Miracle-dz/UniFAR-FTUs huggingface dataset:
Is monocyte to HDL ratio superior to monocyte count in predicting the cardiovascular outcomes: evidence from a large cohort of Chinese patients undergoing coronary angiography

Abstract Aim: Recently, monocyte-to-high density lipoprotein ratio (MHR) has been proposed as a novel prognostic indicator of cardiovascular diseases. However, no study is currently available regarding the comparison between MHR and monocyte count (MC) in predicting the outcomes among patients undergoing coronary angiography. Methods: A total of 3798 patients scheduled for selective coronary angiography were enrolled and followed up to capture major adverse cardiovascular events (MACEs, death, acute myocardial infarction, unstable angina, stroke, heart failure, and unexpected coronary revascularization). Cox proportional hazards models were used to evaluate the risk of MHR or MC on MACEs. Results: During a median of 24.6 months follow-up, 347 (9.1%) MACEs occurred. The upper tertiles of MC and MHR have a significant lower event-free survival (p = 0.011; p = 0.014, respectively). Significantly, both MC and MHR were associated with increased MACEs risk after adjusting for potential confounders [adjusted HR (95% CI): 2.734 (1.547–4.832); 2.031 (1.268–3.254), respectively]. Additionally, the area under the receiver-operating characteristic curves of MC or MHR in predicting MACEs were 0.574 (0.542–0.606) and 0.562 (0.530–0.594) (p < 0.001, both), respectively. Conclusions: Our data firstly indicated that MHR was an independent predictor of MACEs whereas the prognostic impact was not superior to MC in patients who underwent coronary angiography. Key Messages MHR has been suggested as a novel prognostic indicator of several cardiovascular diseases. No study is currently available regarding the comparison of MHR to MC in predicting the outcomes in a large cohort of patients undergoing coronary angiography. Our data firstly indicate that MHR is independently associated with MACEs in patients undergoing coronary angiography whereas the prognostic impact is similar to MC.
Small cell carcinoma of the prostate presenting with Cushing Syndrome. A narrative review of an uncommon condition

Abstract Small cell carcinoma (SCC) of the prostate is an uncommon condition; there are very few cases in which presenting symptoms are consistent with Cushing Syndrome (CS). We report a new case in which CS triggers the suspicion of an SCC of the prostate and a review of the published cases of SCC of the prostate presenting with CS. The origin of these neoplasms is still unclear. It may be suspected when laboratory features appear in patients diagnosed with prostatic adenocarcinoma which becomes resistant to specific therapy. SCC usually occurs after the 6th decade. Patients suffering SCC of the prostate presenting with CS usually present symptoms such as hypertension, hyperglycemia, alkalosis or hypokalemia; cushingoid phenotype is less frequent. Cortisol and ACTH levels are often high. Prostatic-specific antigen levels are usually normal. CT scan is the preferred imaging test to localize the lesion, but its performance may be improved by adding other tests, such as FDG-PET scan. All patients have metastatic disease at the time of diagnosis. Lymph nodes, liver and bone are the most frequent metastases sites. Surgery and Ketokonazole are the preferred treatments for CS. The prognosis is very poor: 2- and 5-year survival rates are 27.5 and 14.3%, respectively. Key messages When a patient presents with ectopic Cushing Syndrome but lungs are normal, an atypical localization should be suspected. We should suspect a prostatic origin if Cushing Syndrome is accompanied by obstructive inferior urinary tract symptoms or in the setting of a prostatic adenocarcinoma with rapid clinical and radiological progression with relatively low PSA levels. Although no imaging test is preferred to localize these tumors, FDG-PET-TC can be very useful. Hormone marker scintigraphy (e.g. somatostatin) could be used too. As Cushing Syndrome is a paraneoplastic phenomenon, treatment of the underlying disease may help control hypercortisolism manifestations. These tumors are usually metastatic by the time of diagnosis. They have very poor prognosis.
The association between fetal position at the onset of labour and birth outcomes

