Miracle-dz/UniFAR-FTUs huggingface dataset:
Estabilidad de la capacidad antioxidante y pH en leche humana refrigerada durante 72 horas: estudio longitudinal

Maternal milk is the optimal feeding way for the infant at least for the first six months of life. Its properties include nutrients intake and, particularly, to provide the infant with several beneficial compounds improving his growth and protecting him from the diseases typical of this time period. These properties justify the manipulating processes before its intake in order to promote and warrant the adherence to it, both at the hospital and at home, being more important in premature infants and/or with low birth weight given their increased vulnerability, is spite of the fact that during these processes some of its properties may be partially lost. There exist, therefore, an interest in knowing the impact of the procedures applied to human milk on its qualitative properties, such as the antioxidant capacity. Objective: This work assesses the stability of the antioxidant capacity of human milk during its storage at 4o C, longitudinally from its extraction until 48 h of refrigeration, as well as the pH changes. Method: the milk from 30 healthy women was analyzed. The milk’s antioxidant capacity was assessed by the following parameters: total antioxidant capacity and level of malondialdehyde. The results obtained showed that pH decreases gradually from the storage beginning, whereas the antioxidant capacity remains constant for the first 24 hours, with a different result depending on the parameter used, and thereafter significant changes were observed. Conclusions: In case of needing extraction and storage of maternal milk before its consumption, the storage time should be minimized, preferably less than 24 hours in order to preserve the oxidative stress.
Management of spheno-orbital en plaque meningiomas: clinical outcome in a consecutive series of 40 patients

Abstract Objective. The clinical results of combined surgical–radiosurgical treatment of the spheno-orbital en plaque meningiomas in a consecutive series of 40 patients are presented. The clinical outcome is evaluated in terms of surgical morbidity, tumour control, visual function and cosmetic result. Methods. Forty patients harbouring spheno-orbital en plaque meningiomas were treated. Forty-two surgical procedures were performed through a fronto-temporal craniotomy. The reconstruction of the orbital walls was performed using a titanium mesh. In case of sub-total resection, the patients underwent Gamma-Knife radiosurgery on residual tumour. Visual function was evaluated considering visual acuity tested with a Snellen chart, funduscopy and Goldmann perimetry for visual field defects. Proptosis was quantified on CT scans. Results. Total or gross-total tumour resection was achieved in 56.1% of cases. Permanent morbidity was recorded in three patients after surgery. Visual acuity and visual field defect both improved in 66.7% of patients; improvement of proptosis was recorded in 92.7% of cases. Eighteen patients were treated with Gamma-Knife radiosurgery for residual tumour after surgery and four patients for tumour relapse at follow-up. The mean follow-up period was 72.6 months. Conclusions. Surgical treatment of spheno-orbital en plaque meningiomas is safe and effective: a low morbidity rate was recorded and visual function improved in about two-thirds of patients. Reconstruction of the orbital walls with titanium mesh provides for good functional and cosmetic results. In case of superior orbital fissure and cavernous sinus invasion, the combined surgical–radiosurgical treatment allows to minimise surgical morbidity and to achieve tumour control.
International Osteoporosis Foundation and International Federation of Clinical Chemistry and Laboratory Medicine Position on bone marker standards in osteoporosis

Abstract The International Osteoporosis Foundation (IOF) and the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) Working Group on Bone Marker Standards (WG-BMS) has evaluated the clinical potential of bone turnover markers (BTMs) in the prediction of fracture risk and for monitoring treatment. Research evidence suggests that BTMs may provide information on fracture risk independently from BMD, so that fracture risk prediction might be enhanced by their inclusion in assessment algorithms. The potential use of BTMs to predict the response to treatments for osteoporosis in the individual patient is also of great interest. Treatment-induced changes in specific markers account for a substantial proportion of fracture risk reduction. However, there is still a need for stronger evidence on which to base practice in both situations. IOF/IFCC recommends one bone formation marker (serum procollagen type I N propeptide, s-PINP) and one bone resorption marker (serum C-terminal cross-linking telopeptide of type I collagen, s-CTX) to be used as reference markers and measured by standardised assays in observational and intervention studies in order to enlarge the international experience of the application of markers to clinical medicine and to help resolve uncertainties over their clinical use.
Predictors of major neurological improvement after intravenous thrombolysis in acute ischemic stroke: a hospital-based study from south India.

