Miracle-dz/UniFAR-FTUs huggingface dataset:
The factors associated with the failure of transcatheter pelvic arterial embolization for intractable postpartum hemorrhage

*Corresponding author: Dr. Sandro Gerli, MD, Department of Obstetrics and Gynecology, University of Perugia, S. Andrea delle Fratte, 06156 Perugia, Italy, Tel. : +39.075. 578.3231, E-mail: sandro.gerli@unipg.it Alessandro Favilli and Gian Carlo Di Renzo: Department of Obstetrics and Gynecology, University of Perugia, 06156 Perugia, Italy Stefano Mosca: Department of Radiology, University of Perugia, 06156 Perugia, Italy
Protective Effect of Caffeine on Ethyl Methanesulfonate-Induced Wing Primordial Cells of Drosophila Melanogaster

Objectives: The antimutagenic effect of caffeine is evaluated against ethyl methanesulfonate (EMS)-induced mutation rate in Drosophila. Materials and Methods: The mutation rate is evaluated using wing mosaic assay. In transheterozygous larvae, multiple wing hair (mwh 0.3-3) and flare (flr 3-38.8) genes were used as markers of the extent of mutagenicity. Results: The results at 0.5 and 1.0 mM EMS concentration at both 48 ± 4 and 72 ± 4 h have shown consistent increase in mutation rate, which was being measured as frequency of clone formation per 105 cells. Toxicity of caffeine at 5 mM concentration was parallel to that of distilled water alone. At 0.5 mM EMS concentration at 42 ± 4 and 72 ± 4 h, Drosophila larvae mutation rate was significantly increased. Although caffeine prevented mutation rate in all pre, post, and combined treatment, it was more significant in pretreatment experiments where it was found to be effective in reducing the genotoxicity of EMS. However, the concentration of caffeine as recommended in dietary allowance did not induce the frequency of mutant clones in somatic mutation and recombination test (SMART) recorded. Conclusion: This study shows that caffeine significantly reduced the genotoxicity induced by EMS. However, the limitation in completely abolishing genotoxicity induced by EMS as observed at the dietary allowance of caffeine makes it interesting for further in-depth study. Further studies on the molecular mechanism of antigenotoxic effect of caffeine will also be interesting.
MANAGING MULTIDRUG-RESISTANT TUBERCULOSIS IN HOSPITALIZED PATIENTS AT SIZWE TROPICAL DISEASES HOSPITAL: A FIVE YEAR REVIEW OF TREATMENT OUTCOMES

ABTSRACT Management of multidrug-resistant tuberculosis (MDR-TB) is more expensive, lengthy and is associated with less favourable outcomes and more adverse reactions than management of susceptible tuberculosis. The aim of this study was to review the management and treatment outcomes of registered MDR-TB patients hospitalized at Sizwe hospital during a five-year period. A cross-sectional study with both descriptive and analytic features was done on 237 MDR-TB patients hospitalized from the beginning of June 1998 to the end of May 2003. Data were analysed using SPSS version 12 Software. Main outcome measures were interim treatment outcomes at the end of hospitalization period. These outcomes comprised culture conversion rates, time to culture conversion, transfer out, interruption, and death rates. Multiple logistic regression analysis was performed to determine risk factors for poor treatment outcomes. These poor outcomes were defined as treatment interruption, failure and mortality rates. The burden of institutional care for MDR-TB patients in this setting was found to involve high numbers of MDR-TB patients for whom the allocated hospital beds were insufficient. Patients with primary MDR-TB, who had no history of nonadherence to treatment, were paradoxically more likely to be hospitalized shortly after diagnosis. Acquired MDR-TB patients were mostly managed as outpatients immediately after diagnosis only to be hospitalized later due to persistent nonadherence or disease severity. Overall, acquired MDR-TB patients were hospitalized in larger numbers than those with primary disease. This reflects the higher prevalence of acquired MDR-TB compared to primary MDR-TB.
Diffusion Tensor Imaging in the Cervical Spinal Cord: Implementing methods for acquisition, processing and evaluation

