Miracle-dz/UniFAR-FTUs huggingface dataset:
Corticosteroids for acute ischaemic stroke.

BACKGROUND The majority of strokes are due to cerebral infarction. Ischaemic cerebral tissue tends to develop cytotoxic oedema which, if the blood-brain barrier is disrupted, may be followed by vasogenic oedema. Large infarcts can develop life-threatening massive oedema. Early treatment with corticosteroids could theoretically help reduce both cytotoxic and vasogenic oedema and so improve the clinical outcome after a stroke. OBJECTIVES To assess the effect of corticosteroids in acute presumed ischaemic stroke. SEARCH STRATEGY We searched the Cochrane Stroke Group Trials Register (last searched: 17 February 2011). SELECTION CRITERIA Published randomised trials comparing corticosteroids with placebo or a control group in people with acute (presumed or definite) ischaemic stroke. Trials were included if treatment began within 48 hours of stroke onset and if clinical outcomes were assessed. DATA COLLECTION AND ANALYSIS Two review authors independently applied the inclusion criteria, assessed trial quality and extracted the data. MAIN RESULTS Eight trials involving 466 people were included. Details of trial quality that may relate to bias were not available for most trials. No difference was shown in the odds of death within one year (odds ratio (OR) 0.87, 95% confidence interval (CI) 0.57 to 1.34). Treatment did not appear to improve functional outcome in survivors. Seven trials reported neurological impairment but pooling the data was impossible because no common scale or time interval was used. The results were inconsistent between individual trials. The only adverse effects reported were small numbers of gastrointestinal bleeds, infections and deterioration of hyperglycaemia across both groups. The results are unchanged since the previous update. AUTHORS' CONCLUSIONS There is not enough evidence to evaluate corticosteroid treatment for people with acute presumed ischaemic stroke. The conclusions are unchanged since the previous update.
Studies on Fluorinated Pyrimidines XVI. Metabolism of 5-Fluorouracil-2-C14 and 5-Fluoro-2′-deoxyuridine-2-C14 in Cancer Patients

Summary 5-Fluorouracil-2-C14 (FU) and 5-fluoro-2′-deoxyuridine-2-C14 (FUDR) were administered to cancer patients by oral, intravenous, intramuscular, and intraperitoneal routes. The radioactivity in the plasma, respiratory CO2, and urine was measured, and fractionation of radioactive materials on ion-exchange columns into the unchanged drug and the various degradation products was carried out with urines and some acid-soluble extracts of plasma. The level of radioactivity in the plasma was higher for the first 2 hours after intravenous injections of FU-2-C14 and FUDR-2-C14 than after administration by any other route. The unchanged drugs persisted longer in urine after intravenous injections than after oral, intramuscular, or intraperitoneal administrations. The excretion of radioactivity as respiratory CO2 was least after the intravenous injection of FUDR. It was concluded, therefore, that intravenous administration of both drugs is the method of choice in the clinical use of these drugs. There was more degradation of FU injected as a continuous infusion than following rapid intravenous injection, and the opposite was true for FUDR. One patient, who tolerated large doses of FUDR without toxic manifestations, degraded the drug rapidly; whereas a second patient, who rapidly became toxic to FUDR, degraded the drug at a much slower rate. When the degradation of 3′,5′-diacetyl-5-fluoro-2′-deoxyrudine-2-C14 and FUDR-2-C14, both given orally to the same patient, was compared, it was found that 5′-monoacetyl-FUDR was present in the urine 24 hours after administration of the diacetyl compound, whereas no unchanged drug was found in the urine after administration of FUDR. After intravenous injections of FU-2-C14 and FUDR-2-C14, radioactivity was found in the cerebrospinal fluid. Fractionation of the radioactive compounds demonstrated the presence of unchanged drug in the cerebrospinal fluid.
Triptans for Acute Migraine: Drug Class Review to Help Inform Policy Decisions

In Ontario, triptans are publicly funded through the Ontario Drug Benefit's Exceptional Access Program, a prior authorization program. However, it was unclear whether this listing aligned with current evidence of safety and effectiveness for triptans in migraine. Using a comprehensive and novel drug class review framework, we describe our review of triptans for the management of acute migraine to evaluate the appropriateness of triptan listing on the public drug formulary in Ontario.
Blood Sampling from the Tail Vein, in Comparison with Two Other Techniques, Causes Less Stress to Mice

