Miracle-dz/UniFAR-FTUs huggingface dataset:
Polymorphisms in NLRP1 Gene Are Associated with Type 1 Diabetes

Objective The aim of this study was to clarify the association of two single-nucleotide polymorphisms (SNPs) (rs11651270 and rs2670660) in the NLRP1 (NLR family pyrin domain containing 1) gene with type 1 diabetes (T1D) in the Chinese Han population. We hypothesize that mutations in the NLRP1 gene may affect the susceptibility to T1D. Materials and Methods A case control study was designed, and participants fulfilling the diagnostic criteria of classical T1D as well as nondiabetic controls were enrolled in the study. The polymorphisms rs11651270 and rs2670660 were genotyped by polymerase chain reaction (PCR) and Sanger sequencing. Chi-squared test and logistic regression analysis were performed to compare the distributions of the allele and genotype between cases and controls. Kruskal-Wallis one-way ANOVA was used to compare the characteristics of different genotypes in participants with T1D. Results A total of 510 participants with classical T1D as well as 531 nondiabetic controls were enrolled in the study. The two groups were matched in sex (p = 0.418). The age (p < 0.001) and BMI (p < 0.001) were significantly lower in cases compared to controls. Significantly higher values were observed for fasting plasma glucose (FPG) (p < 0.001) and 2 h postprandial plasma glucose (PPG) (p < 0.001) in individuals with T1D. Regarding the allelic model, the minor allele C of rs11651270 was significantly associated with lower risk of T1D compared with the T allele (OR = 0.714, 95% CI = 0.579-0.882). Both rs11651270 and rs2670660 polymorphisms were associated with T1D in the Chinese Han population under a dominant model (OR = 0.648, 95% CI = 0.503-0.834 and OR = 0.716, 95% CI = 0.549-0.934, respectively) and an overdominant model (OR = 0.663, 95% CI = 0.511-0.860 and OR = 0.711, 95% CI = 0.541-0.935, respectively). Additionally, the polymorphism rs11651270 was also related to T1D in an additive model (OR = 0.719, 95% CI = 0.583-0.887). Most importantly, when we analyzed the clinical characteristics of T1D individuals with different genotypes, we found that the age of onset with the TT genotype at rs11651270 was younger than those with the other two genotypes (p = 0.001). Conclusions SNPs in the NLRP1 gene were associated with T1D, as well as the age of onset in the Chinese Han T1D individuals. Our study indicated that the NLRP1 gene might play a pivotal role in the etiopathogenesis of T1D and could be applied to genetic screening of T1D in the Chinese Han population.
Diabetes Mellitus in Pediatric Patients with Cystic Fibrosis