Diffusion tensor magnetic resonance imaging (DT-MRI or DTI) is an imaging technique that is sensitive to the diffusion movement of water contained in tissue. It is used to quantify parameters such as the diffusivity and its directionality. Because diffusion is intimately connected to the tissue microarchitecture DTI is one of the few techniques that can quantify tissue microstructure non-invasively in vivo. Further, it has been established that DTI parameters such as mean diffusivity and fractional anisotropy are sensitive to the influence of a variety of diseases, among them are neurodegenerative diseases such as multiple sclerosis. Although still in its cradle several papers have reported successful implementation of DTI in the spinal cord, noting that there are still challenges to be solved before it can be clinically implemented. The aim of this work was to create, optimize and implement a DTI protocol of the cervical spine in a clinical setting and to evaluate its potential as a complement to current conventional diagnostics. The main work was performed using the Siemens Skyra (3T) located at the Lund University Hospital. The imaging protocol was based on similar protocols used in DTI of the brain although several modifications were implemented to adapt the acquisition to the anatomically complicated region of the spine. The protocol was designed to include three imaging series; the main DTI series; a turbo spin echo (TSE) reference series for distortion correction purposes; and a high resolution T2-weighted series for conventional diagnostics. An automated tractography based segmentation method was devised to facilitate fast and reproducible evaluation of the DTI parameters. The method was tested by means of validation and an in vivo pilot study. Validation was performed to gauge system performance. The pilot study was performed as a proof of concept for the acquisition, processing and evaluation methods. Results show that using DTI parameters for individual diagnostics is currently limited by the large inter and intra-subject variation, however the in vivo pilot study proved the suggested methods to be viable in a clinical setting; adding only 5 minutes to the standard scan time and allowing for quick and highly automated evaluation of data which is suitable for large group comparisons.
Rutin Ameliorates Cyclophosphamide-induced Reproductive Toxicity in Male Rats

Cyclophosphamide (CYC) as an anticancer alkylating agent has been known as a male reproductive toxicant. This study was aimed to evaluate the protective effect of rutin (RUT) on CYC-induced reproductive toxicity. Sexually mature Wistar rats (weighing 199 ± 10 g with five animals in each group) were given CYC (15 mg/kg) and/or RUT (30 mg/kg) twice a week via gavage for 4 weeks. The sperm counts, sperm motility, sperm morphology, daily sperm production (DSP), testicular, and epididymal antioxidant systems: superoxide dismutase (SOD), catalase (CAT), reduced glutathione (GSH), glutathione reductase (GR), glutathione-S-transferase (GST), glutathione peroxidase (GSH-Px), malondialdehyde (MDA), and testicular steroidogenic enzymes (3β-hydroxysteroid dehydrogenase and 17β-HSD and spermatogenesis marker enzymes (lactate dehydrogenase (LDH), sorbitol dehydrogenase (SDH), alkaline phosphatase (ALP), acid phosphatase (ACP) in the testes, epididymis and seminal vesicles were investigated at the end of the fourth week. By the end of the fourth week, RUT prevented lower sperm counts, sperm motility, DSP, and higher abnormal sperm numbers induced by CYC. In testes, RUT decreased SOD, LDH, and SDH and increased CAT, 3β-HSD, 17β-HSD, ALP, and ACP induced by CYC. In epididymis, RUT increased SOD, CAT, GSH, GSH-Px, GR, GST SDH, ALP and ACP and decreased MDA and LDH induced by CYC. In seminal vesicles, marker enzymes were unchanged in rats given CYC alone or in combination with RUT. It appears that RUT ameliorates CYC reproductive toxicity at the investigated dose.
Comparison between two surgical techniques for prenatal correction of meningomyelocele in sheep

