Miracle-dz/UniFAR-FTUs huggingface dataset:
Selective gray matter damage in neuropsychiatric lupus.

OBJECTIVE Damage of brain parenchyma in patients with primary diffuse neuropsychiatric systemic lupus erythematosus (NPSLE) has been indicated by magnetization transfer imaging (MTI). However, the location of MTI abnormalities is unknown. This study was undertaken to assess the distribution of MTI abnormalities over gray matter (GM) and white matter (WM) in SLE patients with a history of NP symptoms without explanatory magnetic resonance imaging (MRI) evidence of focal disease. METHODS MTI was performed in 24 female SLE patients with a history of diffuse NP symptoms and 24 healthy female controls. Magnetization transfer ratio (MTR) maps were calculated for GM and WM separately, and GM and WM MTR histograms were generated. Univariate and multivariate analyses with age as an additional covariate were performed on the histogram parameters peak location (PL), peak height (PH), and mean MTR. RESULTS Compared with controls, significantly reduced PH (mean +/- SD 136 +/- 22 arbitrary units versus 151 +/- 13 arbitrary units) and mean MTR (33.3 +/- 1.0 percent units versus 33.6 +/- 0.5 percent units) were found in the GM of NPSLE patients (P = 0.002 and P = 0.033, respectively, in multivariate analyses). No significant differences were observed for WM MTR parameters. CONCLUSION This is the first study to demonstrate, using MTI, that in SLE patients with a history of NP symptoms and without explanatory focal abnormalities on MRI, the GM is particularly affected. These findings support the hypothesis that neuronal injury may underlie central nervous system manifestations in NPSLE.
Determinants for zidovudine-induced anemia in HIV adult patients: A Thai multicenter study

Objectives: This study was aimed to analyze the prevalence of zidovudine (AZT)-induced anemia, severity and determinants for the anemia in Thai human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) patients. Materials and Methods: A cross-sectional, multicenter study was carried out in HIV/AIDS adult out-patients who were taking AZT as part of the highly active antiretroviral therapy regimens, met relevant eligibility criteria and attended the eight antiretroviral clinics of community hospitals in Chumphon Province during January 2010-May 2012. Data on the prevalence and anemia characteristics were collected and analyzed. A binary logistic regression was performed to determine relevant factors with a significance level (α) of 0.05. Results: A total of 303 patients were included and nearly 71.6% of these started AZT + lamivudine + nevirapine as the primary regimen. Nearly half were male (48.8%) and the mean age was 39.5 years (standard deviation [SD] =8.6). Of 303 patients, 34 developed anemia that clearly started from 4 to 24 weeks after AZT-based therapy; the prevalence rate was 11.2%. With the AZT-induced anemia, patients mostly had the baseline CD4 count lower than 200 cells/mm 3 ( 64.7%), baseline body mass index (BMI) >18.5 kg/m 2 ( 61.8%) and baseline hemoglobin (Hb) in the range of 8.0-9.5 g/dL (85.3%); the mean Hb change from the baseline was 4.5 g/dL (SD = 3.2). The severity of anemia was mainly classified as grade 1 (55.9%) or 4 (32.4%). Four risk factors, i.e. baseline CD4 levels, Hb, BMI and duration of AZT use, significantly attributed to the anemia (P = 0.018, 0.004, 0.009 and 0.002, respectively). The risk of anemia could be predicted by 33.3% using the equation: Logit P anemia = 6.186 + 1.666 × Baseline CD4 level-0.501 × Baseline Hb-0.225 × Baseline BMI + 2.338 × Duration of AZT therapy. Conclusion: HIV patients using AZT may experience mild-to-severe anemia with salient features. Four determining factors for the anemia should be closely monitored by pharmacists or health care professionals before altering the regimen.
Vaccines for preventing pneumococcal infection in adults.

