Miracle-dz/UniFAR-FTUs huggingface dataset:
Eficacia de la asociación paracetamol-metamizol vs. paracetamol-dexketoprofeno en manejo de dolor agudo postoperatorio

espanolObjetivo: El uso de farmacos con mecanismos diferentes combinados entre si para el tratamiento del dolor, en concreto del dolor agudo postoperatorio, forma parte fundamental de un tipo de analgesia llamada multimodal. El objetivo de este trabajo es evaluar la eficacia de la asociacion de paracetamol mas metamizol y compararla con la asociacion de paracetamol mas dexketoprofeno en dolor agudo postoperatorio. Metodos: Disenamos un estudio prospectivo de intervencion en el que se incluyeron 42 pacientes sometidos bajo anestesia general a cirugias de probable bajo nivel algesico y duracion 0,05). Conclusion: Nuestros resultados sugieren que la combinacion de paracetamol y metamizol como terapia combinada para el manejo de dolor agudo postoperatorio es eficaz y equiparable a la combinacion de paracetamol y dexketoprofeno, pudiendo constituir, por tanto, una alternativa a esta ultima. EnglishObjective: The use of drugs with different mechanisms, in combination for the treatment of pain, particularly acute postoperative pain, is a main part of the multimodal analgesia. The aim of this study was to evaluate the efficacy of metamizol plus paracetamol and compare it with the association of paracetamol plus dexketoprofen in acute postoperative pain. Methods: We designed a prospective interventional study that included 42 patients undergoing general anesthesia for probably low algesic and duration of surgery 3, they received the drug of the group that they were assigned (metamizol: group M; dexketoprofen: group D), with evaluation of variations in the scale score. We examined in both groups demographic variables, variables related to anesthesia and surgery, simple numeric scale (NSE) changes, complications and the incidents during the process. Results: 20 patients were studied in the M group and 22 patients in D group. Both groups had a similar distribution in terms of demographic variables, medical history, type and duration of surgery. Both group showed a clinically relevant decrease in the score of the simple numeric scale (p 0.05). Conclusion: Our results suggest that the combination of paracetamol plus metamizol in combined therapy for management of acute postoperative pain is effective and comparable to the combination of paracetamol plus dexketoprofen and can constitute an alternative therapy.
Kupffer cells promote hepatic steatosis via interleukin‐1β–dependent suppression of peroxisome proliferator‐activated receptor α activity

Kupffer cells have been implicated in the pathogenesis of various liver diseases. However, their involvement in metabolic disorders of the liver, including fatty liver disease, remains unclear. The present study sought to determine the impact of Kupffer cells on hepatic triglyceride storage and to explore the possible mechanisms involved. To that end, C57Bl/6 mice rendered obese and steatotic by chronic high‐fat feeding were treated for 1 week with clodronate liposomes, which cause depletion of Kupffer cells. Loss of expression of marker genes Cd68, F4/80, and Clec4f, and loss of Cd68 immunostaining verified almost complete removal of Kupffer cells from the liver. Also, expression of complement components C1, the chemokine (C‐C motif) ligand 6 (Ccl6), and cytokines interleukin‐15 (IL‐15) and IL‐1β were markedly reduced. Importantly, Kupffer cell depletion significantly decreased liver triglyceride and glucosylceramide levels concurrent with increased expression of genes involved in fatty acid oxidation including peroxisome proliferator‐activated receptor alpha (PPARα), carnitine palmitoyltransferase 1A (Cpt1α), and fatty acid transport protein 2 (Fatp2). Treatment of mice with IL‐1β decreased expression of PPARα and its target genes, which was confirmed in primary hepatocytes. Consistent with these data, IL‐1β suppressed human and mouse PPARα promoter activity. Suppression of PPARα promoter activity was recapitulated by overexpression of nuclear factor κB (NF‐κB) subunit p50 and p65, and was abolished upon deletion of putative NF‐κB binding sites. Finally, IL‐1β and NF‐κB interfered with the ability of PPARα to activate gene transcription. Conclusion: Our data point toward important cross‐talk between Kupffer cells and hepatocytes in the regulation of hepatic triglyceride storage. The effect of Kupffer cells on liver triglycerides are at least partially mediated by IL‐1β, which suppresses PPARα expression and activity. (HEPATOLOGY 2010.)
Effect of toothbrushing, chemical disinfection and thermocycling procedures on the surface microroughness of denture base acrylic resins.

