Miracle-dz/UniFAR-FTUs huggingface dataset:
A randomised controlled comparison between stimulating and standard catheters for lumbar plexus block

The aim of this randomised, prospective, blinded study was to evaluate if stimulating catheters can decrease the minimum effective anaesthetic volume in 50% of patients during lumbar plexus block using mepivacaine 1.5% compared with standard catheters. Fifty‐eight patients of ASA physical status 1–3 were randomly allocated to receive a lumbar plexus block via a stimulating or standard catheter, with 29 in each group. The first dose was 30 ml and subsequent doses were determined using the up‐and‐down staircase method. The minimum effective anaesthetic volume50 was 12.2 ml (95% CI 7.3–17.1 ml) using the stimulating catheter and 24.8 ml (95% CI 23.2–27.5 ml) with the standard catheter (p < 0.0001). Complete lumbar plexus block was achieved with the initial dose of mepivacaine in 29 (100%) patients in the stimulating catheter group and 20 (69%) patients in the standard catheter group (p = 0.002). This study showed that use of a stimulating catheter halves the minimum effective anaesthetic volume50 of mepivacaine 1.5% while increasing the success rate in patients receiving continuous lumbar plexus block.
Comprehensive analyses of oxidized phospholipids using a measured MS/MS spectra library[S]

Oxidized phospholipids (OxPLs) are widely held to be associated with various diseases, such as arteriosclerosis, diabetes, and cancer. To characterize the structure-specific behavior of OxPLs and their physiological relevance, we developed a comprehensive analytical method by establishing a measured MS/MS spectra library of OxPLs. Biogenic OxPLs were prepared by the addition of specific oxidized fatty acids to cultured cells, where they were incorporated into cellular phospholipids, and untargeted lipidomics by LC-quadrupole/TOF-MS was applied to collect MS/MS spectra for the OxPLs. Based on the measured MS/MS spectra for about 400 molecular species of the biogenic OxPLs, we developed a broad-targeted lipidomics system using triple quadrupole MS. Separation precision of structural isomers was optimized by multiple reaction monitoring analysis and this system enabled us to detect OxPLs at levels as low as 10 fmol. When applied to biological samples, i.e., mouse peritoneal macrophages, this system enabled us to monitor a series of OxPLs endogenously produced in a 12/15-lipoxygenase-dependent manner. This advanced analytical method will be useful to elucidate the structure-specific behavior of OxPLs and their physiological relevance in vivo.
Weight change associated with antiepileptic drugs

Aim To investigate antiepileptic drug (AED)-related weight changes in patients with epilepsy through a retrospective observational study. Method We analysed the anonymised electronic primary care records of 1.1 million adult patients in Wales. We included patients aged 18 years and over with a diagnosis of epilepsy, whose body weight had been measured up to 12 months before starting, and between 3 and 12 months after starting, one of five AEDs. We calculated the weight difference after starting the AED for each patient. Results 1423 patients were identified in total. The mean difference between body weight after and before starting each AED (together with 95% CI and p values for no difference) were: carbamazepine (CBZ) 0.43 (−0.19 to 1.05) p=0.17; lamotrigine (LTG) 0.31 (−0.38 to 1.00) p=0.38; levetiracetam (LEV) 1.00 (0.16 to 1.84) p=0.02; sodium valproate (VPA) 0.74 (0.10 to 1.38) p=0.02; topiramate (TPM) −2.30 (−4.27 to −0.33) p=0.02. Conclusions LEV and VPA were associated with significant weight gain, TPM was associated with significant weight loss, and LTG and CBZ were not associated with significant weight change.
Body posture during simulated tracheal intubation: GlideScope® videolaryngoscopy vs Macintosh direct laryngoscopy for novices and experts

Tracheal intubation requires the anaesthetist to adopt an awkward body posture. To investigate how posture may be improved, we compared the effects of laryngoscopy technique (GlideScope® vs Macintosh blade) and experience (novices vs experts) on body posture angles and the Rapid Entire Body Assessment postural analysis score. Novices (25 medical students) and experts (26 anaesthetists) were video‐recorded performing intubation in a manikin using both devices. The GlideScope resulted in smaller deflections for all analysed posture angles (all p values < 0.001) except the wrist compared with the Macintosh blade. Novices showed more trunk (p < 0.001) and neck (p = 0.002) flexion than experts. Using the GlideScope resulted in a lower Rapid Entire Body Assessment score compared with using the Macintosh blade (p < 0.001), indicating that the GlideScope resulted in body posture less likely to induce musculoskeletal injuries. From an ergonomic point of view, the GlideScope should be the preferred technique for laryngoscopy.
Excessive daytime sleepiness and its risk factors in incident Parkinson's disease