BACKGROUND Diseases caused by Streptococcus pneumoniae (S. pneumoniae) continue to cause substantial morbidity and mortality globally. Whilst pneumococcal polysaccharide vaccines (PPVs) have the potential to prevent disease and death, the degree of protection afforded against various clinical endpoints and within different populations is uncertain. OBJECTIVES To assess the efficacy and effectiveness of PPVs in preventing pneumococcal disease or death in adults. We did not assess adverse events. SEARCH METHODS We searched CENTRAL 2012, Issue 6, MEDLINE (January 1966 to June Week 2, 2012) and EMBASE (1974 to June 2012). SELECTION CRITERIA We considered randomised controlled trials (RCTs) in adults, provided the study outcome met the definition of the outcome considered in the review. We also considered non-RCTs in adults, where the study assessed PPV effectiveness against culture-confirmed invasive pneumococcal disease (IPD), provided the study controlled for important confounding factors. DATA COLLECTION AND ANALYSIS Two review authors assessed trial quality of RCTs and three review authors extracted the data. We estimated odds ratios (ORs) and 95% confidence intervals (CIs) using a random-effects model. Two review authors assessed study quality and extracted data for non-RCTs. We calculated ORs and 95% CIs using a random-effects model following the conversion of each study outcome to a log OR and standard error (SE). MAIN RESULTS Twenty-five studies met our inclusion criteria (18 RCTs involving 64,852 participants and seven non-RCTs involving 62,294 participants). Meta-analysis of the RCTs found strong evidence of PPV efficacy against IPD with no statistical heterogeneity (OR 0.26, 95% CI 0.14 to 0.45; random-effects model, I(2) statistic = 0%). There was efficacy against all-cause pneumonia in low-income (OR 0.54, 95% CI 0.43 to 0.67, I(2) statistic = 19%) but not high-income countries in either the general population (OR 0.71, 95% CI 0.45 to 1.12, I(2) statistic = 93%) or in adults with chronic illness (OR 0.93, 95% CI 0.73 to 1.19, I(2) statistic = 10%). PPV was not associated with substantial reductions in all-cause mortality (OR 0.90, 95% CI 0.74 to 1.09; random-effects model, I(2) statistic = 69%). Vaccine efficacy against primary outcomes appeared poorer in adults with chronic illness. Non-RCTs provided evidence for protection against IPD in populations for whom the vaccine is currently utilised (OR 0.48, 95% CI 0.37 to 0.61; random-effects model, I(2) statistic = 31%). This review did not consider adverse events as it was outside the scope of the review. AUTHORS' CONCLUSIONS This meta-analysis provides evidence supporting the recommendation for PPV to prevent IPD in adults. The evidence from RCTs is less clear with respect to adults with chronic illness. This might be because of lack of effect or lack of power in the studies. The meta-analysis does not provide evidence to support the routine use of PPV to prevent all-cause pneumonia or mortality.
Speech and language therapy for aphasia following stroke.

BACKGROUND Aphasia is an acquired language impairment following brain damage which affects some or all language modalities: expression and understanding of speech, reading and writing. Approximately one-third of people who have a stroke experience aphasia. OBJECTIVES To assess the effectiveness of speech and language therapy (SLT) for aphasia following stroke. SEARCH STRATEGY We searched the Cochrane Stroke Group Trials Register (last searched April 2009), MEDLINE (1966 to April 2009) and CINAHL (1982 to April 2009). In an effort to identify further published, unpublished and ongoing trials we handsearched the International Journal of Language and Communication Disorders, searched reference lists of relevant articles and contacted other researchers and authors. SELECTION CRITERIA Randomised controlled trials comparing SLT versus no SLT, SLT versus social support or stimulation, and one SLT intervention versus another SLT intervention. SLT refers to a formal speech and language therapy intervention that aims to improve language and communication abilities and in turn levels of communicative activity and participation. Social support and stimulation refers to an intervention which provides social support or communication stimulation but does not include targeted therapeutic interventions. Direct comparisons of different SLT interventions refers to SLT interventions that differ in terms of duration, intensity, frequency or method of intervention or in the theoretical basis for the SLT approach. DATA COLLECTION AND ANALYSIS Two review authors independently extracted the data and assessed the quality of included trials. We sought missing data from study investigators if necessary. MAIN RESULTS We included 30 trials (41 paired comparisons) in the review: 14 subcomparisons (1064 participants) compared SLT with no SLT; six subcomparisons (279 participants) compared SLT with social support and stimulation; and 21 subcomparisons (732 participants) compared two approaches to SLT. In general, the trials randomised small numbers of participants across a range of characteristics (age, time since stroke and severity profiles), interventions and outcomes. Suitable statistical data were unavailable for several measures. AUTHORS' CONCLUSIONS This review shows some indication of the effectiveness of SLT for people with aphasia following stroke. We also observed a consistency in the direction of results which favoured intensive SLT over conventional SLT, though significantly more people withdrew from intensive SLT than conventional SLT. SLT facilitated by a therapist-trained and supervised volunteer appears to be as effective as the provision of SLT by a professional. There was insufficient evidence to draw any conclusions in relation to the effectiveness of one SLT approach over another.
ROLE OF ANOXIA IN PRODUCTION OF EPILEPTIFORM SEIZURES: WITH STUDIES OF THE ACID-BASE EQUILIBRIUM

