Miracle-dz/UniFAR-FTUs huggingface dataset:
Acute Drug Poisoning at Critical Care Departments in Japan

During 1996, 1188 patients with acute drug poisoning were admitted to 59 critical care departments in Japan. The patients were predominantly female (68.4%) and relatively young (69.2%, under the age of 40). Further analysis of the 1188 patients indicated that the majority (77.9%) were admitted as a result of deliberate self-poisoning, while 15.1 % of the cases were admitted due to accidental poisoning (unknown cause 7%). A total of 2517 drugs was taken by these patients. The most common group of drugs involved were benzodiazepines (32.1 %), followed by neuroleptics (12.2%), antidepressants (10.2%), analgesics (9.1%), antihistamines (7.3%) and barbiturates (6.2%). An important difference observed in the pattern of acute drug poisoning, when compared with that in other countries, was the preferential use of bromvalerylurea by young individuals for deliberate self-poisoning. This drug has not been used in any other country recently.There were twelve cases of fatal drug poisoning in the 59 critical care departments during 1996, including nine women. Four patients had taken barbiturates and six patients had taken a combination of benzodiazepines. In order to treat patients with acute drug poisoning, it is important to provide physicians with essential information on the incidence, mechanism of poisoning, and metabolism of the drug involved. In the case of rare drug poisoning, however, as it would take consideiable time for any one critical care department alone to amass enough admissions for generating a reliable information databese regarding management and prognosis, we therefore believe that a national approach is required to address the issue of management of patients with acute drug poisoning.
Endothelin receptor blockade ameliorates renal injury by inhibition of RhoA/Rho-kinase signalling in deoxycorticosterone acetate-salt hypertensive rats

Purpose of review: Excessive production of fibrosis is a feature of hypertension-induced renal injury. Activation of RhoA/Rho-kinase (ROCK) axis has been shown in deoxycorticosterone acetate (DOCA)-salt hypertensive rats. We assessed whether selective endothelin receptor blockers can attenuate renal fibrosis by inhibiting RhoA/ROCK axis in DOCA-salt rats. Methods: At 4 weeks after the start of DOCA-salt treatment and uninephrectomization, male Wistar rats were randomized into three groups for 4 weeks: vehicle, ABT-627 (endothelin-A receptor inhibitor) and A192621 (endothelin-B receptor inhibitor). Results: DOCA-salt was characterized by increased blood pressure, decreased renal function, increased proteinuria, increased glomerulosclerosis and tubulointerstitial fibrosis with myofibroblast accumulation, increased renal endothelin-1 levels and RhoA activity along with increased expression of connective tissue growth factor at both mRNA and protein levels as compared with uninephrectomized control male Wistar rats. Treatment with a selective mineralocorticoid receptor antagonist, eplerenone, ameliorated proteinuria. Impaired renal function and histological changes were overcome by treatment with ABT-627, but not with A192621. The beneficial effects of bosentan, a nonspecific endothelin receptor blocker, on proteinuria, RhoA activity, and connective tissue growth factor levels were similar to ABT-627. Furthermore, in an isolated perfuse kidney, a RhoA inhibitor, C3 exoenzyme, and two ROCK inhibitors, fasudil and Y-27632, significantly attenuated connective tissue growth factor levels. Conclusions: These results indicate that DOCA-salt elevates renal endothelin-1 levels and RhoA activity via activation of mineralocorticoid receptor, resulting in renal fibrosis and proteinuria. Endothelin-A receptor blockade can attenuate DOCA-salt-induced renal fibrosis probably through the inhibition of RhoA/ROCK activity and connective tissue growth factor expression.
Addressing risk factors of overweight and obesity among adolescents in out-of-home care: the Healthy Eating and Active Living (HEAL) study

Rates of overweight and obesity increase significantly whilst children and young people are in out-of-home care. This paper provides the protocol for a study, funded by the Australian Research Council (2012–2014), being conducted to evaluate the effectiveness of a Healthy Eating and Active Living intervention programme for adolescents who live in out-of-home residential care. This randomised trial will be conducted with 118 adolescents aged 13–17 years of age in out-of-home residential care and the residential staff who look after them. Adolescents' eating habits, physical activity levels, psychological well-being, body dissatisfaction and weight status will be assessed at baseline, immediately post the programme (which runs for 6 months), and again 12 months post baseline. Similar measures will be obtained from residential carers (across the same time points). If effective, this programme could be implemented as usual care to modify levels of obesity amongst these vulnerable young people.
Do other cardiovascular risk factors influence the impact of age on the association between blood pressure and mortality? The MORGAM Project