OBJECTIVE This study verified the surface microroughness of denture acrylic resins submitted to toothbrushing, chemical disinfection and thermocycling procedures. MATERIAL AND METHODS Samples were prepared according to conventional, microwaved and boiled resins and submitted to microroughness measurements before and after procedures using a profilometer (Ra). Data were subjected to anova and Tukey's test (5%). RESULTS Before thermocycling, a difference was found among treatments for microwaved and boiled resins, with greater values for toothbrushing and lower values for Efferdent and hypochlorite; control was intermediate. Differences among resins were observed for treatments, with higher values for boiled resin and lower values for conventional and microwaved resins. After thermocycling, differences were found for microwaved resin, with a higher value for toothbrushing and a lower value for Efferdent and hypochlorite; control was intermediate. Tooth-brushed boiled resin presented higher values and hypochlorite lower values; control and Efferdent were intermediates. Differences among resins were seen for treatments, with higher values for boiled resin and lower values for conventional and microwaved resins. Boiled resin presented differences for toothbrushing and hypochlorite, before and after thermocycling procedures were compared. CONCLUSIONS For microwaved and boiled resins, toothbrushing and chemical disinfection promoted different levels of surface microroughness when associated or not with thermocycling.
Variability in ethanol biodisposition in whites is modulated by polymorphisms in the ADH1B and ADH1C genes

Association between genetic variations in alcohol‐related enzymes and impaired ethanol biodisposition has not been unambiguously proven, and the effect of many newly described polymorphisms remains to be explored. The aims of this study are to elucidate the influence of genetic factors in alcohol biodisposition and effects. We analyzed alcohol pharmacokinetics and biodisposition after the administration of 0.5 g/kg ethanol; we measured ethanol effects on reaction time and motor time in response to visual and acoustic signals, and we analyzed 13 single nucleotide polymorphism (SNPs) in the genes coding for ADH1B, ADH1C, ALDH2, and CYP2E1 in 250 healthy white individuals. Variability in ethanol pharmacokinetics and biodisposition is related to sex, with women showing a higher area under the curve (AUC) (P = 0.002), maximum concentration (Cmax) (P < 0.001) and metabolic rate (P = 0.001). Four nonsynonymous SNPs are related to decreased alcohol metabolic rates: ADH1B rs6413413 (P = 0.012), ADH1C rs283413 (P < 0.001), rs1693482 (P < 0.001), and rs698 (P < 0.001). Individuals carrying diplotypes combining these mutations display statistically significant decrease in alcohol biodisposition as compared with individuals lacking these mutations. Alcohol effects displayed bimodal distribution independently of sex or pharmacokinetics. Most individuals had significant delays in reaction and motor times at alcohol blood concentrations under 500 mg/L, which are the driving limits for most countries. Conclusion: Besides the identification of new genetic factors related to alcohol biodisposition relevant to whites, this study provides unambiguous identification of diplotypes related to variability in alcohol biodisposition. (HEPATOLOGY 2010;51:491–500.)
Oral health-related quality of life and nutritional status of institutionalized elderly population aged 60 years and above in Mysore City, India.

OBJECTIVE To assess whether oral health-related quality of life (OHRQoL) is associated with nutritional status in the institutionalised elderly population of Mysore. BACKGROUND Malnutrition in the elderly has an evident impact on their general health and quality of life. Analysis of data of the Geriatric Oral Health Assessment Index (GOHAI) and their association with the Mini Nutritional Assessment (MNA) results improves our understanding of the complex relationship between oral health and malnutrition. MATERIALS AND METHODS The study was conducted among the institutionalised elderly population in Mysore city, Karnataka. Data on socio-demographic, oral health status were gathered. OHRQoL was evaluated using GOHAI, and malnutrition risk using MNA. RESULTS Out of 141 elderly, 41.1% were men and 58.9% were women with mean age of 72.2 ±7.5 years. Mean GOHAI score was 47.03 ± 9.2, with 69.5% had low perception of oral health. Mean MNA score was 9.91 ± 2.4, 15.6% were malnourished, 52.5% were at risk of malnutrition and 31.9% were adequately nourished. A strong association was found between the mean GOHAI and MNA scores. CONCLUSION Oral health-related quality of life was associated with nutritional deficit, and it requires a greater integration between dentistry and nutrition in the health promotion of older adults.
Battlefield Compassion and Posttraumatic Growth in Combat Servicepersons