For many years different workers have attempted to show that voluntary hyperpnea can produce seizures in a patient with epilepsy. Numerous theories have been advanced for the mode of action, all of them being connected either with changes in the concentration of specific ions in the blood or with alterations in the acid-base equilibrium. In voluntary hyperpnea a state of alkalosis is encountered. Because of this, Lennox 1 suggested, for the first time, that anoxia may play a part in the production of seizures, in that in alkalosis the blood gives up oxygen less readily, thereby causing oxygen lack in the tissues. On the basis of this premise it should be possible to predict the occurrence of seizures as the result of voluntary hyperpnea. A review of the literature shows a lack of agreement as to the incidence and mechanism of the production of seizures by hyperventilation or anoxia. 2
St John's wort for major depression.

BACKGROUND In some countries extracts of the plant Hypericum perforatum L. (popularly called St. John's wort) are widely used for treating patients with depressive symptoms. OBJECTIVES To investigate whether extracts of hypericum are more effective than placebo and as effective as standard antidepressants in the treatment of major depression; and whether they have fewer adverse effects than standard antidepressant drugs. SEARCH STRATEGY Trials were searched in computerised databases, by checking bibliographies of relevant articles, and by contacting manufacturers and researchers. SELECTION CRITERIA Trials were included if they: (1) were randomised and double-blind; (2) included patients with major depression; (3) compared extracts of St. John's wort with placebo or standard antidepressants; (4) included clinical outcomes assessing depressive symptoms. DATA COLLECTION AND ANALYSIS At least two independent reviewers extracted information from study reports. The main outcome measure for assessing effectiveness was the responder rate ratio (the relative risk of having a response to treatment). The main outcome measure for adverse effects was the number of patients dropping out due to adverse effects. MAIN RESULTS A total of 29 trials (5489 patients) including 18 comparisons with placebo and 17 comparisons with synthetic standard antidepressants met the inclusion criteria. Results of placebo-controlled trials showed marked heterogeneity. In nine larger trials the combined response rate ratio (RR) for hypericum extracts compared with placebo was 1.28 (95% confidence interval (CI), 1.10 to 1.49) and from nine smaller trials was 1.87 (95% CI, 1.22 to 2.87). Results of trials comparing hypericum extracts and standard antidepressants were statistically homogeneous. Compared with tri- or tetracyclic antidepressants and selective serotonin reuptake inhibitors (SSRIs), respectively, RRs were 1.02 (95% CI, 0.90 to 1.15; 5 trials) and 1.00 (95% CI, 0.90 to 1.11; 12 trials). Both in placebo-controlled trials and in comparisons with standard antidepressants, trials from German-speaking countries reported findings more favourable to hypericum. Patients given hypericum extracts dropped out of trials due to adverse effects less frequently than those given older antidepressants (odds ratio (OR) 0.24; 95% CI, 0.13 to 0.46) or SSRIs (OR 0.53, 95% CI, 0.34-0.83). AUTHORS' CONCLUSIONS The available evidence suggests that the hypericum extracts tested in the included trials a) are superior to placebo in patients with major depression; b) are similarly effective as standard antidepressants; c) and have fewer side effects than standard antidepressants. The association of country of origin and precision with effects sizes complicates the interpretation.
Isokinetic measurements of ankle strength and proprioception in patients with flatfoot

