Miracle-dz/UniFAR-FTUs huggingface dataset:
Blunt renal trauma: comparison of contrast-enhanced CT and angiographic findings and the usefulness of transcatheter arterial embolization.

BACKGROUND The purpose of this study was to evaluate the role of contrast-enhanced CT and the usefulness of superselective embolization therapy in the management of arterial damage in patients with severe blunt renal trauma. PATIENTS AND METHODS Nine cases of severe renal trauma were evaluated. In all cases, we compared contrast-enhanced CT findings with angiographic findings, and performed transcatheter arterial embolization (TAE) in six of them with microcoils and gelatin sponge particles. Morphological changes in the kidney and site of infarction after TAE were evaluated on follow-up CT Chronological changes in blood biochemistry findings after injury, degree of anemia and renal function were investigated. Adverse effects or complications such as duration of hematuria, fever, abdominal pain, renovascular hypertension and abscess formation were also evaluated. RESULTS The CT finding of extravasation was a reliable sign of active bleeding and useful for determining the indication of TAE. In all cases, bleeding was effectively controlled with superselective embolization. There was minimal procedure-related loss of renal tissue. None of the patients developed abscess, hypertension or other complications. CONCLUSIONS In blunt renal injury, contrast-enhanced CT was useful for diagnosing arterial hemorrhage. Arterial bleeding may produce massive hematoma and TAE was a useful treatment for such cases. By using selective TAE for a bleeding artery, it was possible to minimize renal parenchymal damage, with complications of TAE rarely seen.
Sickle cell anaemia: awareness among health professionals and medical students at the Lagos University Teaching Hospital, Lagos.

BACKGROUND Sickle cell anaemia (SCA) is a chronic haemolytic disorder caused by homozygous inheritance of abnormal haemoglobin called 'haemoglobin S' (HbS). The disease burden is enormous to the patient, family and community. One potential weapon in its prevention is health information and awareness among the populace. OBJECTIVE The study is to detrmine the awareness of sickle cell anaemia among health professionals and medical students at the Lagos University Teaching Hospital Idiaraba, Lagos. METHODS Part of a large study which was cross-sectional and descriptive study, carried out at the Lagos University Teaching Hospital (LUTH), between the months of August and September 2006. Data were collected from 403 health professionals and students using structured questionnaires. RESULTS Majority (98.7%) of the respondents had heard about SCA. Only 211 (55%) of the respondent felt genotype screening should be done at pre-school age. 128 (33.7%) felt it should be done during childhood. Doctors had a statistically significantly better knowledge of best time for detecting genotype. In all, 85% of the respondents had been involved in the management of sickle cell anaemia with the highest proportion among nurses (p = 0.02). Only 93 (24.3%) of the respondents knew most of the complications of sickle cell anaemia, 176 (46.3%) knew some of it, while 111 (29.2%) knew only a law complications. Nurses had a statistically significantly poorer knowledge of the complication of sickle cell anaemia. More nurses felt that engagement should be ended if there was a risk of having a child with sickle cell anaemia. CONCLUSION Continuing medical education for health professionals about sickle cell anaemia, its management and complication is necessary.
Ammonium Accumulation and Use of Mineral Oil Overlay Do Not Alter Imprinting Establishment at Three Key Imprinted Genes in Mouse Oocytes Grown and Matured in a Long-Term Follicle Culture1

Imprinted genes are differentially methylated during gametogenesis to allow parent-of-origin-specific monoallelic expression. Follicle culture under oil overlay has been associated with altered imprinting establishment in mouse oocytes. We previously demonstrated normal imprinting establishment at four key imprinted genes in mouse oocytes grown and matured in a long-term in vitro follicle culture system without oil overlay. Ammonium (300 μM) has been linked to aberrant imprinting in in vitro preimplantation embryo culture. Compared to culture without oil, mineral oil overlay during follicle culture led to a dramatic increase in ammonia levels in culture medium: mean ammonia levels were, respectively, 39 and 290 μM at Day 4 of culture, 73 and 465 μM at Day 8, and 101 and 725 μM at Day 12 (P < 0.0001). Mineral oil overlay and high ammonia levels (comparable to the follicle culture system for which aberrant imprinting was previously described) during follicle culture did not affect follicle survival, metaphase II (MII) rate, or MII oocyte diameter. Bisulphite sequencing revealed that high levels of ammonia and mineral oil overlay during follicle culture did not alter the methylation status of differentially methylated regions of three key imprinted genes (Snrpn, Igf2r, and H19) in MII oocytes. In the current culture setup, ammonium accumulation and mineral oil overlay during follicle culture do not induce aberrant imprinting establishment at the studied regulatory sequences in mouse oocytes.
Increased Na+/Mg2+ Antiport in Erythrocytes of Patients with Cystic Fibrosis