OBJETIVO: Comparar a tecnica neurocirurgica classica a uma nova tecnica simplificada, para correcao de mielomeningocele, em fetos de ovelhas. METODOS: Em 9 fetos, foi criado um defeito semelhante a mielomeningocele (laminectomia e excisao de dura-mater) no 90o dia de gestacao. O tipo de correcao foi randomizado. No Grupo 1, o defeito foi corrigido usando a tecnica neurocirurgica classica, com a sutura de tres camadas (dura-mater, musculo e pele), realizada por um neurocirurgiao. No Grupo 2, um especialista em Medicina Fetal utilizou a tecnica simplificada, colocando um fragmento de celulose biossintetica sobre a medula e suturando apenas da pele sobre a celulose. Proximo ao termo da gestacao (132 dias), os fetos foram sacrificados para analise anatomopatologica. RESULTADOS: Ocorreram dois casos de aborto e uma morte materna, restando seis casos para avaliacao - tres em cada grupo. No Grupo 1, todos os casos mostraram aderencia da medula a cicatriz (meningoadesao) e perda da arquitetura medular, com destruicao do funiculo posterior e perda da visualizacao da substância cinzenta. No Grupo 2, observou-se, em todos os casos, a formacao de uma neodura-mater, separando o tecido nervoso do musculo adjacente, sendo que o funiculo posterior e a substância cinzenta estavam preservados. CONCLUSAO: A tecnica simplificada foi superior a neurocirurgica, com maior preservacao da medula e evitando as aderencias do tecido nervoso. Os presentes achados sugerem que a tecnica utilizada atualmente na correcao de mielomeningocele em fetos humanos deva ser reavaliada.
Cytogenetic and comorbidity profile of Down syndrome in Mansoura University Children's Hospital, Egypt

BACKGROUND: Down syndrome (DS) is the most common chromosomal disorder. It has three chromosomal patterns. AIM: To determine the cytogenetic and comorbidity profiles of DS in the Genetic Unit of Mansoura University Children's Hospital, Mansoura, Egypt. MATERIALS AND METHODS: A retrospective analysis was performed on the case records of 712 cytogenetically diagnosed cases of DS at the Genetic Unit of Mansoura University Children's Hospital, Egypt, during a 10-year period. RESULTS: About 19% of the cases had one or more cardiac anomalies and about 8% were hypothyroid. Nondisjunction was the most common type of abnormality, followed by translocation and lastly mosaic: 96.1, 3.1, and 0.8%, respectively. Hypothyroidism was significantly more common in translocation and mosaic karyotypes than in the nondisjunction karyotypes. First and second birth orders were significantly higher in the translocation and mosaic groups than in the nondisjunction group. Mothers are significantly older at the index pregnancy in the nondisjunction group than in the other two groups. We compared our findings with those of previous studies. CONCLUSION: Knowing karyotype of DS will help in genetic counseling of the parents. Wide-scale national community-based survey with DS registry could help in estimating the size of the problem.
Injectable PLA-based in situ forming implants for controlled release of Ivermectin a BCS Class II drug: solvent selection based on physico-chemical characterization

In situ forming implants (ISI) prepared from biodegradable polymers such as poly(d,l-lactide) (PLA) and biocompatible solvents can be used to obtain sustained drug release after parenteral administration. The aim of this work was to study the effect of several biocompatible solvents with different physico-chemical properties on the release of ivermectin (IVM), an antiparasitic BCS II drug, from in situ forming PLA-based implants. The solvents evaluated were N-methyl-2-pyrrolidone (NMP), 2-pyrrolidone (2P), triacetine (TA) and benzyl benzoate (BB). Hansen’s solubility parameters of solvents were used to explain polymer/solvent interactions leading to different rheological behaviours. The stability of the polymer and drug in the solvents were also evaluated by size exclusion and high performance liquid chromatography, respectively. The two major factors determining the rate of IVM release from ISI were miscibility of the solvent with water and the viscosity of the polymer solutions. In general, the release rate increased with increasing water miscibility of the solvent and decreasing viscosity in the following order NMP>2P>TA>BB. Scanning electron microscopy revealed a relationship between the rate of IVM release and the surface porosity of the implants, release being higher as implant porosity increased. Finally, drug and polymer stability in the solvents followed the same trends, increasing when polymer-solvent affinities and water content in solvents decreased. IVM degradation was accelerated by the acid environment generated by the degradation of the polymer but the drug did not affect PLA stability.
Design and evaluation of a self-microemulsifying drug delivery system for apigenin