Excessive daytime sleepiness (EDS) can be a feature of various neurodegenerative diseases including Parkinson's disease (PD). EDS puts patients at increased risk of accidents while driving and it is important to identify such patients in order to advise them and others about their individual level of risk and the potential therapeutic options available to them. The most commonly used method for assessing EDS in the clinic is the Epworth Sleepiness Scale (ESS)—a self-completed questionnaire which scores the tendency to fall asleep during eight everyday situations. The final score ranges from 0–24, with scores greater than 10 generally considered pathological. This questionnaire has been widely used in unselected PD cohorts, with the prevalence of EDS ranging from 3–50%. 1 Although there is a general consensus that dopaminergic medications contribute to EDS in PD,2 there is less agreement about other risk factors. One possible explanation for these disparities is that heterogeneous PD cohorts were studied at different points in their disease course. Some studies have also suggested that the Catechol O-methyltransferase ( COMT ) val158met polymorphism (which is known to significantly alter enzyme activity) may be associated with EDS. In this study, we report on the prevalence of EDS and its risk factors in a population-representative incident PD cohort. This cohort was recruited between December 2000 and December 2002, when we attempted to collect all newly diagnosed cases of parkinsonism in the country …
Suicide ideation and behaviours after STN and GPi DBS surgery for Parkinson’s disease: results from a randomised, controlled trial

Background The risk of suicide behaviours post–deep brain stimulation (DBS) surgery in Parkinson’s disease (PD) remains controversial. We assessed if suicide ideation and behaviours are more common in PD patients (1) randomised to DBS surgery versus best medical therapy (BMT); and (2) randomised to subthalamic nucleus (STN) versus globus pallidus interna (GPi) DBS surgery. Methods In Phase 1 of the Veterans Affairs CSP 468 study, 255 PD patients were randomised to DBS surgery (n=121) or 6 months of BMT (n=134). For Phase 2, a total of 299 patients were randomised to STN (n=147) or GPi (n=152) DBS surgery. Patients were assessed serially with the Unified Parkinson's Disease Rating Scale Part I depression item, which queries for suicide ideation; additionally, both suicide behaviour adverse event data and proxy symptoms of increased suicide risk from the Parkinson's Disease Questionnaire (PDQ-39) and the Short Form Health Survey (SF-36) were collected. Results In Phase 1, no suicide behaviours were reported, and new-onset suicide ideation was rare (1.9% for DBS vs 0.9% for BMT; Fisher's exact p=0.61). Proxy symptoms of relevance to suicide ideation were similar in the two groups. Rates of suicide ideation at 6 months were similar for patients randomised to STN versus GPi DBS (1.5% vs 0.7%; Fisher's exact p=0.61), but several proxy symptoms were worse in the STN group. Conclusions Results from the randomised, controlled phase of a DBS surgery study in PD patients do not support a direct association between DBS surgery and an increased risk for suicide ideation and behaviours.
Characterization of desnutrin functional domains: critical residues for triacylglycerol hydrolysis in cultured cells[S]

Murine desnutrin/human ATGL is a triacylglycerol (TAG) hydrolase with a predicted catalytic dyad within an α-β hydrolase fold in the N-terminal region. In humans, mutations resulting in C-terminal truncation cause neutral lipid storage disease with myopathy. To identify critical functional domains, we measured TAG breakdown in cultured cells by mutated or truncated desnutrin. In vitro, C-terminally truncated desnutrin displayed an even higher apparent Vmax than the full-length form without changes in Km, which may be explained by our finding of an interaction between the C- and N-terminal domains. In live cells, however, C-terminally truncated adenoviral desnutrin had lower TAG hydrolase activity. We investigated a role for the phosphorylation of C-terminal S406 and S430 residues but found that these were not necessary for TAG breakdown or lipid droplet localization in cells. The predicted N-terminal active sites, S47 and D166, were both critical for TAG hydrolysis in live cells and in vitro. We also identified two overlapping N-terminal motifs that predict lipid substrate binding domains, a glycine-rich motif (underlined) and an amphipathic α-helix (bold) within amino acid residues 10–24 (ISFAGCGFLGVYHIG). G14, F17, L18, and V20, but not G16 and G19, were important for TAG hydrolysis, suggesting a potential role for the amphipathic α-helix in TAG binding. This study identifies for the first time critical sites in the N-terminal region of desnutrin and reveals the requirement of the C-terminal region for TAG hydrolysis in cultured cells.
Neurological manifestations related to level of voltage-gated potassium channel antibodies

