Miracle-dz/UniFAR-FTUs huggingface dataset:
Light-based therapies in acne treatment

The use of light and laser in the treatment of acne is increasing as these modalities are safe, effective, and associated with no or minimal complications when used appropriately. These light and laser sources are also being used in combination with pharmacological and/or physical measures to synergize their effects and optimize the therapeutic outcome. This review focuses on optical devices used in treating acne and serves to delineate the current application of various methods, including their utility and efficacy.
An alternative therapy for post-traumatic endophthalmitis: Preserving capsule and primary intraocular lens implantation combined complete vitrectomy

The purpose of the present study was to investigate whether preserving capsule and primary intraocular lens implantation in vitrectomy could influence the therapeutic effect and safety in the treatment of post-traumatic endophthalmitis. A prospective, randomized, controlled trial was performed in this study. A total of 89 patients with post-traumatic endophthalmitis that occurred between January 2008 and December 2010 were randomly divided into two groups: 45 patients underwent complete vitrectomy with preserved capsule and primary intraocular lens implantation, and 44 patients underwent complete vitrectomy with lensectomy and without intraocular lens implantation. There were no significant differences in patients’ age, sex, injuries in detail, intraocular tamponade, culture-proven bacteria, and preoperative and postoperative visual acuity between two groups. No recurrence of bacterial infection was found in any case in both groups, and there was no severe complications happened in two groups during follow-up. Our results suggested that preserving capsule and primary intraocular lens implantation with complete vitrectomy in post-traumatic endophthalmitis was a safe and feasible surgery procedure with benefits in postoperative visual quality, which could be recommended as an alternative therapy.
RELATIONSHIP OF LEGG-PERTHES DISEASE TO THE FUNCTION OF THE THYROID GLAND

Dr. A. Bruce Gill has called attention to an error which appeared in the footnote to Table I of his article on "Relationship of Legg-Perhes Disease to the Function of the Thyroid Gland", published in the October issue of The Journal (Volume XXV, page 897, 1943). The fourth footnote. "(S) indicates Shim units" should have read, "(S) stands for Shin. , and indicates that the method of phosphatase estimation used was that of Shinowara, Reinhart, and Jones".
Challenges in the provision of palliative care at resource-limited South African hospice settings

Parts of the results of this study were presented at the Third Tri-Annual African Palliative Care Association and Hospice Palliative Care Association of South Africa’s Palliative Care Conference, Johannesburg, 17-20 September 2013, (poster) South African Association of Hospital and Institutional Pharmacists (SAAHIP), 28th Annual Conference, Drakensberg, 6-9 March 2014 (podium), South African Society of Clinical Pharmacy (SASOCP), 4th Annual Conference, Cape Town, 19-22 June 2014 (podium), and at the Hospice Palliative Care Association of South African (HPCA) Annual Conference Cape Town 15-18 September 2014 (podium).
Emergency Preparedness for Disasters and Crises in the Hotel Industry

Safety and security are the most important issues to tourist while traveling and the first aspect they consider is to be protected from hazards. Emergency planning and preparedness for a crisis are the most significant components of dealing with disasters. Hospitality practitioners noticed a rising number of natural and man-made crises that harm the hospitality industry, regarding its vulnerability to crisis and internal and external hazards. By using secondary data, this study aims to shed some light on this issue, contributing to knowledge and awareness on emergency preparedness for the hospitality industry. Moreover, the study aims to explain the management’s commitment to adopt, develop, and update emergency plans. The results of this study explain that tourism as an international mobile industry must respond to internal and external hazards such as disease movement and terrorist attacks. Marketing safety is important to promote hotels and tourist destinations to the guests and holiday advisors. Hotels have a long history of being a soft target for terrorist attacks, as can be seen in several accidents that have shaken the hotel industry in the past few decades. Hotels invest a lot to install protective techniques, but terrorists are becoming more organized. Practitioners propose disaster management frameworks using several measurements. Recovery from crisis and learning help business retention that minimizes negative impacts and prevent losses. Finally, evaluation and feedback are very important to overcome the hazards and return to normal, as well as adopting new ideas to deal with emergencies. Single- and double-loop organizational learning should benefit proactive preparedness.
Immune Stimulated Regional Inflammatory Responses Mediating Lung Reactivity in Rats

