Miracle-dz/UniFAR-FTUs huggingface dataset:
Predictive values of neutrophil CD64 expression compared with interleukin‐6 and C‐reactive protein in early diagnosis of neonatal sepsis

Background: Despite major advances in the management of newborn infants, neonatal sepsis (NS) remain important causes of neonatal morbidity and mortality in the newborn, mainly among preterm and low birth weight infants. Objective: The aim of this study was to investigate the usefulness of neutrophil CD64 expression alone and together with other infection markers in NS. Methods: Peripheral blood samples were taken from 109 neonates, who were categorized into three groups: proven or clinical sepsis (n=35); disease without infection (n=42); and healthy controls (n=32). Complete blood count with differential, interleukin‐6 (IL‐6), C‐reactive protein (CRP), and cell surface expression of CD64 on neutrophils have been evaluated in a prospective manner as a diagnostic aid for NS. Results: Expression of CD64 was significantly enhanced in neonates with sepsis compared with newborns with disease without infection and healthy controls (P=0.001 and P=0.001, respectively). Cutoff values of IL‐6, CRP, CD64MFI, and CD64i were 24.9 pg/ml, 4.05 mg/l, 87.7, and 4.39, respectively. Sensitivity–negative predictive values of IL‐6, CRP, and CD64MFI/CD64i were 80.0–90.6%, 80.0–88.8%, and 88.6–94.0%, respectively. Combining all three tests increased the sensitivity to 100%; however, specificity and positive predictive value decreased to 62.1 and 55.5%, respectively. Conclusions: CD64 might be used either alone or combined with IL‐6 and CRP for early diagnosis of NS. The advantages of CD64 when compared with IL‐6 and CRP are rapid quantitation, very small blood volume required, and easy handling. J. Clin. Lab. Anal. 24:363–370, 2010. © 2010 Wiley‐Liss, Inc.
Computer-aided diagnosis of multiple sclerosis

The study aims to develop a computer-assisted decision support based on cerebrospinal fluid (CSF) and blood findings to improve their value and ease the diagnostic procedure of chronic inflammatory diseases (CIDs) of central nervous system (CNS). Data were collected from patients suffering from multiple sclerosis (MS, n ¼ 73), from another CID of the CNS (n ¼ 22), or a psychiatric disease (control group, CTRL, n ¼ 12). Univariate and multivariate analyses were performed using multiple logistic regression and artificial neural networks. Differentiating between MS and CID, no parameter could be disclosed that could provide a meaningful decision support. However, multivariate analysis obtained a statistically significant classification (sensitivity ¼ 84.9%, specificity ¼ 54.5%, p , 0.001). On the contrary, multivariate analysis based on the differentiation between MS vs. CTRL, gave good results (sensitivity ¼ 95.9%, specificity ¼ 83.3%, p , 0.001). It became evident from standard laboratory findings that there is a significant potential for computer-aided decision support.
The effectiveness of antegrade percutaneous approach on impacted proximal ureteral stones

Objective: To evaluate the efficacy of anterograde percutaneous nephrolithotomy (PNL) for impacted proximal ureteral stones larger than 15 mm. Materials and methods: We retrospectively evaluated the data of the patients who underwent PNL for impacted proximal ureteral stones between February 2007 and April 2009. Patients, who underwent PNL for a radiopaque stone larger than 15 mm localized between the upper border of the 4th lumbar vertebra and ureteropelvic junction on intravenous pyelography were included. Patients with associated renal stones and a history of previous retroperitoneal surgery were excluded. The demographics, stone-free rates, hospitalization duration, bleeding and complication rates were evaluated. Results: Totally 39 patients underwent PNL for impacted proximal ureteral stones. Eleven patients were excluded due to previous PNL or retroperitonoscopic surgery for renal or ureteral stones. The mean age of the patients was 43.07±15.9 years and stone size was 271±85.43 mm2, the male to female ratio was 16:12. Access was achieved to the upper or middle calix through an supracosal entry in 18 (%64) and subcostal entry in 10 (%36) patients. Residual-free treatment was obtained in 27 (%96.4) patients, 2 (%7.1) patients required double J stents due to ureteral perforations, and 2 (%7.1) required post-operative blood transfusion. The mean hemoglobin decrease was 1.92±1.04, hospitalisation time was 48.4±14.6 hours, the need for of analgesic use was 172.4±54.3 mg, and operation time was 78.4±19.3 min. Conclusion: PNL is technique with high success rate in the presence of surgical experience and appropriate equipment for the management of impacted proximal ureteral stones.
THORACOSCOPIC REPAIR OF ESOPHAGEAL ATRESIA WITH DISTAL FISTULA IN A NEW BORN: A TECHNICAL CASE REPORT

