Miracle-dz/UniFAR-FTUs huggingface dataset:
Pure laparoscopic hepatectomy as repeat surgery and repeat hepatectomy.

AIM To assess clinical outcomes of laparoscopic hepatectomy (LH) in patients with a history of upper abdominal surgery and repeat hepatectomy. METHODS This study compared the perioperative courses of patients receiving LH at our institution that had or had not previously undergone upper abdominal surgery. Of the 80 patients who underwent LH, 22 had prior abdominal surgeries, including hepatectomy (n = 12), pancreatectomy (n = 3), cholecystectomy and common bile duct excision (n = 1), splenectomy (n = 1), total gastrectomy (n = 1), colectomy with the involvement of transverse colon (n = 3), and extended hysterectomy with extensive lymph-node dissection up to the upper abdomen (n = 1). Clinical indicators including operating time, blood loss, hospital stay, and morbidity were compared among the groups. RESULTS Eighteen of the 22 patients who had undergone previous surgery had severe adhesions in the area around the liver. However, there were no conversions to laparotomy in this group. In the 58 patients without a history of upper abdominal surgery, the median operative time was 301 min and blood loss was 150 mL. In patients with upper abdominal surgical history or repeat hepatectomy, the operative times were 351 and 301 min, and blood loss was 100 and 50 mL, respectively. The median postoperative stay was 17, 13 and 12 d for patients with no history of upper abdominal surgery, patients with a history, and patients with repeat hepatectomy, respectively. There were five cases with complications in the group with no surgical history, compared to only one case in the group with a prior history. There were no statistically significant differences in the perioperative results between the groups with and without upper abdominal surgical history, or with repeat hepatectomy. CONCLUSION LH is feasible and safe in patients with a history of upper abdominal surgery or repeat hepatectomy.
Pregnant women's use of the internet in relation to their pregnancy in Izmir, Turkey

This descriptive and cross-sectional study was conducted in order to determine the extent of internet use by pregnant women to gain information about their pregnancy. The research was conducted in two hospitals in Izmir, Turkey between August and October 2009, after written permission had been obtained. The research sample consisted of 185 pregnant women in at least the 28th week of pregnancy, who accepted to take part in the study. Forty-five percent of the pregnant women had used the internet to obtain information at least once during their pregnancy, and the most researched topics were fetal development, nutrition in pregnancy and the stages of birth. There is a significant difference between the age group, educational level, work status and number of pregnancies and the usage of internet among pregnant women. The women gave the information on the internet 7.13 ± 1.54 out of 10 points for correctness and dependability. Fifty-one percent of the pregnant women stated that they shared the information which they had obtained on the internet with health professionals. About half of the women in the study had used the internet to obtain information on pregnancy, birth and the fetus under various headings.
Venous Thrombotic Events in Hospitalized Children and Adolescents With Inflammatory Bowel Disease

Background: Adults with inflammatory bowel disease (IBD) have an increased risk of venous thrombotic events (TEs). We sought to evaluate the risk for TE in children and adolescents with IBD using a large population database. Methods: The triennial Healthcare Cost and Utilization Project Kids’ Inpatient Database was used in a retrospective cohort study of hospitalized children in the United States across 1997, 2000, 2003, 2006, and 2009. Billing codes were used to identify discharges with Crohn disease, ulcerative colitis, pulmonary embolism, deep vein thrombosis, thrombophlebitis, thrombosis of intracranial venous sinus, Budd-Chiari syndrome, and portal vein thrombosis. A logistic regression model was fitted to quantify the increased risk of TE in children with IBD, while adjusting for other risk factors of thrombosis. Results: The total weighted number of pediatric discharges was 7,448,292, and 68,394 (0.92%) were identified with IBD. The incidence of any TE in a hospitalized child or adolescent with IBD was 117.9/10,000 with a relative risk (95% confidence interval) of 2.36 (2.15–2.58). The adjusted odds ratio for any TE in a patient with IBD without surgery was 1.22 (1.08–1.36). Risk factors for TE among patients with IBD include older age, central venous catheter, parenteral nutrition, and an identified hypercoagulable condition. There is an increasing trend of TE in both the IBD and non-IBD patients. Conclusions: Hospitalized children and adolescents with IBD are at increased risk for TE. Conservative methods of TE prevention including hydration, mobilization, or pneumatic devices should be considered in hospitalized patients with IBD.
Human cytomegalovirus, Epstein-Barr virus and bone resorption-inducing cytokines in periapical lesions of deciduous teeth.