Na+/Mg2+ antiport and Na(+)-independent Mg2+ efflux were investigated in erythrocytes of 41 patients with cystic fibrosis and 26 controls. Na(+)-independent Mg2+ efflux was unchanged in cystic fibrosis, but a significantly increased activity of Na+/Mg2+ antiport was detected (control: 0.16 +/- 0.02, cystic fibrosis: 0.39 +/- 0.06, Mg2+ efflux, mmol/30 min x 1 cells, mean +/- SEM, p < 0.01). An increased activity of Na+/Mg2+ antiport was only found in patients with severe clinical symptoms. There was no correlation of the increased Na+/Mg2+ antiport to the dF508 genotype. In a patient with increased Na+/Mg2+ antiport, the capacity of this transport system was unchanged 14 weeks after double lung transplantation but reached control values after 53 weeks. The sweat of cystic fibrosis patients with severe clinical symptoms showed a significantly increased Mg2+ concentration (control (n = 12): 0.053 +/- 0.08, cystic fibrosis (n = 9): 0.123 +/- 0.016 mmol/l, mean +/- SEM, p < 0.001).
Antimicrobial Susceptibility and Genetic Characteristics of Streptococcus pneumoniae Isolates Indicating Possible Nosocomial Transmission Routes in a Community Hospital in Japan

ABSTRACT A clinical study was designed to study Streptococcus pneumoniae isolates recovered from a community hospital in Japan from April 2001 to November 2002. A total of 73 isolates were defined as derived from inpatient, outpatient, and hospital staff groups. The MIC results showed that 20 strains (27.4%) were susceptible to penicillin G, 39 strains (53.4%) had intermediate resistance, and 14 strains (19.2%) had full resistance. Low susceptibility to macrolides was also detected: 32.9%, 32.9%, and 34.2% of all strains were resistant to erythromycin, clarithromycin, and azithromycin, respectively. Thirty strains (41%) were resistant to at least two different kinds of antibiotics. Nineteen disparate serotypes were detected besides two nontypeable strains, and the predominant serotypes were 19F and 23F. Pulsed-field gel electrophoresis (PFGE) pattern A was dominant in the serotype 19F group; this pattern was similar to that of the international clone Taiwan 19F. A total of 10 different patterns were detected in the 23F group and were distinguishable from those of the international clones Spain 23F and Taiwan 23F. Pattern b strains were identified in the same ward, and pattern d strains were found both in patients with nosocomial pneumococcal infections (NPI) and in outpatients. In conclusion, drug-resistant S. pneumoniae was spreading rapidly, especially isolates of the serotype 19F and 23F groups. PFGE data revealed interpatient transmission and suggested that there might be some association between NPI patient strains and outpatient strains.
[Treatment of relapsing-remitting multiple sclerosis with fingolimod in routine clinical practice].

INTRODUCTION Fingolimod is a selective immunosuppressant that targets the S1P receptor, and is indicated in the treatment of aggressive relapsing-remitting multiple sclerosis (RRMS) and following treatment failure with first-order drugs. AIM To investigate the safety and effectiveness of fingolimod under the conditions of routine clinical practice. PATIENTS AND METHODS We conducted an observational study with prospective follow-up of patients with RRMS who received fingolimod from January 2011 until February 2014. Data assessed were the annualised relapse rate (ARR), disability measured by the Expanded Disability Status Scale (EDSS), magnetic resonance activity and the appearance of side effects. RESULTS Our sample consisted of 122 patients, 79.5% of them females and with a mean age of 26.8 years. They were classified, according to the last treatment received, as being: naive (aggressive RRMS; n = 17), previous treatment failure (n = 67) and withdrawal of natalizumab due to risk of progressive multifocal leukoencephalopathy (n = 38). After a mean follow-up of 29.9 ± 15.9 months, the ARR and the appearance of new lesions with gadolinium enhancement were reduced in both the naive and the previous treatment failure groups. There were no differences between the various subgroups as regards the progression of EDSS or the time elapsed until the first attack or treatment failure. The risk of treatment failure is higher with a baseline EDSS > 3 (hazard ratio: 4.24; p = 0.001) and presence of IgM oligoclonal bands (hazard ratio: 2.45; p < 0.022). CONCLUSIONS Fingolimod is an effective and well-tolerated drug under conditions of routine clinical practice. Having a baseline EDSS > 3 and IgM oligoclonal bands is predictive of a poor response to fingolimod.
Gestational age correlates to genotype in girls with CYP21 deficiency.