Objective: To investigate age-related shifts in the relative importance of SBP and DBP as predictors of cardiovascular mortality and all-cause mortality and whether these relations are influenced by other cardiovascular risk factors. Methods: Using 42 cohorts from the MORGAM Project with baseline between 1982 and 1997, 85 772 apparently healthy Europeans and Australians aged 19–78 years were included. During 13.3 years of follow-up, 9.2% died (of whom 7.2% died due to stroke and 21.1% due to coronary heart disease, CHD). Results: Mortality risk was analyzed using hazard ratios per 10-mmHg/5-mmHg increase in SBP/DBP by multivariate-adjusted Cox regressions, including SBP and DBP simultaneously. Because of nonlinearity, SBP and DBP were analyzed separately for blood pressure (BP) values above and below a cut-point wherein mortality risk was the lowest. For the total population, significantly positive associations were found between stroke mortality and SBP [hazard ratio = 1.19 (1.13–1.25)] and DBP at least 78 mmHg [hazard ratio = 1.08 (1.02–1.14)], CHD mortality and SBP at least 116 mmHg [1.20 (1.16–1.24)], and all-cause mortality and SBP at least 120 mmHg [1.09 (1.08–1.11)] and DBP at least 82 mmHg [1.03 (1.02–1.05)]. BP values below the cut-points were inversely related to mortality risk. Taking into account the age × BP interaction, there was a gradual shift from DBP (19–26 years) to both DBP and SBP (27–62 years) and to SBP (63–78 years) as risk factors for stroke mortality and all-cause mortality, but not CHD mortality. The age at which the importance of SBP exceeded DBP was for stroke mortality influenced by sex, cholesterol, and country risk. Conclusion: Age-related shifts to the superiority of SBP exist for stroke mortality and all-cause mortality, and for stroke mortality was this shift influenced by other cardiovascular risk factors.
TRPV1 Antagonist Suppresses Allergic Conjunctivitis in a Murine Model

ABSTRACT Purpose: To determine the immunologic functions of TRPA1 or TRPV1 in allergic conjunctivitis (AC). Methods: Mice were sensitized with ovalbumin (OVA), after which TRPA1 antagonist or TRPV1 antagonist was administered before topical OVA challenge. Expression of TRPV1 or TRPA1 in AC was examined by western blotting and multicolor immunofluorescence. Clinical signs, OVA-specific IgE, infiltration of inflammatory cells into conjunctivae (CJs), and Th2 cytokine in draining lymph nodes (LNs) were evaluated by microscopy, flow cytometry, and ELISA. Results: TRPV1 expression was increased in CJs and LNs from AC mice, but TRPA1 expression was only increased in LNs. TRPV1 antagonist but not TRPA1 antagonist attenuated the clinical signs of AC and OVA-specific IgE in sera. TRPV1 antagonist furthermore inhibited the infiltration of inflammatory cells into CJ and the production of Th2 cytokines in LNs. Conclusion: TRPV1 antagonist but not TRPA1 antagonist may ameliorate AC by suppressing the Th2 response in LNs.
Hypertension in India.

H ypertension is a leading public health challenge globally due to its high prevalence and related morbidity and mortality [1–3]. An estimated 978 million adults, or 28% of the world’s adult population, had uncontrolled hypertension in 2008 [3]. More alarming, conservative estimates indicate that the global burden of hypertension will increase to more than 1.56 billion by 2025 [1]. As the most important modifiable risk factor for cardiovascular disease andall-causemortality, highblood pressure was responsible for approximately 7.6 million deaths globally, or 13.5% of all deaths, in 2001[1–3]. Although the prevalence of hypertension is generally higher in economically developed countries, due to larger population sizes, the absolute number of individuals with hypertension is higher in developing regions of the world [1]. Kearney et al. [1] estimated that 639 million hypertensive patients reside in economically developing countries compared with only 333 million in economically developed regions of the world. Hypertension has also emerged as a leading risk factor for morbidity and mortality in developing regions, responsible for over 6 million deaths in low and middle-income nations in 2001 [2]. The disease burden resulting from hypertension translates into a substantial economic toll. For example, in China, the estimated annual direct medical costs of chronic diseases caused by/or related to hypertension were approximately 3 billion dollars in 2003 [4]. In Brazil, the costs of direct treatment and productivity losses were as high as 72 billion dollars in 2005 [4]. Furthermore, it is likely that the negative health and economic consequences of hypertension will only increase over time in low and middle-income countries where disease patterns continue to shift from communicable to noncommunicable conditions [5]. As the leading modifiable risk factor for cardiovascular disease and mortality [6,7], quantification of the absolute burden and distribution of hypertension in developing nations is critical. Such information will aid in the
Old spontaneously hypertensive rats gather together typical features of human chronic left-ventricular dysfunction with preserved ejection fraction