It is important to use the optimal method for repeated blood sampling to ensure minimal stress to mice,Â and also to provide better pharmacokinetic and pharmacodynamic data. The aim of the present study wasÂ to compare the impact of blood sampling methods on corticosterone and adrenocorticotropic hormoneÂ (ACTH) levels in mice. Â Hsdwin:NMRI mice were divided into four sampling groups: control group (I), vena facialis (II), tail veinÂ (III) and saphenous vein (IV). The first blood samples, obtained from vena facialis, tail or saphenous veinÂ of conscious mice, were taken at time point 0. The second blood sample was taken by decapitation fromÂ groups II-IV with isoflurane anaesthesia at time point 20 min. The control group animals were anesthetizedÂ and decapitated at 20 min time point. Corticosterone levels in plasma were analyzed at time point 0 and 20Â min, and ACTH at time point 20 min.Â Saphenous bled mice, in comparison with vena facialis and tail vein sampled mice, indicated statisticallyÂ significant greater (P < 0.05) level of corticosterone at sampling point (0 min). Rising levels of corticosteroneÂ in all groups differed statistically (P < 0.05) from the control group level, indicating that all tested bleedingÂ methods were stressful to the experimental animals. However, the tail vein bleeding method stressedÂ statistically significantly (P < 0.05) less in comparison with vena facialis and saphenous vein bleeding. Â At time point 20 min, only saphenous vein bled mice showed statistically significant greater (P < 0.05)Â blood levels of ACTH compared to tail vein bled mice. Â Conditions in sampling and rising levels of corticosterone and/or ACTH level did not show direct correlation. Â In conclusion the results suggest that the tail bleeding method accomplished least stress to mice and nextÂ less vena facialis bleeding. Blood collection technique from the saphenous vein was the most stressful toÂ the experimental animals. Â
WITHDRAWN: Ribavirin for respiratory syncytial virus infection of the lower respiratory tract in infants and young children.

BACKGROUND Respiratory syncytial virus (RSV) is a common cause of lower respiratory tract infection in infants and is responsible for many hospitalizations annually. Ribavirin is approved for treatment of these infections, but its use is controversial because of questions about its efficacy, concerns about occupational exposure, and its high cost. OBJECTIVES The objective of this review is to assess the efficacy of aerosolized ribavirin for infants and children with lower respiratory tract infection due to RSV. SEARCH STRATEGY We performed an updated electronic search of the Cochrane Central Register of Controlled Trials (CENTRAL), the Database of Abstracts of Reviews of Effects (DARE) and the NHS Economic Evaluation Database (EED) (The Cochrane Library 2006, issue 3) which contains the Acute Respiratory Infections Group's specialized register; MEDLINE (Ovid) (2004 to September Week 3 2006); and EMBASE (WebSpirs) (2004 to June 2006). SELECTION CRITERIA Randomized trials comparing ribavirin with placebo in infants and children with lower respiratory tract infection attributable to RSV. DATA COLLECTION AND ANALYSIS Two review authors independently extracted data and assessed trial quality. Unpublished data were requested from trial authors when necessary. MAIN RESULTS Twelve trials were included. All trials enrolled infants below the age of six months. In four trials with 158 participants, mortality with ribavirin was 5.8% compared with 9.7% with placebo (odds ratio (OR) 0.58; 95% confidence interval (CI) 0.18 to 1.85). In three trials with 116 participants the probability of respiratory deterioration with ribavirin was 7.1% compared with 18.3% with placebo (OR 0.37; 95% CI 0.12 to 1.18). In three studies with 104 ventilated participants, the mean difference in days of hospitalization was 1.9 fewer days with ribavirin (95% CI -4.6 to +0.9) and the mean difference in days of ventilation was 1.8 fewer days with ribavirin (95% CI -3.4 to -0.2). No statistically significant differences in long-term pulmonary function or in incidence of recurrent wheezing following RSV infection were associated with the use of ribavirin. AUTHORS' CONCLUSIONS Trials of ribavirin for RSV lack sufficient power to provide reliable estimates of the effects. The cumulative results of three small trials show that ribavirin may reduce the duration of mechanical ventilation and may reduce days of hospitalization. In addition, use of ribavirin may be associated with a decrease in the long-term incidence of recurrent wheezing following RSV disease. A large randomized controlled trial of ribavirin for ventilated and other high-risk participants is indicated.
Central Nervous System Underpinnings of Sensory Hypersensitivity in Migraine: Insights from Neuroimaging and Electrophysiological Studies