BACKGROUND A connection of herpesvirus periapical infection with symptomatic and large-size periapical lesions has been recognized in adult patients, but no data exist about a possible involvement of herpesviruses in severe periapical pathosis in children. Herpesviruses have the potential to elicit potent bone resorption-inducing cytokines in mammalian cells. AIM This study aimed to determine the occurrence of human cytomegalovirus and Epstein-Barr virus DNA, and mRNA transcripts of receptor activator of nuclear kappa B ligand (RANKL), osteoprotegerin, core binding factor alpha-1, colony stimulating factor-1, transforming growth factor-beta, and monocyte chemoattractant protein-1 in periapical symptomatic pathosis of deciduous teeth. MATERIAL AND METHODS Twelve deciduous molar teeth from patients aged 2-8 years were extracted due to severe periapical infection, and granulomatous tissue adherent to the root tip of the extracted teeth was collected using a surgical knife. Non-diseased pulpal tissue, obtained from 12 teeth extracted for orthodontic reasons, served as negative control. Polymerase chain reaction assays were employed to identify herpesvirus DNA and cytokine gene expression, using established polymerase chain reaction primers and procedures. RESULTS Seven (58%) of the periapical lesions yielded human cytomegalovirus and eight (67%) Epstein-Barr virus. Only one (8%) periapical lesion showed neither human cytomegalovirus nor Epstein-Barr virus. In healthy pulpal tissue, one (8%) specimen demonstrated human cytomegalovirus and another (8%) specimen revealed Epstein-Barr virus. Of the cytokines examined, RANKL expression showed significantly higher occurrence in periapical pathosis than in healthy pulpal tissue (P < 0.040). No relationship was identified between the type of herpesvirus and cytokine expression in the periapical lesions studied. CONCLUSIONS The present findings provide evidence of a putative role of human cytomegalovirus and Epstein-Barr virus in the pathogenesis of symptomatic periapical pathosis in deciduous teeth. Increased RANKL expression in periapical lesions may be of pathogenetic significance.
Inflammatory bowel disease: Epidemiology, pathogenesis, and therapeutic opportunities

&NA; Ulcerative colitis (UC) and Crohn's disease (CD), the primary constituents of inflammatory bowel disease (IBD), are precipitated by a complex interaction of environmental, genetic, and immunoregulatory factors. Higher rates of IBD are seen in northern, industrialized countries, with greater prevalence among Caucasians and Ashkenazic Jews. Racial gaps are closing, indicating that environmental factors may play a role. IBD is multigenic, with the most clearly established genetic link between certain NOD2 variants and CD. Regardless of the underlying genetic predisposition, a growing body of data implicates a dysfunctional mucosal immune response to commensal bacteria in the pathogenesis of IBD, especially CD. Possible triggers include a chronic inflammatory response precipitated by infection with a particular pathogen or virus or a defective mucosal barrier. The characteristic inflammatory response begins with an infiltration of neutrophils and macrophages, which then release chemokines and cytokines. These in turn exacerbate the dysfunctional immune response and activate either TH1 or TH2 cells in the gut mucosa, respectively associated with CD and, less conclusively, with UC. Elucidation of immunological and genetic factors indicate multiple points at which the inflammatory cascade may be interrupted, yielding the possibility of precise, targeted therapies for IBD.
The role of medical/nursing skills training in caregiver confidence and burden: A CanCORS study

