Miracle-dz/UniFAR-FTUs huggingface dataset:
Surgical Rehabilitation of Paralytic Lagophthalmus by Platinum Chain Lid Loading: Focusing on Patient Benefit and Health-Related Quality of Life

Objective To evaluate patient benefit and health-related quality of life after lid loading with platinum chains in adult patients with facial palsy. Study Design Retrospective data collection. Setting Germany’s largest university clinic for otorhinolaryngology, head and neck surgery. Subjects and Methods Thirty-five patients received validated questionnaires determining the effects of the operation on the patients’ health-related quality of life (Glasgow Benefit Inventory). Scores can range from −100 (maximal adverse effect), through 0 (no effect), to 100 (maximal positive effect). Furthermore, satisfaction, complaints, and complications regarding the platinum chain implant were inquired. Results Twenty-two patients (63 %) returned a valid questionnaire. The mean follow-up time was 31.5 months. A complete coverage of the cornea was achieved in 95% of the patients after the first operation and in the remaining patients after a revision with implantation of a heavier weight. Complete symmetry to the nonaffected eye was perceived by 64%. Recurrent conjunctivitis was complained preoperatively by 18% and postoperatively only by a single patient. In 2 patients, a mild pseudoptosis was found postoperatively, and a single patient complained about blurred vision. The median total Glasgow Benefit Inventory score was 27.8 (p < 0.001). The health-related quality of life was raised in 91% of the patients; 87% were fully satisfied with the functional result, and 91% with the aesthetical result. 100% would again decide in favor of platinum chain lid loading. Conclusion Platinum chain lid loading in facial palsy patients can significantly increase patients’ health-related quality of life and leads to a high rate of patient satisfaction.
Pigmented Hypertrichotic Dermatosis and Insulin Dependent Diabetes: Manifestations of a Unique Genetic Disorder?

Abstract: A novel pigmented dermatosis was observed in four unrelated boys, three of whom had insulin‐dependent diabetes. Three patients were the offspring of consanguineous parents. All four boys had pigmented hypertrichotic patches or induration on the upper inner thighs, with variable involvement of the genitalia, trunk, and limbs. Two boys had episcleritis and orbital proptosis with similar facies and musculoskeletal abnormalities including clinodactyly, flat feet, and short stature. One child had paraaortic and inguinal lymphadenopathy and three patients had an enlarged liver and spleen. A large, swollen pancreas was observed on ultrasound imaging in one patient with insulin dependent diabetes who also had echocardiographic evidence of pericardial inflammation. Three boys had elevated laboratory markers of inflammation. Biopsy specimens from the skin and orbit showed a chronic inflammatory cell infiltrate composed of polyclonal lymphocytes, histiocytes, and plasma cells; fibrosis was observed in two patients, one of whom had previously received radiation therapy to the orbit. Two boys responded to treatment with subcutaneous interferon‐α, combined with a short course of oral prednisone in the child without diabetes. We believe these inflammatory pigmented skin lesions represent a unique dermatosis associated with diabetes mellitus and systemic disease. The pathogenesis is unknown. The presence of consanguinity in three of four families, and similar dysmorphic features in two boys, suggest a genetic disorder, possibly with autosomal recessive inheritance.
[Sequential microbiological monitoring of tracheal aspirates in intubated patients admitted to a pediatric intensive care unit].

