Miracle-dz/UniFAR-FTUs huggingface dataset:
Mirtazapine induced nightmares in an adult male.

A 21-year-old medical student was prescribed mirtazapine 15 mg once daily at bed time for his depressive symptoms. After taking the drug for approximately 2 weeks,he again presented to the psychiatry outpatient department with a history of severe nightmares almost every night. During history taking, he could recollect few of the horrifying experiences that he dreamt of. In one of the dreams he saw an unknown person trying to stab him with a knife. In another, he saw himself tied up to a pole over the bridge and gun shots hitting him from the sides. In the third, he visualized his girlfriend dead under a collapsed building. He also reported dreaming about his own cremation proceedings going on at a barren place, while he was still alive. Each time he woke up with confusion, palpitations, sweating and fear. In addition, he complained of malaise, confusion and increased sedation during day time, while on therapy. The drug was consequently stopped and, not surprisingly, the nightmares disappeared completely within a couple of days.Thereafter,he was put on fluoxetine and no such episodes were reported.On careful evaluation of past history, it was found that the patient had shown poor compliance to mirtazapine a few years back and had experienced similar nightmares. Therewasnohistoryofconcomitantuseofothermedications (including herbal medicines) or alcohol intake.The temporal relationship between the initiation of treatment with mirtazapine and onset of nightmares and their disappearance with discontinuation of the drug, and also their
Tonotopic projection from the dorsal to the anteroventral cochlear nucleus of mice

To understand how auditory information is processed in the cochlear nuclei, it is crucial to know what circuitry exists and how it functions. In slice preparations, horseradish peroxidase (HRP) injections into the anteroventral cochlear nucleus (AVCN) reveal two circuits: a connection between the dorsal cochlear nucleus (DCN) and AVCN and a local circuit confined to the AVCN. Extracellular injection in the AVCN labels a band of cells in the DCN. The labeled cells in the DCN lie within a band of auditory nerve fiber terminals that are labeled by the same injection, showing that the connection from the DCN to the AVCN is frequency specific. The injections into the AVCN also labeled a cluster of neurons in the AVCN dorsal to the injection site. These cells may be interneurons that relay information from areas encoding higher frequencies to areas encoding lower frequencies within the AVCN. In the parasagittal plane, the AVCN is organized along two orthogonal axes that are indicated with HRP labeling of fibers and cell bodies. The tonotopic axis runs approximately dorsoventrally; the isofrequency axis runs approximately rostrocaudally. The axons of labeled DCN neurons and the cluster lie along the tonotopic axis, whereas the labeled auditory nerve fibers define the isofrequency axis. Where they cross is where HRP is taken up by the fibers. The area of uptake is small and lies in the middle of the darkly stained injection site.
Genotoxicity biomonitoring in regions exposed to vehicle emissions using the comet assay and the micronucleus test in native rodent Ctenomys minutus

Exposure to motor vehicle emissions represents an important concern for possible long‐term health effects. The present report describes: 1) the application and verification of the alkaline comet assay in Ctenomys minutus to detect the possible genotoxicity of automobile emissions; 2) a comparison of the comet assay results with peripheral blood micronucleus (MN) assay results performed in the same animals; and 3) the identification of agents involved in the responses and in the seasonal variation of the effects. Ctenomys minutus (Octodontidae‐Rodentia) were captured in two different fields from both sides of RS/030, a highway on the coastal plain of the Brazilian state of Rio Grande do Sul. Reference animals were obtained from a nearby field that was about 3 km distant from any road. By the end of this study, 123 rodents (73 females and 50 males) were live‐trapped. Our results indicate that there was an increase in cells with DNA damage for C. minutus environmentally exposed to automobile emissions, as demonstrated by the alkaline comet assay, but there was no increase in micronucleated cells. The alkaline comet assay showed age and gender differences in the response. The comet assay results suggest that adult females are the principal population affected by air pollutants from vehicle emissions. Chemical data were also collected from areas exposed to automobile exhaust and these indicated that elevated levels of hydrocarbons, metals, and NO2 were associated with the elevated levels of damaged cells observed in the wild rodent C. minutus. Our results agree with previous data on engine and fuel components, where weak increases in damage for native rodents exposed to emissions have been observed. Other larger, controlled studies are needed to better understand how the metabolism of C. minutus affects its response to emission exposure. Environ. Mol. Mutagen. 40:227–235, 2002. © 2002 Wiley‐Liss, Inc.
Cytoarchitecture, neuronal composition, and entorhinal afferents of the flying fox hippocampus

