Miracle-dz/UniFAR-FTUs huggingface dataset:
Maternal appraisal of information given around the time of preterm delivery

This study addressed the extent to which mothers recall and understand information given to them at the time of preterm delivery of an infant at high risk and requiring neonatal intensive care. Mothers of 76 preterm babies were interviewed at 6 weeks post notional term, 46 weeks post menstrual age, using a semi-structured interview format. The babies had a median birthweight of 1,190 g and a median gestational age of 28 weeks. Approximately half were delivered vaginally, and half by caesarean section. In approximately half of the sample, cerebral lesions considered to be likely to lead to cerebral palsy had been identified by ultrasound scan. Mothers' responses to the interview were coded to indicate their degree of recall and understanding of information, and their feelings at the time. Their predictions for their babies were also elicited. Maternal depression was assessed. The mothers' recall and understanding often appeared limited, and their predictions for the future did not reflect diagnosis. The majority had considerable negative feelings about the birth. Delivery type appeared to have little or no impact on response. Maternal depression seen in 18 mothers did not appear to influence recall or understanding, although there were indications that depression did affect satisfaction with the information given by professionals. Further work is needed to ensure that parental cognitive coping strategies in the face of an overwhelming experience are understood so that parents are supported appropriately in coping with their experiences and planning for the future.
Repigmentation and curling of hair after acitretin therapy

Drug‐induced hair colour and texture changes have been reported rarely. We describe a 70‐year‐old woman with psoriasis who noticed darkening of her previously white hair, which also gained a curly appearance after 6 months of acitretin treatment. We present this case to emphasize that acitretin can be added to the list of drugs that induce changes in hair colour and texture.
The Treatment of Provoked Vestibulodynia: A Critical Review

ObjectiveTo carry out a critical review of published studies concerning the treatment of provoked vestibulodynia. MethodsMEDLINE, PsycINFO, and Cochrane were used to identify treatment studies published between January 1996 and December 2006. All studies published in English that dealt specifically with the treatment of provoked vestibulodynia were included in the review regardless of their methodological quality. Thirty-eight treatment studies were thus examined in the present paper. ResultsSince 1996, surgical treatment has received somewhat less empirical attention. Nevertheless, it still boasts the best success rates, which range from 61% to 94%. More studies have focused on medical treatments, yielding success rates varying between 13% and 67%. Behavioral treatments have been the least studied, although 35% to 83% of patients benefit from them. Despite these interesting results, only 5 of the 38 treatment studies reviewed are randomized clinical trials. Furthermore, the majority of studies have several methodological weaknesses, such as the absence of (1) control or placebo group, (2) double-blind evaluation, (3) pretreatment pain evaluation, and (4) validated measures of pain and sexual functioning. DiscussionOn the basis of the results of the reviewed prospective studies and the randomized clinical trials, vestibulectomy is the most efficacious treatment to date. Though some medical treatments seem little effective, others appear promising and should be investigated further, as is the case with behavioral treatments. Additional randomized clinical trials are necessary to confirm the efficacy of surgery and validate nonsurgical treatments for provoked vestibulodynia.
Prognostic impact of hs‐CRP and IL‐6 in patients with persistent atrial fibrillation treated with electrical cardioversion

Objective. The aim of this study was to assess the role of inflammatory processes in the development of atrial fibrillation (AF) and the prognostic impact of inflammatory markers in predicting long‐term risk of AF recurrence after electrical cardioversion (CV). Methods. High‐sensitivity C‐reactive protein (hs‐CRP) and interleukin‐6 (IL‐6) were measured in 56 patients with persistent AF (lasting mean 128 days (range 14–960), mean age 65 years (34–84)), 19 healthy volunteers and 19 patients with permanent AF. Patients with persistent AF underwent CV. Blood samples were taken prior to CV and after 1, 30 and 180 days. Results. The immediate success rate of CV was 88 %, while the total recurrence rate after 180 days was 68 %. Patients with permanent AF had significantly higher levels of hs‐CRP and IL‐6 than patients with persistent AF (p = 0.0011, p<0.001). Patients in sinus rhythm (SR) after 180 days had significantly lower baseline hs‐CRP (1.25 mg/L (0.5–2.4) versus 2.0 mg/L (0.9–3.3), p<0.001) and IL‐6 (1.96 pg/mL (1.35–2.7) versus 2.75 pg/mL (1.55–3.62), p<0.001) than patients with recurrent AF. Baseline IL‐6 was the only independent predictor of recurrent AF (p = 0.04) in a multivariate Cox analysis. Patients in the lowest hs‐CRP quartile (<0.8 mg/L) had significantly lower AF recurrence rates after 180 days (50 % versus 74 % in the other three quartiles combined; p = 0.0069). Conclusion. Patients with AF had elevated levels of inflammatory markers. Low hs‐CRP and IL‐6 prior to CV are associated with a lower risk of AF recurrence after CV.
Clinical improvement in Darier's disease with photodynamic therapy