OBJECTIVE To evaluate, sequentially, tracheal aspirates from patients admitted to a pediatric intensive care unit and to associate these pathogens with length of hospital stay, previous use of antimicrobial therapy and diagnoses of ventilator-associated pneumonia. METHODS The study population consisted of patients admitted to a pediatric intensive care unit, between November 2002 and December 2003, on ventilator support. Three tracheal aspirates were collected serially from each patient. The first tracheal aspirate sample was obtained 6 hours after admission to the intensive care unit and the remaining samples were collected after 48 and 96 hours. RESULTS One hundred patients aged from one day to 14 years were assessed. Positive tracheal cultures were observed to have increased in the three tracheal aspirate samples collected from each patient for Pseudomonas aeruginosa, from 6 to 22% (p = 0.002), and to have decreased for Staphylococcus aureus, from 23 to 8% (p = 0.009). Isolation of Candida spp increased for the subset that had received previous antimicrobial therapy (p < 0.05). Sixteen (23.5%) out of 68 patients admitted without pneumonia developed ventilator-associated pneumonia. Positive tracheal aspirate cultures were obtained in 10 out of 16 of these patients: six were positive for Staphylococcus aureus (three associated with Acinetobacter baumanii), two for Klebsiella spp (one associated with Enterobacter spp), one for Pseudomonas aeruginosa and one for Candida spp. CONCLUSION Sequential evaluation of tracheal aspirates may be useful to track changes in bacterial flora at pediatric intensive care units.
Treatment of chronic respiratory failure: lung volume reduction surgery versus rehabilitation

Several treatment options are available for end-stage chronic obstructive pulmonary disease (COPD). Respiratory rehabilitation and lung volume reduction surgery are reviewed here. Respiratory rehabilitation can now be considered a prime treatment for COPD. Indeed, it has been clearly shown to improve exercise capacity and health status in these patients. Improvements in the former fell just below the minimal clinically important difference, whereas those in the latter exceeded it. In addition, after a respiratory rehabilitation programme, a reduction in the number of hospital admissions and duration of each admission was demonstrated. It remains, however, difficult to predict accurately which patients will improve after rehabilitation and which will not. Factors that may contribute to this prediction are: baseline peak exercise ventilation/maximal voluntary ventilation, maximal inspiratory pressure, peripheral muscle force, and 6‐min walking distance. Several studies have clearly shown that training effects are as pronounced in patients with severe as in those with moderate airflow obstruction. This is the most significant insight in this area of the 1990s. Lung volume reduction surgery may also be of benefit in patients with end-stage COPD. It is clear that lung function, exercise capacity and health status improve after this procedure, although the results of only six randomised studies are currently available. It remains difficult to accurately predict which patients will benefit from the procedure. From a model analysis, the most important action mechanism appears to be resizing of the lungs. Only in patients with an increased residual volume/total lung capacity ratio are beneficial effects expected. The model analysis, however, did not fit the experimental data very well in a recent publication. Emphysema heterogeneity is also likely to be related to the response. The question remains as to whether or not lung volume reduction surgery accelerates the decline in forced expiratory volume in one second in the long run. The technique is undergoing considerable progress as numerous new surgical and endoscopic procedures are currently being developed. The results of these procedures have not yet been systematically evaluated.
Operative Versus Nonoperative Treatment of Displaced Intra-Articular Calcaneal Fractures: A Meta-Analysis of Randomized Controlled Trials

Objectives: To compare the clinical outcomes of operative and nonoperative treatment for displaced intra-articular calcaneal fractures (DIACFs). Data Sources: PubMed, Embase, Cochrane library, and ClinicalTrial.gov. Study Selection: Randomized controlled trials comparing operative and nonoperative treatment for DIACFs. Data Extraction: Information on study methods and clinical outcomes. Data Synthesis: We performed data synthesis on relevant clinical outcomes. Weighted mean differences with 95% confidence intervals were calculated for continuous data and relative risks with 95% confidence intervals were calculated for dichotomous data. A fixed-effect model or a random-effect model was used. Results: Seven randomized controlled trials involving 908 patients were included. Operative treatment for DIACFs reduced problems associated with shoe wear and increased walking ability but increased the risks of overall complications and infection. There were no significant differences between the groups in American Orthopaedic Foot and Ankle Society scores, The Short Form (36) Health Survey, return to work, rate of subsequent subtalar fusion, or the rate of reflex sympathetic dystrophy. Conclusions: This meta-analysis documented that when surgery was performed correctly, better shoe wear and improved walking ability could be expected. These outcomes seemed to be based on the surgeon's ability to obtain an acceptable reduction. Benefits were tempered by the increase in wound complications associated with this intervention. Level of Evidence: Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.
How patients adapt diabetes self-care recommendations in everyday life.

