Miracle-dz/UniFAR-FTUs huggingface dataset:
Association of Hypoglycemia With Mortality for Subjects Hospitalized With Pneumonia

Background:Previous research has shown that hypoglycemia is associated with worse outcomes for the elderly, in sepsis, and in children with pneumonia. The purpose of this study was to examine whether hypoglycemia (<70 mg/dL) is associated with increased 30-day mortality, after adjusting for potential confounders, for adults hospitalized with pneumonia. Methods:A retrospective cohort study conducted at 2 tertiary teaching hospitals. Eligible subjects were admitted with a diagnosis of, and had a chest x-ray consistent with, community-acquired pneumonia. Our primary analysis was a multivariable logistic regression with the dependent variable of 30-day mortality and with independent variable of hypoglycemia, diabetes, severity of illness determined using the pneumonia severity index, and pneumonia-related processes of care. Results:Data were abstracted on 787 subjects at the 2 hospitals. Mortality was 8.1% at 30 days. At presentation, 55% of subjects were at low risk, 33% were at moderate risk, and 12% were at high risk. In our cohort, 2.8% (n = 22) had hypoglycemia at presentation. Unadjusted mortality for those who were hypoglycemic was 27.3% versus 8.6% for those who were not (P = 0.0003). In the multivariable analysis, hypoglycemia (odds ratio: 4.1, 95% confidence interval: 1.4–11.7) was significantly associated with 30-day mortality. Conclusions:After adjusting for severity of illness and other potential confounders, hypoglycemia is significantly associated with 30-day mortality for patients hospitalized with pneumonia. Patients with hypoglycemia should be placed in closely monitored settings even when by pneumonia specific risk systems they would normally be discharged.
Diagnostic accuracy and clinical utility of biopsy in musculoskeletal lesions: A comparison of fine‐needle aspiration, core, and open biopsy techniques

Selection of biopsy technique for musculoskeletal lesions is complex. Fine‐needle aspiration (FNA) is uncommonly used due to concerns regarding accuracy. We compared diagnostic accuracy of FNA, core, and open biopsy in a series of musculoskeletal lesions. Records of the University of Utah were searched for biopsy and resection specimens of musculoskeletal lesions. Results of corresponding imaging studies were obtained. Biopsy and FNA diagnoses were correlated with resection diagnoses. For each technique, diagnostic accuracy, utility, and frequency of subsequent biopsy were calculated. Open biopsy had the highest diagnostic accuracy (89%) followed by FNA (82%) and core biopsy (78%). Clinically significant errors occurred with all methods. The likelihood of an open biopsy being performed was affected by prior performance of an FNA or core biopsy and by diagnostic imaging and FNA results. Diagn. Cytopathol. 2014;42:476–486. © 2014 Wiley Periodicals, Inc.
Comparison of histological features of vulvar lichen sclerosis with and withoutadjacent squamous cell carcinoma

Scurry J, Vanin K, Ostor A. Comparison of histologicalfeatures of vulvar lichen sclerosis with and without adjacent squamous cellcarcinoma. Int J Gynecol Cancer 1997; 7: 392–399. To compare the histological features of vulvar lichen sclerosis with andwithout adjacent squamous cell carcinoma, sections of 132 consecutive cases ofvulvar squamous cellcarcinoma were examined to determine the characteristics of the epidermisadjacent to the carcinoma. Where lichen sclerosis was observed, its featureswere compared to those ofvulvar lichen sclerosis from 86 women without associated carcinoma. Lichensclerosis was seen in adjacent skin of 63 of 132 (48%) women with vulvarsquamous cell carcinoma. In61 of these 63, the epidermis was also significantly thickened. The changescausing the thickened epidermis could not be distinguished from superimposedlichen simplex chronicus in21 women. In the other 40, the main, but not the only, distinguishing featurewas differentiated vulvar intraepithelial neoplasia (basal atypia), which wasseen in 33. Otherdifferences were alterations in the ratios of hyperkeratosis, granulosis,acanthosis, and irregular prolongation of rete ridges. In lichen sclerosiswithout cancer, 73 women hadassociated epidermal thickening and in 69 of these the changes could not bedistinguished from superimposed lichen simplex chronicus; the other 4 showeddifferentiated andundifferentiated vulvar intraepithelial neoplasia in two women each. Weconclude that epidermal thickening is common in vulvar lichen sclerosis,whether occurring alone or inassociation with squamous cell carcinoma. Superimposed lichen simplex chronicuscannot fully explain the histological features of the epidermal thickening inlichen sclerosis inthe majority of women with carcinoma, but can do so in the majority of womenwithout carcinoma. In individual cases, however, there are no definitehistological criteria to distinguish hyperplasia from superimposed lichensimplex chronicus.
The production and antiprotozoal activity of abietane diterpenes in Salvia austriaca hairy roots grown in shake flasks and bioreactor