Introducción: La Fibrosis Quística (FQ) es una enfermedad hereditaria recesiva que afecta a varios órganos, fundamentalmente de los aparatos respiratorio y digestivo. La Diabetes Relacionada con la Fibrosis Quística (DRFQ) es una de sus principales complicaciones.Objetivos: Estudiar las complicaciones específicas de los pacientes pediátricos que padecen DRFQ y cómo afectan a su calidad de vida. Comparar las tasas de mortalidad de los pacientes pediátricos con FQ y con DRFQ. Poner de manifiesto la importancia del personal de enfermería en el manejo de los pacientes pediátricos con DRFQ. Metodología: Se llevó a cabo una revisión bibliográfica sistemática. Se incluyeron estudios publicados, en inglés y castellano, durante los últimos 10 años, y que analizaban una muestra de población de entre 0 y 9 años con FQ y/o DRFQ.Resultados: Se utilizaron 4 bases de datos para la búsqueda sistemática. Se analizaron 10 artículos para la resolución de los objetivos.Conclusiones: Las complicaciones que provocan la DRFQ, y los cuidados que requieren afectan a la calidad de vida de los pacientes. La progresión del diagnóstico y los tratamientos ha hecho que mejore su calidad de vida y que la diferencia de mortalidad entre los pacientes con FQ y con DRFQ se reduzca. El personal enfermero que atiende a los niños con DRFQ es un recurso de información esencial para los pacientes y sus familias. Las enfermeras deben transmitir la importancia de la adhesión a los tratamientos para conseguir una mejor calidad de vida. Introduction: Cystic Fibrosis (CF) is a hereditary recessive disease that affects several organs, mainly within the respiratory and digestive systems. Cystic Fibrosis Related Diabetes (CFRD) is one of its main complications.Objectives: To study the specific complications of pediatric patients suffering from CFRD and how they affect a patient’s quality of life. To compare the mortality rates of pediatric patients with CF and with CFRD. To highlight the importance of nurses in the management of pediatric patients with CFRD.Methodology: A systematic bibliographic review was conducted. We included studies, in English and Spanish, published over the last 10 years, which analysed a population aged between 0 and 9 years old with CF and/or CFRD.Results: Four databases were used for the systematic search. We analysed 10 articles to address the objectives.Conclusions: The complications caused by CFRD and the care that patients require affect the patient’s quality of life. Progress both with diagnosis and with treatment has improved the quality of life of patients, and has contributed to reductions in the difference between the mortality rates of patients with CF and without CFRD. Nurses who care for children with CFRD are essential as an information resource for patients and their families. Nurses must convey the importance of therapeutic adherence to achieve a better quality of life.
Posterior Reversible Encephalopathy Syndrome Caused by Fioricet (Butalbital-Acetaminophen-Caffeine)

A common side effect of Fioricet (butalbital-acetaminophen-caffeine) is high blood pressure caused by the caffeine content. We report a case of a 54-year-old female who developed the worst headache of her life after taking 2 tablets of butalbital-acetaminophen-caffeine every six hours for three days before presenting to the emergency department, where her blood pressure was 178/87 mmHg. A brain MRI showed edema in the subcortical white matter of the right occipital lobe, right parietal lobe, and left occipital lobe. Posterior reversible encephalopathy syndrome (PRES) was diagnosed. The patient returned within the week with severe headaches, visual hallucinations, and a blood pressure of 150/80 mmHg. Repeat brain MRI showed slight improvement of edema. Her brain imaging studies completely normalized at 10 months after diagnosis. Although the patient received appropriate treatment, she was unable to make full recovery. Due to her inability to work and the constant pain, the patient continues to struggle with depression.
Exploring the factors associated with non-urgent emergency department utilisation for mental health care

Background Emergency department visits for mental health care are on the rise across North America. Patients with mental illness are at an increased risk for frequent and non-urgent emergency department visitation. Aims The purpose of this study was to examine the independent predictors of non-urgent emergency department use for mental health care. Methods A secondary data analysis was conducted with archived data provided by the Erie St. Clair Local Health Integration Network in Ontario. Results A total of 13,114 mental health-related emergency department visits were analysed using logistic regression with generalised estimating equations modelling. The findings suggest the following characteristics are predictive of non-urgent emergency department use for mental health care: age, season, time of day, access to primary health care, mode of arrival, hospital type, referral source and patient diagnosis. Conclusions The findings of this study can be utilised to assist clinicians and policy makers in identifying and managing patients using the emergency department for non-urgent mental health care.
Statin use and Vital Organ Failure in Patients With Asthma–Chronic Obstructive Pulmonary Disease Overlap: A Time-Dependent Population-Based Study