Whereas considerable data have been generated about the pathophysiology of pain processing during migraine attacks, relatively little is known about the neural basis of sensory hypersensitivity. In migraine, the term “hypersensitivity” encompasses different and probably distinct pathophysiological aspects of sensory sensitivity. During attacks, many patients have enhanced sensitivity to visual, auditory and/or olfactory stimuli, which can enhance headache while interictally, migraineurs often report abnormal sensitivity to environmental stimuli that can cause nonpainful discomfort. In addition, sensorial stimuli can influence and trigger the onset of migraine attacks. The pathophysiological mechanisms and the origin of such sensitivity (individual predisposition to develop migraine disease or consequence of repeated migraine attacks) are ill understood. Functional neuroimaging and electrophysiological studies allow for noninvasive measures of neuronal responses to external stimuli and have contributed to our understanding of mechanisms underlying sensory hypersensitivity in migraine. The purpose of this review is to present pivotal neuroimaging and neurophysiological studies that explored the basal state of brain responsiveness to sensory stimuli in migraineurs, the alterations in habituation and attention to sensory inputs, the fluctuations of responsiveness to sensory stimuli before and during migraine attacks, and the relations between sensory hypersensitivity and clinical sensory complaints.
Examining the Sexual Health Experiences of Men Who Cruise Public Sex Environments

Abstract This paper examines the sexual health of men who 'cruise' public sex environments (PSEs). A cross-sectional survey (response rate 56%) recruited 216 men from an urban-based PSE in the UK. Half of participants reported lifetime STI experience and 16% reported an STI in the last year. Half attendd an STI clinic in the previous year, with similar proportions vaccinated against hepatitis A and B. Men who recently attended STI clinic (OR = 3.03) and those educated to A level or higher (OR = 3.12) were significantly more likely to report lifetime STI experience. Unlike commercial venues, PSEs do not represent centres of STI transmission. However, sub-optimal STI clinic attendance may mask undiagnosed infections. A public health imperative remains to encourage more PSE users to attend STI clinic on a prophylactic basis and increase hepatitis vaccination. Furthermore, the sexual health needs of PSE users with higher qualifications, in terms of STIs other than HIV, must be addressed.
Anthelmintics for people with neurocysticercosis.

BACKGROUND Neurocysticercosis is an infection of the brain by the larval stage of the pork tapeworm. In endemic areas it is a common cause of epilepsy. Anthelmintics (albendazole or praziquantel) may be given to kill the parasites. However, there are potential adverse effects, and the parasites may eventually die without treatment. OBJECTIVES To assess the effectiveness and safety of anthelmintics for people with neurocysticercosis. SEARCH STRATEGY In May 2009 we searched the Cochrane Infectious Diseases Group Specialized Register, CENTRAL (The Cochrane Library 2008, Issue 3), MEDLINE, EMBASE, LILACS, and the mRCT. SELECTION CRITERIA Randomized controlled trials comparing anthelmintics with placebo, no anthelmintic, or other anthelmintic regimen for people with neurocysticercosis. DATA COLLECTION AND ANALYSIS Two authors independently selected trials, extracted data, and assessed each trial's risk of bias. We calculated risk ratios (RR) for dichotomous variables, with 95% confidence intervals (CI). We pooled data from trials with similar interventions and outcomes. MAIN RESULTS For viable lesions in children, there were no trials. For viable lesions in adults, no difference was detected for albendazole compared with no treatment for recurrence of seizures (116 participants, one trial); but fewer participants with albendazole had lesions at follow up (RR 0.56, 95% CI 0.45 to 0.70; 192 participants, two trials). For non-viable lesions in children, seizures recurrence was less common with albendazole compared with no treatment (RR 0.49, 95% CI 0.32 to 0.75; 329 participants, four trials). There was no difference detected in the persistence of lesions at follow up (570 participants, six trials). For non-viable lesions in adults, there were no trials.In trials including viable, non-viable or mixed lesions (in both children and adults), headaches were more common with albendazole alone (RR 9.49, 95% CI 1.40 to 64.45; 106 participants, two trials), but no difference was detected in one trial giving albendazole with corticosteroids (116 participants, one trial). AUTHORS' CONCLUSIONS In patients with viable lesions, evidence from trials of adults suggests albendazole may reduce the number of lesions. In trials of non-viable lesions, seizure recurrence was substantially lower with albendazole, which is counter-intuitive. It may be that steroids influence headache during treatment, but further research is needed to test this.
Factors Associated With Primary Headache According To Diagnosis, Sex, and Social Group