ABSTRACT The biomass and concentration of bioactive quinone methide-type diterpenes in hairy roots of Salvia austriaca were determined and compared with levels of these metabolites in roots of field-grown plants. The cultures were maintained in shake flasks and a nutrient sprinkle bioreactor. Diterpene production was more efficient in the shake flask root culture than the bioreactor one. Biomass and diterpene production within the shake flask culture was evaluated using Schenk and Hildebrandt (SH), Gamborg (B5), and woody plant medium (WPM), with both full- and half-strength macro and micronutrient concentrations (1/2 SH, 1/2 B5, and 1/2 WPM). Among the tested media, SH medium proved to be most effective for biomass and diterpene production. In this medium, the transformed roots accumulated the levels of taxodone (3.89 mg g−1 DW; equivalent to 63.3 mg L−1), taxodione (1.15 mg g−1 DW; equivalent to 17.4 mg L−1), 15-deoxy-fuerstione (2.15 mg g−1 DW; equivalent to 32.5 mg L−1), and 7-(2′-oxohexyl)-taxodione (0.076 mg g−1 DW; equivalent to 1.1 mg L−1). Three diterpenes were also detected in the roots of S. austriaca intact plants, but their concentrations were lower than those in hairy root culture. No 7-(2′-oxohexyl)-taxodione was found in the roots of field-grown plants. The hairy roots were able to maintain high metabolite levels even for 6 years of cultivation. Taxodone, taxodione, 15-deoxy-fuerstione, and 7-(2′-oxohexyl)-taxodione were tested for in vitro activity against Trypanosoma brucei rhodesiense, T. cruzi, and Plasmodium falciparum and their cytotoxicity was determined using L6 cells. Among these compounds, taxodione was the most active against T. brucei rhodesiense [IC50 = 0.05 µM with high selectivity, selectivity index (SI) = 38]. Taxodione was found to inhibit the growth of P. falciparum and T. cruzi by 50% at respective concentrations of 1.9 and 7.1 µM (SI values of 1.0 and 0.27). Other diterpenoids demonstrated weaker activity against tested parasites (IC50 values ranging from 0.62 to 194.7 µM) and lower selectivity (SI value ranged from 0.4 to 5.0).
The impact of illness representations and disease activity on adjustment in women with rheumatoid arthritis: A longitudinal study

This longitudinal study examined the extent to which illness representations and disease indicators predict physical and psychological outcomes in patients with rheumatoid arthritis. Baseline data was collected on 75 women attending an out-patient clinic in the west of Ireland. Data was available for a final study sample of 52 at two-year follow-up. Disease status was assessed by physician ratings of joint involvement and laboratory indices of erythrocyte sedimentation rate and c-reactive protein. The Illness Perception Questionnaire and the Arthritis Impact Measurement Scale were administered during a semi-structured interview held at yearly intervals over a three-year period. In hierarchical regression analyses the illness representations accounted for 17–33% of the variance in measures of physical function, pain, depression and anxiety. All relationships were in the expected direction. Disease status explained 10–15% of the variance in illness related aspects of physical function and pain and predicted pain over time. Illness perceptions outweighed the impact of medical disease status on concurrent physical and psychological adjustment. Interventions based on understanding and modifying illness representations may prove useful in facilitating patient well-being.
Late paraphrenia — a follow‐up study

We report a 3.7 year follow‐up study carried out on 42 patients with an original diagnosis of late paraphrenia who had had a CT scan and simple tests of cognition in addition to an assessment by means of the Geriatric Mental State Schedule. Mortality was found to be no different than in a control group. Patients showed improvement in target symptoms but exhibited a good deal of residual morbidity, particularly of motor and cognitive function. Cognitive performance, which was previously mildly impaired, showed some futher deterioration, usually falling short of clear‐cut dementia. Ventricular size on the CT scan was not a predictor of outcome. The article highlights the organic substrate of late paraphrenia but suggests that the cerebral changes are relatively subtle and slowly progressive.
Trichomonas Vaginalis and Associated Microorganisms in Women with Vaginal Discharge in Kerkuk-Iraq

