Miracle-dz/UniFAR-FTUs huggingface dataset:
Effectiveness of recombinant human platelet‐derived growth factor for the treatment of diabetic neuropathic foot ulcers

The goal of this study was to estimate the effectiveness in actual clinical practice of recombinant human platelet‐derived growth factor (rhPDGF) for the treatment of diabetic neuropathic foot ulcer (DNFU). Previously published pivotal trials have shown that by the 20th week of care 35 percent more ulcers healed in the group randomized to receive rhPDGF than those who did not receive rhPDGF (i.e., a relative risk [RR] of about 1.35). This represents an estimate of the efficacy of rhPDGF under the tightly controlled conditions of randomized clinical trials. Treatment effectiveness under standard clinical practice was estimated in a retrospective cohort study, controlling for treatment selection bias using propensity scores. We noted 24,898 individuals with a DNFU, of whom 9.6 percent received rhPDGF. We successfully created a propensity score model that evenly balanced many wound characteristics between those who received rhPDGF and those who did not. We created five groups, which varied from those least likely to receive rhPDGF to those most likely to receive rhPDGF. The RR, controlling for the propensity, to receive rhPDGF for a healed wound after treatment with rhPDGF as compared with standard care was 1.32 (1.22, 1.38). With respect to amputation, the RR for undergoing amputation after receiving rhPDGF was 0.65 (0.54, 0.78) as compared with those who did not receive rhPDGF. Within the limitations of our study, rhPDGF is more effective than standard therapy in both helping a wound to heal and preventing amputation, and its effect is similar to the efficacy estimates from previously published randomized controlled trials.
Ambient particulate matter affects occludin distribution and increases alveolar transepithelial electrical conductance

Background and objective: Inhaled particulate matter (PM) causes lung inflammation and epithelial dysfunction. However, the direct effect of PM on alveolar epithelial barrier integrity is not well understood. Our aim is to determine whether PM exposure affects the alveolar epithelial cells (AEC) transepithelial electrical conductance (Gt) and tight junction (TJ) proteins.
Influence of urine pH and urinary flow on the renal excretion of memantine.

AIMS The present study assessed the influence of urinary flow rate and urine pH on the renal excretion of the NMDA-receptor antagonist memantine. METHODS In a randomized, open, four-period cross-over trial, 12 healthy male volunteers received 10 mg memantine daily for 43 days. After reaching steady state conditions the volunteers were allocated to four different regimens to alter urine pH and urinary flow, which were each separated by a 1 week period while the study medication continued (A: acidification of urine pH, low urinary flow; B: acidification of urine pH, high urinary flow; C: alkalinization of urine pH, low urinary flow; D: alkalinization of urine pH, high urinary flow). RESULTS The renal clearance of memantine (CL(R)) in regimen A and B was 7-10 fold higher in comparison with regimen C and D (P<0.05). There were small but statistically significant differences of CL(R) between the two regimens with acidic urine pH (A: median: 210.2 ml min(-1) vs B: median: 218.7 ml min(-1)) and between the two regimens with alkaline urine pH (C: median: 19.4 ml min(-1) vs D: median: 30.5 ml min(-1)). The amount of memantine excreted into the urine within one regimen (Ae0-24h) was 5.7-7.4 fold higher in regimens A and B than C and D (P< 0.05). Differences of the AUC(0,24 h) and Cmax/AUC(0,24 h) were significant (P<0.05) between each of the regimens with acidic urine pH (A, B) and regimens (C, D) with alkaline urine pH (A vs C, A vs D, B vs C, B vs D) but not between regimens A vs B or C vs D. CONCLUSIONS The present study demonstrated a considerable effect of urine pH, whereas no clinically relevant change of the renal excretion of memantine with urinary flow could be detected. As the renal excretion of memantine may have an impact on therapeutic efficacy changes of dietary habits that may alter urine pH should be avoided during treatment with memantine.
Febrile Seizures: Clinical Characteristics and Initial EEG