CONTEXT The mechanisms behind onset of labor and prolongation of pregnancy are not fully understood, but steroid hormones are thought to contribute. 17-Hydroxyprogesterone has been shown to prolong pregnancy in humans. Male fetuses have been reported to have longer gestation than females. OBJECTIVE The objective of the study was to investigate whether severity of 21-hydroxylase gene (CYP21) deficiency in fetuses with congenital adrenal hyperplasia (CAH) correlates with length of pregnancy. DESIGN AND SUBJECTS The gestational age (GA) of a cohort of CAH patients born between 1978 and 2004 was studied retrospectively. The GA was correlated to the severity of disease indicated by CYP21 genotype in 114 patients. The results were compared with respect to sex and the normal Swedish population data. RESULTS In female fetuses with CAH, we found a correlation between GA and CYP21 genotype. Females with the most severe form of the disease, null mutation, had the longest GA and differed significantly from the normal population. No difference between the sexes was detected for fetuses with CAH as a group. There were no significant differences between CYP21 genotype groups for males. CONCLUSIONS Female patients with severe CYP21 deficiency had longer GA than patients with the milder form of the disease, indicating that androgen excess, increased 17-hydroxyprogesterone levels, or cortisol deficiency or a combination of these factors is of importance for prolongation of pregnancy. The same correlation was not observed for male patients. The results of this study support the notion that steroid hormones affect the prolongation of pregnancy or onset of labor or both.
A Before-After Study Using OncoDoc, a Guideline-Based Decision Support-System on Breast Cancer Management: Impact upon Physician Prescribing Behaviour

Guideline-based decision support systems have been developed to influence the prescribing behaviour of clinicians, but they have not yet shown to increase physician compliance with best practices in routine. OncoDoc is a non-automated system that allows flexibility in guideline interpretation to obtain best patient-specific recommendations at the point of care. OncoDoc is applied to breast cancer management. We have experimented the system at the Institut Gustave Roussy with a before-after study in which treatment decisions for breast cancer patients were measured before and after using the system in order to evaluate its impact upon physicians' prescribing behaviour. After 4 months, 127 decisions were recorded. Physicians compliance with OncoDoc was significantly improved (p < 10(-4) ) to reach 85.03% after using the system. Comparison of initial and final decisions showed that physicians modified their prescription in 31% of the cases. Clinical trial accrual rate increased of 50%, though not statistically significant because estimated on small figures.
Neurodevelopmental outcomes in HIV-exposed-uninfected children versus those not exposed to HIV

Human immunodeficiency virus (HIV)-negative children born to HIV-infected mothers may exhibit differences in neurodevelopment (ND) compared to age- and gender-matched controls whose lives have not been affected by HIV. This could occur due to exposure to HIV and antiretroviral agents in utero and perinatally, or differences in the environment in which they grow up. This study assessed neurodevelopmental outcomes in HIV-exposed uninfected (HEU) and HIV-unexposed uninfected (HUU) children enrolled as controls in a multicenter ND study from Thailand and Cambodia. One hundred sixty HEU and 167 HUU children completed a neurodevelopmental assessment using the Beery Visual Motor Integration (VMI) test, Color Trails, Perdue Pegboard, and Child Behavior Checklist (CBCL). Thai children (n = 202) also completed the Wechsler Intelligence Scale (IQ) and Stanford-Binet II memory tests. In analyses adjusted for caregiver education, parent as caregiver, household income, age, and ethnicity, statistically significant lower scores were seen on verbal IQ (VIQ), full-scale IQ (FSIQ), and Binet Bead Memory among HEU compared to HUU. The mean (95% CI) differences were −6.13 (−10.3 to −1.96), p = 0.004; −4.57 (−8.80 to −0.35), p = 0.03; and −3.72 (−6.57 to −0.88), p = 0.01 for VIQ, FSIQ, and Binet Bead Memory, respectively. We observed no significant differences in performance IQ, other Binet memory domains, Color Trail, Perdue Pegboard, Beery VMI, or CBCL test scores. We conclude that HEU children evidence reductions in some neurodevelopmental outcomes compared to HUU; however, these differences are small and it remains unclear to what extent they have immediate and long-term clinical significance.
Comparison of Genotypic and Phenotypic Methods for Species-Level Identification of Clinical Isolates of Coagulase-Negative Staphylococci