Ozet Amac: Trichomonas vaginalis trikomoniazisin etkeni olan anaerobik flajellali protozoan bir parazittir. Amacimiz, Temmuz 2007 -Mayis 2008 araliginda Kerkuk hastanelerine basvuran vajinal akintili kadinlarla eslerinde Trichomonas vaginalis ve diger mikroorganizmalarin sikligini arastirmaktir. Materyal ve Metod: Vajinal ve servikal suruntu ve idrar ornekleri uzerinde laboratuar incelemeleri yapildi, uygun ortamda suruntu ve idrar kulturleri ve kan orneklerinde serolojik testler yapildi. Bulgular: Vajinal akintili kadinlarda T. vaginalis orani %2.8 iken, eslik eden mikroorganizmalar %8.0 Candida albicans ve %0.8 Neisseria gonorrhoea olmustur. T. vaginalis and C. albicans'in mikst enfeksiyon orani %1.6, T. vaginalis ve Escherichia coli koenfeksiyon orani %1.6, Staphylococcus aureus ile % 0.8, proteus ile %0.4 olarak bulunmustur. Vajinal suruntudeki enyaygin patojen mikroorganizma %l2.4 Staph. Aureus, ardindan %11.6 E. coli ve %8.0 C. albicans olmustur. Idrar orneklerindeki patojen ajan orani daha dusuk bulunmustur. Uretral suruntude N. gonorrhea orani %35.0, E. coli orani %. 5.0 bulunmus, vajinal suruntu ve idrarda en yuksek enfeksiyon orani 15-29 yas grubunda bulunmustur. Sonuc: Trikomoniazisle ilgili patojen enfeksiyonlar bayanlarda daha sik izlenir, orani 15-29 yas grubunda en yuksektir ve idrarda gonore orani yuksektir.
Evaluation of Right Ventricular Function in Early Period Following Transcatheter Closure of Atrial Septal Defect

Aims: There is limited data on alterations in novel right ventricular (RV) function indices like tricuspid annular plane systolic excursion (TAPSE) and tricuspid annular systolic velocity (TASV) after transcatheter atrial septal defect (ASD) closure. We aimed to evaluate RV function by echocardiography (ECG) with these novel indices in early period in patients with secundum‐type ASD that was closed percutaneously. Methods: Patients were enrolled to study if they had secundum‐type ASD that was suitable for percutaneous closure. Patient population consisted of 4 men and 16 women. Echocardiography was performed before and 1 month after closure. Results: Mean age was 37 ± 16. Mean diameter of ASD and total atrial septum length measured by ECG were 19 ± 6 mm and 49 ± 7 mm, respectively. Mean diameter of defect in transesophageal echocardiography was 20 ± 6 mm. Stretched mean diameter in catheterization was 23 ± 6 mm. One month after closure, there were statistically significant decreases in RV end‐diastolic diameters (43.3 ± 10.7 mm vs. 34.9 ± 5.5 mm; P < 0.001), RV/left ventricular (LV) end‐diastolic diameter ratio (1.1 ± 0.3 vs. 0.87 ± 0.1; P < 0.001), TASV (16.9 ± 3.2 cm/sec vs. 14.3 ± 3.3 cm/sec; P < 0.05), early diastolic tricuspid annular velocity (15.3 ± 3.1 cm/sec vs. 13.4 ± 2.4 cm/sec P <0.05), late diastolic tricuspid annular velocity (16.2 ± 5.4 cm/sec vs. 14.3 ± 6.3 cm/sec; P < 0.05), and TAPSE (29.9 ± 6.2 mm vs. 22.4 ± 7.4 mm; P < 0.001). LV end‐diastolic diameter (38.0 ± 6.9 mm and 40.0 ± 4.5 P < 0.05) was increased, whereas there was no change in LV ejection fraction. Conclusion: Closure of ASD by using Amplatzer devices led to decrease in right heart chamber size, tissue Doppler–derived tricuspid annular velocities and TAPSE in early period. (Echocardiography 2012;29:358‐362)
The Role of Peers in the Initiation and Continuation of Ecstasy Use