Summary: We examined the relationship between clinical characteristics and EEG classification in all children with febrile seizures examined at the University Pediatric Clinic, Skopje, Yugoslavia between 1982 and 1984. This is the only facility in Macedonia providing EEG or neurologic consultation for children. EEGs were classified as paroxysmally abnormal if they contained spikes, sharp waves, or spike‐wave complexes considered abnormal for age. In all, 22% of the 676 children had an abnormal initial EEG. The most common basis for classification as abnormal was spike‐wave complexes > 3 Hz; the next most common basis was the presence of spikes. Birth weight, gender, accompanying illness, and family history of seizures, and whether the index seizure was single or multiple were not associated with differences in rate of abnormal EEG. Clinically focal index seizures and longer duration were associated with EEG abnormality. Number of previous febrile seizures was associated with an increasing rate of EEG abnormality, from 18% in children with no previous seizures to 63% in those with four or more previous seizures. Age at EEG was linearly related to likelihood of paroxysmal EEG abnormality, both for the total cohort and for the 376 children with no previous seizures. In the total cohort, logistic regression identified leading predictors of abnormal initial EEG to be older age, number of previous febrile seizures, preexisting motor abnormality, and focal seizures. For children with a first febrile seizure, leading predictors were focal seizure, older age, and preexisting motor abnormality.
Psychological treatment for atypical non-cardiac chest pain: a controlled evaluation

Synopsis Thirty-one patients with atypical non-cardiac chest pain which had persisted despite negative medical investigation were treated in a controlled trial of cognitive-behavioural therapy. The average duration of pain was 4·7 years. Patients were randomized to either immediate treatment or as a control to assessment only. Treatment involved teaching patients how to anticipate and control symptoms, and modification of inappropriate health beliefs. The average number of sessions given was 7·2. There were significant reductions in chest pain, limitations and disruption of daily life, autonomic symptoms, distress and psychological morbidity in the treated group as compared with the control group who were unchanged. The assessment-only group were treated subsequently and showed comparable changes. Improvements were fully maintained by both treated groups at four to six-months follow-up.
[Computer-aided electronic prescribing in Spanish hospitals].

OBJECTIVE To describe electronic prescribing in a sample of Spanish hospitals and activities derived from its implementation in Hospital Pharmacy Departments, software features and acceptance. METHOD A survey that included data related to program implantation and performance in hospitals with diverse characteristics was designed. It was posted at the Sociedad Española de Farmacia Hospitalaria website for a 6-month period and completed by phone. RESULTS A total of 47 hospitals answered the survey. 13 (27.7%) had electronic prescribing systems, and of these, 8 of them had more than 75% of beds included in the system. In 15 (31.9%) hospitals that did not have it, its implementation was in project in the near future. Software applications used in this new health technology were not homogeneous, while integration of applications that facilitate Pharmaceutical Care tasks was infrequent. In 61.5% of the hospitals with electronic prescribing, transcription used to be the pharmacist s task. In 92.3% of these hospitals, order validation is currently carried out by pharmacists. The degree of satisfaction with the system was rated as good or very good by 92.3% of pharmacists. CONCLUSIONS Computer-aided electronic prescribing appears to be a helpful tool for restructuring Department organization and investing time in new activities. A more ambitious and effective approach to clinical activities will therefore be possible. System optimization requires taking into account factors such as worker time investment, since new activities will be developed, along with the need for training courses.
Dogs, distemper and Paget's disease

The cause of Paget's disease is still unknown, despite many years of intensive study. During this time, evidence has sporadically emerged to suggest that the disease may result from a slow viral infection by one or more of the Paramyxoviruses. More recently, epidemiologic and molecular studies have suggested that the canine paramyxovirus, canine distemper virus, is the virus responsible for the disease. If true, then along with rabies, this would be a further example of a canine virus causing human disease. Studies in the natural host have now supported these findings. Further investigations have proposed that the bony abnormalities seen in Paget's disease are due to the effects of the virus on osteoclastic interleukin‐6 and c‐FOS production, possibly via the transcription factor NF‐kB.
Clinical characteristics and outcome of hospitalized patients with congestive heart failure: results of the HIJC-HF registry.