We previously showed that migraine and tension‐type headache (TTH) have a high prevalence that differs markedly between social groups. Here, we aim to identify factors associated with migraine and TTH (possible risk factors) in three social groups to better understand the difference in prevalence between sexes, between different headache diagnoses, and between different social groups.
The Pharmacology of Indomethacin

Over 50 years ago, indomethacin emerged as an extremely potent non‐steroidal anti‐inflammatory drug (NSAID) during a massive effort to find effective anti‐inflammatory and analgesic medications. The 1960s saw acetic acid derivatives developed into indomethacin, diclofenac, and sulindac, and propionic derivatives into ibuprofen, naproxen, and ketoprofen. Indomethacin was likely the most potent of these compounds and one of the earliest to enter clinical trials. It is not surprising that indomethacin was among the first of the NSAID medications to be used in treatment of migraine and for headaches that eventually became known as “indomethacin‐responsive” headache disorders. Potential pharmacokinetic and bio‐mechanistic differences between indomethacin and other NSAIDs are of great clinical and research interest to explain this observation.
Vitamin D and vitamin D analogues for preventing fractures associated with involutional and post-menopausal osteoporosis.

BACKGROUND Vitamin D and related compounds have been used to prevent osteoporotic fractures in older people. OBJECTIVES To determine the effects of vitamin D or related compounds, with or without calcium, for preventing fractures in older people. SEARCH STRATEGY We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register, the Cochrane Central Register of Controlled Trials (The Cochrane Library 2007, Issue 3), MEDLINE, EMBASE, CINAHL, and reference lists of articles. Most recent search: October 2007. SELECTION CRITERIA Randomised or quasi-randomised trials comparing vitamin D or related compounds, alone or with calcium, against placebo, no intervention, or calcium alone, reporting fracture outcomes in older people. DATA COLLECTION AND ANALYSIS Two authors independently assessed trial quality, and extracted data. Data were pooled, where admissible, using the fixed-effect model, or random-effects model if heterogeneity between studies appeared high. MAIN RESULTS Forty-five trials were included. Vitamin D alone appears unlikely to be effective in preventing hip fracture (nine trials, 24,749 participants, RR 1.15, 95% CI 0.99 to 1.33), vertebral fracture (five trials, 9138 participants, RR 0.90, 95% CI 0.42 to 1.92) or any new fracture (10 trials, 25,016 participants, RR 1.01, 95% CI 0.93 to 1.09). Vitamin D with calcium reduces hip fractures (eight trials, 46,658 participants, RR 0.84, 95% CI 0.73 to 0.96). Although subgroup analysis by residential status showed a significant reduction in hip fractures in people in institutional care, the difference between this and the community-dwelling subgroup was not significant (P = 0.15). Overall hypercalcaemia is significantly more common in people receiving vitamin D or an analogue, with or without calcium (18 trials, 11,346 participants, RR 2.35, 95% CI 1.59 to 3.47); this is especially true of calcitriol (four trials, 988 participants, RR 4.41, 95% CI 2.14 to 9.09). There is a modest increase in gastrointestinal symptoms (11 trials, 47,042 participants, RR 1.04, 95% CI 1.00 to 1.08, P = 0.04) and a small but significant increase in renal disease (11 trials, 46,537 participants, RR 1.16, 95% CI 1.02 to 1.33). AUTHORS' CONCLUSIONS Frail older people confined to institutions may sustain fewer hip fractures if given vitamin D with calcium. Vitamin D alone is unlikely to prevent fracture. Overall there is a small but significant increase in gastrointestinal symptoms and renal disease associated with vitamin D or its analogues. Calcitriol is associated with an increased incidence of hypercalcaemia.
Zinc supplementation for improving pregnancy and infant outcome.