BACKGROUND Our study explored behavioral factors affecting what patients with type 2 diabetes do for self-care and why they do it. The findings were used to develop clinical recommendations to improve intervention strategies. METHODS Interviewers, using open-ended questions, explored patients' own perceptions and assessments of self-care behaviors. The fifty-one subjects were self-identified Mexican Americans who had type 2 diabetes for at least 6 months, and had no major impairment as a result of this diabetes. Texts of patient interviews were analyzed by building and refining matrixes to display and compare central themes regarding treatment strategies and their contexts. RESULTS All patients were trying to control their diabetes, but none of them followed recommendations completely. Instead, they adapted self-care behaviors to the exigencies of everyday life. Key factors influencing patients' treatment choices were: (1) the belief in the power of modern medicine; (2) the desire to act and feel "normal"; (3) the desire to avoid physical symptoms; and (4) limited economic resources. CONCLUSIONS As patients apply treatment recommendations in the context of their everyday lives, they continually must make many small decisions affecting self-care behavior. The specific contexts of patients' lives, including their economic, educational, and cultural circumstances, determine how the generalized principles of type 2 diabetes management are implemented. Clinical strategies must be responsive to these circumstances in order to enable patients to make appropriate decisions when adapting their self-care behaviors to their own situations.
Demethoxy-Q, An Intermediate of Coenzyme Q Biosynthesis, Fails to Support Respiration in Saccharomyces cerevisiae and Lacks Antioxidant Activity*

Caenorhabditis elegans clk-1 mutants cannot produce coenzyme Q9 and instead accumulate demethoxy-Q9 (DMQ9). DMQ9 has been proposed to be responsible for the extended lifespan of clk-1 mutants, theoretically through its enhanced antioxidant properties and its decreased function in respiratory chain electron transport. In the present study, we assess the functional roles of DMQ6 in the yeast Saccharomyces cerevisiae. Three mutations designed to mirror the clk-1 mutations of C. elegans were introduced into COQ7, the yeast homologue of clk-1: E233K, predicted to disrupt the di-iron carboxylate site considered essential for hydroxylase activity; L237Stop, a deletion of 36 amino acid residues from the carboxyl terminus; and P175Stop, a deletion of the carboxyl-terminal half of Coq7p. Growth on glycerol, quinone content, respiratory function, and response to oxidative stress were analyzed in each of the coq7 mutant strains. Yeast strains lacking Q6 and producing solely DMQ were respiratory deficient and unable to support 6either NADH-cytochrome c reductase or succinate-cytochrome c reductase activities. DMQ6 failed to protect cells against oxidative stress generated by H2O2 or linolenic acid. Thus, in the yeast model system, DMQ does not support respiratory activity and fails to act as an effective antioxidant. These results suggest that the life span extension observed in the C. elegans clk-1 mutants cannot be attributed to the presence of DMQ per se.
Protection of mice against Trypanosoma cruzi by immunization with paraflagellar rod proteins requires T cell, but not B cell, function.

Previous studies have shown that immunization of mice with the paraflagellar rod proteins (PAR) of Trypanosoma cruzi induces an immune response capable of protecting mice against an otherwise lethal challenge with this parasite. Herein, we define immunologic responses that do or do not play a critical role in PAR-mediated protection. Firstly, PAR-immunized Ab-deficient (muMT) strain mice survived an otherwise lethal T. cruzi challenge, indicating that a B cell response is not required for PAR-induced immunity. However, beta2m -/- mice, which are severely deficient in MHC class I and TCR alphabeta+ CD8+ CD4- T cells, did not survive challenge infection following PAR immunization, indicating that MHC class I/CD8+ T cell function is necessary for protection induced by PAR immunization. Surprisingly, PAR-immunized mice depleted of CD4+ T cells survived a T. cruzi challenge for >84 days postinfection while maintaining a parasitemia that is generally thought to be lethal (i.e., >10(6) trypomastigotes/ml), thus associating CD4+ T cell function with the process of parasite clearance. Consistent with this association, CD4+ T cells from PAR-immunized mice released INF-gamma and stimulated T. cruzi-infected macrophages to release nitric oxide. The importance of IFN-gamma in PAR-induced protective immunity is further indicated by the observation that PAR-immunized INF-gamma knockout mice developed an extremely high parasitemia and did not survive a challenge infection. Thus, while Ab-mediated immune mechanisms are not required for protection induced by PAR immunization, T cell responses are necessary for both elimination of bloodstream parasites and survival.
Phene Plate (PhP) biochemical fingerprinting