The literature is replete with studies related to the negative outcomes of serving in combat. However, for some military servicepersons, healing could be assisted by understanding the positive experiences and outcomes related to combat service. This study surveyed 59 servicepersons to identify acts of battlefield compassion, as well as other positive military experiences. In addition, participants were asked to identify personal changes as a result of compassionate experiences and to give an overall rating of their time in combat. Results are compared to the posttraumatic growth (PTG) literature and reveal that participants identified positive changes associated with experiences of compassion.
Response to Letter Regarding Article, “Relationship of Echocardiographic Dyssynchrony to Long-Term Survival After Cardiac Resynchronization Therapy”

Cardiac resynchronization therapy (CRT) has undoubtedly been of major benefit to many patients who have heart failure with wide QRS complexes, improving symptoms and survival. Unfortunately, the CRT nonresponder rate remains at about one third with the use of the current selection criteria. An appropriate goal is to better understand the factors related to nonresponse to improve patient care. In a recent study of 229 CRT patients, we reported that the absence of echocardiographic dyssynchrony was associated with a significantly less favorable event-free survival with the use of the combined end point of death, heart transplantation, or left ventricular assist device over 4 years after CRT.1 We appreciate the commendation from Fornwalt et al in their letter and …
Urorectal septum malformation sequence: A report of seven cases

ABSTRACT Urorectal septum malformation (URSM) sequence is an extremely uncommon anomaly. We report herein seven cases of URSM sequence that were identified after reviewing all autopsies conducted at our hospital over a period of 26 years (1981–2006). The URSM spectrum includes partial and full URSM sequences. Absent perineal and anal openings with ambiguous genitalia are included under ‘full URSM sequence’, and a single perineal or anal opening draining a common cloaca with an imperforate anus is called ‘partial URSM sequence’. Of our seven cases of URSM, three were full URSM sequence and four were partial URSM sequence. Associated renal anomalies were found in all of the cases. Three cases had unilateral renal agenesis and one each had bilateral renal agenesis and bilateral renal dysplasia, respectively. The remaining two cases had unilateral renal agenesis with contralateral kidney showing features of cystic dysplastic kidney and renal hypoplasia, respectively. Congenital anomalies involving other organs were also found in some of the cases. The longest survival period in our series was 10 days, in accordance with the short survival period usually associated with URSM. Five of the patients were females, one was male, and the sex of one neonate could not be ascertained. One of the neonates was from a twin pregnancy; the other twin was normal.
Sirolimus‐based immunosuppression is associated with increased survival after liver transplantation for hepatocellular carcinoma

Liver transplantation is an important treatment option for selected patients with nonresectable hepatocellular carcinoma (HCC). Several reports have suggested a lower risk of posttransplant tumor recurrence with the use of sirolimus and a higher one with calcineurin inhibitors, but the selection of an ideal immunosuppression protocol is still a matter of debate. The aim of this study was to define the immunosuppression associated with the best survival after liver transplantation for HCC. It was based on the Scientific Registry of Transplant Recipients and included 2,491 adult recipients of isolated liver transplantation for HCC and 12,167 for non‐HCC diagnoses between March 2002 and March 2009. All patients remained on stable maintenance immunosuppression protocols for at least 6 months posttransplant. In a multivariate analysis, only anti‐CD25 antibody induction and sirolimus‐based maintenance therapy were associated with improved survivals after transplantation for HCC (hazard ratio [HR] 0.64, 95% confidence interval [CI]: 0.45–0.9, P ≤ 0.01; HR 0.53, 95% CI: 0.31–0.92, P ≤ 0.05, respectively). The other studied drugs, including calcineurin inhibitors, did not demonstrate a significant impact. In an effort to understand whether the observed effects were due to a direct impact of the drug on tumor or more on liver transplant in general, we conducted a similar analysis on non‐HCC patients. Although anti‐CD25 induction was again associated with a trend toward improved survival, sirolimus showed a trend toward lower rates of survival in non‐HCC recipients, confirming the specificity of its beneficial impact to cancer patients. Conclusion: According to these data, sirolimus‐based immunosuppression has unique posttransplant effects on HCC patients that lead to improved survival. (HEPATOLOGY 2010.)
Serotonin promotes tumor growth in human hepatocellular cancer

