Miracle-dz/UniFAR-FTUs huggingface dataset:
Review article: drug‐induced microscopic colitis – proposal for a scoring system and review of the literature

The pathophysiology of microscopic colitis is unknown, although it is thought to be because of an abnormal immune reaction to luminal antigens in predisposed hosts. Specific antigens have not been proved, although various infectious triggers and drugs have been proposed. The responsibility of several drugs has been questioned, some with strong clinical and/or histological evidence suggesting causality. The issue of drug‐induced microscopic colitis is important because of the burden of this disease. Thus, any case that can be cured by withdrawal of a drug must be identified. In this report, we propose a scoring system for drug‐induced microscopic colitis, adapting existing criteria of drug causality, and review the literature using this framework. Based on this review, several drugs are identified with intermediate or high likelihood of inducing microscopic colitis. Finally, we suggest how to treat individual patients suspected of having drug‐induced colitis according to the level of evidence for that particular drug.
Football and netball in women’s struggle against HIV/AIDS in Africa

The HIV/AIDS problem has improved in recent years. The number of newly infected persons is declining year after year (2.1 million new cases in 2013). However, the news is still grim and especially so for young women. Why does HIV seem to discriminate against women, especially younger women? Women are physiologically more susceptible than men, but among the most significant causes are gender inequity and related poverty and human rights issues. A number of strategies and tactics are used in the struggle with HIV/AIDS. Some are old ideas, found successful in campaigns against other diseases. Others are of more recent origin. Among the latter has been the use of sport. In this essay, we discuss some of the ways in which sport is used to assist women in the struggle against HIV/AIDS. A survey of problems associated with the spread and the prevention of HIV/AIDS is indicative of the difficulties faced. Of the many strategies and tactics, is there a role for sport? Sport has been able to assist with some of the associated problems. Although in some instances a sport activity is aimed at a single issue, more often the purposes are multiple. Often, events and programmes are not specifically aimed at a female audience, though frequently separate activities are used for each gender.
Long-term effects of troglitazone: open-label extension studies in type 2 diabetic patients.

OBJECTIVE To determine the long-term effects of troglitazone as monotherapy or in combination with sulfonylureas or insulin regarding glycemic and lipid measures. RESEARCH DESIGN AND METHODS Patients who completed one of three double-blind studies (a 6-month troglitazone monotherapy study, a 52-week study of troglitazone in combination with micronized glyburide, or a 6-month study of troglitazone in combination with insulin) were allowed to enter open-label extensions of their respective double-blind studies. Troglitazone dose titrations were allowed to a maximum of 600 mg in response to inadequate glycemic control during the open-label phases of troglitazone monotherapy or sulfonylurea combination therapy but not with insulin combination therapy. This article focuses on the effectiveness of the highest dose of troglitazone used in these studies (600 mg daily). Safety data from all patients studied at all doses are also presented. RESULTS For patients who received a fixed dose of 600 mg troglitazone, mean changes in fasting serum glucose and HbA1c levels from baseline to the end of the open-label phase were -57 mg/dl and -0.4%, respectively (monotherapy); -49 mg/dl and -1.8%, respectively (sulfonylurea combination); and -31 mg/dl and -1.0%, respectively (insulin combination). The proportion of patients achieving an HbA1c level of < or =8% from the combined cohort of all three studies was 54% versus only 19% at baseline. The mean decrease in triglycerides from baseline to the end of the open-label phase was 18% among all patients in the three studies who received a fixed dose of 600 mg troglitazone. Troglitazone was well tolerated in these three open-label studies; a total of 758 patients completed a total exposure of 16,264 patient-months to troglitazone in these three studies with minimal adverse events. CONCLUSIONS Long-term use of troglitazone alone or in combination with sulfonylureas or insulin is safe and effective in sustaining glycemic control and in reducing hypertriglyceridemia in type 2 diabetic patients.
CD40 activation in epithelial ovarian carcinoma cells modulates growth, apoptosis, and cytokine secretion