ABSTRACT To compare commonly used phenotypic methods with genotypic identification methods 47 clinical isolates of coagulase-negative staphylococci (CONS), 10 CONS ATCC strains, and a Staphylococcus aureus clinical isolate were identified using the API Staph ID test, BD Phoenix Automated Microbiology System, and 16S rRNA gene and tuf gene sequencing. When necessary part of the sodA gene was sequenced for definitive identification. The results show that tuf gene sequencing is the best method for identification of CONS, but the API Staph ID test is a reasonably reliable phenotypic alternative. The performance of the BD Phoenix Automated Microbiology System for identification of CONS is poor. The present study also showed that although genotypic methods are clearly superior to phenotypic identifications, a drawback of sequence-based genotypic methods may be a lack of quality of deposited sequences in data banks. In particular, 16S rRNA gene sequencing suffers from the lack of high quality among sequences deposited in GenBank. Furthermore, genotypic identification based on 16S rRNA sequences has limited discriminating power for closely related Staphylococcus species. We propose partial sequencing of the tuf gene as a reliable and reproducible method for identification of CONS species.
Antioxidant and Immunomodulatory Constituents of Henna Leaves

Abstract The immunomodulatory bioassay-guided fractionation of the methanolic extract of henna (Lawsonia inermis L.; syn. Lawsonia alba L.) leaves resulted in the isolation of seven compounds; three have been isolated for the first time from the genus, namely p-coumaric acid, 2-methoxy-3-methyl-1,4-naphthoquinone and apiin, along with the previously isolated compounds: lawsone, apigenin, luteolin, and cosmosiin. Structural elucidation of the isolated compounds was based upon their physical, chemical as well as spectroscopic characters. Their immuomodulatory profile was studied using an in vitro immunoassay, the lymphocyte transformation assay. The ABTS [2,2′-azino-bis (3-ethyl benzthiazoline-6-sulfonic acid)], free radical scavenging assay depicted that all isolated compounds exhibited antioxidant activity comparable to that of ascorbic acid.
Coronary artery calcium scoring using 16-MDCT and a retrospective ECG-gating reconstruction algorithm.

OBJECTIVE Our aim was to compare detection, quantification, and cardiovascular risk stratification of coronary artery calcium (CAC) between electron beam CT and 16-MDCT with retrospective reconstruction. SUBJECTS AND METHODS. One hundred patients underwent both electron beam CT and 16-MDCT, and coronary artery calcium score, volume, and mass were obtained. RESULTS Correlation between the two CT scanners was high for both calcium score (r(2) = 0.955), volume (r(2) = 0.952), and mass (r(2) = 0.977). Although electron beam CT is viewed as the gold standard, the sensitivity and specificity in the detection of CAC using 16-MDCT with a threshold of 130 H were 98.7% and 100%, respectively. The variability of calcium scores between the two CT scanners (26.5%) was comparable with two electron beam CT scanners reported previously. The variability of calcium volume (20.7%) and mass (20.3%) was lower than that of the score (Student's t test, r = 0.05, 0.01). In clinical cardiovascular risk stratification based on two CT calcium scores, the Cohen's kappa value was 0.929. There was no significant difference between the two scanners using Wilcoxon's signed rank test (p = 0.157). CONCLUSION The 16-MDCT scanner with retrospective reconstruction, showing high agreement for detection and quantification of CAC with electron beam CT, holds promise in the detection of coronary artery atherosclerosis.
Continuity of care after inpatient discharge of patients with schizophrenia in the Medicaid program: a retrospective longitudinal cohort analysis.