Informal cancer caregivers provide essential support to cancer patients, including performing direct medical/nursing tasks, assisting with activities of daily living, and offering social support. This study examined associations between the receipt of medical/nursing skills training and the caregiver burden as well as the mediation of caregiving confidence on this relationship in a sample of caregivers of lung and colorectal cancer patients.
Endothelial Progenitor Cell Mobilization and Increased Intravascular Nitric Oxide in Patients Undergoing Cardiac Rehabilitation

PURPOSE: We investigated whether cardiac rehabilitation participation increases circulating endothelial progenitor cells (EPCs) and benefits vasculature in patients already on stable therapy previously shown to augment EPCs and improve endothelial function. METHODS: Forty-six of 50 patients with coronary artery disease completed a 36-session cardiac rehabilitation program: 45 were treated with HMG-CoA reductase inhibitor (statin) therapy ≥1 month (average baseline low-density lipoprotein cholesterol = 81 mg/dL). Mononuclear cells isolated from blood were quantified for EPCs by flow cytometry (CD133+/VEGFR-2+ cells) and assayed in culture for EPC colony-forming units (CFUs). In 23 patients, EPCs were stained for annexin-V as a marker of apoptosis, and nitrite was measured in blood as an indicator of intravascular nitric oxide. RESULTS: Endothelial progenitor cells increased from 35 ± 5 to 63 ± 10 cells/mL, and EPC-CFUs increased from 0.9 ± 0.2 to 3.1 ± 0.6 per well (both P < .01), but 11 patients had no increase in either measure. Those patients whose EPCs increased from baseline showed significant increases in nitrite and reduction in annexin-V staining (both P < .01) versus no change in patients without increase in EPCs. Over the course of the program, EPCs increased prior to increase in nitrite in the blood. CONCLUSIONS: Cardiac rehabilitation in patients receiving stable statin therapy and with low-density lipoprotein cholesterol at goal increases EPC number, EPC survival, and endothelial differentiation potential, associated with increased nitric oxide in the blood. Although this response was observed in most patients, a significant minority showed neither EPC mobilization nor increased nitric oxide in the blood.
Identification of a fibronectin-binding protein (GfbA) in pathogenic group G streptococci

Attachment to eukaryotic cell surfaces is an essential step in the establishment of colonization and infection by bacterial pathogens. This report examines the adherence capabilities of pathogenic group G streptococci and demonstrates that certain group G streptococcal clinical isolates express a fibronectin-binding protein. This protein, termed GfbA for group G streptococcal fibronectin-binding protein, mediates adherence to human skin fibroblasts (HSF). The gene encoding this protein, gfbA, was isolated, and the complete DNA sequence of gfbA was determined. From this sequence GfbA was predicted to be a 580-amino-acid protein (molecular weight = 64,979) with significant amino acid identity to the group A streptococcal fibronectin-binding proteins SfbI and protein F (PrtF) (76 and 78% identity, respectively). GfbA contains regions with notable identity to the fibronectin-binding repeat domains of PrtF. gfbA(+) strains were able to bind to HSF, and preincubation of the gfbA(+) strains with fibronectin blocked this adherence. In addition, gfbA(+) strains were able to bind radiolabeled fibronectin, and this binding was inhibited with addition of excess unlabeled fibronectin. gfbA-negative strains were not able to bind either the HSF or radiolabeled fibronectin. DNA homologous to gfbA was found in 36% of the group G streptococcal isolates examined. Since not all group G streptococcal strains examined contained gfbA, this suggests there might be other tissue-specific adherence molecules expressed by these pathogenic strains.
Aliskiren Reduces Morning Blood Pressure in Hypertensive Patients with Diabetic Nephropathy