In addition to its function as a neurotransmitter and vascular active molecule, serotonin is also a mitogen for hepatocytes and promotes liver regeneration. A possible role in hepatocellular cancer has not yet been investigated. Human hepatocellular cancer cell lines Huh7 and HepG2 were used to assess the function of serotonin in these cell lines. Characteristics of autophagy were detected with transmission electron microscopy, immunoblots of microtubule‐associated protein light chain 3(LC3) and p62 (sequestosome 1). Immunoblots of the mammalian target of rapamycin (mTOR) and its downstream targets p70S6K and 4E‐BP1 were used to investigate signaling pathways of serotonin. Two different animal models served as principle of proof of in vitro findings. Clinical relevance of the experimental findings was evaluated with a tissue microarray from 168 patients with hepatocellular carcinoma. Serotonin promotes tumor growth and survival in starved hepatocellular carcinoma cells. During starvation hepatocellular carcinoma cells exhibited characteristics of autophagy, which disappeared in serotonin‐treated cells. Rapamycin, an inhibitor of mTOR, is known to induce autophagy. Serotonin could override rapamycin by an mTOR‐independent pathway and activate common downstream signals such as p70S6K and 4E‐BP1. In two tumor models of the mouse, inhibition of serotonin signaling consistently impaired tumor growth. Human biopsies revealed expression of the serotonin receptor HTR2B, correlating with downstream signals, e.g., phosphorylated p70S6K and proliferation. Conclusion: This study provides evidence that serotonin is involved in tumor growth of hepatocellular cancer by activating downstream targets of mTOR, and therefore serotonin‐related pathways might represent a new treatment strategy. (HEPATOLOGY 2010.)
Cerebro‐costo‐mandibular syndrome: Prognosis and proposal for classification

Cerebro‐costo‐mandibular syndrome (CCMS) is a very rare syndrome characterized by micrognathia and posterior rib gap, with a poor prognosis. To date, only 75 cases have been reported worldwide. The overall survival rate for patients with this disorder has not been reported, and a classification of the patients on the basis of the prognosis is not yet available. The present study analyzed the figures and prognoses of past patients and documented a new case of CCMS. Formerly published case reports and personal communications were used to reveal the prognosis and classification of CCMS. The occurrence ratios of rib gap defects and of missing ribs were examined. Patients were divided into the following three groups according to their life span: lethal type, where the patients died before 1 month; severe type, where the patients lived for 1–12 months; and mild type, where they survived for more than 1 year. A comparison was made of the number of rib gaps, missing ribs, and the rib gap ratio (defined as the number of rib gaps divided by the number of all existing ribs) among these three groups. A significant difference in the number of rib defects between the lethal type and other types was noted. Short life span of severe type patients, compared to mild type, was attributed to their subjection to severe respiratory infection. CCMS can be classified into three categories – lethal, severe, and mild – according to the severity of the symptoms and prognosis.
Role of rare cases in deciphering the mechanisms of congenital anomalies: CHARGE syndrome research

In this review, our work on CHARGE syndrome will be used to exemplify the role of rare cases in birth defects research. The analysis of 29 cases with mutations of CHD7, the causative gene for CHARGE syndrome, clarified the relative importance of the cardinal features, including facial nerve palsy and facial asymmetry. Concurrently, in situ hybridization using chick embryos studies were performed to delineate the expression pattern of Chd7. The Chd7‐positive regions in the chick embryos and the anatomical defects commonly seen in patients with CHARGE syndrome were well correlated: expression in the optic placode corresponded with defects such as coloboma, neural tube with mental retardation, and otic placode with ear abnormalities. The correlation between expression in the branchial arches and nasal placode with the clinical symptoms of CHARGE syndrome, however, became apparent when we encountered two unique CHARGE syndrome patients: one with a DiGeorge syndrome phenotype and the other with a Kallman syndrome phenotype. A unifying hypothesis that could explain both the DiGeorge syndrome phenotype and the Kallman syndrome phenotype in patients with CHARGE syndrome may be that the mutation in CHD7 is likely to exert its effect in the common branch of the two pathways of neural crest cells. As exemplified in CHARGE syndrome research, rare cases play a critical role in deciphering the mechanisms of human development. Close collaboration among animal researchers, epidemiologists and clinicians hopefully will enhance and maximize the scientific value of rare cases.
Patterns and reasons for childhood tooth extraction in Northwest Nigeria