OBJECTIVE This study seeks to identify patient, facility, county, and state policy factors associated with timely schizophrenia-related outpatient treatment following hospital discharge. METHOD A retrospective longitudinal cohort analysis was performed of 2003 national Medicaid claims data supplemented with the American Hospital Association facility survey, the Area Resource File, and a Substance Abuse and Mental Health Services Administration Medicaid policy report. The analysis focuses on treatment episodes of adults, aged 20 to 63 years, who received inpatient care for ICD-9-CM-diagnosed schizophrenia (59,567 total treatment episodes). Rate and adjusted odds ratio (AOR) of schizophrenia-related outpatient visits within 7 days and 30 days following hospital discharge are assessed. RESULTS Of the 59,567 hospital discharges, 41.7% received schizophrenia-related outpatient visits in 7 days and 59.3% in 30 days following hospital discharge. The adjusted odds of 30-day follow-up outpatient visits were significantly related to preadmission outpatient mental health visits (AOR = 3.72; 99% CI, 3.44-4.03), depot (AOR = 2.83; 99% CI, 2.53-3.18) or oral (AOR = 1.73; 99% CI, 1.62-1.84) antipsychotics as compared with no antipsychotics, and absence of a substance use disorder diagnosis (AOR = 1.35; 99% CI, 1.25-1.45). General hospital as compared with a psychiatric hospital treatment (AOR = 1.32; 99% CI, 1.14-1.54) and patient residence in a county with a larger number of psychiatrists per capita (AOR = 1.27; 99% CI, 1.08-1.50) were related to receiving follow-up outpatient visits. By contrast, residence in a county with a high poverty rate (AOR = 0.60; 99% CI, 0.54-0.67) and treatment in a state with prior authorization requirements for < 12 annual outpatient visits (AOR = 0.69; 99% CI, 0.63-0.75) reduced the odds of follow-up care. CONCLUSIONS Patient characteristics, clinical management, geographical resource availability, and the mental health policy environment all appear to shape access to care following hospital discharge in the community treatment of adult schizophrenia.
Clinical, Immune, and Microbiome Traits of Gingivitis and Peri-implant Mucositis

Tissues surrounding dental implants and teeth develop clinical inflammation in response to microbial stimuli. However, the literature suggests that differences exist in the microbial insult and inflammatory responses leading to gingivitis and peri-implant mucositis. In this pilot study, the authors use for the first time a systems biology approach to comprehensively evaluate clinical parameters, selected inflammatory markers, and the microbiome of subject-matched tooth and implant sites during native inflammation and in response to experimental plaque accumulation. Fifteen subjects with 2 posterior implants and corresponding contralateral teeth were examined at enrollment; at day 0, after reinstitution of gingival/mucosal health; at days 7, 14, and 21, during stent-mediated oral hygiene (OH) abstention; and at day 42, after resumption of OH. The subgingival microbiome was evaluated via 16S rRNA gene sequencing and 8 selected inflammatory markers measured in crevicular fluid. Comparison of teeth and implants via general linear models based on orthogonal polynomials showed similar responses in clinical parameters, inflammatory mediators, and proportions of individual microbial taxa during OH abstention. Implants, however, accumulated less plaque and underwent more heterogeneous shifts in microbiome structure. A multilevel, within-group, sparse partial least squares analysis of covariation of microbial, inflammatory, and clinical parameters throughout all study visits found inflammation around teeth and implants positively correlated with IL-1 alpha and IL-1 beta and with the proportions of Selenomonas, Prevotella, and 5 species-level phylotypes. Gingivitis, however, showed a stronger positive correlation with lactoferrin and IL-1ra and a stronger negative correlation with Rothia. Peri-implant mucositis, on the contrary, correlated positively with certain microbial taxa not associated with gingivitis by a previous study or the current one. In summary, differences existed between implants and tooth sites in microbiome evolution during OH abstention and in the correlation of specific inflammatory mediators and microbial taxa with clinical inflammation. Common biological features, however, were also identified for gingivitis and mucositis.
Molecular Identification and Barcodes for the Genus nymphaea

Nymphaea species, the most popular decorative plants, were collected for specificity of inter-simple sequence repeat (ISSR) analyses in species identification and differentiation of cultivars and natural populations. Dendrogram constructed from ISSR analyses separated out wild species, namely Nymphaea cyanea, N. nouchali, N. capensis, N. lotus and an outgroup N. mexicana , and cultivars. The dendrogram indicates that the cultivars should be differentiated from N. capensis , as they are sister individuals of N. capensis. The ISSR banding data and the dendrogram are concordantly concluded that wild N. capensis would be an effective type species for producing different cultivars. After plant identification by ISSR markers, DNA barcodes of all sample materials were done to provide species specific markers which can be used for rapid and accurate further plant identification without morphological characters. DNA barcoding sequence analysis indicates genetic distance values. All sequences were recorded in GenBank database.