Voltage-gated potassium channels (VGKC) are essential for the cellular action potential. Antibodies against the VGKC-complex are associated with a wide spectrum of diseases involving both the peripheral and central nervous system, including neuromyotonia, Morvan disease, limbic encephalitis, faciobrachial dystonic seizures and cerebellar ataxia.1 Leucine-rich, glioma-inactivated 1 antigen (LGI1) and contactin-associated protein-2 (Caspr2) have been found to be part of the VGKC-complex and targets for auto-antibodies.2 ,3 However, for the majority of the VGKC-complex antibodies, the specific antibody targets remain unknown. Moreover, apart from a recent study,4 little information exists on the relevance of VGKC-complex antibody level and neurological diseases, or the subgroups of VGKC antibodies and the presence of other encephalitic or paraneoplastic antibodies. We decided therefore to characterise our patients according to these parameters. The study was approved by the regional committee for medical and health research ethics in Western-Norway. We identified 36 patients tested positive for VGKC-complex antibodies (tested by radioimmunoprecipitation in Oxford, >100 pM) at Haukeland University Hospital, Bergen, Norway, between 2001 and 2012. The sera were sent by neurologists who decided the indications for the test. The highest VGKC-complex antibody level was chosen for each patient (table 1). Two patients were of foreign origin and excluded …
Significance of arterial hyperoxia and relationship with case fatality in traumatic brain injury: a multicentre cohort study

Objective In this retrospective multi-centre cohort study, we tested the hypothesis that hyperoxia was not associated with higher in-hospital case fatality in ventilated traumatic brain injury (TBI) patients admitted to the intensive care unit (ICU). Methods Admissions of ventilated TBI patients who had arterial blood gases within 24 h of admission to the ICU at 61 US hospitals between 2003 and 2008 were identified. Hyperoxia was defined as PaO2 ≥300 mm Hg (39.99 kPa), hypoxia as any PaO2 <60 mm Hg (7.99 kPa) or PaO2/FiO2 ratio ≤300 and normoxia, not defined as hyperoxia or hypoxia. The primary outcome was in-hospital case fatality. Results Over the 5-year period, we identified 1212 ventilated TBI patients, of whom 403 (33%) were normoxic, 553 (46%) were hypoxic and 256 (21%) were hyperoxic. The case-fatality was higher in the hypoxia group (224/553 [41%], crude OR 2.3, 95% CI 1.7-3.0, p<.0001) followed by hyperoxia (80/256 [32%], crude OR 1.5, 95% CI 1.1-2.5, p=.01) as compared to normoxia (87/403 [23%]). In a multivariate analysis adjusted for other potential confounders, the probability of being exposed to hyperoxia and hospital-specific characteristics, exposure to hyperoxia was independently associated with higher in-hospital case fatality adjusted OR 1.5, 95% CI 1.02-2.4, p=0.04. Conclusions In ventilated TBI patients admitted to the ICU, arterial hyperoxia was independently associated with higher in-hospital case fatality. In the absence of results from clinical trials, unnecessary oxygen delivery should be avoided in critically ill ventilated TBI patients.
Differential effects of conjugated linoleic acid isomers on macrophage glycerophospholipid metabolism[S]

Conjugated linoleic acids (CLA) are dietary fatty acids. Whereas cis-9,trans-11-(c9,t11)-CLA can be found in meat and dairy products, trans-9,trans-11-(t9,t11)-CLA is a constituent of vegetable oils. Previous studies showed that these two isomers activate different nuclear receptors and, thus, expression of genes related to lipid metabolism. Here we show that these CLA isomers are differentially elongated and desaturated in primary monocyte-derived macrophages isolated from healthy volunteers by using gas chromatography-mass spectrometry (GC-MS). We further demonstrate that c9,t11-CLA incorporates in phosphatidylcholine (PC) and phosphatidylethanolamine (PE) species and activates de novo glycerophospholipid synthesis by quantitative electrospray ionization-tandem mass spectrometry (ESI-MS/MS). c9,t11-CLA leads to strong shifts of the species profiles to PC 18:2/18:2 and PE 18:2/18:2, which are due to de novo synthesis and fatty acid remodeling. In contrast, t9,t11-CLA is preferentially bound to neutral lipids, including triglycerides and cholesterol esters. Taken together our results show that c9,t11-CLA and t9,t11-CLA have differential effects on PC and PE metabolism. Moreover, these data demonstrate that the structure of fatty acids not only determines their incorporation into lipid classes but also modulates the kinetics of lipid metabolism, particularly PC synthesis.
Cardiac Rehabilitation and Resistance Training: Are They Compatible?