BACKGROUND Heart failure (HF) represents a major public health issue in an aging population. Although HF is a leading cause of morbidity and mortality in developed countries, the clinical features of HF in Japan remain unclear. METHODS AND RESULTS This observational cohort study analyzed data from the Heart Institute of Japan--Department of Cardiology (HIJC)-HF Registry, which is based on a nationwide survey by the HIJC, Tokyo Women's Medical University and its affiliated hospitals. Of 3,578 consecutive patients (average age, 69.8 years; females 40.7%) hospitalized for HF between January 2001 and December 2002, 95.0% were followed up until the end of 2005 (median, 2.8 years). The 1- and 3-year mortality rates were 11.3% and 29.2%, respectively. Multivariate analysis revealed that advanced age (hazard ratio 1.71 [95% confidence interval 1.38-2.12]; p<0.001), symptomatic HF at hospital discharge (3.76 [2.30-6.17]; p<0.001), renal impairment (1.96 [1.50-2.57]; p=0.008), anemia (1.46 [1.18-1.80]; p=0.02) and low pulse pressure (2.88 [1.62-5.13]; p=0.0003) were significantly associated with total death. CONCLUSION Although the long-term mortality rate for Japanese patients with HF is lower than in other countries, several markers are modifiable. The data demonstrate that continued improvements in the treatment of Japanese patients with HF are still needed.
Prevalence of yeasts in saliva and root canals of teeth associated with apical periodontitis.

AIMS To determine: (i) the relative prevalence and diversity of yeasts in salivary and root canal samples from the same patients; and (ii) the clinical factors associated with their presence in saliva and root canals. METHODOLOGY Sixty root canal samples from teeth associated apical periodontitis and the corresponding whole unstimulated saliva samples were obtained from 55 patients. The medical history including antibiotic therapy and clinical/radiographic data on the teeth were recorded. The samples were serially diluted and cultured on yeast & fungi-selective sabouraud dextrose agar. Isolates were characterized and speciated by the germ tube formation test, hyphal morphology and a commercial biochemical test kit (Rapid ID32C(R) system). RESULTS Twenty-three yeast isolates were recovered from 19 saliva samples and eight isolates from six root canal samples. Candida albicans (17/23 & 3/8) and Rodotorula mucilaginosa (2/23 & 4/8) were the most prevalent isolates from saliva and root canal samples. It was significantly (13.8 times) more probable that yeasts would be recovered from root canals when they were also present in the saliva (P = 0.021). The effect of coronal restoration leakage (P = 0.08) and previous root canal treatment (P = 0.123) were equivocal. The history of antibiotic therapy had no association with the presence of yeasts in saliva (OR = 1.1). CONCLUSIONS Yeasts occurred relatively infrequently (10%) in root canals. Their presence in root canals was significantly associated with their presence in saliva. The role of yeasts in the initiation and perpetuation of periapical disease remains to be determined.
Metropolitan-area estimates of binge drinking in the United States.

OBJECTIVES We estimated adult binge drinking prevalence in US metropolitan areas. METHODS We analyzed 1997 and 1999 Behavioral Risk Factor Surveillance System data for 120 metropolitan areas in 48 states and the District of Columbia. RESULTS The prevalence of binge drinking varied substantially across metropolitan areas, from 4.1% in Chattanooga, Tenn, to 23.9% in San Antonio, Tex, (median = 14.5%). Seventeen of the 20 metropolitan areas with the highest estimates were located in the upper Midwest, Texas, and Nevada. In 13 of these areas, at least one third of persons aged 18 to 34 years were binge drinkers. There were significant intrastate differences for binge drinking among metropolitan areas in New York, Tennessee, and Utah. CONCLUSIONS Metropolitan-area estimates can be used to guide local efforts to reduce binge drinking.
MicroRNA‐138 suppresses ovarian cancer cell invasion and metastasis by targeting SOX4 and HIF‐1α

Metastasis is the major factor affecting patient survival in ovarian cancer. However, its molecular mechanisms remain unclear. Our study used isogenic pairs of low‐ and high‐invasive ovarian cancer cell lines to demonstrate the downregulation of miRNA‐138 in the highly invasive cells, and its functioning as an inhibitor of cell migration and invasion. An orthotopic xenograft mouse model further demonstrated that the expression of miRNA‐138 inhibited ovarian cancer metastasis to other organs. Results indicated that miR‐138 directly targeted SRY‐related high mobility group box 4 (SOX4) and hypoxia‐inducible factor‐1α (HIF‐1α), and overexpression of SOX4 and HIF‐1α effectively reversed the miR‐138‐mediated suppression of cell invasion. Epidermal growth factor receptor acted as the downstream molecule of SOX4 by way of direct transcriptional control, whereas Slug was the downstream molecule of HIF‐1α by way of proteasome‐mediated degradation. Analysis of human ovarian tumors further revealed downregulation of miR‐138 and upregulation of SOX4 in late‐stage tumors. Patients with miR‐138low/SOXhigh signature are predominant in late stage and tend to have malignant phenotypes including lymph nodes metastasis, larger ascites volume and higher tumor grade. Our study demonstrates the role and clinical relevance of miR‐138 in ovarian cancer cell invasion and metastasis, providing a potential therapeutic strategy for suppression of ovarian cancer metastasis by targeting SOX4 and HIF‐1α pathways.
Impact of transjugular intrahepatic portosystemic shunt implantation on liver perfusion measured by volume perfusion CT