Diabetic nephropathy (DN) is a leading disease that requires renal replacement therapy. The progression of renal dysfunction in DN is faster than the other renal diseases. While antihypertensive therapy reduces albuminuria, a good indicator for the progression, hypertension in DN is treatment resistant. Among patients with DN who took angiotensin receptor blockers (ARBs), 27 patients who exhibited poor control of albuminuria were enrolled into the study. Angiotensin receptor blocker was exchanged to aliskiren (150–300 mg/d) and clinical parameters were followed for 6 months. Exchange to aliskiren decreased albuminuria (1.57 ± 0.68 to 0.89 ± 0.45 g/gCr, P < .01) without changes in estimated glomerular filtration rate and office blood pressure (BP). Body weight and hemoglobin A1c were not altered. Aliskiren also reduced plasma renin activity (2.0 ± 0.9 to 1.2 ± 0.6 ng/mL/h, P < .01). While evening BP was unchanged, morning systolic BP (139 ± 8 to 132 ± 7 mm Hg, P < .01) and diastolic BP (81 ± 7 to 76 ± 6 mm Hg, P < .05) were decreased significantly after 6 months. Our results indicated that aliskiren decreased BP, especially morning BP in hypertensive patients with DN. The present data suggest that aliskiren exerts renoprotective actions including reduction in albumin excretion for patients with DN.
Vesico‐ureteric reflux and other risk factors for renal damage: identification of high‐ and low‐risk children

This article reviews the literature with respect to various risk factors for permanent renal damage in children with urinary tract infection. Vesico‐ureteric reflux is an important risk factor, but renal damage can occur in the absence of reflux. Renal damage does not always occur in the presence of gross reflux. Renal scars always develop at the same site as a previous infection in the kidney. Recurrent pyelonephritis and delay in therapy increase the likelihood of renal damage, although it is not known how long a delay is dangerous to the human kidney. Recent studies using 99mtechnetium‐dimercaptosuccinic acid (DMSA) scintigraphy have not confirmed the findings of previous studies showing that children below 1 y of age are more vulnerable to renal damage. It is more likely that all children run the risk of renal scarring in cases of acute pyelonephritis. The role of bladder pressure is still not entirely understood. Therefore more studies are needed in order to determine the relationship between high voiding pressures in some, otherwise healthy, children with urinary tract infection and renal scarring. The importance of bacterial virulence in the development of renal scarring is unclear. DMSA scintigraphy and voiding cystourethrography are the most reliable tools for identifying children at risk of renal scarring. As a single method DMSA scintigraphy appears to be better than voiding cystourethrography.
An investigation of the relationship between subjective sleep quality, loneliness and mood in an Australian sample: Can daily routine explain the links?

Background: Loneliness and low mood are associated with significant negative health outcomes including poor sleep, but the strength of the evidence underlying these associations varies. There is strong evidence that poor sleep quality and low mood are linked, but only emerging evidence that loneliness and poor sleep are associated. Aims: To independently replicate the finding that loneliness and poor subjective sleep quality are associated and to extend past research by investigating lifestyle regularity as a possible mediator of relationships, since lifestyle regularity has been linked to loneliness and poor sleep. Methods: Using a cross-sectional design, 97 adults completed standardized measures of loneliness, lifestyle regularity, subjective sleep quality and mood. Results: Loneliness was a significant predictor of sleep quality. Lifestyle regularity was not a predictor of, nor associated with, mood, sleep quality or loneliness. Conclusions: This study provides an important independent replication of the association between poor sleep and loneliness. However, the mechanism underlying this link remains unclear. A theoretically plausible mechanism for this link, lifestyle regularity, does not explain the relationship between loneliness and poor sleep. The nexus between loneliness and poor sleep is unlikely to be broken by altering the social rhythm of patients who present with poor sleep and loneliness.
Comparative Genomic Analyses of the Vibrio Pathogenicity Island and Cholera Toxin Prophage Regions in Nonepidemic Serogroup Strains of Vibrio cholerae