Objective of this study was to prepare, characterize and evaluate a self-microemulsifying drug delivery system (SMEDDS) with the aim to improve the solubility and dissolution of apigenin. Ternary phase diagrams were constructed in order to obtain the most efficient self-emulsification region, and the formulation of apigenin loaded SMEDDS was optimized by a simplex lattice experiment design. The optimal formulation of SMEDDS obtained was comprised of 60% Cremophor®EL, 30% Transcutol®HP and 10% Capryol™ 90. The equilibrium solubility of apigenin in SMEDDS was about 15 mg/g, and it could increase the solubility of apigenin in water for about 7500 folds. Apigenin loaded SMEDDS could turn into microemulsion when diluted with distilled water and the droplets were spherical under transmission electron microscope (TEM), the average particle size was 17.1 nm and zeta potential −5.18 mV. In vitro dissolution studies showed about 95% of apigenin was released within 10 min. All of the results showed that SMEDDS could enhance the solubility and dissolution of apigenin, and would be a potential carrier to improve the oral absorption of apigenin, a poorly water soluble drug.
An Outcome‐Based Approach to Domiciliary Care

The article presents an approach to commissioning and providing domiciliary care on the basis of outcomes, in the context of current policy. It is suggested that this approach may provide a solution to the over‐rigid prescription of time and tasks which has militated against flexibility and responsiveness. It is also a means of ensuring the centrality of service users to the process. The concepts of outcome‐based working are explained, and key steps to implementing an outcome approach are discussed. Early feedback from authorities in the vanguard of this movement are reported.
Nivel de actividad física global en la población adulta de Bogotá (Colombia): Prevalencia y factores asociados

Objetivo: Determinar la prevalencia de los grados de actividad fisica global en las personas de 18 a 65 anos de la ciudad de Bogota (Colombia) e identificar los factores asociados con la regularidad en la actividad. Metodos: Se realizo una encuesta poblacional, aplicada a 3.000 adultos residentes en la ciudad de Bogota durante el ano 2003, seleccionados en una muestra probabilistica multietapica. Los niveles de actividad fisica fueron determinados por medio de la version abreviada del IPAQ. La aplicacion de un modelo de regresion logistico permitio identificar los factores asociados con la regularidad en la actividad. Resultados: La prevalencia ajustada de personas regularmente activas fue del 36,8%. Despues del ajuste de las potenciales variables de confusion, las posibilidades de ser regularmente activo fueron mayores en los varones (odds ratio [OR] = 1,62; intervalo de confianza [IC] del 95%,1,31-2,01) y en personas con una autopercepcion del estado de salud buena o muy buena (OR = 1,87; IC del 95%, 1,41-2,49). Las posibilidades fueron menores en las personas de los grupos de edad de 30-49 y 50-65 anos (OR = 0,78; IC del 95%, 0,63-0,96 y OR = 0,60; IC del 95%, 0,43-0,82, respectivamente) y en aquellas cuya principal actividad en los ultimos 30 dias era buscar trabajo (OR = 0,71; IC del 95%, 0,51-0,97) o realizar labores del hogar (OR = 0,72; IC del 95%, 0,54-0,96). En las mujeres, a diferencia de los varones, los grupos de edad no tuvieron asociacion con la regularidad en la actividad. Conclusion: En este estudio se ponen de manifiesto diferencias entre los sexos en las prevalencias de los niveles de actividad fisica global y en sus factores asociados. En futuros trabajos se debera establecer, en el contexto de ciudades latinoamericanas, si es pertinente determinar, ademas de los grados de actividad fisica global, los indicadores especificos en cada dominio
Beads made of α-cyclodextrin and soybean oil: the drying method influences bead properties and drug release

Freeze-dried beads made of α-cyclodextrin and soybean oil were reported previously as an efficient system for the oral delivery of lipophilic drugs. In the present study, oven-drying was evaluated as another method for drying beads. Oven-drying was optimised and the properties of the resulting beads were assessed. The behavior of oven-dried beads and the release of indomethacin from these beads were evaluated in vitro in simulated gastrointestinal fluids and compared with those of freeze-dried beads. The stability of freeze-dried and oven-dried unloaded beads stored at 25°C for 12 months and at 40°C for 6 months in closed and open vials was also studied by different techniques. An oven-drying time of 6 hours at 25°C was chosen as optimal conditions. Oven-dried beads exhibited a sticky texture making them difficult to handle. They were harder, less fragile and smaller than the freeze-dried ones. The characteristics of oven-dried beads make them more resistant in vitro even in media containing bile salt. The rate of indomethacin release from oven-dried beads was much slower than that from the freeze-dried ones. Whatever the drying method, beads must be stored at room temperature protected from humidity. However, no products of oil degradation were detected with both kinds of beads. This work clearly emphasized that the drying method of the beads had a strong influence on their properties, behavior in simulated gastrointestinal fluids and drug release.
Doctors’ experience of a bespoke physician consultation service: cross-sectional investigation