We report a patient with Darier's disease successfully treated with photodynamic therapy. She had previously been recalcitrant to treatment with emollients, topical corticosteroids and retinoids. Photodynamic therapy was trialled with significant clinical improvement in her cutaneous symptoms and signs that was maintained for over 27 months.
Correlates of Pain-rating Concordance for Adolescents With Sickle Cell Disease and Their Caregivers

ObjectivesAs sickle cell pain in children and adolescents with sickle cell disease (SCD) is managed primarily at home, understanding convergence of caregiver and youth pain reports may contribute to improvements in home pain management. The goal of this study was to examine concordance in pain ratings for a sample of 53 adolescents with SCD and their caregivers and to assess sociodemographic and psychosocial factors associated with concordance. MethodsAdolescents and caregivers completed a paper-and-pencil retrospective pain questionnaire and also SCD knowledge and disease management self-efficacy questionnaires. In addition, adolescents completed a SCD pain-coping questionnaire and a performance-based measure of cognitive functioning. ResultsAlthough Pearson correlations supported convergence across measures, intraclass correlation coefficients suggested only moderate consistency in pain ratings. Significant variation in interference with daily activities (caregivers higher) and pain descriptors (adolescents higher) was identified. Few correlates were supported; SCD knowledge and disease self-efficacy were identified in correlation analyses, but younger age, higher income, and increased adolescent disease self-efficacy were the strongest independent predictors of concordance in regression analyses. DiscussionEfforts to improve home management of pain in SCD should incorporate programming designed to increase parent-child communication about pain and pain interference, confidence in disease management abilities, and improved knowledge of SCD and its care, particularly for families of older adolescents.
Determination of salivary cortisol by liquid chromatography-tandem mass spectrometry

Abstract Background: Late evening salivary cortisol concentrations are increasingly used as a screening test in suspected Cushing's syndrome partly because of easy sample collection. The cortisol immunoassays are prone to interference by cross-reacting steroids and therefore there is a need for improvement. The high specificity of an LC-MS assay provides a solution to the problem. Methods: Our liquid chromatography-tandem mass spectrometric (LC-MS/MS) analysis utilizes only 0.1 ml of saliva. The samples were extracted with dichloromethane. The extract was evaporated to dryness and cortisol was analysed by LC-MS/MS operating in the negative mode ESI after separation on a reversed-phase column. Results: The calibration curves for analysis of salivary cortisol exhibited consistent linearity and reproducibility in the range of 0.5–20nmol/L. Interassay CVs were 4.3–11% at cortisol concentrations of 0.6–14nmol/L. The lower limit of quantitation (LOQ) was 70pmol/L (signal to noise ratio=10). The mean recovery of the analyte added to saliva samples ranged from 95–106%. The upper limit of the reference range (95%) was 3.0nmol/L. Conclusions: Our method is rapid, sensitive and simple to perform with a routine LC-MS/MS spectrometer.
Detection of blood volumes and haemoglobin mass by means of CO re-breathing and indocyanine green and sodium fluorescein injections