ABSTRACT Two major virulence factors are associated with epidemic strains (O1 and O139 serogroups) of Vibrio cholerae: cholera toxin encoded by the ctxAB genes and toxin-coregulated pilus encoded by the tcpA gene. The ctx genes reside in the genome of a filamentous phage (CTXφ), and the tcpA gene resides in a vibrio pathogenicity island (VPI) which has also been proposed to be a filamentous phage designated VPIφ. In order to determine the prevalence of horizontal transfer of VPI and CTXφ among nonepidemic (non-O1 and non-O139 serogroups) V. cholerae, 300 strains of both clinical and environmental origin were screened for the presence of tcpA and ctxAB. In this paper, we present the comparative genetic analyses of 11 nonepidemic serogroup strains which carry the VPI cluster. Seven of the 11 VPI+ strains have also acquired the CTXφ. Multilocus sequence typing and restriction fragment length polymorphism analyses of the VPI and CTXφ prophage regions revealed that the non-O1 and non-O139 strains were genetically diverse and clustered in lineages distinct from that of the epidemic strains. The left end of the VPI in the non-O1 and non-O139 strains exhibited extensive DNA rearrangements. In addition, several CTXφ prophage types characterized by novel repressor (rstR) and ctxAB genes and VPIs with novel tcpA genes were found in these strains. These data suggest that the potentially pathogenic, nonepidemic, non-O1 and non-O139 strains identified in our study most likely evolved by sequential horizontal acquisition of the VPI and CTXφ independently rather than by exchange of O-antigen biosynthesis regions in an existing epidemic strain.
High level of urokinase‐type plasminogen activator is a new prognostic marker in patients with gastric carcinoma

Prognosis of gastric carcinoma is related to invasion and metastasis. Evidence has accumulated that invasion and metastasis in solid tumors require the action of tumor‐associated proteases, which promote the dissolution of the surrounding tumor matrix and the basement membrane. The serine protease urokinase‐type plasminogen activator (uPA) and its inhibitor, plasminogen activator inhibitor‐1 (PAI‐1), appear to have a major function in these processes. Recent reports have demonstrated that expression of these proteolytic enzymes is elevated in breast and colon carcinoma and that it can be associated with invasiveness and poor prognosis. Therefore, the authors evaluated whether the expression and activation of uPA and PAI‐1 might be of clinical value as a tumor/biologically defined risk factor in patients with gastric carcinoma.
Prevalence of hepatitis C virus antibodies among health care workers in Damascus, Syria.

OBJECTIVE Health care workers exposed to accidental inoculation with infected blood represent a high risk group of acquiring hepatitis C virus infection. Hepatitis C virus is considered the most common parenterally transmitted pathogen to which needle-stick recipients are exposed. Therefore, the prevalence of hepatitis C virus antibodies among different health care workers was studied. METHODS Antibodies of hepatitis C virus were studied by 3rd generation enzyme immunoassay. Hepatitis B surface antigen and antibodies to hepatitis B core were carried out using enzyme immunoassays. Liver enzymes (alanine aminotransferase, aspartate aminotransferase) and total bilirubin were measured using reagents on chemistry autoanalyzer. The studied group (189 members, aged 28.1+/-6.2 years, 86 males and 103 females) consisted of laboratory workers (65), hemodialysis staff (34), dentistry workers (24), surgery workers (35), and a 5th group contained other medical care workers (31) in Damascus, Syria. RESULTS The prevalence of hepatitis C virus antibodies among health care workers was 3%. The positivity of anti-hepatitis C was 0% in the laboratory group, dentistry group, and surgery group. Whereas, it was 6% in the hemodialysis group, and 10% in the other medical workers group. The prevalence of hepatitis B surface antigen was 6% among health care workers in Damascus. Means of biochemical parameters were 23.2+/-15.9 U/L for alanine aminotransferase, 21.8+/-7.8 U/L for aspartate aminotransferase, and 0.58+/-0.35 mg/dl for total bilirubin. CONCLUSION The prevalence of hepatitis C virus antibodies among health care workers was higher than the prevalence among the general population (1%) which was determined during our study. However, the prevalence of anti-hepatitis C virus is lower than the prevalence of hepatitis B surface antigen among health care workers. There was no significant difference between means of biochemical parameters in each health workers and the general population. Factors related to infrastructure and operational system might be responsible for such prevalence of anti-hepatitis C virus among health care workers. An intensive periodic educational program for the medical and paramedical staff is important, in order to minimize the prevalence of anti-hepatitis C virus among this important high risk group.