Background: Flexible flatfoot deformity is likely to be caused by ligamentous laxity of the medial longitudinal arch, and this deformity could change the mechanics of other joints, ligaments and tendons as well as foot alignment. Aim: We hypothesized that position sense and muscle strength could be impaired in patients with flatfoot compared to normal controls, therefore we investigated position sense and ankle eversion inversion strengths of individuals with flexible flatfoot. Design: Cross sectional study. Setting: A rehabilitation center. Population: Twenty-six individuals with flexible flatfoot and 27 healthy control subjects were evaluated. Methods: Absolute error (in degrees) for passive reproduction of joint position tests and peak isokinetic strength of ankle muscles for eversion and inversion were tested using the Biodex isokinetic dynamometer. Results: For individuals with flatfoot, passive reproduction of joint position error scores in eversion were significantly higher for the dominant side compared with the control group. No significant differences in eversion and inversion muscle strength between flexible flatfoot and control groups were found. Conclusion: We suggest that flexible flatfoot deformity may cause deficits in proprioception accuracy. Clinical Rehabilitation Impact: In our opinion, clinicians must be aware and should take into account this possible deficit in the management of these patients.
Barrier agents for adhesion prevention after gynaecological surgery.

BACKGROUND Pelvic adhesion can form as a result of inflammation, endometriosis or surgical trauma. During pelvic surgery, strategies to reduce pelvic adhesion formation may include placing synthetic barrier agents such as oxidised regenerated cellulose, polytetrafluoroethylene or Fibrin sheets between the pelvic structures. OBJECTIVES To assess the effect of physical barriers used during pelvic surgery in women of reproductive age on pregnancy rates, pelvic pain, or postoperative adhesion reformation. SEARCH STRATEGY We searched the Cochrane Menstrual Disorders and Subfertility Group Trials Register (searched September 2007) which is based on regular searches of MEDLINE, EMBASE, CINAHL, PsycINFO and CENTRAL, plus handsearching of 20 relevant journals and conference proceedings, and searches of several key grey literature sources. In addition, companies were contacted for unpublished trials. SELECTION CRITERIA Any randomised controlled trials (RCTs) comparing the use of physical barriers versus no treatment or other physical barriers in the prevention of adhesions in women undergoing gynaecological surgery. DATA COLLECTION AND ANALYSIS Review authors assessed trial eligibility and quality. MAIN RESULTS Sixteen RCTs were included. Five trials randomised patients while the remainder randomised pelvic organs. Laparoscopy (six trials) and laparotomy (10 trials) were the primary surgical techniques. Indications for surgery included myomectomy (five trials), ovarian surgery (five trials), pelvic adhesions (four trials), endometriosis (one trial), and mixed (one trial). Eleven trials assessed Interceed versus no treatment, two assessed Interceed versus Gore-Tex, one trial assessed Gore-Tex versus no treatment, and one trial assessed Seprafilm versus no treatment. A single trial assessed Fibrin sheet versus no treatment. No studies reported pregnancy or reduction in pain as outcomes. The use of Interceed was associated with reduced incidence of pelvic adhesion formation, both new formation and reformation following laparoscopic surgery or laparotomy. However, this result should be interpreted with caution. Gore-Tex was more effective than no barrier or Interceed in preventing adhesion formation. There was only limited evidence that Seprafilm was effective in preventing adhesion formation following myomectomy and no evidence to support Fibrin sheet. AUTHORS' CONCLUSIONS The absorbable adhesion barrier Interceed reduces the incidence of adhesion formation following laparoscopy and laparotomy, but there are insufficient data to support its use to improve pregnancy rates. Gore-Tex may be superior to Interceed in preventing adhesion formation but its usefulness is limited by the need for suturing and later removal. There was no evidence of effectiveness of Seprafilm and Fibrin sheet in preventing adhesion formation.
Combined contrast-enhanced ultrasound and rt-PA treatment is safe and improves impaired microcirculation after reperfusion of middle cerebral artery occlusion