Childhood tooth extraction is widespread in developing nations especially in sub-Saharan African owing to high prevalence of oral diseases in the population. Purpose of this study is to analyze the reasons and pattern of tooth extraction among children from Northwest Nigeria. Case records of children <14 years seen at the dental clinic of the Federal Medical centre, Gusau, Zamfara state between January 2011 and December 2012 were retrieved from the Medical Records Department and analyzed for analyzed for gender, age, indication for extraction and tooth/teeth extracted. A total of 181 teeth were extracted in 127 patients (1.4 extractions per patients) over a 2 years study period. There were 66 (51.9%) males and 61 (48.1%) females (M:F = 1.08:1). Dental caries and its sequelae 141 (77.9%) was the leading aetiology for tooth extraction followed by trauma 24 (13.3%). Permanent teeth 121 (66.9%) were twice frequently extracted than primary teeth 60 (33.1%). Mandibular teeth 112 (61.9%) were more commonly extracted than maxillary teeth 69 (38.1%). Posterior teeth 115 (63.5%) extractions nearly double that of anterior teeth 66 (36.5%). First permanent molar extraction predominates 51 (28.1%). Majority of the extractions occurred in the 6-9 years age group 96 (53%). Mandibular posteriors constituted the principal teeth removed in the 6-9 years and 10-13 years age groups. In contrast, maxillary anteriors were the main teeth extracted in the younger age group of 0-5 years. For maxillary anteriors trauma was the highest indication for tooth extraction. In conclusion, dental caries and its sequelae was the primary reason for tooth extraction in the study across all age groups and trauma accounted significantly for removal of maxillary anteriors. Thus, there is a need to critically embark on public enlightenment campaign on preventive oral health.
Progenitor‐derived hepatocellular carcinoma model in the rat

Human hepatocellular carcinoma (HCC) is a heterogeneous disease of distinct clinical subgroups. A principal source of tumor heterogeneity may be cell type of origin, which in liver includes hepatocyte or adult stem/progenitor cells. To address this issue, we investigated the molecular mechanisms underlying the fate of the enzyme‐altered preneoplastic lesions in the resistant hepatocyte (RH) model. Sixty samples classified as focal lesions, adenoma, and early and advanced HCCs were microdissected after morphological and immunohistochemical evaluation and subjected to global gene expression profiling. The analysis of progression of the persistent glutathione S‐transferase (GSTP)+ focal lesions to fully developed HCC showed that approximately 50% of persistent nodules and all HCCs expressed cytokeratin 19 (CK19), whereas 14% of remodeling nodules were CK19+. Unsupervised hierarchical clustering of the expression profiles also grouped the samples according to CK19 expression. Furthermore, supervised analysis using the differentially expressed genes in each cluster combined with gene connectivity tools identified 1308 unique genes and a predominance of the AP‐1/JUN network in the CK19+ lesions. In contrast, the CK19‐negative cluster exhibited only limited molecular changes (156 differentially expressed genes versus normal liver) consistent with remodeling toward differentiated phenotype. Finally, comparative functional genomics showed a stringent clustering of CK19+ early lesions and advanced HCCs with human HCCs characterized by poor prognosis. Furthermore, the CK19‐associated gene expression signature accurately predicted patient survival (P < 0.009) and tumor recurrence (P < 0.006). Conclusion: Our data establish CK19 as a prognostic marker of early neoplastic lesions and strongly suggest the progenitor derivation of HCC in the rat RH model. The capacity of CK19‐associated gene signatures to stratify HCC patients according to clinical prognosis indicates the usefulness of the RH model for studies of stem/progenitor‐derived HCC. (HEPATOLOGY 2010.)