Aims and method Our aim was to follow-up on a cohort of self-referred doctors who attended MedNet. We used a two-point cross-sectional design. Measures included three standardised self-report questionnaires administered before and after consultation. Doctors were also asked to complete a service user questionnaire, and data regarding engagement and onward referrals were gathered through case-note review. Results A statistically significant improvement in scores on all three questionnaires was found after intervention; however, scores on one subscale, the risk domain of the Clinical Outcomes in Routine Evaluation - Outcome Measure, did not change significantly. Of the doctors at no risk of suicide at intake, nearly two-thirds ( n = 41/70, 59%) were sufficiently helped by the consultations provided to not need further treatment. Of the doctors at some risk of suicide at intake, two-thirds ( n = 34/51, 67%) did need an onward referral. Only one doctor required hospital admission, an outcome that suggests the approach used is containing and clinically responsive. Clinical implications This paper highlights the efficacy, need and importance of specialist services for doctors in difficulty. We found that the bespoke consultation model provided at MedNet is valued highly by the doctors as service users.
Increased Blood Pressure in α-Calcitonin Gene–Related Peptide/Calcitonin Gene Knockout Mice

Abstract —Nerves that contain calcitonin gene–related peptide (CGRP) are components of the sensory nervous system. Although these afferent nerves have traditionally been thought to sense stimuli in the periphery and transmit the information centrally, they also have an efferent vasodilator function. Acute administration of a CGRP receptor antagonist increases the blood pressure (BP) in several models of hypertension, which indicates that this potent vasodilator plays a counterregulatory role to attenuate the BP increase in these settings. To determine the role of this peptide in the long-term regulation of cardiovascular function, including hypertension, we obtained mice that have a deletion of the α-calcitonin gene–related peptide (α- CGRP ) gene. Although the β-calcitonin gene–related peptide (β- CGRP ) gene is intact in these mice, α- CGRP is by far the predominant species of CGRP produced in dorsal root ganglia (DRG) sensory neurons. Initially, we examined the effect of deletion of the α- CGRP on baseline BP and β- CGRP and substance P mRNA expression. Systolic BP was significantly higher in the knockout mice (n=7) compared with wild-type in both male (160±6.1 vs 125±4.8 mm Hg) and female (163±4.8 vs 135±33 mm Hg) mice. Next, groups (n=7) of knockout and wild-type mice had catheters surgically placed in the right carotid artery for mean arterial pressure recording. With the animals fully awake and unrestrained, the knockout mice displayed an elevated mean arterial pressure compared with wild-type in both male (139±4.9 vs 118±4.9 mm Hg) and female (121±3.4 vs 107±3.1 mm Hg) mice. Northern blot analysis of DRG RNA samples confirmed the absence of α- CGRP mRNA in the knockout mice. Substance P mRNA content in DRG was unchanged between the 2 groups; however, β- CGRP mRNA levels were reduced 2-fold in the knockout mice. These results indicate for the first time that α- CGRP may be involved in the long-term regulation of resting BP and suggest that these mice are particularly sensitive to challenges to BP homeostasis because of the loss of a compensatory vasodilator mechanism.
Immediate complications of percutaneous central venous cannulation in children

Objective: To study the incidence of immediate complications associated with percutaneous central venous catheterization. Materials and Methods: A total of 103 central venous catheters were inserted in 70 children over a period of 18 months, governed by a uniform protocol. Sixty-three percent of the catheters were inserted in neonates, 23.3% in infants and 13.6% in children between 1 and 12 years of age. Statistical Analysis Used: Software SPSS version 15. Results: There were a total of 41 insertion-related immediate complications, of which 75.6% were in neonates. Neonatal age, hemodynamic instability and more number of attempts to catheterize the vein had a higher risk of insertion-related problems. There was no mortality directly as a result of the procedure. Conclusion: In our practice, it was observed that complications were fewer with increasing familiarity with the procedure. Hence, percutaneous central venous catheterization is a safe procedure when performed in experienced hands.