Miracle-dz/UniFAR-FTUs huggingface dataset:
Influence of Infant Feeding Method on Postpartum Relapse of Mothers With MS

In an effort to determine relapse rates in breast-feeding and non—breast-feeding mothers with multiple sclerosis (MS) as well as differences in symptom prevalence between relapsing and non-relapsing mothers, weekly diaries through the first six postpartum months were kept by mothers to record the frequency and percentages of infant feeding by breast or formula and health problems that the mothers experienced. Of 140 mothers who breast-fed their infants, 35 (25%) experienced at least one neurologist-confirmed MS relapse during the first six months and 47 (33.6%) during the 12-month period; for non—breast-feeding mothers, 18 (51.4%) experienced relapse by six months and 22 (61.1%) by 12 months. MS relapse during pregnancy predicted increased relapse during the first three postpartum months while an increased percentage of infant feedings by breast predicted decreased relapse. Relapse the year before pregnancy and during pregnancy predicted increased relapse during the four- to six-month postpartum period. L.
Intravenous Contrast Agent For Ultrasound Doppler: In Vivo Measurement Of Small Tumor Vessel Dose-response

A new contrast agent capable of traversing pulmonary and cardiac circulations was used to create echo enhancement from arterial blood following peripheral-venous injection. In vivo dose-response measurements for this agent were made by analysis of Doppler signals acquired directly from systemic vessels and tumor tissue. Ten woodchucks with naturally occurring hepatomas were studied using duplex scanning and lOMHz pulsed Doppler transducers positioned surgically on the tumor, portal and celiac vessels. 0.05lmVkg injections of 3.5~ air-filled albumin microspheres (AlbnnexTM) were made into a peripheral vein. Signal enhancement was computed using digital frequency domain methods. Angiographic correlation was obtained in three animals. A 7dB enhancement of systemic arterial signals was measured at the lowest dose of 0.05mVkg. Signal enhancement rose monotonically but non-linearly to 20dB at ImVkg. No effect was detected from saline control injections or from cumulation of consecutive injections. A maximum 13dB was measured in the tumor signals. No enhancement was detected from portal venous blood. It is concluded that the intravenous use of an ultrasound contrast agent is capabl e of lowering the threshold of detectability of tumor and tissue vascularization using conventional Doppler instruments. Enhancement originates from hepatic arterial supply. Intravenous ultrasound contrast agents therefore hold promise for radiologic diagnosis.
Silymarin and milk thistle extract may prevent the progression of diabetic nephropathy in streptozotocin-induced diabetic rats

Objectives: To investigate the effect of silymarin and milk thistle extract on the progression of diabetic nephropathy (DN) in rats. Methods: Diabetes was induced with a single intraperitoneal (IP) injection of streptozotocin (STZ) (60 mg/kg). Silymarin (100 mg/kg/d) or the extract (1.2 g/kg/d) was gavaged for 4 weeks. Blood glucose (BS), serum urea (Su), serum creatinine (Scr), and 24-h urine protein (Up) were measured and glomerular filtration rate (GFR) was calculated. Concentration of thiobarbituric acid reactive species (TBARS) and activities of glutathione peroxidase (GPx), superoxide dismutase (SOD), and catalase (CAT) were evaluated in the renal tissue. Results: Data were expressed as mean ± SEM. Silymarin or the extract had no significant effect on BS, Scr, and GFR. Both milk thistle extract and silymarin, respectively, decreased Su (mg/dL) (87.1 ± 7.78, p < 0.001; 84.5 ± 7.15, p < 0.001), Up (mg) (5.22 ± 1.56, p = 0.014; 5.67 ± 0.86, p = 0.034), and tissue TBARS (nmol/mg protein) (0.67 ± 0.04, p < 0.001; 0.63 ± 0.07, p < 0.001) in diabetic rats, compared to diabetic control (DC) (Su: 131.0 ± 4.55, Up: 8.3 ± 0.84, TBARS: 0.94 ± 0.06). Both the extract and silymarin could increase the activity of CAT (IU/mg protein) (25.5 ± 4.0, p = 0.005; 20 ± 1.8, p = 0.16) and GPx (IU/mg protein) (0.86 ± 0.05, p = 0.005; 0.74 ± 0.04, p = 0.10), respectively, in diabetic rats compared to DC (CAT = 14.4 ± 2.0, GPx = 0.57 ± 0.02). Conclusion: Milk thistle extract, to a lesser extent silymarin, can attenuate DN in rats possibly by increasing kidney CAT and GPx activity and decreasing lipid peroxidation in renal tissue.
Effect of phototherapy on serum calcium level in neonatal jaundice