Background Implantation of a transjugular intrahepatic portosystemic shunt (TIPS) induces changes of liver perfusion. Purpose To determine the changes in arterial, portal venous, and total perfusion of the liver parenchyma induced by TIPS using the technique of volume perfusion computed tomography (VPCT) and compare results with invasively measured hepatic intravascular pressure values. Material and Methods VPCT quantification of liver perfusion was performed in 23 patients (mean age, 62.5 ± 8.8 years) with portal hypertension in the pre-TIPS and post-TIPS setting, respectively. A commercially available software package was used for post-processing, enabling separate calculation of the dual (arterial [ALP] and portal venous [PVP]) blood supply and additionally of the hepatic perfusion index (HPI) (HPI = ALP/(ALP + PVP)*100%). Invasive pressure measurements were performed during the intervention, before and after TIPS placement. Liver function tests performed before and after the procedure were compared. Results Mean decrease of pressure gradient through TIPS was 13.3 mmHg. Mean normal values for ALP, PVP, and total perfusion (ALP + PVP) before TIPS were 15.9, 37.7, and 53.5 mL/100 mL/min, respectively, mean HPI was 35.4%. After TIPS, ALP increased to a mean value of 37.7 mL/100 mL/min, PVP decreased (15.7 mL/100 mL/min, P < 0.05), whereas total perfusion remained unchanged (53.4 mL/100 mL/min, P = 0.97). HPI increased (71.9%; P < 0.05). No correlation between invasive pressure measurement and VPCT parameters was observed. After TIPS, liver function tests were found to worsen with a significant increase of bilirubin (P < 0.05). Conclusion Following TIPS placement, ALP and HPI increased in all patients, whereas PVP markedly decreased. Interestingly, the magnitude of decrease in portosystemic pressure gradients was not found to correlate with VPCT parameters.
CHOROIDAL THICKNESS IN RELATION TO HYPERCHOLESTEROLEMIA ON ENHANCED DEPTH IMAGING OPTICAL COHERENCE TOMOGRAPHY

Purpose: To investigate the relationship of hypercholesterolemia and choroidal thickness in normal healthy volunteers. Method: This was a cross-sectional observational study. Volunteers with no ocular abnormalities were examined using enhanced depth imaging optical coherence tomography. Choroidal and retinal thicknesses were measured at the fovea, and at 4 different locations 1 mm superior, inferior, temporal, and nasal to the fovea. Subjects were further divided into those with hypercholesterolemia (Group 1) and normal control subjects (Group 2) for subgroup analysis regarding the effect of hypercholesterolemia on choroidal thickness. Subjects with hypertension and diabetes were excluded. Results: A total of 322 eyes of 161 subjects were studied. Mean age was 59.9 years (range, 24–84 years). The mean subfoveal choroidal thickness was 261 ± 98.7 &mgr;m. Mean subfoveal choroidal thickness negatively correlated with age (r = −0.326; P = 0.001). The mean serum total cholesterol was 5.02 ± 0.98 mmol/L. In Group 1, it was 5.65 ± 1.15 mmol/L, while in Group 2, it was 4.72 ± 0.73 mmol/L. The difference was statistically significant (P = 0.003). Subjects in Group 1 tended to be older and have worse vision, although the difference did not reach statistical significance. The mean subfoveal choroidal thickness in Group 1 was 306 ± 111 &mgr;m, while that in Group 2 was 258 ± 97 &mgr;m. The difference was statistically significant (P = 0.041). The same difference was also found at the 1 mm nasal (P = 0.041) and 1 mm superior (P = 0.040). Conclusion: The subfoveal choroidal thickness was found to be significantly higher in subjects with hypercholesterolemia. This has to be taken into account when analyzing choroidal thickness.
Efficacy of antibodies against a chimeric synthetic peptide encompassing epitopes of bonnet monkey (Macaca radiata) zona pellucida‐1 and zona pellucida‐3 glycoproteins to inhibit in vitro human sperm‐egg binding