Abstract The main aim of the present study was to quantify the magnitude of differences introduced when estimating a given blood volume compartment (e.g. plasma volume) through the direct determination of another compartment (e.g. red cell volume) by multiplication of venous haematocrit and/or haemoglobin concentration. However, since whole body haematocrit is higher than venous haematocrit such an approach might comprise certain errors. To test this experimentally, four different methods for detecting blood volumes and haemoglobin mass (Hbmass) were compared, namely the carbon monoxide (CO) re-breathing (for Hbmass), the indocyanine green (ICG; for plasma volume [PV]) and the sodium fluorescein (SoF; for red blood cell volume [RBCV]) methods. No difference between ICG and CO re-breathing derived PV could be established when a whole body/venous haematocrit correction factor of 0.91 was applied (p = 0.11, r = 0.43, mean difference −340 ± 612 mL). In contrast, when comparing RBCV derived by the CO re-breathing and the SoF method, the SoF method revealed lower RBCV values as compared to the CO re-breathing method (p < 0.05, r = 0.95, mean difference −728 ± 184 mL). However, compared to the ICG and the SoF methods, the typical error (%TE) and hence reliability of the CO re-breathing method was lower for all measured parameters. Therefore, estimating blood volume compartments by the direct assessment of another compartment can be considered a suitable approach. The CO re-breathing method proved accurate in determining the induced phlebotomy and is at the same time judged easier to perform than any of the other methods.
Mohs surgery in Australia: A survey of work practices

Background: Mohs micrographic surgery is the preferred treatment for certain skin cancers. It had already been considerably refined prior to its introduction into Australia in 1978, refinement has continued since. Documenting the work practices of Australian Mohs surgeons serves to clarify the current role of Mohs surgery and may help tailor future Mohs fellowship programs.
Correlates of Pain Intensity in Men and Women With Hip and Knee Osteoarthritis. Results of a National Survey: The French ARTHRIX Study

Aims of the StudyTo examine the clinical and demographic correlates of pain intensity in patients with hip and knee osteoarthritis (OA). Patients and MethodsIn a national cross-sectional survey, 1811 general practitioners recruited and assessed 5324 patients with hip and knee OA. The patients rated the intensity of pain at rest, on movement over the last 24 hours, and during the last 8 days on 11-point numeric rating scales. The patients also completed the Western Ontario and McMaster Universities Osteoarthritis Index. Clinical and demographic correlates of pain intensity and function were investigated by univariate, stepwise multiple logistic regression and odds ratio analyses. ResultsData for 4598 patients were analyzed (86.4% of surveyed patients). The mean pain intensity was 4.1±2.2 at rest, 5.9±1.8 on movement during the last 24 hours, and 5.1±1.7 during the last 8 days. Pain on movement during the last 24 hours and during the last 8 days showed a strong positive correlation (r=0.78; P<0.0001), which suggests that the most of the latter pain was related to movement. Patients with knee or hip OA did not differ in pain intensity, but patients with both joints affected rated pain intensity significantly higher than did those with only 1 affected joint [4.6±2.1, 6.3±1.8, and 5.5±1.6, for the 3 pain assessments, respectively (P>0.01)]. Patients with high pain ratings were more likely to be women, be older than 75 years, and have a body mass index of greater than 40 kg/m2. In addition, patients who were retired, unemployed, farmers, or widowed, or had a long duration of OA gave high pain ratings. Patients with regular physical activities reported less intense pain. ConclusionsPain intensity ratings for patients with lower limb OA differed significantly with respect to sex, age, body mass index, physical activity, professional activity, marital status, and conditions of assessment.
Calprotectin in patients with chronic rheumatoid arthritis correlates with disease activity and responsiveness to methotrexate