In a comparative approach, the anatomical organization of the hippocampus was investigated in two species of megachiropteran bats, the grey‐headed flying fox, Pteropus poliocephalus, and the little red flying fox,Pteropus scapulatus. In general, the cytoarchitectonic appearance of the flying fox hippocampus corresponded well with that of other mammals, revealing all major subdivisions. While the dentate fascia was trilaminated with a molecular layer, a granule cell layer, and a distinct polymorphic layer, the ammonic subfields were subdivided into stratum lacunosum moleculare, stratum radiatum, stratum lucidum or mossy fiber layer (restricted to the CA3 region), pyramidal cell layer, and stratum oriens. In Ammon's horn, only subfields CA1, CA3, and CA3c were clearly discernible, whereas the CA2 region remained indistinct. In some cytoarchitectonic features, such as the dispersion of the pyramidal layer in CA1, the megachiropteran hippocampus resembled the corresponding region in primates.
Deciphering the alternatively activated (M2) phenotype of macrophages in scleroderma

Section of Anatomy and Histology, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy Correspondence: Mirko Manetti, PhD, Section of Anatomy and Histology, Department of Experimental and Clinical Medicine, University of Florence, Largo Brambilla 3, I-50134 Florence, Italy, Tel. : +39-055-2758077, Fax: +39-055-4379500, e-mails: mirkomanetti@yahoo.it or mirko. manetti@unifi.it
Screening for suspected chronic obstructive pulmonary disease with an eleven-item pre-interview questionnaire (11-Q).

OBJECTIVE Early diagnosis is central to the management of chronic obstructive pulmonary disease (COPD). In time-constrained clinical situations, a pre-interview questionnaire can be a useful method for alerting both clinicians and patients with COPD, particularly for elderly patients. To screen subjects who might have COPD, we have developed an efficient pre-interview questionnaire. METHODS In study I, we developed an 11-item questionnaire (11-Q) to alert primary care providers to the possibility of COPD, and the validity of this questionnaire was investigated. In study II, a randomized and prospective cross-sectional study was performed on a total of 245 subjects with or without respiratory symptoms. RESULTS Good test-retest reliability and validity were shown in study I; the internal consistency of 11-Q was highly preserved (Cronbach alpha value of 0.867), with a high reproducibility of responses by inter- and intra examinees. Study II showed that the 11-Q in COPD patients with more than moderate severity was significantly higher than that in bronchial asthma or non-cardiopulmonary subjects (both, p<0.0001). Among the COPD patients, the total score significantly distinguished the severity of COPD as mild or more than moderate. CONCLUSION The pre-interview questionnaire, 11-Q, was found to be a useful tool to alert primary care providers to subjects with COPD and could also be used to distinguish COPD with a more than moderate severity from bronchial asthma. The 11-Q can be used as a simple and inexpensive method of predicting COPD, thus being a useful tool to alert primary care providers to patients with suspected COPD, particularly among the elderly.
Randomized phase II trial of the clinical and biological effects of two dose levels of gefitinib in patients with recurrent colorectal adenocarcinoma.

PURPOSE The clinical objective of this trial was to evaluate gefitinib in patients with metastatic colorectal cancer that had progressed despite prior treatment. Serial tumor biopsies were performed when possible and analyzed for activation of the epidermal growth factor receptor (EGFR) signaling pathway. Serial serum samples were measured for amphiregulin and transforming growth factor-alpha (TGFalpha). PATIENTS AND METHODS One hundred fifteen patients were randomly assigned to receive gefitinib 250 or 500 mg orally once a day. One hundred ten patients were assessable for clinical efficacy. Biologic evaluation was performed on paired tumor samples from 28 patients and correlated with clinical outcome. RESULTS Median progression-free survival was 1.9 months (95% CI, 1.8 to 2.1 months) and 4-month progression-free survival rate was 13% +/- 5%. One patient achieved a radiographic partial response (RR = 1%; 95% CI, 0.01% to 5%). Median survival was 6.3 months (95% CI, 5.1 to 8.2 months). The most common adverse events were skin rash, diarrhea, and fatigue. In the biopsy cohort, expression of total or activated EGFR, activated Akt, activated MAP-kinase, or Ki67 did not decrease following 1 week of gefitinib. However, a trend toward decreased post-treatment levels of activated Akt and Ki67 was observed in patients with a PFS higher than the median, although these did not reach the . 05 level of significance. CONCLUSION Gefitinib is inactive as a single agent in patients with previously treated colorectal cancer. In tumor samples, gefitinib did not inhibit activation of its proximal target, EGFR. Trends were observed for inhibition of downstream regulators of cellular survival and proliferation in patients achieving longer progression-free survival.
Current Controversies Abdominal Migraine