Immunocontraception achieved by immunization with zona pellucida (ZP) glycoproteins is invariably associated with ovarian dysfunction. Use of ZP glycoprotein‐based synthetic peptides as immunogens has been proposed to overcome adverse side effects on ovaries. In the present study, a chimeric peptide encompassing the epitopes of bonnet monkey (Macaca radiata) ZP glycoprotein‐1 (bmZP1; amino acid residues 251–273) and ZP glycoprotein‐3 (bmZP3; amino acid residues 324–347), separated by a tri‐glycine spacer, was synthesized and conjugated to diphtheria toxoid (DT). Immunization of female BALB/cJ mice and bonnet monkeys with the chimeric peptide led to generation of antibodies that reacted with the chimeric peptide, individual bmZP1 & bmZP3 peptides, and also recombinant bmZP1 and bmZP3 proteins expressed by E. coli in an ELISA. Indirect immunofluorescence studies revealed that the immune serum also recognized human as well as bonnet monkey ZP. A significant inhibition of human sperm binding to ZP was observed with antibodies generated against the chimeric peptide in mice (P = 0.0001) as well as monkeys (P = 0.0002) in a hemizona assay (HZA). The inhibition efficacy was significantly higher than that observed by using antibodies against the individual bmZP1 and bmZP3 peptides. Interestingly, no ovarian pathology was observed in female bonnet monkeys immunized with the chimeric peptide. These studies have demonstrated that the chimeric peptide encompassing peptides of multiple ZP glycoproteins may be a promising candidate antigen for designing immunocontraceptive vaccines. Mol. Reprod. Dev. 70: 247–254, 2005. © 2005 Wiley‐Liss, Inc.
Percutaneous autologous bone-marrow grafting for nonunions. Surgical technique.

BACKGROUND Bone marrow aspirated from the iliac crest contains progenitor cells that can be used to obtain bone-healing of nonunions. However, there is little available information regarding the number and concentration of these cells that are necessary to obtain bone repair. The purpose of this study was to evaluate the number and concentration of progenitor cells that were transplanted for the treatment of nonunion, the callus volume obtained after the transplantation, and the clinical healing rate. METHODS Marrow was aspirated from both anterior iliac crests, concentrated on a cell separator, and then injected into sixty noninfected atrophic nonunions of the tibia. Each nonunion received a relatively constant volume of 20 cm(3) of concentrated bone marrow. The number of progenitor cells that was transplanted was estimated by counting the fibroblast colony-forming units. The volume of mineralized bone formation was determined by comparing preoperative computerized tomography scans with scans performed four months following the injection. RESULTS The aspirates contained an average (and standard deviation) of 612 +/- 134 progenitors/cm(3) (range, 12 to 1224 progenitors/cm(3)) before concentration and an average of 2579 +/- 1121 progenitors/cm(3) (range, 60 to 6120 progenitors/cm(3)) after concentration. An average total of 51 x 10(3) fibroblast colony-forming units was injected into each nonunion. Bone union was obtained in fifty-three patients, and the bone marrow that had been injected into the nonunions of those patients contained >1500 progenitors/cm(3) and an average total of 54,962 +/- 17,431 progenitors. The concentration (634 +/- 187 progenitors/cm(3)) and the total number (19,324 +/- 6843) of progenitors injected into the nonunion sites of the seven patients in whom bone union was not obtained were both significantly lower (p = 0.001 and p < 0.01, respectively) than those in the patients who obtained bone union. The volume of the mineralized callus measured at four months on the computerized tomography scans of the patients who had union ranged from 0.8 to 5.3 cm(3) (mean, 3.1 cm(3)). There was a positive correlation between the volume of mineralized callus at four months and the number (p = 0.04) and concentration (p = 0.01) of fibroblast colony-forming units in the graft. There was a negative correlation between the time needed to obtain union and the concentration of fibroblast colony-forming units in the graft (p = 0.04). CONCLUSIONS Percutaneous autologous bone-marrow grafting is an effective and safe method for the treatment of an atrophic tibial diaphyseal nonunion. However, its efficacy appears to be related to the number of progenitors in the graft, and the number of progenitors available in bone marrow aspirated from the iliac crest appears to be less than optimal in the absence of concentration.