Objective: Heart failure with preserved left-ventricular ejection fraction (HF-PEF) is an entity leading to pulmonary congestion because of impaired diastolic filling. This syndrome usually strikes those who have experienced a long history of hypertension or metabolic risk factors. Pathophysiological mechanisms are not fully understood, and standard therapy is not established. Relevant preclinical models are still lacking. The aim of this work was to evaluate aging spontaneously hypertensive rats (SHRs) as a model of HF-PEF. Methods: Serial echocardiographic and blood pressure (BP) measurements were performed in 28, 36, 43, 47 and 51-week-old SHRs and their normotensive controls (Wistar–Kyoto rats). In 52–53-week-old animals, final investigations included ECG, invasive left-ventricular (LV) and aortic catheterization, brain natriuretic peptide (BNP) plasma concentrations, ventricular reverse transcription-qPCR evaluations (&bgr;-myosin heavy chain, atrial natriuretic peptide, BNP, sarco/endoplasmic reticulum calcium ATPase 2a and collagens 1a, 3a and 2a) and cardiac histology. Results: SHRs develop a progressive alteration of the early diastole, some of the echocardiographic parameters being not sensitive to BP reduction by the calcium blocker, nicardipine. The systolic function evaluated by echocardiography and invasive catheterization was preserved. When the observation period was over, an increase in collagen synthesis and deposits were identified in subendocardial layers. This attested a probable myocardial ischemia that was confirmed by ECG changes of the ST segment. BNP increased in the blood and at the mRNA level in the myocardium. Conclusion: When aging, SHRs progressively develop HF-PEF showed by impaired LV relaxation and hypertrophy, BNP increase but preserved contractility and fibrosis. This model seems pertinent for further pharmacological preclinical studies in the field.
Multiple Sclerosis-Associated Uveitis

Department of Ophthalmology, California Pacific Medical Center, San Francisco, California, USA, Department of Ophthalmology, Stanford University School of Medicine, Stanford, California, USA, The Francis I. Proctor Foundation, UCSF School of Medicine, San Francisco, California, USA, Moorfields Eye Hospital and Biomedical Research Center, NHS Foundation Trust, London, UK, Department of Ophthalmology, Northwestern Feinberg School of Medicine, Chicago, Illinois, USA, Department of Ophthalmology, St. Paul’s Hospital, Vancouver, British Columbia, Canada, and Centre for Ophthalmology, University Tuebingen, Schleichstrasse, Tuebingen, Germany
Acceptability of Vasectomy in Jos, Northern Nigeria

Objective: The paper reports on the ten cases of vasectomy performed in our institution over a sixteen year period. Design: It is a retrospective study of clients\' case-notes from January 1985 to December 2000. Setting: Jos University Teaching Hospital, Plateau State, Nigeria. Results: During the 16 year period, a total of ten males volunteered to have vasectomy performed on them in contrast to 3585 females who had surgical contraception via minilaparotomy during the same period, giving an incidence of 0.28%. Their age range was 41-62 years, range of children per family of 3-14, with 3-11 children alive at the time of the procedure. They were in stable marriages and chose vasectomy because they had completed their family sizes. Compilations attributed to the procedure were minor and resolved with treatment. Conclusion: Vasectomy even though safe, simple and effective is not readily acceptable as a method of fertility control in our institution and this part of Nigeria. Key Words: vasectomy, contraception, safe, effective. [Trop J Obstet Gynaecol, 2004;21:56-57]
Teachers Dietary Practices during School Day in Jeddah, Western Saudi Arabia