This study is a supplement to the Netherlands XTC Toxicity Study (NeXT), funded by grants from the Netherlands Organisation for Health Research and Development as part of its Addiction Programme. To better understand the processes of peer influence and peer selection, in a field study 106 Ecstasy users (67M/39F, average age 25.4 years) were interviewed face-to-face in Amsterdam in 2005. In the initiation of Ecstasy use, peer influence emerged as the dominating mechanism; peer selection was uncommon. In the continuation of Ecstasy use, peer influence and peer selection occurred reciprocally in a dynamic process, although peer influence made a greater relative contribution. Our study confirms that peer influence is a multidimensional process: influence was quite often reciprocal (with respondents both exerting and undergoing influence) and it could have both restraining and encouraging effects on ecstasy use. The study's limitations are noted.
Performance of Screening Instruments for Alcohol Use Disorders in Emergency Department Patients in Argentina

The performance of the Alcohol Use Disorders Identification Test (AUDIT), CAGE, Brief Michigan Alcohol Screening Test (Brief MAST), Rapid Alcohol Problems Screen (RAPS), Rapid Alcohol Problems Screen-Quantity and Frequency (RAPS4-QF), and TWEAK was evaluated against a diagnosis of alcohol dependence and harmful drinking or alcohol abuse from ICD-10 and DSM-IV criteria. Data were collected from a probability sample of 779 patients admitted to the emergency department of a public general hospital in Mar del Plata, Argentina, during the year 2001. The majority of the patients sampled were male. The age range was 18 to 89 years, with a mean value of 36 years and a median of 31 years. Almost half of the sample had an elementary school education or less. All instruments were more sensitive for alcohol dependence than for harmful drinking or abuse and more sensitive for men than for women. Findings suggest the RAPS4 and RAPS4-QF may be preferred when screening for alcohol use disorders in the emergency department in Argentina. The study's limitations are noted.
Creating Integrated Care: Evaluation and Management of Local Care in Sweden

It seems impossible to create a comprehensive evaluation model which fully takes into account the multi‐dimensional context of integrated health and social care. Clinical integration, as a prerequisite for efficient outcomes of integration, must nonetheless get special attention. For more extensive evaluations, a quality chain matrix, including co‐operating acts by different providers, has proven to be useful. Examples of evaluated services in Sweden are given, and the management benefits of the use of evaluation data are highlighted.
Novel Aβ Immunogens: Is Shorter Better?

Active and passive Aβ immunotherapy in Alzheimers disease (AD)-like mouse models lowers cerebral amyloid- β protein (Aβ) levels, especially if given early in the disease process, and improves cognitive deficits. In 2002, a Phase IIa clinical trial was halted due to meningoencephalitis in ∼6% of the AD patients. It is hypothesized that the immunogen, full-length Aβ1-42, may have led to an autoimmune response. Currently, we are developing novel Aβ peptide immunogens for active immunization in amyloid precursor protein transgenic mice (APP Tg) to target Aβ B cell epitopes (within Aβ1-15) and avoid Aβ-specific T cell epitopes (Aβ16-42) so as to generate a safe and effective AD vaccine. Intranasal immunization with dendrimeric Aβ1-15 (16 copies of Aβ1-15 on a lysine core) or a tandem repeat of Aβ1-15 joined by 2 lysines and conjugated to an RGD motif with a mutated form of an E. coli-derived adjuvant generated robust Aβ titers in both wildtype and APP Tg mice. The Aβ antibodies recognized a B cell epitope within Aβ1-7, were mostly T-helper 2 associated immunoglobulin isotypes, bound human AD and APP Tg plaques, and detected Aβ oligomers. Splenic T cells reacted to the immunogens but not full-length Aβ. Six months of intranasal immunization (from 6-to-12 months of age) of J20 mice with each immunogen lowered insoluble Aβ42 by 50%, reduced plaque burden and gliosis, and increased Aβ in plasma. Interestingly, Aβ antibody generation was influenced by route of immunization. Transcutaneous immunization with dβ1-15, but not full-length Abeta, led to high Aβ titers. In summary, our short Aβ immunogens induced robust titers of predominantly Th2 antibodies that were able to clear cerebral Aβ in the absence of Aβ-specific T cell reactivity, indicating the potential for a safer vaccine. We remain optimistic about the potential of such a vaccine for prevention and treatment of AD.
Molecular diagnosis of infectious diseases using cytological specimens