Fetal position throughout labour exerts considerable influence on labour and delivery, with a mal-positioned fetus during active labour known to contribute towards fetal and maternal morbidity. In response there is a move towards promoting the Left Occipito-Anterior (LOA) position at labour onset as optimal. It is thought that the LOA position encourages anterior rotation thus reducing the likelihood of mal-rotation. A systematic review was undertaken which highlighted an absence of scientific evidence. A prospective cohort study was therefore conducted with 1250 nulliparous women who were scanned to accurately determine fetal position, specifically the LOA position at the onset of labour and the association with delivery mode and other birth outcomes was examined. The LOA position at the onset of labour was not associated with mode of delivery, nor were any of the other positions (p=0.39). Pain relief, labour duration, augmentation, and Apgar scores did not show any association with the LOA or other positions. The only association found was that women with a fetus in the posterior position were more likely to use pethidine (p=0.008). This study has shown that the LOA fetal position at labour onset was not associated with improved outcomes and therefore should not be promoted as optimum
Practice of Deep Vein Thrombosis Prophylaxis in Teaching Hospitals of Tabriz

Background: Deep Vein Thrombosis (DVT) and Pulmonary Thromboembolism (PTE) are one of the frequently missed and lethal complications in admitted patients. Unfortunately, in spite of the presence of consensus about prevention of DVT, these guidelines are not applied in most hospitals. Death rates from DVT and PTE are more than those of road accidents and breast cancer. Our study aimed to analyze the situation of DVT/PTE prevention in hospitals of Tabriz. Materials and Methods: Based on 75000/ year admission, we studied the records of 17 teaching wards in 7 hospitals systematically. At least 50 records from each ward were reviewed. Records with insufficient data; admissions of less than 3 days; heparin treated cases; uremic and cirrhotic patients; those with bleeding tendencies, and ENT, ophthalmology, pediatric wards were excluded. 1557 records were collected, and risk of DVT (low-moderate-high-very high) along with appropriate prevention method was stratified according to ACCP 1998 guideline for surgical ward. For stratification of risk factors in medical wards, comparable rate of prevalence of DVT/PTE was used for every medical condition. Results: Highest rate of DVT prevention was related to cardiology unit (63.4%) and lowest rate to thoracic surgery unit(2.7%). Appropriate prevention methods were related to cardiology (73.1%), pulmonary ICU (51.4%), and gynecology (42.3%). Inappropriate methods were related to neurology ICU, neurosurgery, and orthopedic wards (0%). Conclusion: This study shows that in spite of the presence of guidelines for prevention of DVT, and the importance of this in decreasing costs and mortalities, application of appropriate method in most wards is far from reality, and continuous learning of physicians about prevention of DVT and regular control of medical records by medicare is strongly recommended in order
Extraintestinal manifestations of inflammatory bowel disease: Epidemiology, diagnosis, and management

Abstract Extraintestinal manifestations occur rather frequently in inflammatory bowel disease (IBD), e.g. ulcerative colitis (UC) and Crohn's disease (CD). The present paper provides an overview of the epidemiology, clinical characteristics, diagnostic process, and management of rheumatic, metabolic, dermatologic (mucocutaneous), ophthalmologic, hepatobiliary, hematologic, throm-boembolic, urinary tract, pulmonary, and pancreatic extraintestinal manifestations related to IBD. Articles were identified through search of the PubMed and Embase databases, the Cochrane Library, and the web sites of the European Agency for the Evaluation of Medicinal Products (EMEA) and the US Food and Drug Administration (FDA) (cut-off date October 2009). The search terms ‘Crohn's disease’, ‘inflammatory bowel disease’, or ‘ulcerative colitis’ were combined with the terms ‘adalimumab’, ‘anemia’, ‘arthritis’, ‘bronchiectasis’, ‘bronchitis’, ‘cutaneous manifestations’, ‘erythema nodosum’, ‘extraintestinal manifestations’, ‘hyperhomocysteinemia’, ‘infliximab’, ‘iridocyclitis’, ‘lung disease’, ‘ocular manifestations’, ‘osteomalacia’, ‘pancreatitis’, ‘primary sclerosing cholangitis’, ‘renal stones’, ‘sulfasalazine’, ‘thromboembolism’, and ‘treatment’. The search was performed on English-language reviews, practical guidelines, letters, and editorials. Articles were selected based on their relevance, and additional papers were retrieved from their reference lists. Since some of the diseases discussed are uncommon, valid evidence of treatment was difficult to obtain, and epidemiologic data on the rarer forms of extraintestinal manifestations are scarce. However, updates on the pathophysiology and treatment regimens are given for each of these disorders. This paper offers a current review of original research papers and randomized clinical trials, if any, within the field and makes an attempt to point out practical guidelines for the diagnosis and treatment of various extraintestinal manifestations related to IBD.
Factors influencing the choices of infant feeding of HIV-positive mothers in Southern Ghana: The role of counsellors, mothers, families and socio-economic status