Daily sensitization of SPF BNxWi/Fu rats with ovalbumin (OA) in aerosol during 2‐week periods with a 4‐week interval resulted after 7 weeks in IgE, IgA and IgG antibodies in serum and bronchial fluid. After cultivation of the regional, axillary, brachial and mediastinal (ABM) lymph node cells, IgE antibodes were found in the culture supernatant. Such antibodies were not found in culture supernatants of spleen and inguinal lymph nodes. Regional formation of IgE antibodies was also noted in the ABM lymph node cell culture supernatants after subcutaneous (s.c.) injections of 100 ng OA in the neck region. When the injections were given in the tail‐root region, the inguinal but not the ABM lymp nodes produced the IgE antibodies. The s.c. sensitization induced inconsistent and rather low IgG and no IgA antibody responses. The aerosol but not the s.c. sensitization induced accumulations of mononuclear cells and mucous cells in the lungs. Clinically, the rats sensitized s.c. in the neck region reacted to aerosol and intravenous (i.v.) challenge as early as 1 week after sensitization had started, whereas the animals sensitized in the tail‐root regions reacted 7 and 8 weeks after repeated sensitization. The animals sensitized by aerosol showed only weak clinical reactivity after i.v. challenge.
Pharmacokinetic and pharmacodynamic profile of degarelix for prostate cancer

Introduction: Luteinizing hormone-releasing hormone (LHRH) agonists have been the mainstay of androgen deprivation therapy (ADT) for advanced prostate cancer for over two decades. However, their limitations include a transient initial rise in testosterone, failure to reduce testosterone to castrate levels in some patients, incomplete suppression of follicle-stimulating hormone (FSH), and an increased risk of cardiovascular (CV) events in those with pre-existing CV disease. This article considers whether the LHRH antagonist degarelix offers significant advantages over LHRH agonists. Areas covered: This review covers the development and introduction of degarelix, its pharmacodynamic and pharmacokinetic properties, and the efficacy and safety results of Phase II and III clinical studies. Expert opinion: Degarelix has clear pharmacodynamic advantages over the LHRH agonist leuprolide in terms of almost immediate suppression of testosterone to castrate levels and sustained suppression of FSH levels. It reduces the risk of CV events vs agonists in men with pre-existing CV disease. This finding, which may reflect differential effects on FSH and/or endothelial plaques, requires confirmation in a prospective study; however, it is the view of the author that the differential effects on CV events are real and suggest that men with pre-existing CV disease requiring ADT should preferentially be treated with degarelix.
Current understanding of the mechanisms of idiosyncratic drug-induced agranulocytosis

Introduction: Idiosyncratic drug-induced agranulocytosis (IDIAG) is a life-threatening adverse reaction characterized by an absolute neutrophil count < 500 cells/μl of blood. It shares many of the characteristics of other idiosyncratic drug reactions (IDRs), and this presumably reflects mechanistic similarities. Areas covered: This review describes the evidence for mechanistic hypotheses of IDIAG and new hypotheses are explored. Expert opinion: The characteristics of IDIAG are most consistent with an immune mechanism. Where genetic studies have been done, the genes associated with an increased risk of IDIAG are either human leukocyte antigen genes or other genes associated with the immune response, which provides further evidence for an immune mechanism. There is evidence that the immune response leading to most IDRs is triggered by reactive metabolites of the offending drug, and most drugs that are associated with IDIAG are either known to be oxidized to a reactive metabolite by neutrophils or have a functional group that has the potential to be easily oxidized to a reactive metabolite. There is new evidence that drugs that cause IDRs including IDIAG can activate inflammasomes. Thus, the ability of a drug to be oxidized to a reactive metabolite by neutrophils and to activate inflammasomes may be useful biomarkers to predict IDIAG risk.
Iron-based phosphate binders – a new element in management of hyperphosphatemia