BACKGROUND Despite the increasing use of recombinant tissue plasminogen activator (rt-PA) in acute ischemic stroke, uncertainty persists about the short- and long-term outcome of the thrombolysed patients. OBJECTIVE To identify predictors of major neurological improvement at 24 h after intravenous rt-PA administration in patients of acute ischemic stroke and their relationship with outcome at 12 months. MATERIALS AND METHODS We analyzed the data of the patients with acute ischemic stroke treated as per the National Institute of Neurological Disorders and Stroke (NINDS) criteria with intravenous rt-PA between January 2000 and June 2009 at a tertiary care center in south India. Major neurological improvement was defined by an 8-point improvement in National Institute of Health Stroke Scale (NIHSS) score or an NIHSS score of 0 or 1 at 24 h. Good outcome was defined as a 12-month modified Rankin Scale (mRS) of 0 to 1. RESULTS Of the 72 patients with acute ischemic stroke treated with intravenous rt-PA, 23 (32%) patients had major neurological improvement at 24 h. Age <60 years (OR 1.9, 95% CI 1.7 to 3.2), admission glucose levels <8 mmol/L (OR 3.87, 95% CI 1.9 to 9.2) and mild to moderate baseline stroke severity (NIHSS median score 10+ 6) were associated with major neurological improvement after adjusting for co variables. Major neurological improvement at 24 h was an independent predictor of good outcome (mRS=1) at 12 months (OR 13.9, 95% CI 6.84 to 40.2). CONCLUSIONS Age <60 years, glucose levels <8 mmol/L and mild to moderate stroke severity (NIHSS median score 10+/-6) was associated with major neurological improvement after intravenous rt-PA. Major neurological improvement at 24 h after the administration of intravenous thrombolysis independently predicted good outcome at 12 months.
New topical immunological treatments for psoriasis

Topical treatments for psoriasis have been used for a very long time. They were designed to reduce epidermal proliferation and hyperkeratosis. Recent pathophysiological data have led to the use of many immunological therapies, initially systemically in severe forms and, in recent years, topically. Calcineurin inhibitors are now a well-established treatment for atopic dermatitis and have also been evaluated in psoriasis. The first trials of tacrolimus (Protopic®, Astellas) and pimecrolimus (Elidel®, Novartis) failed to demonstrate any positive results on plaque-type psoriasis, but several studies showed a definite efficacy on facial and intertriginous psoriasis. Calcineurin inhibitors do not induce skin atrophy and are therefore particularly useful in sites in which the skin is thinner (face, intertriginous areas). A third substance, sirolimus (Rapamune®, Wyeth), has recently been tested topically in psoriasis. A recent study demonstrated that topical sirolimus crosses the cutaneous barrier and is effective on psoriasis lesions. These studies therefore show an indisputable efficacy of calcineurin inhibitors and sirolimus in the treatment of localized psoriasis. The major advantage is the absence of skin atrophy. However, large-scale efficacy and safety studies must be conducted in this indication.
Antidepressant Treatment Strategies in the Perinatal Period with a Focus on SSRI use

Cor res pon den ce Ad dress/Ya z›fl ma Ad re si: Dr. Omer Saatcioglu, Bakirkoy Research and Training Hospital for Psychiatry, Neurology and Neurosurgery, Istanbul, Turkey Tel. : +90 212 543 65 65 E-mail: osaatcioglu@hotmail.com Ge lis ta ri hi/Re cei ved: 10.01. 2013 Ka bul ta ri hi/Ac cep ted: 10.01. 2013 © No rop si ki yat ri Ar si vi Der gi si, Ga le nos Ya yi ne vi ta ra f›n dan ba s›l m›fl t›r. / © Arc hi ves of Neu ropsy chi atry, pub lis hed by Ga le nos Pub lis hing DOI: 10.4274/Npa.y7029
Dimensions of the pulmonary arteries in rat fetuses with congenital heart disease