Objectives The aim of the study was to determine the effect of phototherapy on serum calcium level in neonatal jaundice. Background Phototherapy plays a significant role in the treatment and prevention of hyperbilirubinemia in neonates. However, this treatment modality may result in the development of some complications such as induction of hypocalcemia. Patients and methods This study included 50 full-term neonates with jaundice (25 males and 25 females) who received phototherapy for treatment of neonatal indirect hyperbilirubinemia and 25 neonates (13 males and 12 females) complaining of exaggerated physiological hyperbilirubinemia taken as control not exposed to phototherapy. Serum calcium was checked before and 48 h after starting phototherapy. A comparative study was conducted between these groups to determine the effect of phototherapy on serum calcium level. Results In the neonates of the study group, the serum bilirubin level before phototherapy was 15.48 ± 1.94 mg/dl. However, the serum bilirubin level after phototherapy was 12.41 ± 2.10 mg/dl. There was highly statistically significant decrease of the serum bilirubin levels after phototherapy as compared with serum bilirubin levels before phototherapy in the study group (P < 0.001). With respect to the calcium level, the total serum calcium level before phototherapy was 9.36 ± 0.29 mg/dl, whereas the serum calcium level after phototherapy was 8.58 ± 0.76 mg/dl. There was highly statistically significant decrease of the serum calcium levels after phototherapy as compared with serum calcium levels before phototherapy in the study group. Conclusion Hypocalcemia is a common complication of phototherapy.
Drugs in preclinical and early-stage clinical development for pancreatic cancer

Introduction: Pancreatic cancer (PC) is the fourth leading cause of cancer-related deaths in the US and Europe, and the lethality of this cancer is demonstrated by the fact that the annual incidences are approximately equal to the annual deaths. Current therapy for PC is multimodal, involving surgery and chemotherapy. Clinical symptoms are unspecific, and consequently about 85% of patients with PC are diagnosed at advanced tumor stages without any surgical therapy options. Since the therapeutic rates for PC are so dismal, it is essential to review the clinical targets for diagnosis and treatment of this lethal cancer. Areas covered: In this review, we discuss potential treatment options for PC by identifying molecular targets including those involved in cell proliferation, survival, migration, invasion and angiogenesis. Targeting these molecules in combination with surgery could improve the clinical outcome for PC patients. Expert opinion: For a decade, gemcitabine has remained the single first-line chemotherapeutic agent for advanced adenocarcinoma of the pancreas; however, less than 25% of patients benefit from gemcitabine. The reason for frequent reoccurrence of PC after conventional methods such as surgery, radiation and/or chemotherapy is due to the lack of understanding of the basic underlying metabolic cause of the cancer and thus consequently remains uncorrected. Our understanding of drug resistance in PC is still not clear and may be answered by focusing on new useful biomarkers and their role in chemo- and radioresistance.
Cross-Cultural Surveys on Healthcare Staff Views of Barriers against Adverse Event Reporting

The views of doctors and nurses about reporting adverse events were surveyed by questionnaires in five countries: Denmark, Iceland, Japan, New Zealand and Nigeria. Staff responses showed two underlying factors behind unwillingness to report adverse events: (a) fear of sanctions and disrepute and (b) lack of support and motivation. The factor structure, on the one hand, is completely consistent across the five country samples, and on the other, large and significant cross-national differences were found in healthcare professional views of error reporting. The reporting rate of each potential reason is also strongly affected by respondents’ experience of reluctance to bring up adverse events. Based on the questionnaire results, we discuss latent causes of perceived obstacles of healthcare staff to reporting errors and strategies for reducing their levels to establish an effective “learning” culture in an organisation.
A Nonrandomized Study of Trichoscopy Patterns Using Nonpolarized (Contact) and Polarized (Noncontact) Dermatoscopy in Hair and Shaft Disorders