Introduction: Management of serum phosphorus in patients with chronic kidney disease remains a significant clinical challenge. A pivotal component of the clinical approach to maintaining serum phosphorus concentrations towards the normal range is the use of phosphate binding agents in addition to comprehensive dietary counseling. The available agents work similarly by capitalizing on a cation within the agent to bind negatively charged phosphorus, forming an insoluble complex and reducing ingested phosphorus absorption. Despite several effective options for phosphate binder therapies, patient adherence remains an issue, mainly due to adverse effect profiles and large daily pill burdens. Areas covered: Two new iron-based phosphate binder therapies have recently become available in the United States, sucroferric oxyhydroxide and ferric citrate. These agents have both been shown to effectively reduce serum phosphorus comparably to widely used calcium-based binders and sevelamer salts. Expert opinion: The two new iron-based binders differ substantially with regard to phosphate binding chemistry and iron absorption profiles. Their place in therapy is still evolving and the impact of pill burden, gastrointestinal adverse effect profiles, potential cost reduction of anemia therapies and physiologic effects of long-term iron exposure need to be further evaluated.
The influence of gut microbiota on drug metabolism and toxicity

Introduction: Gut microbiota plays critical roles in drug metabolism. The variation of gut microbiota contributes to the interindividual differences toward drug therapy including drug-induced toxicity and efficacy. Accordingly, the investigation and elucidation of gut microbial impacts on drug metabolism and toxicity will not only facilitate the way of personalized medicine, but also improve rational drug design. Areas covered: This review provides an overview of the microbiota–host co-metabolism on drug metabolism and summarizes 30 clinical drugs that are co-metabolized by host and gut microbiota. Moreover, this review is specifically focused on elucidating the gut microbial modulation of some clinical drugs, in which the gut microbial influences on drug metabolism, drug-induced toxicity and efficacy are discussed. Expert opinion: The gut microbial contribution to drug metabolism and toxicity is increasingly recognized, but remains largely unexplored due to the extremely complex relationship between gut microbiota and host. The mechanistic elucidation of gut microbiota in drug metabolism is critical before any practical progress in drug design or personalized medicine could be made by modulating human gut microbiota. Analytical technique innovation is urgently required to strengthen our capability in recognizing microbial functions, including metagenomics, metabolomics and the integration of multidisciplinary knowledge.
Recurrent Abdominal Pain: an Etiological Study among in a Referreal Children's Medical Center in Iran

Objective: Recurrent abdominal pain (RAP) affects a significant number of children each year. It can be defined as experience of at least three episodes of pain, severe enough to affect activities, over a period of three months. The purpose of this study was to determine the organic and non-organic causes of RAP. Also, evaluate different variables of RAP such as age, sex, location and duration of pain, accompanying symptoms and stressful life events in two groups. Material & Methods: During one year period from October 2003 to September 2004, 70 children (aged 4-12 years), were investigated in a referral Children’s Center in Tehran. All patients underwent a thorough interview and complete physical examination and an initial sample of blood, urine, and stool evaluation. If any evidence of alarm symptoms (such as vomiting and night pain) were observed, additional studies were performed including abdominal ultrasonography, radiography, and/ or upper gastrointestinal Endoscopy. Findings: An organic cause was found in 21 (30%) patients and non-organic cause was identified in 49 (70%) cases. Main observations in non-organic groups were: more periumblical pain location, positive history for stressful life events in child and their family. Also, gastrointestinal problems were the most common organic causes in 60% of children. Other organic causes were urinary tract infections 10%, kidney stone 10%, cholelitiasis (5%), Giardiasis (15%), and abdominal migraine (5%). Endoscopy seems to be a safe and reliable method in diagnosis of a number of organic lesions otherwise not detected by ordinary investigations. Our data suggest that among the children with RAP, non-organic causes are more commons (70%) than organic causes (30%). Conclusion: This study showed that in spite of accessing to better instruments in medical sciences in recent decades , the percentage of nonorganic RAP in children is still high.
Brain magnetic resonance imaging findings in adult patients with congenital adrenal hyperplasia: Increased frequency of white matter impairment and temporal lobe structures dysgenesis