The study assessed the perspectives of HIV-positive mothers and family members (grand-mothers and fathers) of the infant feeding options recommended for HIV-infected mothers in Ghana. This entailed individual interviews with 40 HIV-positive mothers with infants aged 0 to 12 months and 6 focus group discussions with HIV-positive mothers, fathers and grandmothers of unknown status in two urban districts. All infants born to HIV-positive mothers in both districts had been breastfed. Breastfeeding was initiated between three hours and three days following birth. While some of the infants had been exclusively breast-fed, none had been exclusively formula fed. Early mixed feeding patterns were deeply entrenched. Barriers to exclusive replacement feeding by HIV-positive mothers included cultural and familial influences, socio-economic factors including cost of infant formula, lack of access to fridges, clean water and fuel. Interventions designed to promote safer infant feeding among HIV-infected mothers in these settings need to be mindful of these barriers (socio-economic, cultural and familial) that these women face. Failure by policy makers to incorporate these issues will continue to lead to a gap between well-intended policies and programmes, and actual practices of HIV-positive mothers. Key words: Cultural norms, HIV-positive mothers, socio-economic status, infant feeding.
Are Pharmacists a Viable Channel for Education about Clinical Trial Participation?

Clinical research is fundamental to improving public health, yet public awareness of and engagement in clinical research is very low, as is public trust in the clinical research enterprise. Hypothesizing that pharmacists represent an untapped resource to educate and engage the public about clinical research, this study examines public perspectives on receiving clinical research information from pharmacists. In a 19-item survey, the majority (72%) of the 2,650 respondents were very or somewhat interested in receiving clinical trial information from a pharmacist; but <1% currently receive it and <2% ever asked. Primary interests include information about finding a trial, safety of trials, and ways to learn more; printed information provided at the pharmacy or by email are preferred methods of receiving information. Interest varies significantly among respondent groups, but excepting non-pharmacy users, all respondents desire information at rates greater than 65%, regardless of demographics, knowledge or experience of clinical trials, and patient-pharmacist relationships. These results suggest that pharmacy-directed outreach and recruitment strategies could see high rates of success.
Heart health risk factors in Punjabi early teens

Context: India is experiencing an epidemiological health transition characterized by rapid decline in nutritional and parasitic diseases (pre-transitional diseases) with an alarming rise in cardiovascular diseases, mainly coronary heart disease and stroke (post-transitional diseases). Many of these risk factors manifesting themselves as diseases in adults can be found during adolescence. Aims: To determine the prevalence of risk factors of heart disease among urban high-school students aged 13-15 yrs in Ludhiana city. Materials and Methods: This cross-sectional study included 330 high school-going early teens aged 13-15 years using a pretested questionnaire. Details regarding food habits, physical activity, and family history were collected along with anthropometric measures and blood pressure recordings. Statistical Analysis Used: Data was analysed using frequencies and proportion. Chi-square was the test of significance. Results: The prevalence of at least one risk factor in the population was 48.5%. Family history with prevalence of at least one coronary artery disease risk factor was of 27.4%, diabetic parents 12.2%, hypertension 17.6%, and heart disease was 1.8%. Physical inactivity as a risk factor showed an overall prevalence of 73%. Nearly 50% of the students consumed some junk food every day. Only 18.2% consume 3-5 servings of fruits per day, 11.2% do not take any fruits at all. Prevalence of overweight was 11.2% and 4.6% of them were obese. Hypertension was seen in 20.1% of subjects. Conclusions: The present generation of early teens are at high risk of future cardiovascular disease and schools and society need to address these issues urgently.
Evaluating the functional state of adult-born neurons in the adult dentate gyrus of the hippocampus: from birth to functional integration