Background/Aims: CD40, a member of the tumour necrosis factor (TNF) receptor family, is expressed on a variety of haematopoietic cells and is crucial in orchestrating both humoral and cellular immune responses. CD40 is also expressed on some carcinoma cells, where its function remains largely unknown. This study investigated the effects of CD40 ligation on ovarian carcinoma cell growth and apoptosis and on cytokine production, in addition to the role of the NF-κB and JNK signalling pathways. Methods: CD40 expression was measured in epithelial ovarian carcinoma (EOC) biopsies by immunohistochemistry and in EOC cell lines by flow cytometry. To examine the effects of CD40 ligation on cell growth recombinant soluble CD40 ligand was used to stimulate EOC cell lines and growth was measured by MMT assays. Cytokine production was measured by enzyme linked immunosorbent assays interleukin 8 (IL-8) gene transcription was estimated by means of reverse transcription polymerase chain reaction. The integrity of the CD40 signalling pathway in those cell lines that did not produce cytokines in response to CD40 ligation was assessed by the detection of the transcription factor NF-κB by an electrophoretic mobility shift assay. To investigate the defect in the NF-κB pathway the phosphorylation status of IκBα was determined by an antibody specific to phosphorylated IκBα and dissociation of the IκBα–p65 complex was assessed by co-immunoprecipitation. Results: CD40 is expressed in primary ovarian carcinoma biopsies and EOC cell lines. CD40 ligation resulted in growth inhibition in most of these carcinoma cell lines and was also found to promote apoptosis, with this last effect only being evident in early passage EOC cells. CD40 ligation also induced significant IL-6 and IL-8 production in most of the EOC cell lines examined and it was confirmed for IL-8 that this effect was regulated at the transcriptional level. NF-κB activation in response to CD40 ligation was found in three of the EOC cell lines and specific defects in the CD40 induced NF-κB pathway were identified in two cell lines. However, CD40 engagement induced JNK activation in all the EOC cell lines. Conclusions: These data suggest that the CD40 pathway is functional in ovarian carcinoma cells and highlight the need for further studies to provide insight into the role of CD40 in the carcinogenic process and the possible exploitation of this pathway for novel therapeutic approaches.
Efficacy of low-dose rosuvastatin in patients with type 2 diabetes and hypo high-density lipoprotein cholesterolaemia

Objective To analyse the efficacy of low-dose rosuvastatin for treating hypo high-density lipoprotein (HDL) cholesterolaemia in patients with type 2 diabetes and dyslipidaemia. Methods Patients with HDL-cholesterol (C) <40 mg/dl and triglycerides (TG) <400 mg/dl who were receiving treatment with lipid-lowering drugs other than rosuvastatin (or previously untreated with lipid-lowering drugs) and with low-density lipoprotein [LDL]-C ≥120 mg/dl were included. Patients were treated with 2.5 or 5 mg rosuvastatin orally, once daily, to achieve the target LDL-C level specified in Japanese guidelines. Changes in total cholesterol, HDL-C, TG, LDL-C, LDL-C/HDL-C and non-HDL-C at 3 and 6 months were prospectively analysed. Safety was evaluated by examining changes in hepatorenal function, glucose metabolism and creatine kinase. Results Out of 49 patients, all lipid parameters other than TG were significantly improved at 3 and 6 months. At 3 months, 83.3% of patients had achieved the target LDL-C level. Among nonlipid parameters, no changes were observed except for estimated glomerular filtration rate, which was improved by + 5.2% and + 9.6% at 3 and 6 months, respectively. Conclusions Low-dose rosuvastatin was effective in improving hypo-HDL cholesterolaemia and may have renoprotective effects.
Long-term follow-up of a randomized trial of fludarabine-mitoxantrone, compared with cyclophosphamide, doxorubicin, vindesine, prednisone (CHVP), as first-line treatment of elderly patients with advanced, low-grade non-Hodgkin's lymphoma before the era of monoclonal antibodies.