Introduction . Esophageal atresia encompasses a group of congenital anomalies comprising of an interruption of the esophageal continuity with or without a persistent communication with the trachea. Esophageal atresia with tracheoesophageal fistula (type C) accounts for 85% of all esophageal atresia. Minimally invasive approach to correct esophageal atresia with distal fistula is becoming more generally accepted. The outcome of these technique are critically analyzed and compared with results from open repair. We present one case of type IIIB esophageal atresia treated by a thoracoscopic approach. Case Report. The patient was a 2-days-old infant male, weight 3 kg with esophageal atresia and distal tracheoesophageal fistula without other associated disease. A polidramanios was detected in prenatal age by a prenatal ultrasound evaluation. He underwent to a thoracoscopic repair of the defect. The operation was approached through the right chest using a three-trocar technique (three 5-mm) with the patient placed in a three-quarter prone position. The azygos vein was ligated by Ligature device. The fistula was ligated by two resorbable stiches suture and dissected, the proximal esophagus was opened and an anastomosis was made over a 6 Ch nasogastric tube with interrupted and resorbable stiches suture. On the postoperative day 7, gastrografin swallow was performed and oral feeding was started. The patient’s six month upper Gastrointestinal barium studies was normal. Discussion and conclusion. Thoracoscopic repair of esophageal atresia is considered to be one of the more advanced and most difficult pediatric surgical procedures and it undoubtely has necessary an elevated learning curve. The minimally invasive approach was larged accepted in the last ten years also for the well documented sequelae of traditional open repair of esophageal atresia. More experience is needed to determine the exact place of this approach.
Serum asymmetric dimethylarginine and nitric oxide levels in obese postmenopausal women

Background: It has been reported that estrogen deficiency after menopause might cause a decrement in nitric oxide (NO) bioavailability by increasing the level of asymmetric dimethylarginine (ADMA), a major endogenous nitric oxide synthase inhibitor, thus leading to abnormalities in endothelial function. Because NO plays an important role on feeding behavior, ADMA may be involved in the pathogenesis of obesity, too. This cross‐sectional study aimed to evaluate the relations of ADMA and NO with the obesity‐linked peptides, such as ghrelin, leptin, and adiponectin in postmenopausal women free of hormone replacement therapy. Methods: Adiponectin, ghrelin, leptin, ADMA, and NOx (total nitrite/nitrate) were measured in 22 obese (BMI: 30–47 kg/m2) and 19 normal weight (BMI: 21.5–26 kg/m2) postmenopausal women.Anthropometric measurements (height, weight, BMI, waist, and hip circumferences) were recorded. Statistics were made by the Mann–Whitney U‐test. Results: Ghrelin and adiponectin levels were significantly lower (P<0.001), whereas ADMA and leptin levels were higher in obese women than in normal weight controls (P<0.01 and 0.001, respectively). BMI was correlated negatively with adiponectin and ghrelin and positively with ADMA and leptin levels. No correlation existed between ADMA and NO. Conclusion: Estrogen deficiency alone may not cause an increase in ADMA levels unless the women are prone to disturbances in energy homeostasis. In spite of the high ADMA levels, the unaltered NO levels in plasma may be owing to ongoing inflammatory conditions. J. Clin. Lab. Anal. 25:174–178, 2011. © 2011 Wiley‐Liss, Inc.
Urgent psychiatric assessment in an inner-city A&E department