Aims: The aim was to study the trichoscopy features of selected hair and scalp conditions by two dermoscopic devices with different modes that is, polarized (noncontact) and nonpolarized (contact) mode. Materials And Methods: The present study included 11 clinical varieties of cases with total 112 patients, attending Sir Takhtasinh Hospital, Bhavnagar in the last 2 years. The clinical history was recorded for each case, and images were taken in both the Heine and DermLite II pro dermatoscope. We used polarized mode of the noncontact device (DermLite II) and the nonpolarized mode of the contact device (Heine) for our study. Statistical Analysis Used: Fisher's exact test to study dermoscopic observations for each mode. Results: We observed different nonscarring alopecia cases such as alopecia areata, androgenetic alopecia, trichotillomania, and tinea capitis. Scarring alopecia included discoid lupus erythematosus, lichen planopilaris, pseudopelade of Brocq, systemic lupus erythematosus. Scaling disorders included the psoriasis and seborrheic dermatitis. Furthermore, infestations like pediculosis capitis were included in the study. Various features were divided into follicular, interfollicular, pigmentary, vascular and hair shaft patterns. Each of the features was correlated in both the Heine (nonpolarized) and DermLite II (polarized) dermoscope, and observational finding was put forward accordingly. Conclusions: Various variations were observed in the documentation of dermoscopic patterns of the two dermatoscopes with certain features such as vascular patterns, scaling, and reticular pigmentation being better appreciated in polarized mode, while certain features were better documented in nonpolarized mode that is, black dots and tapered hair.
JAK inhibition for the treatment of rheumatoid arthritis: a new era in oral DMARD therapy

Introduction: In rheumatoid arthritis (RA) there is a significant medical need for safe and effective oral disease-modifying anti-rheumatic drugs (DMARDs) for patients who respond inadequately to methotrexate, the first-line therapy in RA. Oral agents targeting Janus-associated kinases (JAKs) are the most promising new agents in clinical development. This review describes the preclinical and clinical activities of the most advanced JAK inhibitors with different JAK selectivity profiles. Areas covered: This review first describes the current treatment landscape and the pathophysiology of RA. Role for cytokines in the disease pathogenesis followed by significance of JAK/STAT pathway in cytokine signaling are discussed. Available chemical description and enzymatic data on the most advanced JAK inhibitors in clinical development are provided. Preclinical and clinical results that are publicly available are summarized. Review of literature was conducted using National Library of Medicine (NLM) database, ‘PubMed’. In addition, all publicly disclosed data from companies that are developing the JAK inhibitors was researched to obtain the most up-to-date information of the compounds discussed in this report. Expert opinion: Emerging clinical results demonstrate that JAK inhibition is a validated new mechanism for the development of oral DMARD agents that is likely to join the armamentarium against RA in the near future.
BMI, spKt/V, and SBP but Not DBP Are Related to LVH in Chinese Maintenance Hemodialysis Patients

Objective: Left ventricular hypertrophy (LVH) is the strongest predictor of cardiovascular mortality, the leading cause of death in hemodialysis (HD) patients. This study aims to identify the potential risk factors for LVH in HD patients. Methods: Exactly, 164 patients (84 men and 80 women) who had been on HD treatment for at least 6 months were enrolled. Clinical data were collected. Anthropometric measurements, biochemical analyses, and echocardiography were performed. The risk factors were determined by multivariate linear and logistic regression. Results: In all the patients, the prevalence of LVH was 66.5%. The patients with LVH had higher body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure, and lower single-pool kt/V (spKt/V) compared with those without LVH. Multivariate linear regression showed that BMI (β = 7.608, p = 0.014), SBP (β = 9.462, p = 0.001), and spKt/V (β = –14.226, p = 0.024) were independently correlated with left ventricular mass index (LVMI). Multivariate logistic regression showed the same results that BMI (β = 7.193, p = 0.032), SBP (β = 9.382, p = 0.02), and spKt/V (β = –12.535, p = 0.001) were independently correlated with LVH. Conclusions: In Chinese maintenance hemodialysis patients, BMI, single-pool Kt/V (spKt/V), and SBP were independently correlated with left ventricular mass index and were independent risk factors for LVH.
Prevalence of Metabolic Syndrome and its Individual Components among Moroccan Adolescents: The Role of Overweight-Obesity and Excess Body Fat