Objective: The effects of statins on the risk of hepatic, renal, respiratory, and heart failure among patients with asthma–chronic obstructive pulmonary disease overlap (ACO) have not been reported. Design: Time-dependent population-based study. Setting: Patient data from 2000 to 2010 were retrieved from the Taiwan National Health Insurance Research Database. Patients: We divided patients with ACO into cohorts of statin use (N = 1,211) and nonuse (N = 7,443). Measurements and Main Results: The cumulative incidence rates of hepatic, renal, respiratory, and heart failure were analyzed through Cox proportional regression analysis with time-dependent variables. After adjustment for multiple confounding factors, including age, sex, comorbidities, and medications [statins, inhaled corticosteroid (ICS), or oral steroid (OS)], the adjusted hazard ratios (aHRs) [95% confidence intervals (CIs)] for hepatic, renal, respiratory, and heart failure were 0.50 (0.40–0.64), 0.49 (0.38–0.64), 0.61 (0.27–2.21), and 0.47 (0.37–0.60), respectively. The aHRs (95% CIs) for statin use with [ICS, OS] for hepatic, renal, and heart failure were [0.36 (0.20–0.66), 0.52 (0.39–0.70)]; [0.82 (0.51–1.34), 0.46 (0.33–0.63)]; and [0.66 (0.40–1.07), 0.48 (0.37–0.64)], respectively. Conclusions: The ACO cohort with statin use exhibited lower risk of hepatic, renal, and heart failure than any other cohort, regardless of age, sex, comorbidities, or ICS or OS use. Regarding the combined use of statins and ICS, the risks of hepatic failure were lower. For the combined use of statins and OS, hepatic, renal, and heart failure were less frequent.
Sexual Dysfunction in Males and Females with Type 2 Diabetes Referring to Healthcare Centers of Zarand, Kerman: A Cross-Sectional Study

Background: Sexual dysfunction is a common complication of type 2 diabetes in males and females. Although sexual function is important, it is often neglected as a component of type 2 diabetes care. Objectives: This study aimed at investigating the association between sexual function and marital dissatisfaction in males and females with type 2 diabetes living in southern Iran. Methods: This study was a case-control research, which was carried out on 120 non-pregnant females and 120 males with type 2 diabetes. In addition, available samples of healthy individuals (120 females and 120 males), who referred to central cares located in Zarand, Kerman during year 2015, were used as the control group. The female sexual function data was obtained based on a questionnaire compromised of Rosen female sexual function indices (FSFI, 2000). The international index of erectile function (IIEF) questionnaire was used to obtain male sexual dysfunction data. Results: Forty-one diabetic individuals (17.08%) of total diabetic participants had impaired sexual function, 29 of which (70.73%) were male (with higher rates in males than females, P < 0.05). In addition, 12 diabetic patients (5%) had decreased sexual desire and 66.6% were diabetic males. There was no significant difference in sexual desire between healthy and diabetic groups. Sexual arousal was significantly (P < 0.001) lower in the diabetic group compared with healthy individuals. In addition, sexual lubrication (P = 0.008), orgasm (P = 0.003), satisfaction (P = 0.05), and dyspareunia (P = 0.05) scores were significantly higher in the healthy group in comparison to the diabetic group. Severe erectile dysfunction was significantly (P < 0.001) greater between diabetic than the healthy group. Sexual dissatisfaction was significantly (P < 0.001) higher in diabetic males compared to healthy individuals; the amount of libido average and marital life satisfaction were significantly lower in diabetic males (P = 0.01). Conclusions: Based on the findings of this study, counseling, and prevention of diseases, such as diabetes is suggested along with a focus on marital and sexual relations at the age of fertility.
Microbiological profile of biliary tract infections

Background and objectives: Bacterial infection of biliary tract may cause severe inflammatory response or sepsis. An immediate bile culture and appropriate antibiotic administration are important to control the biliary tract infection. The objective of the study was to study the microbial profile and antibiotic sensitivity pattern in patients with biliary tract infection. Materials and methods: Fifty suspected cases of biliary tract infection admitted to the Department of Gastroenterology were enrolled. Bile samples from these patients were aseptically collected and sent to the Department of Microbiology. Samples were processed in automated BACTEC or BacT/ALERT system. Further identification and antimicrobial susceptibility testing was done by VITEK-2 system. Results: Of the 50 suspected cases of biliary tract infection, the majority were male patients and in the age group of 51-60 years. Growth was obtained in 22 (44%) bile samples. The organisms obtained were Escherichia coli (40%), Klebsiella spp. (20%), Pseudomonas spp. (16%), and coagulase-negative Staphylococci (8%). All Gram negative isolates were susceptible to tigecycline and colistin. A high susceptibility was seen to amikacin and carbapenems while low susceptibility was seen to others. All the Gram positive organisms were sensitive to vancomycin, teicoplanin and linezolid with low sensitivity to penicillin. Interpretation and conclusion: E. coli is the most common organism isolated from bile. Antimicrobial sensitivity patterns require a revision of empiric antibiotic therapy policy in cholangitis. Early detection and determination of antimicrobial susceptibility pattern is important to reduce the mortality and morbidity associated with bile fluid infections.
Trends in toxoplasmosis seroprevalence among pregnant women attending the Fann Teaching Hospital in Dakar Senegal