Pulsed‐field gel electrophoresis (PFGE) is currently considered the gold standard for genotyping of enterococci. However, PFGE is both expensive and time‐consuming. The purpose of this study was to investigate whether the PhP system can be used as a reliable clinical screening method for detection of genetically related isolates of enterococci. If so, it should be possible to minimize the number of isolates subjected to PFGE typing, which would save time and money. Ninety‐nine clinical enterococcal isolates were analysed by PhP (similarity levels 0.90–0.975) and PFGE (similarity levels ≤3 and ≤6 bands) and all possible pairs of isolates were cross‐classified as matched or mismatched. We found that the probability that a pair of isolates (A and B) belonging to the same type according to PhP also belong to the same cluster according to PFGE, i.e. p(APFGE=BPFGE • APhP=BPhP), and the probability that a pair of isolates of different types according to PhP also belong to different clusters according to PFGE, i.e. p(APFGE≠BPFGE • APhP≠BPhP), was relatively high for E. faecalis (0.86 and 0.96, respectively), but was lower for E. faecium (0.51 and 0.77, respectively). The concordance which shows the probability that PhP and PFGE agree on match or mismatch was 86%–93% for E. faecalis and 54%–66% for E. faecium, which indicates that the PhP method may be useful for epidemiological typing of E. faecalis in the current settings but not for E. faecium.
Representation-based classification for hyperspectral imagery: An elastic net regularization approach

In hyerspectral image analysis, representation-based classification is a novel concept — a testing pixel is linearly represented by using the labeled samples. The weight coefficients can be solved by an ℓ1-norm penalty for sparse representation, or solved by an ℓ2-norm penalty for collaborative representation. In this work, a convex combination of these two representations using the elastic net model is proposed. The objective is to produce more robust weight coefficients for better classification performance. Experimental results on two hyperspectral data prove that our proposed method outperforms the traditional sparse representation-based classifier and collaborative representation-based classifier.
Clinical spectrum of reversible posterior leukoencephalopathy syndrome.

BACKGROUND Reversible posterior leukoencephalopathy syndrome (RPLS) is characterized by neuroimaging findings of reversible vasogenic subcortical edema without infarction. The clinical syndrome of RPLS typically involves headache, encephalopathy, visual symptoms, and seizures. OBJECTIVE To retrospectively identify patients with RPLS with a characteristic clinical presentation and neuroimaging abnormalities and documented improvement on repeated neuroimaging. DESIGN Retrospective. SETTING Mayo Clinic. PATIENTS Thirty-six patients with RPLS. MAIN OUTCOME MEASURES Associated comorbid medical conditions, presenting clinical symptoms, duration of clinical symptoms, diagnostic test results (magnetic resonance imaging, electroencephalography, and lumbar puncture), and time to clinical and neuroimaging recovery. RESULTS We identified 38 episodes of RPLS in 36 patients (20 females and 16 males) with a mean age of 44.7 years. Comorbid conditions included hypertension (53%), renal disease (45%), dialysis dependency (21%), malignancy (32%), and transplantation (24%). Presenting symptoms included clinical seizures (87%), encephalopathy (92%), visual symptoms (39%), and headache (53%). Mean peak systolic blood pressure at presentation was 187 mm Hg. Clinical symptoms resolved after a mean of 5.3 days. Atypical neuroimaging features included significant frontal involvement in 22 episodes (58%), gray matter lesions in 16 (42%), unilateral lesions in 2 (5%), hemorrhage in 2 (5%), recurrent RPLS in 2 (5%), confluent lesions in 2 (5%), and foci of permanent injury in 10 (26%). Twenty-two episodes (58%) had brainstem/cerebellar involvement on neuroimaging. CONCLUSIONS This is the largest clinical series to date of RPLS with confirmed neuroimaging improvement. Clinical recovery occurred in most patients within days. The condition was rarely isolated to the parieto-occipital white matter, and atypical neuroimaging features were frequent.
Children's Exposure to Environmental Tobacco Smoke in the Home: Comparison of Urine Cotinine and Parental Reports