Abstract So as to understand better the pathogenesis of enlargement or hypoplasia of pulmonary arteries in congenital heart disease, we studied the dimensions of the pulmonary arteries in 74 fetuses with congenital heart disease induced by administration of bis-diamine to pregnant rats. The congenital malformations induced included 12 with large ventricular septal defect, 17 with tetralogy of Fallot, 15 with tetralogy together with severe valvar pulmonary stenosis and absence of the arterial duct, 17 with tetralogy with absent pulmonary valve syndrome and absence of the arterial duct, and 13 with common arterial trunk with a confluent segment supplying the pulmonary arteries. For comparison, 16 fetuses of the same gestational age with normal hearts were studied. After rapid whole-body freezing on the 21st day of gestation, the fetuses were studied by means of serial cross-sectional photographs of the thorax. The diameter of the right pulmonary artery of the fetus was of comparable dimensions in the normal hearts (480±10 µm) (mean±SEM), those with ventricular septal defects (470±10 µm), common arterial trunk (520±20 µm), and tetralogy of Fallot (500±10 µm). These findings suggest that the commonly observed enlargement of the right pulmonary artery in patients with ventricular septal defect and common arterial trunk, and hypoplasia of the right pulmonary artery in tetralogy of Fallot, occur postnatally in response to abnormal postnatal pulmonary blood flow.
Abused Women

This article describes the multiple efforts made by abused women to seek help. Based on detailed interviews with 419 abused women, the analysis shows that only a very small number have failed to seek assistance. Most of the women have used a variety of sources, including lawyers, counselors, ministers, magistrates, shelters, and, most often, the police. Demographic analysis shows that relationship is the strongest and most consistent predictor of help seeking; married women use available services far more than do cohabitants. Other demographic characteristics emerge as mixed or marginal predictors of help seeking. Agencies oriented to providing services to abused women should be particularly attuned to those who might be underserved.
Trefoil factor family peptides are increased in the saliva of children with mucositis

Abstract Background: Mucositis is a painful ulcerative condition of the oral cavity and gastrointestinal tract, occurring in association with chemotherapy and radiotherapy regimes. Trefoil factor family peptides (TFF, trefoil peptides), present in saliva, contribute to epithelial restitution and repair and are therefore potentially important in the healing phase of mucositis. This study aimed to assess any changes in the levels of trefoil peptides in oncology patients with and without mucositis. Methods: Saliva was collected from healthy children, pre-treatment oncology patients, neutropenic patients on treatment with no oral disease and mucositic patients. TFF1, 2 and 3 were quantified using ELISA. Results: In healthy children TFF2 and 3 were positively correlated with age (ρ=0.454, p=0.01 for TFF2; ρ=0.410, p=0.05 for TFF3 Spearman rank correlation). TFF3 was higher in mucositis compared to all other groups. A linear regression prediction model indicated that TFF3, but not TFF1 and TFF2, was significantly different in mucositic and healthy controls, suggesting an altered pattern of trefoil peptide secretion (p=0.021). Conclusions: This study is the first to focus on trefoil peptides in paediatric saliva. It shows the correlation between TFF2, TFF3 and age in healthy children. Paediatric mucositis disease occurs in the presence of increased concentrations and an altered pattern of trefoil peptides.
Thrombomodulin Deficiency in Human Diabetic Nerve Microvasculature

Human diabetic neuropathy is multifactorial in etiology, with ischemia as a final common pathology. Although impaired vascular endothelial cell function in diabetic microvascular injury is established, the role of thrombomodulin (TM)-dependent protein C antithrombotic mechanism in the pathogenesis of neuropathy is unclear. This neuropathologic case-control study investigated whether vascular endothelial TM expression is deficient in peripheral nerve microvessels in diabetic neuropathy. Sural nerve biopsies from 7 patients with diabetic neuropathy and 10 with axonal neuropathy without vasculopathy were immunostained with anti-TM and anti-von Willebrand factor (vWF; an endothelial cell marker) antibodies. The proportion of TM-positive microvessels was expressed relative to total vWF-staining vessels, according to vessel caliber and regional distribution within the nerve. In diabetic nerves compared with reference controls, the proportion of TM-positive endoneurial microvessels was 15-fold lower (0.02 vs. 0.30 in diabetic nerves vs. controls, P < 0.004), and the proportion of small-caliber epineurial microvessels was 10-fold lower (0.04 vs. 0.43, P < 0.001). No TM expression was detected at the perineurium in diabetic or control nerves. We demonstrate a substantial reduction of vascular endothelial TM expression throughout human diabetic neuropathy. These findings suggest that an impaired native TM-dependent protein C antithrombotic mechanism may contribute to microvascular ischemia in the pathogenesis of diabetic neuropathy.
Impact of gender, weight and CYP2B6 genotype on efavirenz exposure in patients on HIV/AIDS and TB treatment: Implications for individualising therapy