Data on day time referrals to a liaison psychiatry team from an inner London accident and emergency department (A&E) were analysed over a two-year period. Despite the availability of local community-based alternatives for urgent assessment almost 5000 patients were seen. A quarter were self-referrals and two-thirds had had no previous contact with psychiatric services. The most common reason for referral was aggressive or disruptive behaviour. Characteristics of patients in this inner-city population suggest a continuing need for a high quality liaison service to the A&E department.
The New LOCI Digoxin Assay on the Vista 1500 Analyzer Is Virtually Free From Interferences of Herbal Supplements Hawthorn and Ashwagandha (Indian Ginseng)

Herbal supplements hawthorn and ashwagandha (Indian ginseng) are indicated for cardiac illnesses and may be taken by patients receiving digoxin therapy. Because both hawthorn and ashwagandha are known to interfere with serum digoxin measurements using certain digoxin immunoassays, we investigated potential interference of these two herbal supplements with the new homogenous sequential chemiluminescent assay for digoxin based on the luminescent oxygen channeling technology (LOCI digoxin) for application on the Dimension and Vista platform. When aliquots of a drug‐free serum pool were supplemented with various amounts of hawthorn (three different commercial preparations) or ashwagandha (two different commercial preparations) and apparent digoxin values were measured using LOCI digoxin assay on Dimension Vista 1500 analyzer we observed none‐detected values except when aliquots were supplemented with very high amounts of the herbal extracts. When aliquots of a serum digoxin pool (prepared by pooling specimens from patients receiving digoxin) where further supplemented with various amounts of these supplements and digoxin concentrations were remeasured, statistically significant falsely higher digoxin values were observed only in specimens containing very high amounts of these supplements. Such interference may not be clinically significant. We conclude that new LOCI digoxin assay is virtually free from interferences of herbal supplements, hawthorn, and ashwagandha. J. Clin. Lab. Anal. 26:227‐231, 2012. © 2012 Wiley Periodicals, Inc.
Detection of Anti‐Aquaporin‐4 Antibodies in Neuromyelitis Optica: Comparison of Tissue‐Based and Cell‐Based Indirect Immunofluorescence Assays and ELISA

NMO‐IgGagainst aquaporin‐4 (AQP4) is a specific marker for neuromyelitis optica (NMO). We evaluated the performance of different NMO‐IgG detecting methods. In 124 sera (from 54 with NMO spectrum disorders including nine with NMO, ten with multiple sclerosis including two with OSMS, and 60 with other neurological diseases), NMO‐IgG was measured with tissue‐based indirect immunofluorescence (IIF‐tissue) using mouse cerebellum, cell‐based IIF (IIF‐AQP4) using transfected HEK293 cells which express human AQP4, and AQP4 autoantibody detecting enzyme linked immunosorbent assay (ELISA‐AQP4). The sensitivities and specificities of three assays were 44.4–55.6% and 87.0–92.2% for detecting NMO, and 11.1–20.4% and 95.7–97.1% for detecting NMO spectrum disorders. Although there was no significant difference, the patients with NMO or NMO spectrum disorders showed higher rates of seropositivity in the ELISA‐AQP4 vs. IIF assays. Out of the 19 sera with NMO‐IgG, in at least one test, only six (31.6%) were found to be positive by all three assays. Among the three methods, the ranges of co‐negativities, co‐positivities, and agreement were 77.4–97.4%, 42.9–75.0%, and 91.1–95.2% (kappa 0.475–0.641), respectively. In patients who had positive ELISA‐AQP4 results, IIF‐AQP4 positivity was associated with NMO (P = 0.01). In summary, we observed an increased prevalence of NMO‐IgG in patients with NMO and NMO spectrum disorders. ELISA‐AQP4 may be more sensitive and specific when confirmed by IIF‐AQP4. J. Clin. Lab. Anal. 26:184‐189, 2012. © 2012 Wiley Periodicals, Inc.
Predominance of Enterobacteriaceae Isolates in Early Positive Anaerobic Blood Culture Bottles in BacT/Alert System