BACKGROUND It has been suggested that low serum zinc levels may be associated with suboptimal outcomes of pregnancy such as prolonged labour, atonic postpartum haemorrhage, pregnancy-induced hypertension, preterm labour and post-term pregnancies, although many of these associations have not yet been established. OBJECTIVES To assess the effects of zinc supplementation in pregnancy on maternal, fetal, neonatal and infant outcomes. SEARCH METHODS We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (30 September 2011) and reference lists of retrieved studies. SELECTION CRITERIA Randomised trials of zinc supplementation in pregnancy. We excluded quasi-randomised controlled trials. DATA COLLECTION AND ANALYSIS Three review authors applied the study selection criteria, assessed trial quality and extracted data. When necessary, we contacted study authors for additional information. MAIN RESULTS We included 20 randomised controlled trials (RCTs) reported in 51 papers involving over 15,000 women and their babies. Trials were generally at low risk of bias. Zinc supplementation resulted in a small but significant reduction in preterm birth (risk ratio (RR) 0.86, 95% confidence interval (CI) 0.76 to 0.97 in 16 RCTs; 16 trials of 7637 women). This was not accompanied by a similar reduction in numbers of babies with low birthweight (RR 0.93, 95% CI 0.78 to 1.12; 14 trials of 5643 women). No significant differences were seen between the zinc and no zinc groups for any of the other primary maternal or neonatal outcomes, except for induction of labour in a single trial. No differing patterns were evident in the subgroups of women with low versus normal zinc and nutrition levels or in women who complied with their treatment versus those who did not. AUTHORS' CONCLUSIONS The evidence for a 14% relative reduction in preterm birth for zinc compared with placebo was primarily represented by trials involving women of low income and this has some relevance in areas of high perinatal mortality. There was no convincing evidence that zinc supplementation during pregnancy results in other useful and important benefits. Since the preterm association could well reflect poor nutrition, studies to address ways of improving the overall nutritional status of populations in impoverished areas, rather than focusing on micronutrient and or zinc supplementation in isolation, should be an urgent priority.
Antibiotics for acute maxillary sinusitis.

BACKGROUND Expert opinions vary on the appropriate role of antibiotics for sinusitis, one of the most commonly diagnosed conditions among adults in ambulatory care. OBJECTIVES We examined whether antibiotics are effective in treating acute sinusitis, and if so, which antibiotic classes are the most effective. SEARCH STRATEGY We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library, 2007, Issue 3); MEDLINE (1950 to May 2007) and EMBASE (1974 to June 2007). SELECTION CRITERIA Randomized controlled trials (RCTs) comparing antibiotics with placebo or antibiotics from different classes for acute maxillary sinusitis in adults. We included trials with clinically diagnosed acute sinusitis, whether or not confirmed by radiography or bacterial culture. DATA COLLECTION AND ANALYSIS At least two review authors independently screened search results, extracted data and quality assessed trials. Risk ratios (RR) were calculated for differences in the intervention and control groups to see whether or not the treatment was a failure. In meta-analysing the placebo-controlled studies, the data across antibiotic classes were combined. Primary outcomes were the clinical failure rates at 7 to 15 days and 16 to 60 days follow up. MAIN RESULTS Fifty-seven studies were included in the review; six placebo-controlled studies and 51 studies comparing different classes of antibiotics. Five studies involving 631 participants provided data for comparison of antibiotics to placebo, when clinical failure was defined as a lack of cure or improvement at 7 to 15 days follow up. These studies found a slight statistical difference in favor of antibiotics, compared to placebo, with a pooled RR of 0.66 (95% confidence interval (CI) 0.44 to 0.98). However, the clinical significance of the result is equivocal, also considering that cure or improvement rate was high in both the placebo group (80%) and the antibiotic group (90%). Based on six studies, when clinical failure was defined as a lack of total cure, there was significant difference in favor of antibiotics compared to placebo with a pooled RR of 0.74 (95% CI 0.65 to 0.84) at 7 to 15 days follow up. None of the antibiotic preparations was superior to each other. AUTHORS' CONCLUSIONS Antibiotics have a small treatment effect in patients with uncomplicated acute sinusitis in a primary care setting with symptoms for more than seven days. However, 80% of participants treated without antibiotics improve within two weeks. Clinicians need to weigh the small benefits of antibiotic treatment against the potential for adverse effects at both the individual and general population level.