BACKGROUND Congenital adrenal hyperplasia (CAH) is an inherited recessive disorder of adrenal steroidogenesis. The enzymes most commonly affected are 21-hydroxylase. Past reports suggested brain magnetic resonance imaging (MRI) abnormalities in CAH patients, affecting white matter signal, temporal lobe and amygdala structure and function. AIMS In the present study, we aimed to investigate the frequency of white matter changes and temporal lobes structures dysgenesis in a population of patients having CAH due to 21-hydroxylase deficiency. MATERIALS AND METHODS Neurological examination and brain MRI were performed in 26 patients. RESULTS Neurological examination revealed mental retardation in three patients, tremor in two patients, tendon reflexes asymmetry in one patient, and cerebellar syndrome in one patient. Eleven patients (42.3%) showed MRI abnormalities: Eight of them had white matter hyperintensities, one patient had moderate atrophy in the right temporal, and hippocampal dysgenesis was found in the remaining two patients. CONCLUSIONS Brain MRI abnormalities in CAH patients include white matter hyperintensities and temporal lobe structures dysgenesis. The mechanisms involved seem related to hormonal imbalances during brain development and exposure to excess exogenous glucocorticoids. Clinical implications of such lesions remain unclear. More extensive studies are required to define better the relationships between brain involvement and different CAH phenotypes and treatment regimens.
Pharmacokinetics and pharmacodynamics of MD1003 (high-dose biotin) in the treatment of progressive multiple sclerosis

ABSTRACT Introduction: Multiple sclerosis (MS) is a chronic, potentially highly disabling neurological disorder. No disease-modifying treatments are approved in the progressive and not active forms of the disease. Areas covered: High doses of biotin were tested in an open-label pilot study involving 23 patients with progressive MS and reported positive results. A randomized, double-blind, placebo-controlled trial in 154 progressive MS patients confirmed the beneficial effect of MD1003 (high-dose biotin) on reversing or stabilizing disability progression, with a good safety profile. It is proposed that MD1003 in progressive MS 1) increases energy production in demyelinated axons and/or 2) enhances myelin synthesis in oligodendrocytes. Biotin is highly bioavailable; absorption and excretion are rapid. The major route of elimination is urinary excretion. Expert opinion: A high oral dose of biotin seems generally well tolerated but a few important safety concerns were identified: 1) teratogenicity in one species and 2) interference with some biotin-based laboratory immunoassays. The animal toxicity data are limited at such high doses. Further preclinical studies would be useful to address the mechanism of action of MD1003. Assessment of clinical benefit duration in responders will be also very important to set. Results of randomized, placebo-controlled trial are reassuring and provide hope for the treatment of progressive MS.
Pharmacodynamics and pharmacokinetics of elbasvir and grazoprevir in the treatment of hepatitis C

ABSTRACT Introduction: Approximately 130 – 150 million people have chronic hepatitis C virus (HCV) infection and upwards of 500,000 deaths annually are attributed to HCV related liver disease worldwide. Pegylated interferon and ribavirin have been the mainstay of treatment for greater than 25 years until recent advent of protease inhibitors which has led to all oral HCV treatment regimens that have changed the outlook of hepatitis C treatment. Areas covered: This review provides summary of pharmacokinetics, pharmacodynamics, efficacy and safety of grazoprevir/elbasvir therapy for treatment of HCV infection. Expert opinion: Grazoprevir/elbasvir provides an all-oral once daily treatment option for HCV infection with high rates of efficacy and tolerability in a pangenotypic fashion. It highly efficacious in treating patients with cirrhosis, patients who have previously failed treatment with pegylated interferon and ribavirin, and patients with HIV co-infection. Grazoprevir/elbasvir has demonstrated higher barrier to resistance even in the presence of variants associated with resistance such as Q41R, F43S, R155K, V36M, T54S, and D168. It is one of only few HCV treatment regimens evaluated for use in patients with advanced chronic kidney disease and dialysis. It is a very promising regimen for treatment of HCV infection.
Carbimazole-induced cholestatic hepatitis in Graves’ disease