Toxoplasma gondii infection during pregnancy can lead to many complications such as abortion, cerebral calcifications, chorioretinitis, and hydrocephalus. In Senegal, toxoplasmosis primary prevention during pregnancy usually refers to prenatal screening of pregnant women, but epidemiological data are needed to help shape human toxoplasmosis prevention policy. This study assessed T. gondii seroprevalence among pregnant women attending the Fann Teaching Hospital in Dakar Senegal. An observational, descriptive study was conducted at the laboratory of parasitology at Fann Teaching Hospital in Dakar. Pregnant woman attending the Fann Teaching Hospital for antenatal visit provided 10 ml of blood collected into a dry container. T. gondii immunoglobin G (IgG) carriage was assessed using an indirect enzyme-linked immunosorbent assay (ELISA) method. One thousand two hundred and thirty six (1236) venous blood samples were collected. Overall, 437 samples were positive; T. gondii seroprevalence was thus evaluated at 35.4% (95% CI: 32.7 - 38.1). T. gondii seroprevalence was more frequent in the age group above 30 years (38.3%) compared to the pregnant women with an age below 30 years (31.9%). In a multivariate logistic regression analysis, after adjustment on the study period, pregnant women above the age of 30 years were more likely to carry T. gondii IgG: adjusted odds ratio 1.37 (95% CI: 1.10 - 1.74; p=0.01). Seroprevalence of T. gondii was significantly higher among pregnant women above the age of 30 years, leaving younger women more susceptible to primary infection with T. gondii and their babies to congenital toxoplasmosis. Improving awareness of toxoplasmosis risk factors and its different modes of transmission in these high-risk groups will be needed; but it should be supported by epidemiological studies on toxoplasmosis risk factors distribution among pregnant women and women of reproductive age. Key words: Toxoplasmosis, pregnancy, Senegal, seroprevalence.
IL-28B genotypes as predictors of long-term outcome in patients with hepatitis C-related severe liver injury.

INTRODUCTION Patients with severe fibrosis or cirrhosis are at high risk for liver-related complications, even after successful antiviral treatment and/or regression of fibrosis. These are the first published results concerning the role of IL-28B genotypes as predictors of the durability of sustained virological response (SVR) and long-term outcome, in patients with baseline severe fibrosis and cirrhosis caused by hepatitis C (HCV) infection. METHODOLOGY Genetic testing for three different single nucleotide polymorphisms (SNP) near the IL28B gene, rs12979860, rs12980275 and rs8099917, was performed in 42 patients with HCV-related advanced fibrosis and cirrhosis, who achieved SVR after successful interferon-based treatment. Baseline clinical and laboratory parameters were analysed, as well as IL28B genotype association with late virological relapse, fibrosis progression and clinical outcomes. RESULTS The most prevalent genotypes in all three tested SNP positions were: CCrs12979860 genotype in 69% of patients, GTrs8099917 in 78.6% and GGrs12980275 in 47.6% of patients. The presence of IL28B CCrs12979860 genotype was identified as a negative predictor of late virological relapse. Further analysis did not confirm the association of other IL28B genotypes with the progression of fibrosis and clinical outcomes. CONCLUSIONS Varying long-term prognosis in patients with HCV-related severe fibrosis and cirrhosis is due to multiple interactions between host genetic factors, virus and environment. These are first published results demonstrating the significance of IL28B CCrs12979860 genotype as a negative predictor of late virological relapse. A further investigation concerning genetic factors is necessary to identify patients under risk for late relapse, complications and unfavorable outcomes, so that they can be reevaluated and offered new treatment options.
Factors Associated with Self Care Practices among Patients with Hepatitis C Virus