Gender, weight and cytochrome P450 2B6 (CYP2B6) 516G>T genetic data of 61 patients on efavirenz containing highly active anti-retroviral therapy (HAART) was collated and analysed. Multivariate data analysis and correlations between variables were done to determine the relative contributions of gender, weight and CYP2B6 genetic polymorphism. Models were derived to guide dose adjustment in patients predicted to have unsafe drug exposure. The data showed that 44% of patients had concentrations above the minimum safe concentrations. Gender, weight and genetics explain 22% of the variation of therapeutic levels efavirenz drug exposure in the model. The model generated indicates that all patients homozygous for the 516G>T variant, irrespective of gender or weight required dose adjustment to 200 mg/day, whilst patients of the G/G genotype should be given the standard 600 mg/day. Patients of the G/T genotype showed mixed outcomes. Analysis of this group showed that females of weight less than 62 kg need dose adjustment to 400 mg/day whereas their male counterparts did not need dose adjustment. Key words: Efavirenz, CYP2B6 516G>T, weight, gender, dose adjustment, partial least squares.
Filament perforation model for mouse subarachnoid hemorrhage: Surgical-technical considerations

Abstract Objective. Mouse subarachnoid hemorrhage (SAH) models are becoming increasingly important. We aimed to report and discuss the detailed technical-surgical approach and difficulties associated with the circle of Willis perforation (cWp) model, with reference to the existing literature. Methods. First, the cWp model was reproduced using ddY mice following scarification at 0 h, Days 1, 2, and 3 after SAH. Second, C57BL/6 mice were subjected to SAH with histological examination on Days 1, 2, and 3. Sham-operated mice were sacrificed on Day 2. Neurological performance, amount of subarachnoid blood, cerebral vasospasm (CVS), and neuronal injury were assessed. Relevant articles found in the MEDLINE database were reviewed. Results. Induction of SAH was successfully reproduced. The volume of subarachnoid blood decreased with time due to resorption. Neurological performance was worse in SAH compared with sham. Signs of CVS could be confirmed on Days 2 and 3, but not Day 1. The cumulative number of microthrombi was significantly higher on Days 2 and 3, but not Day 1. Apoptotic and degenerative neurons were found in the cortex and hippocampal area. Our review of the literature revealed the cWp model to be the most frequently used. The present findings largely confirmed previously published results. However, detailed technical-surgical description and its discussion were sparse, which we provide here. Conclusions. The current study provides additional useful information characterizing the cWp model. This model may be of first choice at present, as important pathologies can be reproduced and most findings in the literature are based on it.
Recent progress in hemorrhagic moyamoya disease

Abstract Moyamoya disease (MMD) is a chronic progressive cerebrovascular disease, which can be divided into three types: ischemic, hemorrhagic, and asymptomatic. Hemorrhagic MMD has attracted considerable attention due to its distinctive imaging features and the controversy over the treatment. This report presents a comprehensive review of the literature on hemorrhagic MMD, focusing on the epidemiological characteristics, etiology and pathogenesis, imaging features, predictors of hemorrhage, and treatment options and their efficacy of hemorrhagic MMD. Hemorrhagic MMD mainly occurs in adult patients in Asian countries, and many factors may contribute to the etiology and development of this disease. Hemorrhagic MMD has two major imaging features: the dilatation and abnormal branching of anterior choroidal artery or posterior communicating artery, and multiple microbleeds, which may predict subsequent hemorrhage. The treatment for hemorrhagic MMD is not standardized, and large sample prospective randomized clinical trials may help to determine which method is better. In hemorrhagic MMD patients, more attention should be paid to cognitive function and quality of life, and these assessments should be included in the evaluation of effectiveness of treatment modalities.
PREVALENCE AND ANTIMICROBIAL SUSCEPTIBILITY OF ENTEROCOCCUS SPECIES ISOLATED FROM DIFFERENT CLINICAL SAMPLES IN A TERTIARY CARE HOSPITAL OF NORTH INDIA