Abstract Hippocampal neurogenesis occurs in the adult brain in various species, including humans. A compelling question that arose when neurogenesis was accepted to occur in the adult dentate gyrus (DG) is whether new neurons become functionally relevant over time, which is key for interpreting their potential contributions to synaptic circuitry. The functional state of adult-born neurons has been evaluated using various methodological approaches, which have, in turn, yielded seemingly conflicting results regarding the timing of maturation and functional integration. Here, we review the contributions of different methodological approaches to addressing the maturation process of adult-born neurons and their functional state, discussing the contributions and limitations of each method. We aim to provide a framework for interpreting results based on the approaches currently used in neuroscience for evaluating functional integration. As shown by the experimental evidence, adult-born neurons are prone to respond from early stages, even when they are not yet fully integrated into circuits. The ongoing integration process for the newborn neurons is characterised by different features. However, they may contribute differently to the network depending on their maturation stage. When combined, the strategies used to date convey a comprehensive view of the functional development of newly born neurons while providing a framework for approaching the critical time at which new neurons become functionally integrated and influence brain function.
Temporal phases of long-term potentiation (LTP): myth or fact?

Abstract Long-term potentiation (LTP) remains the most widely accepted model for learning and memory. In accordance with this belief, the temporal differentiation of LTP into early and late phases is accepted as reflecting the differentiation of short-term and long-term memory. Moreover, during the past 30 years, protein synthesis inhibitors have been used to separate the early, protein synthesis-independent (E-LTP) phase and the late, protein synthesis-dependent (L-LTP) phase. However, the role of these proteins has not been formally identified. Additionally, several reports failed to show an effect of protein synthesis inhibitors on LTP. In this review, a detailed analysis of extensive behavioral and electrophysiological data reveals that the presumed correspondence of LTP temporal phases to memory phases is neither experimentally nor theoretically consistent. Moreover, an overview of the time courses of E-LTP in hippocampal slices reveals a wide variability ranging from <1 h to more than 5 h. The existence of all these conflictual findings should lead to a new vision of LTP. We believe that the E-LTP vs. L-LTP distinction, established with protein synthesis inhibitor studies, reflects a false dichotomy. We suggest that the duration of LTP and its dependency on protein synthesis are related to the availability of a set of proteins at synapses and not to the de novo synthesis of plasticity-related proteins. This availability is determined by protein turnover kinetics, which is regulated by previous and ongoing electrical activities and by energy store availability.
Cystatin C and cardiac hypertrophy in primary hypertension

Abstract Introduction. Cystatin C is a marker of kidney function and a predictor of cardiovascular morbidity and mortality. It is unknown whether this protein may be related to the cardiac involvement that is common among patients with essential hypertension. Patients and methods. We evaluated the relationship between serum cystatin C, serum creatinine, estimated glomerular filtration rate and cardiac structure assessed by echocardiography, in a group of 49 non-diabetic patients with primary hypertension and normal serum creatinine. Results. Mean cystatin C levels were 0.74 ± 0.15 mg/l. Age, body mass index, triglycerides and creatinine, estimated glomerular filtration rate and left ventricular mass index were independently associated with cystatin C levels. Seventy three per cent of patients had cardiac hypertrophy. The prevalence of left ventricular hypertrophy was higher in patients who had cystatin C levels above the 70th percentile (0.79 mg/dl) than patients below this percentile (93.3% vs 66.7%, respectively, p = 0.04). Serum cystatin C (β = 0.48, p = 0.009), but not serum creatinine nor estimated glomerular filtration rate, was independently related to left ventricular mass index in a logistic regression analysis. Conclusion. Cystatin C is closely related to left ventricular mass in hypertensive patients, and could be a marker for cardiac hypertrophy in these patients.
Ultrasonographic backscatter of the carotid artery wall in patients with HIV infection: A pilot study