We are grateful to you for re-opening a long-running controversy in paediatric circles between those who recognize abdominal migraine as a common problem in patients attending their clinics and wards, and those who deny its very existence. It is no coincidence that, of the two protagonists you have chosen to lead this debate, one is a general paediatrician (1) who might be expected as part of his routine clinical work to see large numbers of children with non-specific symptoms such as abdominal pain and headache, and to realize that within both these groups were children with symptom constellations which warranted the diagnosis of migraine, while the other is a neurologist (2) whose clinic would not immediately spring to mind as the obvious place to which to refer a child with recurrent abdominal pain and who is unlikely therefore to have been exposed to the "little belly-achers" who frequent general paediatric clinics, and the even larger numbers of children with recurrent abdominal pain who are dealt with in the surgeries of general practitioners.
Neurotransmitter alterations in a model of perinatal hypoxic‐ischemic brain injury

Vulnerability of neurotransmitter‐specific neurons to hypoxia‐ischemia was examined in the immature rat corpus striatum. Carotid artery ligation plus 2 hours of 8% oxygen atmosphere at 1 week of age produced ipsilateral striatal injury and reduced hemisphere mass 2 and 6 weeks later. Striatal injury was always more severe than damage to overlying cortex. Over half the animals had status marmoratus, a neuropathological change seen in the basal ganglia and thalamus after hypoxic‐ischemic injury in full‐term human infants. Two weeks after the insult, markers for choinergic, dopaminergic, and γ‐aminobutyric acid–containing neurons were all reduced, but the reduction in cholinergic markers was greater than that for the other two transmitters. Muscarinic cholinergic receptors were relatively preserved, but their distribution was disrupted. In adult animals specific activity of cholinergic neuronal markers was normal, suggesting that the balance of neurotransmitters was restored after the early insult.
Prevalence of overweight, obesity, physical activity and tobacco use in Argentine youth: Global School-Based Student Health Survey and Global Youth Tobacco Survey, 2007-2012.

INTRODUCTION In 2007 and 2012, the Global School-Based Student Health Survey (GSHS) and the Global Youth Tobacco Survey (GYTS) were implemented to estimate the prevalence of risk behaviors and protection factors among 13 to 15 year-old adolescents. OBJECTIVE To assess changes in dietary, body weight, tobacco and physical activity indicators in the past five years. POPULATION AND METHODS Cross-sectional study. A randomized, two-stage sampling with 600 schools selected at a national level was used. Students from randomly selected courses were invited to answer a self-administered questionnaire (either the GSHS or the GYTS). RESULTS In 2012, the GSHS was completed by 20 697 students from 544 schools, while the GYTS was completed by 2062 students from 73 schools. Between 2007 and 2012, overweight and obesity prevalence significantly increased (overweight: 24.5% in 2007, 28.6% in 2012; obesity 4.4% in 2007, 5.9% in 2012), while the consumption of sugar-sweetened beverages and fast food remained high. A slight improvement was observed in the level of physical activity (12.7% in 2007, 16.7% in 2012), although it remains below what is recommended. The prevalence of tobacco use was reduced (24.5% in 2007, 19.6% in 2012), but access to tobacco products and exposure to secondhand smoke remains high in public places, including schools. CONCLUSIONS The spread of the overweight and obesity epidemic calls for a need to consolidate actions tending towards a healthy diet and physical activity. Despite a decrease in the prevalence of tobacco use, it is necessary to continue strengthening tobacco control actions.
The anxiety severity interview for children and adolescents: an individualized repeated measure of anxiety severity.