Introduction: The present study was carried out to determine the species of Enterococci isolated from various clinical samples and to determine its antimicrobial susceptibility pattern. Enterococci have emerged as an important cause of nosocomial infections and antibiotic resistance among Enterococcus is a major obstacle for treatment. Material and methods: Enterococcus spp. were isolated and identified from different clinical samples between Sept. 2012 to Aug. 2013 by standard biochemical test. Antimicrobial susceptibility testing was performed by modified Kirby bauers disc diffusion method as per CLSI guidelines. Result: Among the 100 isolates of Enterococcus from various clinical samples maximum isolates were from urine sample 70% and E. faecalis 92% constituted the predominant isolate. They were found to be susceptible to linezolid and vancomycin with least sensitive to ciprofloxacin and tetracycline. Conclusion: Routine speciation and in vitro antimicrobial susceptibility testing of Enterococcus in various clinical samples is emphasized due to the prevalence of wide variety of Enterococcus species and also appearance of high resistant strains.
Apathy, ventriculomegaly and neurocognitive improvement following shunt surgery in normal pressure hydrocephalus

Introduction. Apathy – impaired motivation and goal-directed behaviour – is a common yet often overlooked symptom in normal pressure hydrocephalus (NPH). Caudate atrophy often yields apathetic symptoms; however, this structural and functional relationship has not yet been explored in NPH. Additionally, little is known about the relationship between apathy and post-shunt cognitive recovery. Methods. This audit investigated whether apathetic symptoms improve following shunt surgery in NPH, and whether this relates to cognitive response. In addition, we assessed the relationship between ventriculomegaly and apathy using the bicaudate ratio. Twenty-two patients with NPH completed the Mini-Mental State Examination (MMSE), the Apathy Evaluation Scale (AES) and the Geriatric Depression Scale (GDS) before and 3–9 months after shunt surgery. Pre-operative ventriculomegaly was correlated with pre-operative AES and GDS scores. Difference scores (post-shunt minus baseline values) for AES and GDS were correlated with cognitive outcome. Results. Greater pre-operative ventriculomegaly was associated with increased level of apathy and depression. A reduction in apathetic symptoms following shunt surgery was associated with improved performance on the MMSE. Conclusions. Apathy may be indicative of a greater degree of subcortical atrophy in NPH and may relate to functional outcome.
The Asian project for collaborative derivation of reference intervals: (2) results of non-standardized analytes and transference of reference intervals to the participating laboratories on the basis of cross-comparison of test results

Abstract Background: The 2009 Asian multicenter study for derivation of reference intervals (RIs) featured: 1) centralized measurements to exclude reagent-dependent variations; 2) inclusion of non-standardized analytes (hormones, tumor makers, etc.) in the target; and 3) cross-check of test results between the central and local laboratories. Transferability of centrally derived RIs for non-standardized analytes based on the cross-check was examined. Methods: Forty non-standardized analytes were centrally measured in sera from 3541 reference individuals recruited by 63 laboratories. Forty-four laboratories collaborated in the cross-check study by locally measuring aliquots of sera from 9 to 73 volunteers (average 22.2). Linear relationships were obtained by the major-axis regression. Error in converting RIs using the regression line was expressed by the coefficient of variation of slope b [CV(b)]. CV(b) <10% was set as the cut-off value allowing the conversion. The significance of factors for partitioning RIs was determined similarly as in the first report. Results: Significant sex-, age-, and region-related changes in test results were observed in 17, 15, and 11 of the 40 analytes, respectively. In the cross-comparison study, test results were not harmonized in the majority of immunologically measured analytes, but their average CV(b)s were <10% except for total protein, cystatin C, CA19-9, free thyroxine, and triiodothyronine. After conversion, 74% of centrally derived RIs were transferred to each local laboratory. Conclusions: Our results point to the feasibility of: 1) harmonizing test results across different laboratories; and 2) sharing centrally derived RIs of non-standardized analytes by means of comparative measurement of a set of commutable specimens.