In monitoring of recanalization and in sonothrombolysis, contrast-enhanced ultrasound (CEUS) is applied in extended time protocols. As extended use may increase the probability of unwanted effects, careful safety evaluation is required. We investigated the safety profile and beneficial effects of CEUS in a reperfusion model. Wistar rats were subjected to filament occlusion of the right middle cerebral artery (MCA). Reperfusion was established after 90 minutes, followed by recombinant tissue-type plasminogen activator (rt-PA) treatment and randomization to additional CEUS (contrast agent: SonoVue; 60 minutes). Blinded outcome evaluation consisted of magnetic resonance imaging (MRI), neurologic assessment, and histology and, in separate experiments, quantitative 3D nano-computed tomography (CT) angiography (900 nm voxel size). Nano-CT revealed severely compromised microcirculation in untreated animals after MCA reperfusion. The rt-PA partially improved hemispheric perfusion. Impairment was completely reversed in animals receiving rt-PA and CEUS. This combination was more effective than treatment with either CEUS without rt-PA or rt-PA and ultrasound or ultrasound alone. In MRI experiments, CEUS and rt-PA treatment resulted in a significantly reduced ischemic lesion volume and edema formation. No unwanted effects were detected on MRI, histology, and intracranial temperature assessment. This study shows that CEUS and rt-PA is safe in the situation of reperfusion and displays beneficial effects on the level of the microvasculature. Journal of Cerebral Blood Flow & Metabolism (2010) 30, 1712–1720; doi:10.1038/jcbfm.2010. 82; published online 9 June 2010
Evaluation of a New Hydroxyethyl Starch, Preparation (Hextend™) on Selected Coagulation Parameters

pansion/replacement in surgery, particularly cardiovascular procedures. However, although most consider HES to be a safe and effective agent for the aforementioned purposes, it’s safety regarding hemostasis and potential impairment of hemostasis has been questioned by some. Hydroxyethyl starch is a naturally occurring starch composed almost entirely of amylopectin derived from the sorghum plant. Since its introduction in the early 1960s as a synthetic blood plasma expander, its use has been well documented and ac-
The Development of Drug Therapies for Frontotemporal Dementia Caused by Progranulin Mutations

In this chapter, we discuss the development of therapies for frontotemporal dementia caused by progranulin mutations. Although this is a relatively rare and very specific form of neurodegeneration, the upstream disease cause, being haploinsufficiency of the growth factor progranulin, offers straightforward opportunities for therapy development. Substitution of the progranulin deficiency is likely to counteract the detrimental effects of progranulin haploinsufficiency in patients with frontotemporal dementia and may prevent the manifestation of the disease in presymptomatic mutation carriers. As progranulin has neurotrophic and anti- inflammatory properties, therapeutic interventions aimed at augmenting progranulin levels may also become useful in other forms of neurodegeneration.
Livelihood security through improved goat rearing practices under field conditions

Data were collected from randomly selected 147 goat-rearing households from Raebareli and Barabanki districts of Uttar Pradesh. Ninety percent goat keepers belonged to socio-economically backward communities with their major source of income as labour. Goats were looked after mainly by women and children in the families. All the farmers had non-descript goats maintained on grazing and crop residues. The average flock size was 3.24 in Barabanki and 2.84 in Raebareli district. No separate housing was available for goats and kept in human dwellings. The awareness and adoption levels about improved goat rearing practices such as breeding, strategic and supplementary feeding of concentrates, deworming and vaccination, etc., were negligible. Average gross income was Rs. 2465/goat/yr. Bucks of Sirohi and Barbari breeds were provided to the selected farmers as one of the interventions under Sustainable Livelihood Component-3 of National Agriculture Innovation Project (NAIP) to improve the income and employment of the poor farmers by increasing the productivity of goats. The study revealed 28% increase in income through introduction of Sirohi over non-descript goats along with improved management practices. The study suggested that a unit of 5 Sirohi goats with improved management practices could provide additional income of about Rs 18000 – 22000 in first year which may likely to increase with the increase in flock size and create employment of > 228 man days per year to sustain livelihood of poor people.
Cutaneous manifestations in the new born

Five hundred unselected newborn babies delivered at the department of obstetrics and Gynaecology, command hospital, Air force, Bangalore, were examined from ,the first to the fifth day after birth and details of all cutaneous manifestations, both physiological and pathological were recorded. Of the 500 newborns studied, 262 (52.4 percent) were males and 238 (47.6 percent) were females. Physiological skin changes were observed in all and pathological skin changes in 206 (41.2 percent). The incidence of such changes being similar in both sexes except for the physiological change termed miniature puberty. The incidence of these manifestations and their comparison with other reports in the literature are presented.