The schools teachers dietary practices during the school day should reflect a healthy dietary pattern both in quality and quantity of foods consumed particularly in countries that witness an epidemic of obesity related Type-2 diabetes mellitus. The objective of this study was to identify the local dietary practices of the schools teachers in Jeddah, western Saudi Arabia. A Cross-section observational study using a pre-designed questionnaire to identify the local pattern of dietary practices during school day of a representative sample of schools teachers was conducted in Jeddah. The questionnaire was piloted and administered to a sample of 140 teachers working in 15 schools across Jeddah. A total of 140 Saudi teachers participated. The mean age of the sample was 34.9 ± 6.1 years. Two thirds (66.4%) were females. Overall, 40.5% were overweight and 22.4% were obese. During the school day, tea and Arabic coffee were the commonest daily consumed drinks (67.9%, 65.7% respectively). Almost half of the sample consumed dates on a daily basis (51.4%). Breads and cheese sandwiches were always consumed by 45% and 33.6% respectively. Two thirds of females 67.7% and 55.3% of males were used to have breakfast and/or snack with their colleagues at school. Males preferred to purchase ready-made traditional foods from outside while females preferred the schools canteens. The percentages of overweight and obesity were higher among males compared to females (46.5 versus 37%) and (25.6% versus 20.5%) respecttively. It is concluded that the dietary practices of Saudi school teachers during school day vary according to gender. Findings indicate the need for dietary modification programs directed towards schools teachers in populations which report high prevalence rates of diabetes of similar cultural backgrounds.
The Usefulness of Aqueous Fluid Analysis for Epstein–Barr Virus in Patients with Uveitis

ABSTRACT Purpose: To determine characteristics of patients with laboratory findings indicative of intraocular Epstein–Barr-virus (EBV) infection and to establish the usefulness of the laboratory analysis in patients with uveitis. Methods: Retrospective study of patients who underwent diagnostic aqueous fluid analysis. Diverse demographic data of patients were registered. Results: EBV-PCR tested positive in 3/201 (1%) and EBV-GWC in 22/245 (9%). The prevalence of immunosuppression was similar in EBV positive (by PCR/GWC) and EBV negative patients (7/25; 28% vs. 50/272;18%, P = 0.29). Out of all 22 EBV-GWC positive patients, GWC was between 3 and 10 in 91%. In total, 14 patients had laboratory results indicating only EBV infection. Patients without an alternative explanation for uveitis (6/14; 43%) had a chronic recurrent course and good visual prognosis. Conclusion: Low EBV-GWC values combined with multiple positive GWC and/or PCR for other infectious agents. Intraocular assessment for EBV in the initial examination of uveitis patients has limited value.
ACUTE ANTERIOR POLIOMYELITIS IN KERN COUNTY, CALIFORNIA

Acute anterior poliomyelitis has been reported for some time from Kern County, Calif. , where the disease has been of particular importance since 1934 and 1935. During these two years the incidence increased and localized outbreaks occurred, as shown by Gifford and Bogen 1 in the annual report of the Kern County health department. Most of the cases in which there was some disturbance of the central nervous system were reported as instances of poliomyelitis from this period until late in 1938, when it became evident that, while some of the milder, nonparalytic conditions were due to the virus of this disease, many could be attributed either to the western equine encephalomyelitis virus or to the St. Louis encephalitis virus or to both, as was shown by Howitt 2 and by Buss and Howitt. 3 After laboratory differentiation was established, it was apparent that more than one variety of neurotropic virus
Visual Perceptual Consequences of Stroke

Purpose: Perceptual consequences of stroke include agnosia, alexia, dyschromatopsia, inattention, and hallucinations. Our aim was to evaluate these perceptual consequences in terms of prevalence after stroke. Methods: Prospective multicenter cohort trial involving 14 recruiting centers (Vision in Stroke [VIS] group). Standardized referral and investigation protocol used by local investigators. Data presented from the first year of data collection, May 2006 to April 2007. Information obtained on visual acuity, ocular alignment and motility, visual field, visual inattention, and visual cognition/perception. Results: One hundred seventy-eight patients excluded (49% male, 51% female) mainly due to inability to consent because of cognitive difficulties. Three hundred twenty-three patients recruited (59% male, 41% female). Mean age at onset of stroke of 69 years (range 1–92). Median duration from onset to vision assessment of 22 days (range 0–2543 days). Type of stroke was an infarct in 79.5% and hemorrhagic in 20.5%. Six percent had had a previous stroke. Laterality of stroke was right sided in 48%, left sided in 40%, and bilateral in the remainder. Eight percent of patients had normal visual status; 68.4% had eye movement impairment, 46.1% had visual field impairment, and 25.1% had low vision; and 20.5% had perceptual difficulties. Of these, 14.2% had inattention, 1.3% had difficulty judging depth and distance, 0.3% had color detection problems, 2.5% complained of hallucinations, and 2.2% of agnosia. Conclusions: A substantial proportion (92%) of patients referred with suspected visual difficulty had visual impairment. One fifth of patients referred had perceptual consequences to their stroke relating to inattention and cortical visual processing impairment.
Renal BOLD-MRI relates to kidney function and activity of the renin–angiotensin–aldosterone system in hypertensive patients