Antithyroid medications are one of the treatment options for Graves' disease. Carbimazole is widely used as the drug of choice, except in pregnancy, where propythiouracil is preferred by many. It is generally well-tolerated. Its side-effects include allergy, upper gastrointestinal upset, a rare occurrence of granulocytosis, and others. Hepatitis is another rare, but serious side-effect. We report a healthy 30-year-old male patient with Graves' disease, who developed cholestatic jaundice after Carbimazole therapy for four months. He made a full recovery after the drug was discontinued. An idiosyncratic mechanism seemed likely.
Implications of serum paraoxonase activity in obesity, diabetes mellitus, and dyslipidemia

Human serum paraoxonase 1 (PON1) is an enzyme with esterase activity, and is physically bound to high-density lipoproteins (HDL). It plays a key role in the action of HDL toward protection of lipoprotein and biological membrane against oxidative damage. It may have a protective role against atherosclerosis by virtue of its action on hydrolyzing lipid peroxides and preventing accumulation of phospholipids in oxidized low-density lipoprotein (LDL). PON1 is hypothesized to be an indicator of the risk of atherosclerosis and coronary artery disease development. Numerous studies have implicated PON1 activity in relation to various endocrine disorders. The current article reviews the clinical perspectives of PON1 activity with regards to obesity, diabetes mellitus with its complications, and dyslipidemia.
Evaluation of autonomic functions in subclinical hypothyroid and hypothyroid patients

Background: Autonomic dysfunction may contribute to cardiovascular morbidity in subclinical hypothyroid patients. It is controversial whether the abnormality exists in sympathetic or the parasympathetic function. It is also not known whether the severity of autonomic dysfunction is related to the degree of thyroid deficiency. Design of Study: Prospective case control. Materials and Methods: Autonomic functions based on heart rate (HR) and blood pressure (BP) responses to various maneuvers were evaluated and scored in twenty two subclinical hypothyroid patients, 30-50 years and compared with twenty hypothyroid patients. Biochemical estimation of TSH, fT3, fT4, TPO antibody was done. Result: Sympathetic function abnormalities were seen in 82% subclinical hypothyroid patients and 85%hypothyroid patients when one test was abnormal. Parasympathetic dysfunction was also recorded in eight patients in both groups. When two abnormal tests were used as the selection criteria sympathetic function abnormality was observed in about 41% subclinical hypothyroid and 65% hypothyroid patients. There were no intergroup differences in autonomic functions, score and TPO levels. The TSH levels were not related to type or degree of autonomic dysfunction. Systolic BP in both groups and diastolic BP in hypothyroid patients were higher with lower thyroxine levels but the patients were normotensive. Conclusion: Autonomic dysfunction of comparable degree was seen in subclinical hypothyroid and hypothyroid patients. Sympathetic function abnormality was more common although decreased parasympathetic function reactivity was also present. These abnormalities were unrelated to TSH levels.
Renal phosphate handling: Physiology

Phosphorus is a common anion. It plays an important role in energy generation. Renal phosphate handling is regulated by three organs parathyroid, kidney and bone through feedback loops. These counter regulatory loops also regulate intestinal absorption and thus maintain serum phosphorus concentration in physiologic range. The parathyroid hormone, vitamin D, Fibrogenic growth factor 23 (FGF23) and klotho coreceptor are the key regulators of phosphorus balance in body.
The rise and fall of assertive community treatment?

Assertive community treatment is one of the most researched and clinically replicated of all community mental health teams. It is clearly defined with established scales to measure its model fidelity. In the last decade its earlier claims to substantially reduce hospitalization have not been replicated in research studies. This inconsistency has generated considerable controversy. A careful systematic review and meta-regression analysis was conducted of 64 trials including 7,819 patients. The review included measures of model fidelity and hospitalization outcomes. Variation in reduced hospitalization was found to be mainly due to variation in control service practice but model fidelity to team organization principles was also associated with reduced hospitalization. Low caseloads and specified ACT staffing, however, had no effect at all on outcome. ‘Ordinary CMHTs’ share most of the organizational aspects of ACT and appear to deliver equal outcomes with much reduced resources. The value of investing in high fidelity ACT teams must, therefore, be in doubt.