BACKGROUND This randomized study compared the efficacy and safety of fludarabine-mitoxantrone (FM) with mini-CHVP (cyclophosphamide, doxorubicin, vindesine, prednisone) in elderly patients with advanced, low-grade non-Hodgkin's lymphoma. PATIENTS AND METHODS End points were remission rates [overall response (OR) and complete response (CR)], failure-free survival (FFS), survival and toxicity. One hundred and fifty-five patients were randomized, 144 were evaluable for safety and 142 for response. Each treatment arm was given as six monthly cycles, followed by three bimonthly cycles. FM comprised fludarabine (20 mg/m(2) i.v. ), days 1-5, plus mitoxantrone (10 mg/m(2) i.v. ), day 1. CHVP cycles comprised cyclophosphamide (750 mg/m(2) i.v. infusion), doxorubicin (25 mg/m(2) i.v. ) and vindesine (3 mg/m(2) i.v. ) on day 1, and prednisone (50 mg/m(2)) on days 1-5. RESULTS FM therapy resulted in superior remission rates (OR 81% versus 64%, CR 49% versus 17%; P = 0.0004). Median FFS for FM patients was 36 months, compared with 19 months for CHVP patients, and has not yet been reached for early CR patients at 53 months. Treatment arm was the major risk factor influencing survival. Both treatments were well tolerated, with only few infectious complications. CONCLUSION FM was more effective than CHVP in achieving OR and CR, and favorably affected the outcome.
The effects of racial attitudes on affect and engagement in racially discordant medical interactions between non-Black physicians and Black patients

The association between physicians’ and patients’ racial attitudes and poorer patient–physician communication in racially discordant medical interactions is well-documented. However, it is unclear how physicians’ and patients’ racial attitudes independently and jointly affect their behaviors during these interactions. In a secondary analysis of video-recorded medical interactions between non-Black physicians and Black patients, we examined how physicians’ explicit and implicit racial bias and patients’ perceived past discrimination influenced their own as well as one another’s affect and level of engagement. Affect and engagement were assessed with a “thin slice” method. For physicians, the major findings were significant three-way interactions: physicians’ affect and engagement were influenced by their implicit and explicit racial bias (i.e., aversive racism), but only when they interacted with patients who reported any incidence of prior discrimination. In contrast, patients’ affect was influenced only by perceived discrimination. Theoretical and clinical implications of current findings are discussed.
Prevalence of Group A Streptococcal Carriers in Asymptomatic Children and Clonal Relatedness among Isolates in Malatya, Turkey

ABSTRACT In our study, the prevalence of nasopharyngeal Streptococcus pyogenes was 130 (14.3%) of 909 healthy children. Isolates were found to be susceptible to all antibiotics tested. Pulsed-field gel electrophoresis and arbitrarily primed PCR revealed that 34 (32.4%) of the 105 isolates and 41 (40.6%) of the 101 isolates typed, respectively, were clonally indistinguishable.
Myocardial Protection Provided by Chronic Skeletal Muscle Ischemia Is Not Further Enhanced by Ischemic Pre- or Postconditioning

Chronic skeletal muscle ischemia protects the ischemic heart by preserving coronary flow and inducing arterioangiogenesis. We sought to determine the effect and the underlying molecular mechanisms of preconditioning (PreC) and postconditioning (PostC), applied in a model of chronic skeletal muscle ischemia. Male rabbits were divided into 3 series. In each series, the animals were subjected either to severe hind limb (HL) ischemia, by excision of the femoral artery, or to sham operation (SHO). After 4 weeks, all the animals underwent 30 minutes of regional heart ischemia and 3 hours reperfusion. The animals of the first series received no further intervention (HL and SHO groups), those of the second series underwent PreC (HL + PreC and SHO + PreC), and of the third series PostC (HL + PostC and SHO + PostC). Infarct size (I) and risk zones (R) were determined, and their ratio was calculated in percentage. Three additional series of experiments were performed with respective interventions up to the 10th minute of reperfusion, where sample tissue was obtained for assessment of protein kinase B (Akt), endothelial nitric oxide synthase (eNOS), glycogen synthase kinase 3β (GSK3β), p44/42, signal transducer and activator of transcription (STAT) 3, and STAT5. All groups demonstrated significantly smaller percentage of I/R compared with the SHO group (HL: 14.4% ± 3.7%, HL + PreC: 13.1% ± 1.0%, SHO + PreC: 21.3% ± 1.6%, HL + PostC: 18.0% ± 1.1%, and SHO + PostC: 24.3% ± 1.7%, P < .05 vs 35.7% ± 4.4% in SHO). The PreC and PostC did not further reduce the infarct size in HL groups. The Akt, eNOS, GSK3β, p44/42, and STAT3 were activated in all PreC or PostC groups regardless of the infarct size reduction. The STAT5 was activated only in the HL groups compared with the SHO groups. In conclusion, chronic skeletal muscle ischemia results in effective cardioprotection, which is not further enhanced with application of PreC or PostC. The Akt, eNOS, GSK3β, p44/42, and STAT3 may only be considered as indicators of the intracellular changes taking place during protection. Activation of STAT5 is possibly the end effector, which is responsible for infarct size reduction provided by chronic skeletal muscle ischemia.
Beyond the austerity dispute: new priorities for fiscal policy