The Anxiety Severity Interview for Children and Adolescents (ASICA) was developed for the repeated assessment of the impact of anxiety and control over anxiety symptoms. The ASICA incorporates three main components of anxiety: physical response, avoidant behaviour and anxious thoughts. The objective of this study was to evaluate the psychometric properties of the ASICA in children with anxiety disorder (n = 139, age 8-18 years) and a non-anxious control group (n = 40, age 8-18 years). A confirmatory factor analysis confirmed the intended factor structure. Internal reliability was moderate to good; inter-rater reliability was excellent. Four-week test-retest reliability was good. The ASICA discriminated between anxious and non-anxious children and appeared sensitive to treatment change. A cut-off score of 13 was determined. Convergent validity with anxiety symptoms was moderate; discriminant validity with depressive symptoms was less strong. The results suggest that the ASICA is a reliable instrument that could be used in clinical practice to repeatedly monitor anxiety severity.
Effects of mitochondrial uncouplers on intracellular calcium, pH and membrane potential in rat carotid body type I cells

1 Mitochondrial uncouplers are potent stimulants of the carotid body. We have therefore investigated their effects upon isolated type I cells. Both 2,4‐dinitrophenol (DNP) and carbonyl cyanide p‐trifluoromethoxyphenyl hydrazone (FCCP) caused an increase in [Ca2+]i which was largely inhibited by removal of extracellular Ca2+ or Na+, or by the addition of 2 mm Ni2+. Methoxyverapamil (D600) also partially inhibited the [Ca2+]i response. 2 In perforated‐patch recordings, the rise in [Ca2+]i coincided with membrane depolarization and was greatly reduced by voltage clamping the cell to −70 mV. Uncouplers also inhibited a background K+ current and induced a small inward current. 3 Uncouplers reduced pHi by 0.1 unit. Alkaline media diminished this acidification but had no effect on the [Ca2+]i response. 4 FCCP and DNP also depolarized type I cell mitochondria. The onset of mitochondrial depolarization preceded changes in cell membrane conductance by 3–4 s. 5 We conclude that uncouplers excite the carotid body by inhibiting a background K+ conductance and inducing a small inward current, both of which lead to membrane depolarization and voltage‐gated Ca2+ entry. These effects are unlikely to be caused by cell acidification. The inhibition of background K+ current may be related to the uncoupling of oxidative phosphorylation.
Primary Health Care Follow-Up Visits: Investigation Of Care Continuity Of Preterm Newborns From A Kangaroo-Mother Care Unit

INTRODUCTION: The kangaroo-mother care method is an approach adopted in Brazil as a public police, which has helped in the reduction of neonatal mortality rate. Premature birth and its vulnerabilities can trigger, especially in mothers, feelings of fear and insecurity related to taking care of newborns. OBJECTIVE: Investigate care continuity of preterm newborns from a kangaroo-mother care method unit in primary health care facilities. METHODS: It was a transversal study performed with 43 mothers of preterm newborns who were hospitalized in the rooming-in care unit of a kangaroo-mother care method unit of a Brazilian public maternity school. Data collection was carried out through a questionnaire, which was used to interview mothers between September 2015 and February 2016. RESULTS: It was found a relationship between sociodemographic status and risk of premature birth, and the following variables: age, education, marital status, and family income. Regarding findings from the follow-up home visits in primary health care, most of the participants were still breastfeeding and using the kangaroo position. However, 60.5% of the interviewed mothers reported not receiving home visits from health professionals of primary health care facilities. CONCLUSION: It is essential the support of health professionals and the participation of mothers and families to improve, through health education, quality of life promotion for newborns from kangaroo care approach.
Exacerbation of chronic urticaria in the course of house dust mite immunotherapy

It has been hypothesized that the house dust mite (HDM) is an etiopathogenic factor in some cases of chronic urticaria. In addition, it seems that some patients suffering from HDM-induced respiratory allergy and concomitant chronic urticaria may additionally benefit from allergen immunotherapy, manifesting as remission or alleviation of the symptoms. In this report we describe a patient with a history of respiratory HDM allergy and chronic urticaria who manifested exacerbation of urticarial symptoms in the course of HDM immunotherapy. This observation may confirm previous studies, suggesting that in some cases of chronic urticaria house dust mite allergens are causative or deteriorating factors contributing to development of this disorder.
The provision of 'same-day' care in general practice: an observational study.