Abstract Aims. The aim of our study was to measure carotid intima-media thickness (cIMT) and risk factors associated with its development and progression, and to evaluate arterial wall characteristics through integrated backscatter analysis (IBS) in HIV patients. Methods. Perspective cohort study enrolling 44 HIV patients treated with antiretroviral drugs who underwent standard B Mode cIMT measurement and tissue characterization of carotid wall by means of dedicated software by acoustic densitometry, at time 0 and 2 years later. Major findings. Cross-sectional evaluation performed at baseline found that cIMT value correlated significantly with age (r = 0.42, p = 0.005) and systolic blood pressure (r = 0.31, p = 0.04). No correlation was found between cIMT and CD4, HIV-RNA, triglycerides or total cholesterol. There was no difference between the group with versus the group with no protease inhibitors treatment. cIMT progression during 2 years of observation was statistically significant (median, interquartile range [IQR]: 0.005, 0–0.031). No correlation was found between IBS and duration of disease and kind of therapy, whereas a significant association was found between cIMT and IBS (r = 0.33, p = 0.03). No noticeable changes of IBS were observed during 2 years observation. Conclusions. Classic risk factors greatly affect cIMT than time of HIV infection, duration of antiretroviral therapy exposure and use of protease inhibitors. IBS is a promising technique for the evaluation of arterial wall composition in HIV patients.
Masked hypertension unfavourably affects haemostasis parameters

Abstract Objective. Recent evidence demonstrates that masked hypertension (MH) is a significant predictor of cardiovascular disease. The aim of our study was to examine the impact of MH on haemostasis parameters and to compare the findings to those of healthy normotensives matched for age, sex, body mass index and the rest of risk factors. Design and method. 130 (60 male, 70 female) healthy subjects mean age 45 ± 12 years who had clinic blood pressure < 140/90 mmHg were studied. The whole study population underwent 24-h ambulatory blood pressure monitoring (ABPM). According to the ABPM recordings, 24 individuals (eight males, 16 females) had MH (daytime systolic blood pressure ≥ 135 mmHg or daytime diastolic blood pressure ≥ 85 mmHg – group A) and the remaining 106 subjects (52 males, 54 females) had normal ABPM recordings – group B. Fibrinogen, thrombomodulin ™, the antigens of plasminogen activator inhibitor 1 (PAI-1Ag) and tissue plasminogen activator (tPA-Ag) were determined in the two groups. Results. The PAI-1 Ag, tPA-Ag, fibrinogen and TM levels were significantly higher in the masked hypertensive group than to normotensive control group. Conclusions. Our findings suggest that subjects with MH have significantly higher fibrinogen, TM, PAI-1Ag and tPA-Ag plasma levels compared with normotensives. This observation may have prognostic significance for future cardiovascular events in subjects with MH and needs further investigation.
Comparison of the cheese-wiring effects among three sutures used in rotator cuff repair

Purpose: The goal of this study was to compare the cheese-wiring effects of three sutures with different coefficients of friction. Materials and Methods: Sixteen human cadaveric shoulders were dissected to expose the distal supraspinatus and infraspinatus muscle tendons. Three sutures were stitched through the tendons: #2 Orthocord™ suture (reference #223114, DePuy Mitek, Inc., Raynham, MA), #2 ETHIBOND* EXCEL Suture, and #2 FiberWire® suture (FiberWire®, Arthrex, Naples, FL). The sutures were pulled by cyclic axial forces from 10 to 70 N at 1 Hz for 1000 cycles through a MTS machine. The cut-through distance on the tendon was measured with a digital caliper. Results: The cut-through distance in the supraspinatus tendons (mean ± standard deviation, n = 12) were 2.9 ± 0.6 mm for #2 Orthocord™ suture, 3.2 ± 1.2 mm for #2 ETHIBOND* suture, and 4.2 ± 1.7 mm for #2 FiberWire® suture. The differences were statistically significant analyzing with analysis of variance (P = 0.047) and two-tailed Student's t-test, which showed significance between Orthocord™ and FiberWire® sutures (P = 0.026), but not significant between Orthocord™ and ETHIBOND* sutures (P = 0.607) or between ETHIBOND* and FiberWire® sutures (P = 0.103). Conclusion: The cheese-wiring effect is less in the Orthocord™ suture than in the FiberWire® suture in human cadaveric supraspinatus tendons. Clinical Relevance: Identification of sutures that cause high levels of tendon cheese-wiring after rotator cuff repair can lead to better suture selection.