Background: The renin–angiotensin–aldosterone system (RAAS) and the sympathetic nervous system are key factors in the pathophysiology of hypertension. Renal hypoxia is the putative mechanism stimulating both systems. Blood oxygen level-dependent MRI (BOLD-MRI) provides a noninvasive tool to determine renal oxygenation in humans. The aim of the current study was to investigate the relation between blood pressure (BP) and kidney function with renal BOLD-MRI. Moreover, the relation between direct and indirect variables of the RAAS and sympathetic nervous system and renal BOLD-MRI was studied. Method: Seventy-five hypertensive patients (38 men) were included. Antihypertensive medication was temporarily stopped. Patients collected urine during 24 h (sodium, catecholamines), blood samples were taken (creatinine, renin, aldosterone), a captopril challenge test was performed, and ambulatory BP was measured. Results: Mean age was 58 (±11) years, day-time BP was 167 (±19)/102 (±16) mmHg, and estimated glomerular filtration rate was 75 (±18) ml/min per 1.73 m2). In multivariable regression analysis, renal medullary R2*-values inversely related to estimated glomerular filtration rate (P = 0.02). Moreover, the BP-lowering effect of captopril positively related to cortical (P = 0.02) and medullary (P = 0.008) R2*-values, as well as to P90 (P = 0.02). Conclusion: In patients with hypertension, kidney function relates to medullary R2*-values. Activation of the RAAS is also positively related to the renal R2*-values.
Protein kinase C&bgr; mediates downregulated expression of glucagon-like peptide-1 receptor in hypertensive rat renal arteries

Objective: Glucagon-like peptide-1 (GLP-1) exerts its actions via activating GLP-1 receptor (GLP-1R). Our previous study showed a reduced GLP-1R expression in spontaneously hypertensive rat (SHR) renal arteries. The present study investigated the mechanisms underlying GLP-1R downregulation in hypertension. Methods: Intrarenal arteries of normotensive Wistar-Kyoto rat (WKY) and SHR were suspended in the myograph for force measurement. GLP-1R expression was evaluated by both immunofluorescence and western blotting. Protein kinase C&agr; (PKC&agr;), PKC&bgr;, PKC&dgr;, and total PKC levels were assayed by western blotting. Results: Immunofluorescence revealed reduced GLP-1R level in SHR renal arteries compared with WKY renal arteries. GLP-1R agonist exendin-4 induced concentration-dependent relaxations in WKY arteries, which mainly depended on the presence of endothelium. GLP-1R antagonist exendin 9–39 inhibited this relaxation in WKY arteries, whereas the relaxations were significantly less in SHR arteries. Ex-vivo treatment with PKC inhibitor GFX, PKC&agr; and PKC&bgr; inhibitor Gö6976, and PKC&bgr; inhibitor hispidin but not PKC&dgr; inhibitor rottlerin improved the impaired relaxations and restored the diminished GLP-1R expression in SHR arteries. Furthermore, PKC&bgr; level was greater in SHR than WKY arteries, with no difference in PKC&agr;, PKC&dgr;, or total PKC expressions between two rat strains. Treatment with PKC-activating agent phorbol-12-myristate-13-acetate attenuated exendin-4-induced relaxations and reduced GLP-1R expression in WKY arteries, which were reversed by GFX, Gö6976, or hispidin. More relevantly, immunofluorescence of human renal arteries also showed a reduced GLP-1R level in hypertensive patients. Conclusion: The present results provide novel evidence that the reduced GLP-1R expression in SHR renal arteries is most likely mediated through PKC&bgr; upregulation; the latter probably contributes to the impaired GLP-1R-mediated vasorelaxations in hypertension.