Abstract Objective: Calprotectin (myeloid-related protein 8/14) is elevated in inflammatory diseases and a correlation of serum calprotectin and disease activity in rheumatoid arthritis (RA) has been shown. In this study, we investigated plasma calprotectin as a disease marker in patients with chronic RA treated with methotrexate (MTX) monotherapy and compared plasma calprotectin with C-reactive protein (CRP) in this matter. Methods: Seventy-six patients with chronic RA were included in this open prospective study and of these 40 were included prior to initiation of MTX therapy. The patients were followed with laboratory and clinical parameters for 52–56 weeks. Plasma calprotectin was analyzed at the start of study and at various intervals. Radiographic evaluation was performed at baseline and after 17.2 months and progression in joint destruction was measured with Larsen score. The response to MTX was evaluated according to the American College of Rheumatology criteria. Results: Patients starting MTX treatment had significantly higher levels of plasma calprotectin compared to patients well established on MTX therapy (p = .008). Among the 40 patients naive to MTX, 25 responded to MTX therapy and serum calprotectin decreased significantly in these patients (p = .0007). The radiographic damage showed no relation to calprotectin. Conclusions: Plasma calprotectin is associated with disease activity in patients with chronic RA and is more strongly correlated to MTX response compared to CRP. The role of calprotectin as a disease marker is promising and the advantages compared to CRP needs to be further investigated.
The Relation of Social Functioning to School Impairment Among Adolescents With Chronic Pain

ObjectivesTo further our understanding of social functioning in children with chronic pain, and particularly how social functioning relates to school impairment in this population. MethodsThis study involved 126 adolescents (12 to 17 y) evaluated at a multidisciplinary pain clinic. Adolescents completed measures assessing social functioning, pain, physical limitations, somatic symptoms, and school impairment. ResultsLower social functioning scores were significantly associated with pain, physical limitations, somatic symptoms, and school impairment. Social functioning mediated the relations between adolescents' pain experience (ie, pain, physical symptoms, physical limitations) and school impairment. DiscussionsThese findings highlight the importance of assessing and addressing social functioning in youth with chronic pain. Future research targeting school impairment should include evaluating the potential role that peer difficulties may play.
The rapid onset of multiple squamous cell carcinomas in two patients commenced on ustekinumab as treatment of psoriasis

We report the cases of two patients who developed eruptive cutaneous squamous cell carcinomas (SCC) soon after commencement of ustekinumab, as treatment of moderate to severe plaque type psoriasis. Ustekinumab is a human monoclonal antibody with a novel mechanism, selectively targeting the shared p40 subunit of interleukin‐12 (IL‐12) and IL‐23. Its efficacy has been well documented in three large phase‐III trials (PHOENIX I, PHEONIX 2, ACCEPT). Safety data on this new biological agent continue to grow. To date, no link between ustekinumab and cutaneous carcinogenesis has been demonstrated and, to our knowledge, these cases are the first of their kind. Importantly, both these patients had independent risk factors for developing non‐melanoma skin cancers; however, the specific time correlation with the administration of ustekinumab is of note. Our report suggests that ustekinumab may allow the development of cutaneous carcinomata in predisposed individuals.
Intraperitoneal Lidocaine Instillation and Postcesarean Pain After Parietal Peritoneal Closure: A Randomized Double Blind Placebo-controlled Trial

ObjectiveTo evaluate the effects of intraperitoneal instillation of lidocaine on postcesarean pain in patients with pariental periotoneal closure. MethodsA sample of 370 pregnant women, presenting early in labor, with no history of abdominal surgery and with indications for cesarean section were operated on with closure of the parietal peritoneum. They randomly received either 200 mg of intraperitoneal lidocaine or sterile saline (0.9%). Pain scores on the first and fifteenth postoperative days were recorded and followed up every 2 weeks up to 8 months after surgery. ResultsOverall incidence and pain scores of epigastric and global abdominal pain were more frequent in the controls than in the lidocaine group. The incidence of persistent postcesarean pain after 8 months dropped from 20.8. 0% to 10.8% (P<0.001) when intraperitoneal lidocaine was instilled. ConclusionsIntraperitoneal instillation of 200 mg of lidocaine decreased the incidence and scores of postcesarean pain when the parietal peritoneum was sutured. Further studies in a setting offering more effective acute pain control protocols, preferably with patient-controlled analgesia, are recommended to assess the use of lidocaine before it can be widely practiced.
Accuracy in skin cancer diagnosis: A retrospective study of an Australian public hospital dermatology department

Background/Objectives: Accurate identification of skin lesions is vital in ensuring malignancies are not missed and that they are treated early to avoid mortality. It is also important that appropriate lesions are submitted for biopsy to decrease the costs and morbidity associated with the unnecessary removal of benign lesions. This study attempted to assess current accuracy in skin cancer diagnosis.
Allergic contact dermatitis to topical preparations of bufexamac