Pathologists have an important role in the diagnosis of infectious disease (ID). In many cases, a definitive diagnosis can be made using cytopathology alone. However, several ancillary techniques can be used on cytological material to reach a specific diagnosis by identifying the causative agent and consequently defining the management of the patient. This review aims to present the effectiveness of the application of molecular studies on cytological material to diagnose IDs and discuss the advantages and disadvantages of the various molecular techniques according to the type of cytological specimen and the infectious agents. Diagn. Cytopathol. 2016;44:156–164. © 2015 Wiley Periodicals, Inc.
Predictors of Internal Medicine Resident Satisfaction with Teaching by Attendings

This study identifies factors that predict internal medicine resident satisfaction with the quality of teaching by attendings. A key issue facing educators is whether high-quality instruction can be maintained in an environment in which attending physicians have many competing demands placed on their time. A national survey of clinical third-year internal medicine residents in 125 academically affiliated generally medical training programs was conducted. Univariate analyses describe the characteristics of the sample, and multivariate analyses evaluate the factors associated with resident satisfaction with teaching. The response rate was 64.1% (n=1354). Positive factors relating to satisfaction with teaching on inpatient ward rotations included: number of patients seen during rounds, attendings were fulltime, attending did clinical teaching during bedside work rounds, attending gave spontaneous and prepared presentations, and attendings were reached soon when needed. Negative factors included: number of residents in a ward team, number of patients admitted on overnight call, attendings seemed rushed and eager to finish rounds, and attendings were temporarily called away during rounds. Positive factors relating to satisfaction with teaching in continuity clinics included: residents being female and amount of time spent on talking to or examining patients. Negative factors included: amount of time spent on paperwork or routine work, attending changed residents decisions, attendings were difficult to reach, and attendings were temporarily called away during teaching. Different clinic settings also affected satisfaction. This study identifies several factors associated with internal medicine residents satisfaction with teaching and highlights mutable factors that faculty may consider changing to improve education and satisfaction.
The Environmental Tobacco Smoke Social Movement: Impact on Tobacco Use and Smoking Cessation

Tobacco cigarette smoking entered the 20th century as what was then considered a minor vice. Although cigarette manufacturing had been automated for almost two decades, only 2.5 billion cigarettes were manufactured annually, and per capita consumption was less than 100 cigarettes per year in the United States. Very few women smoked at that time, and for the most part men smoked only cigars. Children and adolescents, with a few exceptions, just did not smoke. Cigarette smoking was a misbehavior practiced mostly by men of the lower socioeconomic class, sometimes referred to as the underworld of society. All of those patterns were to change rapidly after the turn of the century.
Accumulation of Mast Cells in the Lesions and Effects of Antiallergic Drugs on the Patients with Inflammatory Bowel Disease

The pathomechanism of inflammatory bowel disease (IBD) has not yet been fully demonstrated. However, it is well known that mast cells are present in the gastrointestinal tract, suggesting that mast cells may take part in it. So, we investigated the number of mast cells in IBD, such as ulcerative colitis (UC) and eosinophilic colitis, and showed that the number of mast cells was increased in the inflammatory lesions. We also presented a case of UC which was treated successfully with an antiallergic drug, tranilast. Furthermore, possible new approaches to treating the disease with immunomodulators including suplatast are introduced. However, our investigations were performed with a limited number of patients with IBD, and additional further studies are required to confirm the findings.
Killing Time With Enjoyment: A Qualitative Study of Initiation into Injecting Drug Use in North-East India

Manipur and Nagaland are north-east Indian states characterized by a high prevalence of injecting drug use and HIV in a context of socio-economic underdevelopment and political instability. This qualitative study aims to increase understanding of the contextual factors associated with initiation into injecting drug use in these two states. Forty semi-structured in-depth interviews were conducted among injecting drug users (10 women, 30 men) aged 18–28 years in mid-2006. The interview transcripts were thematically analyzed. All participants were initiated into injecting by another person, most commonly a friend and often in the context of well-established social networks. Most were poly-drug users and unsafe injecting practices were frequently associated with the initiation experience. The subjective reasons for deciding to inject were pleasure-seeking, influence of peers, and economic reasons. We hypothesize that initiation into injecting in this part of the world is also linked to ideas of masculinity, and that young men engage in drug use in order to fill a social vacuum created by limited opportunities to meaningfully engage in adult roles within the community. The findings from this study suggest that harm reduction programs need to target (noninjecting) drug users, and that existing social networks could be creatively used to extend the reach of these programs.