The workshop aimed at moving forward the fiscal policy debate, which in the crisis years was unavoidably focused on how to regain fiscal credibility and to implement sizable and fast consolidation plans. Four main themes have been proposed for the debate during the workshop. First, the two-way link between fiscal consolidation and inequality, with the idea that consolidation efforts cannot be successful in the long run if they entail a socially unsustainable increase in inequality. Second, the importance of preserving, even in contexts in which the fiscal policy stance is necessarily restrictive, growth-enhancing public investments. Third, the challenges posed to fiscal management by a low inflation context, taking into account that a subdued price dynamics not only makes the real burden of debt heavier, but it also has subtle effects, at least in the short term, on several budgetary items. Finally, the need for a simpler and more appropriate set of rules for the governance of the EMU. The latter topic was also the object of the high-level panel at the end of the workshop. While differences in emphasis emerged among the panellists, they agreed that the current framework could be streamlined, and – more importantly – that no set of rules can work if trust and a sense of sharing a common objective is not rebuilt among the Member States.
Positioning Between Structure and Performance

There are two possible interpretations of what the term narrative implies in Labov and Waletzky's original 1967 (this issue; henceforth L&W) framework in terms of how narrative is linked to personal experience in particular and to sense-making in general. The first, more simplistic reading implies that narratives-particularly those of personal experience-are representations of something that on,:e happened and what this past happening meant (or "now" means) to the narrator. The second, more indirect reading requires the act of telling-or "representing" at a particular occasion in the form of a particular story-to intervene, so to speaK, between the actual experience and the story. It was the first reading of L&W that originally fascinated me and lured me into exploring narratives as a window to people's experiences. However, in the course of having worked with narratives overthelast two decades, I have moved more and more to adopt the second reading. Other contributors to this issue have commented in one or another way on this tension between a traditional, structural approach and a more performance-based, pragmatic approach to narrative and narrative analysis. Whereas the first takes its starting point from what was said (and the way it was said) and works toward why it was said, that is, its meaning, the second focuses more strongly on how it was performed as the main index for what the narrative as an act of instantiation means to the performer. It also should be noted that within this second reading the audience is much more of a factor that impinges on the shape of the narrative and its performance. What actually is being said is one of the many different performance features in what the speaker aims to achieve in the act of narrating.
Utilization of dietary energy for maintenance, milk production and lipogenesis by lactating crossbred cows during their midstage of lactation