In Australia bufexamac is mainly used for pharmacist‐initiated local treatment of various dermatoses. The European Medicines Agency's Committee for Medicinal Products for Human Use recently recommended that marketing authorisation for bufexamac‐containing preparations be revoked throughout the European Union because of the risk of severe allergic contact dermatitis. We retrospectively reviewed the patch test database at the Skin and Cancer Foundation Inc. and identified 19 cases of positive reactions to bufexamac (5% petrolatum) from 451 people patch tested. The bufexamac reaction was deemed relevant to the presenting dermatitis in 13 of 19 (68%) patients. Bufexamac allergic contact dermatitis is under‐reported in the English literature. We wish to emphasise the severity and the unusually polymorphic eruptions observed in some of the cases. Clinicians should consider the possibility of allergic contact dermatitis to bufexamac‐containing preparations in all patients where there is a history of exposure, even if used for only a short time.
Engagement in Multidisciplinary Interventions for Pediatric Chronic Pain: Parental Expectations, Barriers, and Child Outcomes

ObjectivesTo examine the adherence to the recommendations of pain treatment among children and adolescents evaluated for a variety of chronic and recurrent pain conditions. MethodsSeveral measures during initial evaluation and after 3 months were collected to assess satisfaction with initial evaluation, adherence to multidisciplinary recommendations, pain ratings, somatic symptoms, functional limitations, and school attendance. ResultsOf the 120 patients who initially enrolled in the study, 70 parents and 57 children participated in 3-month follow-up interviews and reported significantly fewer doctor visits, decreased somatic symptoms, fewer functional limitations, and decreased pain compared with their initial evaluation. Adherence to multidisciplinary recommendations ranged from 46.7% to 100% with the highest level of overall adherence to physical therapy. Factors associated with adherence varied across type of recommendation. For medical recommendations, higher parent-reported patient satisfaction and expectations that medical tests would be beneficial were associated with engagement in medical treatment, whereas parent reports of negative attitude-type barriers and experience with surgery were associated with less frequent engagement in recommended treatment. With regard to physical therapy recommendations, only earlier experience with exercise was associated with better adherence. For psychologic recommendations, familiarity with hypnosis and biofeedback in addition to positive expectations regarding psychologic treatment and biofeedback were all associated with subsequent engagement in psychologic treatment. Lastly, we identified modest associations between functional improvements and adherence to specific recommendations. DiscussionResults of this study support the importance of examining adherence to multidisciplinary interventions among children and adolescents with chronic pain.
Acute expression of hepatitis C core protein in adult mouse liver: Mitochondrial stress and apoptosis

Objective. In infection with hepatitis C virus (HCV), spontaneous clearance of the virus occurs in 30–40% of cases. By contrast, in chronic infection, this is rare. The basis for viral clearance in acute disease is unknown. Whereas cellular immune responses have been studied in detail, few data exist on the role of viral structural proteins, such as the core protein. The purpose of this study was to investigate the effects of core produced de novo within adult mouse hepatocytes by using a new transgenic mouse line in which expression of HCV core is regulated by tetracycline (tet-off). Material and methods. In this work, transgenic mice with conditional HCV core were created, to study the acute expression of HCV core protein in the context of the mature liver. The subcellular distribution of the core, hepatocellular oxidative stress and apoptosis were monitored. Results. Core protein is readily detectable and strongly associated with cytoplasmic lipid vesicles, endoplasmic reticulum and mitochondria. Mitochondrial oxidative stress was evidenced by a reduction in thioredoxin-2 (trx2). Concurrently, caspase-3 activity and TUNEL increased and, over time, the level of core protein in the liver declined. Conclusions. Mice that are conditionally transgenic for HCV core protein, which is readily detected and morphologically associated with steatosis in individual hepatocytes, were developed. Acute expression of core protein causes mitochondrial stress, as demonstrated by a reduction in trx2 and in the apoptosis of core-positive hepatocytes. We speculate that these events could be involved in the clearance of virus during acute hepatitis C, by both reducing the burden of virus in the liver and effectively priming the immune response.