Hepatitis C virus (HCV) is an important public health problem both in developed and developing countries. Living with hepatitis C involves learning to live with the physical, emotional, social and financial consequences of the disease. All of these changes can affect patient's ability to cope with chronic HCV with profound negative impacts on self-care practices. Self-care as a part of daily living is the care taken by individuals towards their own health and well-being, which includes the care extended to their children, family, friends and others in neighborhoods and local communities. Self-care practices play an important role in disease management, treatment and achieving better health outcome. Objective: Identify factors associated with self-care practices among patients with hepatitis C virus. Setting: The study was conducted at outpatient clinic of Liver Institute in Kafr El-Sheikh (Ministry of Health). Subjects: 340 adult patients diagnosed with HCV infection. Tools: Three tools were utilized for the purpose of data collection; socio-demographic and clinical data interview schedule, hepatitis C virus patients' knowledge structured interview questionnaire, and hepatitis C Virus self-care practices structured interview questionnaire. Results: There were multiple factors influencing patients' self-care practices including age, sex, educational level, marital status, type of work, income, residence and clinical onset and duration of disease, history of associated diseases and taking medications for these associated diseases. Conclusion: There were four factors together statistically significant influence patients self-care practices including educational level, age, income and residence. Recommendations: Development of health education programs for HCV patients and their families to teach them how to apply self-care practices and how to deal with factors affecting patients' self-care practices to avoid subsequent complications of HCV.
The Evolving Role of Taxanes in Combination With Cetuximab for the Treatment of Recurrent and/or Metastatic Squamous Cell Carcinoma of the Head and Neck: Evidence, Advantages, and Future Directions

The addition of cetuximab to platinum-based chemotherapy (cisplatin or carboplatin plus 5-fluorouracil [5-FU]), followed by maintenance cetuximab until disease progression (EXTREME), resulted in the first regimen to yield significantly improved survival outcomes in the first-line treatment of patients with recurrent and/or metastatic squamous cell carcinoma of the head and neck (R/M SCCHN) in over 30 years. Currently, the EXTREME regimen is a guideline-recommended treatment in the first-line R/M setting, and, therefore, it is used as a control arm in all new first-line, phase 3 immunotherapy trials. More recently, new checkpoint inhibitor approaches have emerged and are changing the treatment landscape for PD-L1–positive patients with R/M SCCHN. Additionally, alternative chemotherapy backbones in R/M SCCHN are continually investigated. Replacing 5-FU with a taxane in the EXTREME regimen seeks to take advantage of the potential immunogenic and proapoptotic synergy between cetuximab and docetaxel or paclitaxel. These cetuximab-, platinum-, and taxane-based treatments have demonstrated promising survival results and cytoreductive properties in single-arm studies. Thus, these combination treatments may be of importance to patients with high tumor burden and dangerous site involvements (e.g., causing bleeding, suffocation, dysphagia, or ulceration), in whom symptom relief is a key treatment goal. TPExtreme is the first large, randomized trial comparing a cetuximab, platinum, and taxane combination regimen with EXTREME. Currently, the substitution of 5-FU with a taxane is a feasible and clinically beneficial option for patients with contraindications to 5-FU. The TPEx regimen appears to be a new option in first-line R/M SCCHN, with a shorter time on CT and significantly lower toxicity than the EXTREME regimen. For patients with R/M disease in whom further cisplatin- or carboplatin-based treatment is unsuitable, or whose disease has already progressed on first-line R/M therapy, treatment options such as cetuximab plus a taxane, which capitalize on the combinative ability of the 2 agents, can be considered. Notably, it is as of yet unknown what second-line treatments may be suitable to follow a checkpoint inhibitor-based first-line therapy.