Background: The prevalence of obesity and related diseases such as metabolic syndrome (MetS) are increasing in young populations over the world, especially in developing countries. This study aimed to estimate the prevalence of MetS and its individual components, and to assess their association with both overweight/obesity and excess body fat. Methods: This study included 192 adolescents (77 boys and 115 girls) aged 11 to 17 years. Blood pressure and anthropometric measurements were done using standardized techniques. Fasting blood samples were taken for determination of glucose and lipids levels. Percent body fat was estimated using deuterium oxide. The international diabetes federation criteria were applied for the diagnosis of MetS. Results: The prevalence of MetS among overweight/obese adolescents was 18.6% while it was not observed in their normal weight counterparts. The most common abnormality found in the study population was reduced HDLcholesterol (26.6%) followed by elevated fasting blood glucose (22.4%) and high waist circumference (19.3%). Among overweight/obese groups, the rates of individuals with raised TG and reduced HDL-cholesterol were significantly higher in boys than girls (35.0% vs. 15.2%, p=0.044; and 32.5% vs. 13.0%, p=0.038, respectively). Compared to normal-weight adolescents, overweight/obese subjects had higher odds of having at least two MetS components (OR=5.37, 95%CI: 2.72-10.59), or at least three MetS components (OR=11.80, 95%CI: 3.40-41.03). Excess body fat showed similar degrees of association with clustering MetS components. Conclusions: The prevalence of MetS and its individual components was quite high among the study population, particularly among overweight/obese adolescents. MetS components were strongly associated with both overweight/ obesity and excess body fat. MetS and its components might be best predicted by obesity indexes, determined according to age and body mass index in adolescents, than accurate percent body fat.
Community-Acquired urinary tract infection by pseudomonas oryzihabitans

Pseudomonas oryzihabitans and Chrysomonas luteola has been placed in CDC group Ve2 and Ve1 respectively. These bacteria appear to be emerging pathogens. P. oryzihabitans was isolated from cases of bacteremia, CNS infections, wound infections, peritonitis, sinusitis, catheter associated infections in AIDS patient, and pneumonia. Most of the reports of P. oryzihabitans infection were of nosocomial origin in individuals with some predisposing factors. We report here a case of community acquired UTI by P. oryzihabitans in an immune-competent patient with stricture of urethra.
A review of iniparib in ovarian cancer

Introduction: Patients with metastatic ovarian cancer continue to experience high recurrence rates and significant morbidity from standard treatments. There is a great need for efficacious tumor-specific agents in ovarian cancer. Iniparib (BSI-201) is a targeted drug currently under investigation. Areas covered: The authors identified the mechanistic and clinical data available on the role of iniparib in ovarian cancer. Iniparib was initially thought to act via the poly-ADP ribose polymerase 1 (PARP-1) pathway, but recent studies have shown only nonspecific interactions between the drug and PARP proteins. Although iniparib is only active in cancer cells, the exact mechanism of action remains unclear. Iniparib was well tolerated at all dose levels in Phase I studies of solid organ malignancies. Preliminary data from Phase II studies of iniparib for the treatment of platinum-sensitive and platinum-resistant recurrent ovarian cancer show improvement in survival compared to historic controls. There are currently no Phase III studies. Expert opinion: Iniparib shows promise in early clinical trials; however, understanding the pathways of cytotoxicity will be crucial as cancer therapy becomes increasingly individualized.
Invited Manuscript Poster on Renal-Related Education American Society of Nephrology, Nov. 16–21, 2010 E-Pediatric Nephrology in India

Abstract New tools such as blogs, social media networks, and audio and video podcasts in Web 2.0 have allowed better exchange of information among physicians across distances. The medical world has started embracing this new technology as it emerges. Wikis, blogs, and podcasts carry the potential of complementing, improving, and adding new collaborative dimensions to the health education currently in existence. There is a need for physicians in all specialities to adopt the new Web 2.0 technologies. This review features the innovative use of internet in disseminating renal education in Pediatric Nephrology in India.
Assessment of Quality of Life in a Cohort of Newly Diagnosed Patients on HAART Regimen, in Resource Restricted Tribal Region of Chhattisgarh, India: A Prospective Study