We collected and analyzed the time to detection (TTD) of blood cultures in the BacT/Alert automated system from 2002 to 2007. Among the 10,893 monomicrobial isolates from a total of 133,735 blood culture sets, the recoveries of aerobic bottles were compared with those of anaerobic bottles in this study. Significantly more Gram‐positive cocci (except Staphylococcus aureus and enterococci), glucose nonfermentative Gram‐negative bacteria, and yeast were recovered from aerobic bottles than from anaerobic bottles. The average TTD was 19.0 hr and 20.1 hr for the aerobic and anaerobic bottles, respectively, and 96.8% of the microorganisms were detected within the first 72 hr. Of the 5,489 microorganisms recovered from both of the blood culture bottle pair, microbial growth was significantly more often detected first in the anaerobic bottles than the aerobic bottles for Enterobacteriaceae except Serratia marcescens, while S. aureus, coagulase‐negative staphylococci and Pseudomonas aeruginosa were more often detected first in the aerobic bottles. According to these data, we conclude that the earlier positivity of anaerobic bottles is a useful marker for rapid presumptive identification of Enterobacteriaceae infection. J. Clin. Lab. Anal. 27:113–120, 2013. © 2013 Wiley Periodicals, Inc.
Treatment of migraine in the emergency department

Migraine is defined as a severe, episodic, unilateral, throbbing headache accompanied by nausea, photophobia, visual symptoms, and neurological manifestations. The goal of acute migraine treatment is to ensure a prompt cessation of pain and associated symptoms and resumption of normal activity. Additional considerations include minimizing adverse effects and cost of therapy. As for all neurological patients, a careful history is the first and most critical step in diagnosis and management. For many years, NSAIDs and dihydroergotamine were the main medications used to treat migraine in the emergency setting. In 1993, sumatriptan was introduced as an effective medication to treat migraine. Since then a generation of medications mechanistically similar to sumatriptan have been introduced that show notable benefits in the treatment of migraine. Over the years, other treatments have been introduced including dexamethasone, magnesium, and metoclopramide. In this article, we review the best evidence regarding the acute treatment of migraine, describing major advances and the conventional drugs that remain as effective treatments. Drug Dev Res 68:360–368, 2007. © 2007 Wiley‐Liss, Inc.
Comparison of Chronic Kidney Disease Prevalence Examined by the Chronic Kidney Disease Epidemiology Collaboration Equation With That by the Modification of Diet in Renal Disease Equation in Korean Adult Population

The new estimated glomerular filtration (eGFR) equation, Chronic Kidney Disease Epidemiology Collaboration (CKD‐EPI) equation, was recently introduced. We compared the prevalence of CKD examined by the CKD‐EPI equation with that by the Modification of Diet in Renal Disease (MDRD) equation.
Evaluation of the Relationship Between Ischemia‐Modified Albumin Levels and Thyroid Hormone Levels

A novel ischemia marker named ischemia modified albumin was previously considered as an early marker of myocardial ischemia, however due to recent reports, its contribution was demonstrated in different pathologies such as oxidative stress, diabetes, stroke and cancer. We aimed to investigate the relation between oxidative stress and thyroid dysfunctions determining IMA levels since IMA is closely related with increased oxidative stress.
Repeated Transsphenoidal Surgery for Resection of Pituitary Adenoma

AbstractTo investigate the surgical strategy of repeated microscopic transsphenoidal surgery (TSS) for treatment of pituitary adenoma, surgical techniques and treatment outcomes for 29 patients with pituitary adenoma were reviewed and analyzed. There were 17 patients who underwent TSS 18 times and 12 patients who underwent TSS 13 times. The interval between each TSS ranged from 3 months to 18 years, with a median time of 4 years. The tumor height was 15 to 45 mm on the last surgery. Among the 29 patients, 16 patients underwent total tumor resection, 11 patients underwent subtotal resection, and 2 patients underwent partial resection. Cerebrospinal fluid leak occurred in 10 patients. Among 24 patients who were followed up effectively, 1 patient developed abducens paralysis after surgery, 1 patient had chronic diabetes insipidus, and 1 patient received steroid-dependent alternative treatment. The repeated TSS may present satisfied outcomes in experienced hands. The upper edge of the posterior choanae should be identified to ensure the right orientation. The openings of the anterior wall of the sphenoid sinus and the sellar floor should be appropriately expanded to improve tumor exposure. The artificial materials should be identified and removed carefully. Intraoperative cerebrospinal fluid leakage should be managed well.
Time is Money: Life Cycle Rational Inertia and Delegation of Investment Management