1. Twenty-four energy and nitrogen balances were determined using twenty-four crossbred cows (Brown Swiss × Sahiwal) during their midstage of lactation. Energy balances were estimated by subtracting milk energy and heat production from the metabolizable energy (me) intake. Heat production was estimated by indirect calorimetry, by collection and analysis of respiratory gases. The cows were given amounts corresponding to 90, 110 and 130 % of the me and 90 and 110% of the digestible crude protein (DCP) standards of the (US) National Research Council (1966). 2. Energy requirements were estimated by partitioning the me intake for maintenance, milk production and energy gain or loss by multiple regression of energy balance values. Heat production (and thus energy balance) was corrected for excess N intake. 3. Energy requirements for maintenance were 585.18, 580.17 and 574.41 kJ me/kg body-weight0.75 per d for cows in negative balance, cows in positive balance and for all cows, respectively. 4. The efficiency of utilization of me for milk production was 68.52, 65.48 and 66.12% respectively, for cows in negative balance, for cows in positive balance and all cows. Energy required per kg fat-corrected milk production was 4.580, 4.791 and 4.746 MJ me for the respective groups of cows. 5. The efficiency of utilization of me for tissue gain was 67.67 and 64.86 % for cows in positive balance and for all cows respectively.
Clinical Significance of Positive Immunoblotting but Negative Immunofluorescence for Antimitochondrial Antibodies in Patients with Liver Diseases Other than Primary Biliary Cirrhosis

The serum reaction to anti-2-oxo-acid dehydrogenase complex (2-OADC) enzymes, the antigens recognized by antimitochondrial antibodies (AMA), can be detected by immunoblotting in patients with liver diseases other than primary biliary cirrhosis (PBC), who are negative for AMA by conventional indirect immunofluorescence. Whether the presence of anti-2-OADC is related to PBC or represents preclinical PBC in such patients is obscure at present. We examined the immunoreactivity of AMA by immunofluorescense, immunoblotting, and enzyme inhibition assay in serum samples from 59 patients with liver diseases other than PBC and 71 healthy subjects. We also examined the clinical course of the patients in whom a positive result was obtained to elucidate whether such reaction was a "true" or "false" phenomenon. None of the 130 sera was positive for AMA by indirect immunofluorescence or for anti-pyruvate dehydrogenase complex (PDC) by enzyme inhibition assay. However, seven of 71 (10%) sera from healthy subjects contained weak IgG class antibody to PDC-E2 (four sera) or E2 subunit of branched-chain oxo-acid dehydrogenase complex (BCOADC-E2) (three sera). Of the 59 sera from patients with liver diseases other than PBC, four (7%) reacted against 2-OADC by immunoblotting. Of these, three sera were from patients with chronic hepatitis C virus (HCV) infection, and contained IgG class autoantibody to BCOADC-E2. The serum reactivity to BCOADC-E2 detected by immunoblotting in these three patients diminished after absorption with recombinant BCOADC-E2 fusion protein. During the 3-5 year follow-up period, AMA by immunofluorescence and anti-PDC activity by enzyme inhibition assay were always negative in these three patients. The other one serum was from patient with alcoholic cirrhosis, and contained IgM class autoantibody to E3 binding protein (E3-BP). This patient did not develop PBC during the following 2 years. Our results showed that anti-2-OADC antibodies could be detected in some patients with liver diseases other than PBC, and even in healthy individuals. The clinical significance of the presence of these serum reactions is obscure at this stage, but the production of anti-BCOADC-E2 may be linked to the presence of HCV in certain patients, Further prospective studies of larger population should clarify whether anti-2-OADC reaction can precede the clinical development of PBC.
Suicidal Ideation and Sex Differences in Relation to 18 Major Psychiatric Disorders in College and University Students: Anonymous Web-Based Assessment

Abstract College/university students are at high risk for psychiatric disorder and suicide secondary to age, campus stressors, and social pressures. We therefore report frequencies of 18 Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision disorders and suicidal ideation (SI) acquired anonymously from a Web site receiving 113,181 visits from more than 1,500 predominantly US colleges/universities. Depression was foremost, followed by social phobia and eating disorders. Substance-related disorders were less frequent than expected. SI occurred in 47.1% of students, with women evidencing somewhat stronger findings than men. SI was more associated with substance, bipolar, and panic disorders than depression. Self-reported emotional volatility exceeded thoughts of self-harm for all disorders. The results support two subtypes of suicide risk: dysphoric premeditators and those primarily angry and/or impulsive. Clinicians and researchers should therefore consider suicide as an independent psychopathological phenomenon that includes emotional volatility as a risk factor and thoroughly evaluate psychiatric disorders potentially conferring greater suicidal propensity than depression.