Background: Highly active antiretroviral therapy regimens have resulted in the systemic/clinical healing for human immune deficiency virus-infected patients but the consequence of antiretroviral therapy on the whole quality of life has become a major concern. The current study correlates the relationship of quality of life with successful highly active antiretroviral therapy. Aim: To determine the health-related quality of life in human immune deficiency virus-infected patients on highly active anti-retroviral therapy regimen in tribal region of Chhattisgarh. Design: An open label prospective study. Materials and Methods: Health-related quality of life was assessed using a standardized questionnaire, the Medical Outcomes Survey Short Form 36. Physical health summary scores and mental health summary scores were compared of pre-Highly Active Anti-Retroviral Therapy (at baseline) and post 12 months of therapy. Results: The increase in CD4 cell counts was extremely significant (P < 0.0001). The Physical Composite Summary (P value = 0.0003) improved significantly, whereas the Mental Composite Summary (with a baseline value of 40.7), post 12 months, was calculated as 42.8 (P value = 0.2371) and was statistically not significant. Conclusion: Efficacy measurement is the key ingredient of highly active anti-retroviral therapy, which must also include assessment of health-related quality of life to maximize the holistic approach towards disease.
FES-supported standing after paraplegia: traditional versus event-driven closed-loop strategies

Standing after spinal cord injury by means of FES is a topic of interest in neurorehabilitation research. This study compared a handcontrolled (HC) strategy to avert knee-buckle during stance with two event-driven anti-fatigue strategies automated by the use of motion sensors. The control variable modulated was the quadriceps m. stimulation amplitude. The two automated strategies differed in their rate of increases of stimulation when knee unlock was detected. Two ASIA-A subjects participated in standing trials over a standing frame. Surface stimulation was applied to quadriceps and glutei. For both subjects, the total standing times over three trials per day showed significant advantages in using the automated strategies. From total standing times of approximately 10min using HC, the best automated strategy improved this time by 2min15s and 2min51s for subjects S1 and S2, respectively. An automated approach demonstrated efficient control of knee extension, which minimized muscle work and improved user safety.
Assessment of Overall Prevalence of Undernutrition Using Composite Index of Anthropometric Failure (CIAF) among Preschool Children of West Bengal, India

Objective: U nder‐nutrition continues to be a primary cause of ill‐health and premature mortality among children in developing countries. Present study attempted to assess the overall prevalence of undernutrition using composite index of anthropometric failure (CIAF) among rural preschool children of Arambag, Hooghly District, West Bengal, India. Methods: A total of 1012 rural children (498 boys; 514 girls) aged 2‐6 years were measured. Three commonly used undernutrition indicators, ie, stunting, wasting and underweight, as well as the Composite Index of Anthropometric Failure (CIAF) were used to evaluate the nutritional status of the subjects following internationally accepted cut‐off points. For assessing CIAF, Svedberg’s model of six groups of children was used. Findings: Among the studied children, 26.6%, 50.0% and 63.3% were stunted, wasted and under weight, respectively. The CIAF showed a higher prevalence of undernutrition of 73.1% of the studied children suffering from anthropometric failure, in comparison to other three indicators (stunting, underweight and wasting). Out of six subgroups of CIAF with undernourished children, group C (containing children who are wasted and underweight) is the highest (32.0%), more‐or less one‐third of the studied children and children of group F (stunted only) is the lowest (2.7%). Group B (wasting only) and Y (underweight only) show the same prevalence ie 7.2% and 7.1% respectively. Children who simultaneously have wasting, stunting and underweight (ie group D) account for 10.7%. There was no significant age group difference between no failure and CIAF. Conclusion: We found that CIAF may be a better indicator of nutritional stress as compared to the traditional measures of stunting, underweight and wasting. The distinct advantage of the CIAF may be that it can highlight the seriousness and severity of overall undernutrition ie the actual load of undernutrition in a population.
In command of care: Toward the theory of congruent leadership

This is the second of two papers that discuss clinical leadership in the light of a research study which explored who the clinical nurse leaders are, what the characteristics and qualities of clinical leaders might be, why some nurses are seen as clinical leaders and what their experiences might be (Part 1 (Stanley, 2006)). Outlined are contemporary views about leadership and nursing, with emphasis on transformational leadership. Also explored is the new theory of congruent leadership. It is proposed that congruent leadership is a theory best suited for understanding clinical leadership because it is defines leadership in terms of a match (congruence) between the activities, actions and deeds of the leader and the leader's values, principles and beliefs.