Many households display inertia in investment management over their life cycles. Our calibrated dynamic life cycle portfolio choice model can account for such an apparently 'irrational' outcome, by incorporating the fact that investors must forgo acquiring job-specific skills when they spend time managing their money, and their efficiency in financial decision making varies with age. Resulting inertia patterns mesh well with findings from prior studies and our own empirical results from Panel Study of Income Dynamics (PSID) data. We also analyze how people optimally choose between actively managing their assets versus delegating the task to financial advisors. Delegation proves valuable to both the young and the old. Our calibrated model quantifies welfare gains from including investment time and money costs as well as delegation in a life cycle setting.
Inadequate response to ustekinumab in atopic dermatitis – a report of two patients

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Intralesional Injection of Diprospan is Effective for Infantile Hemangioma

BackgroundThe use of glucocorticoid in infantile hemangioma has remained the main stream for over 30 years. Intralesional corticosteroids got good effects in small-size hemangioma. Here, we introduce a new compound glucocorticoids preparation, Diprospan. Diprospan 1 mL/ampoule contains betamethasone disodium phosphate 2 mg and betamethasone dipropionate 5 mg. It is the combination of short-acting and long-acting components. MethodsFrom January 2005 to December 2013, 57 children with hemangioma were enrolled into this study. The area of tumor ranged from 1 cm2 to 60 cm2. The average age of them receiving the first treatment was 3.9 months. The compound betamethasone preparation was given directly into the lesion at multiple sites along the edge and in the center of tumor. The dosage ranged from 3.5 mg to 14 mg glucocorticoids. In the follow-up, the treatment could be repeated if the tumor tended to grow again. ResultsNineteen patients received the treatment once, 35 patients twice, and 3 patients thrice. At the end of follow-up, 80.7% (46/57) of the patients’ tumors involuted completely. Moreover, 15.8% (9/57) of the patients’ tumors shrank but did not involute completely. Also, 3.5% (2/57) of the patients’ tumors showed no obvious change and so switched to systemic propranolol treatment. The adverse effects included local atrophy in 3 patients, local ulcer in 2 patients, and Cushing-like manifestations in 2 patients, all of which recovered in a short period. ConclusionsIntralesional compound betamethasone preparation is a feasible choice for the small-size hemangioma. For a few of the patients who had no response to it, other treatments including oral propranolol should be adopted in time.
Free energies of (Co, Fe, Ni, Zn)Fe2O4 spinels and oxides in water at high temperatures and pressure from density functional theory: results for stoichiometric NiO and NiFe2O4 surfaces

A set of effective chemical potentials (ECPs) are derived that connect energies of (Co, Fe, Ni, Zn)Fe2O4 spinels and oxides calculated at 0 K from density functional theory (DFT) to free energies in high temperature and pressure water. The ECPs are derived and validated by solving a system of linear equations that combine DFT and experimental free energies for NiO, ZnO, Fe2O3, Fe3O4, FeO(OH), CoFe2O4, ZnFe2O4, NiFe2O4 and H2O. To connect to solution phase chemistry, a set of ECPs are also derived for solvated Ni2+, Zn2+, Fe2+ and Fe3+ ions using an analogous set of linear equations and the solid ECPs. The ECPs are used to calculate free energies of low index stoichiometric surfaces of nickel oxide (NiO) and nickel ferrite (NiFe2O4) in water as a function of temperature from 300 to 600 K at a pressure of 155 bar. Surface denuding at high temperatures is predicted, the implications of which for the formation of oxide corrosion products on heat transfer surfaces in light-water nuclear reactors are discussed.