Abstract The authors examined the relationship between parent-reported estimates of children's exposure to environmental tobacco smoke (ETS) in the home and children's urinary cotinine levels. Data were collected from a largely ethnic minority, low-income, urban sample of households in which a child had asthma and at least 1 household member smoked. Information about level of household smoking restriction, parental smoking status, and number of cigarettes smoked per day accounted for approximately 45% of the variance in cotinine concentration. Detailed information about the duration of household smoking or children's ETS exposure added no additional significant information. Questionnaires eliciting detailed information about smoking habits and children's ETS exposure may be no better at predicting children's urinary cotinine levels than simpler surveys that inquire about smoking restrictions in the home, parental smoking status, and number of cigarettes smoked at home per day.
Functional Recovery Measures for Spinal Cord Injury: An Evidence-Based Review for Clinical Practice and Research

Abstract Background/Objective: The end goal of clinical care and clinical research involving spinal cord injury (SCI) is to improve the overall ability of persons living with SCI to function on a daily basis. Neurologic recovery does not always translate into functional recovery. Thus, sensitive outcome measures designed to assess functional status relevant to SCI are important to develop. Method: Evaluation of currently available SCI functional outcome measures by a multinational work group. Results: The 4 measures that fit the prespecified inclusion criteria were the Modified Barthel Index (MBI), the Functional Independence Measure (FIM), the Quadriplegia Index of Function (QIF), and the Spinal Cord Independence Measure (SCIM). The MBI and the QIF were found to have minimal evidence for validity, whereas the FIM and the SCIM were found to be reliable and valid. The MBI has little clinical utility for use in the SCI population. Likewise, the FIM applies mainly when measuring burden of care, which is not necessarily a reflection of functional recovery. The QIF is useful for measuring functional recovery but only in a subpopulation of people with SCI, and substantial validity data are still required. The SCIM is the only functional recovery outcome measure designed specifically for SCI. Conclusions: The multinational work group recommends that the latest version of the SCIM (SCIM III) continue to be refined and validated and subsequently implemented worldwide as the primary functional recovery outcome measure for SCI. The QIF may continue to be developed and validated for use as a supplemental tool for the nonambulatory tetraplegic population.
Effect of oral creatine supplementation on urinary methylamine, formaldehyde, and formate.

PURPOSE It has been claimed that oral creatine supplementation might have potential cytotoxic effects on healthy consumers by increasing the production of methylamine and formaldehyde. Despite this allegation, there has been no scientific evidence obtained in humans to sustain or disprove such a detrimental effect of this widely used ergogenic substance. METHODS Twenty young healthy men ingested 21 g of creatine monohydrate daily for 14 consecutive days. Venous blood samples and 24-h urine were collected before and after the 14th day of supplementation. Creatine and creatinine were analyzed in plasma and urine, and methylamine, formaldehyde, and formate were determined in 24-h urine samples. RESULTS Oral creatine supplementation increased plasma creatine content 7.2-fold (P < 0.001) and urine output 141-fold (P < 0.001) with no effect on creatinine levels. Twenty-four-hour urine excretion of methylamine and formaldehyde increased, respectively, 9.2-fold (P = 0.001) and 4.5-fold (P = 0.002) after creatine feeding, with no increase in urinary albumin output (9.78 +/- 1.93 mg x 24 h(-1) before, 6.97 +/- 1.15 mg x 24 h(-1) creatine feeding). CONCLUSION This investigation shows that short-term, high-dose oral creatine supplementation enhances the excretion of potential cytotoxic compounds, but does not have any detrimental effects on kidney permeability. This provides indirect evidence of the absence of microangiopathy in renal glomeruli.