BACKGROUND Surveys suggest that general practice is perceived to be inaccessible, with long delays before it is possible to be seen by a doctor. Although there is demand for rapid access to care, this has the potential to decrease continuity of care, which research consistently shows to be valued by patients but stressful for doctors. OBJECTIVE Our aim was to investigate the provision of 'same-day' care and the characteristics, treatment expectations and priorities of patients attending for 'routine' and 'same-day' appointments. METHODS The uptake of same-day and routine appointments was determined from appointment system records. A self-completed questionnaire survey of people attending 362 same-day and 362 routine appointments at 15 general practices in Avon and Gloucestershire enabled comparisons with respect of patient characteristics and consultation experiences, patients' preferences for rapid access, seeing a known practitioner or seeing a doctor rather than a nurse. RESULTS The uptake per 1000 practice population per day was 7.6 [95% confidence interval (CI) 7.1-8.1] for routine appointments and 3.8 (95% CI 3.5-4.2) for same-day appointments. In univariable analyses, use of same-day care was greater by people who were younger, non-white, in work and with educational qualifications. They had attended the practice less often, waited less time to see a doctor previously, had their current problem for a shorter time and were more likely to expect a prescription. From multivariable analyses, only age, speed of previously obtaining appointments, expecting a prescription and having the problem for a short time were independently associated with receiving same-day care. Rapid access to care was rated as more important than seeing a known doctor for two clinical scenarios. CONCLUSIONS Much care is provided currently on the day it is requested in general practice. The use of same-day care was related to acute illness and expectations but was not associated with deprivation or patient characteristics apart from age.
Chronic Peritoneal Dialysis in the Elderly

Available data indicate that peritoneal dialysis (PD) offers some advantages for the increasing number of elderly patients with ESRD, such as hemodynamic stability, steady‐state metabolic control, good control of hypertension, independence from hospital visits, and avoidance of repeated vascular access. Early referral promotes the establishment of peritoneal access and minimizes the consequences of uremia and subsequent morbidity and frequent hospitalization. Elderly patients have similar modality‐related complications such as peritonitis, catheter‐related complications, exit‐site and tunnel infection, and hernias as younger patients. Comorbid conditions, malnutrition, and psychosocial status influence the survival of elderly patients on PD. Elderly patients are compliant and highly motivated to cooperate in treatment. They are more tolerant of changes and losses and have a greater sense of well‐being, less illness and modality‐related stress, and fewer mood disturbances. Despite comorbid conditions, that significantly impair self‐performance of dialysis, PD can be performed successfully if they have family support or access to a network of medical and social support, that is, home nurses, rehabilitation services, and chronic care dialysis units, or nursing homes.
Mesenchymal stem cells protect against neonatal rat hyperoxic lung injury

Objectives: Bronchopulmonary dysplasia (BPD) is a significant global health problem and currently lacks effective therapy. We established a neonatal rat model of BPD to investigate therapeutic potential of bone marrow-derived mesenchymal stem cells (BMSCs) in neonatal hyperoxic lung injury. Methods: BMSCs were isolated, identified, and transfected by lentiviral vector carrying green fluorescent protein gene in vitro. Neonatal Sprague-Dawley rats were injected intravenously with either BMSCs or phosphate-buffered saline following 95% oxygen exposure, and assessed for the survival rate and alveolar injury during recovery. Results: Treatment with BMSCs after oxygen exposure for 7 days improved survival of neonatal rat during recovery. BMSCs protected against neonatal rat hyperoxic lung injury during recovery as demonstrated by enhanced expression of AQP5 and SP-C, likely due to the suppression of alveolar cell apoptosis and lung inflammation responses to oxygen with up-regulation of the expression of BCL-2 gene and down-regulation of the expression of BAX gene and stimulation of vascular endothelial growth factor and so on. Conclusions: BMSCs protect against O2-mediated injury partially through stimulation of potent mediators that participate in tissue repair.