-coupled receptors is a complex process that involves sequential receptor conformational changes, ligand translocation, and possibly ligand-induced receptor oligomerization. Binding events at muscarinic acetylcholine receptors are usually interpreted from radioligand binding studies in terms of two-step ligand-induced receptor isomerization. We report here, using a combination of fluorescence approaches, on the molecular mechanisms for Bodipy-pirenzepine binding to enhanced green fluorescent protein (EGFP)-fused muscarinic M1 receptors in living cells. Real time monitoring, under steady-state conditions, of the strong fluorescence energy transfer signal elicited by this interaction permitted a fine kinetic description of the binding process. Time-resolved fluorescence measurements allowed us to identify discrete EGFP lifetime species and to follow their redistribution upon ligand binding. Fluorescence correlation spectroscopy, with EGFP brightness analysis, showed that EGFP-fused muscarinic M1 receptors predominate as monomers in the absence of ligand and dimerize upon pirenzepine binding. Finally, all these experimental data could be quantitatively reconciled into a three-step mechanism, with four identified receptor conformational states. Fast ligand binding to a peripheral receptor site initiates a sequence of conformational changes that allows the ligand to access to inner regions of the protein and drives ligand-receptor complexes toward a high affinity dimeric state.