Cardiac rehabilitation serves to improve the functional capacity for individuals who have suffered a cardiac event. Aerobic activities, such as walking, swimming, or cycling, have traditionally been employed to enhance the cardiovascular fitness levels of such patients. Resistance training has typically been avoided for fear of eliciting deleterious effects such as increased heart rate and blood pressure responses. This in turn leads to an increased rate pressure product that may possibly cause an ischemic event within a cardiac population. Within the past 15–20 years, however, resistance training has gained support from researchers and clinicians as a safe mode of exercise that may heighten the rehabilitation process. Cardiac patients may benefit occupationally and recreationally from resistance training because of improvements in upper-and lower-body strength, as well as increased self-confidence to perform daily tasks that require moderate amounts of strength. It is the intent of this review to discuss safety and efficacy issues regarding resistance training, list improvements for physiological and psychological parameters observed following resistance training, provide guidelines for screening and patient selection, and provide a rationale for exercise prescription.
Aplicação da versão em português do instrumento de avaliação de qualidade de vida da Organização Mundial da Saúde (WHOQOL-100)

INTRODUCAO: O Grupo de Qualidade de Vida da OMS desenvolveu um instrumento de avaliacao de Qualidade de Vida, o WHOQOL-100 que esta traduzido para 20 idiomas (WHOQOL GROUP, 1998). A aplicacao do instrumento na versao em portugues e o objetivo do trabalho. METODOS: Foram aplicados em 250 pacientes provenientes de quatro grandes areas medicas (psiquiatria, clinica, cirurgia e ginecologia) de um hospital de clinicas de Porto Alegre, RS, e em 50 voluntarios-controles o Instrumento de Avaliacao de Qualidade de Vida da OMS (WHOQOL-100), o Inventario de Beck para a depressao (BDI) e a Escala de Desesperanca de Beck (BHS). RESULTADOS E CONCLUSOES:O Instrumento mostrou bom desempenho psicometrico com caracteristicas satisfatorias de consistencia interna, validade discriminante, validade de criterio, validade concorrente e fidedignidade teste-reteste. Concluiu-se que o instrumento esta em condicoes de ser usado no Brasil, sendo importante avaliar seu desempenho em outras regioes e em diferentes amostras de individuos.
Psychosomatic Aspects of Skin Care and Therapy of Atopic Dermatitis with Regard to the Patient’s Dealing with Himself and the Parents’ Dealing with Their Child

Due to their exposed localization, skin diseases have characteristic individual and social consequences as compared to other diseases. In the first section of this review, general psychosomatic and psychosocial aspects of the skin and common skin diseases are described. Since atopic dermatitis is characterized by a chronic inflammatory course and associated with intermittent attacks of intensive pruritus, it is more frequently associated with intraand interpersonal conflicts than other skin diseases. Therefore, certain aspects of atopic dermatitis such as coping and compliance/adherence-to-treatment are reviewed and discussed in detail. Finally, clinically important issues of psychosomatic care and dermatological therapy (skin care and topical therapy) of patients with atopic dermatitis are reviewed.
GNE myopathy: current update and future therapy

GNE myopathy is an autosomal recessive muscle disease caused by biallelic mutations in GNE, a gene encoding for a single protein with key enzymatic activities, UDP-N-acetylglucosamine 2-epimerase and N-acetylmannosamine kinase, in sialic acid biosynthetic pathway. The diagnosis should be considered primarily in patients presenting with distal weakness (foot drop) in early adulthood (other onset symptoms are possible too). The disease slowly progresses to involve other lower and upper extremities’ muscles, with marked sparing of the quadriceps. Characteristic findings on biopsies of affected muscles include ‘rimmed’ (autophagic) vacuoles, aggregation of various proteins and fibre size variation. The diagnosis is confirmed by sequencing of the GNE gene. Note that we use a new mutation nomenclature based on the longest transcript (GenBank: NM_001128227), which encodes a 31-amino acid longer protein than the originally described one (GenBank: NM_005476), which has been used previously in most papers. Based upon the pathophysiology of the disease, recent clinical trials as well as early gene therapy trials have evaluated the use of sialic acid or N-acetylmannosamine (a precursor of sialic acid) in patients with GNE myopathy. Now that therapies are under investigation, it is critical that a timely and accurate diagnosis is made in patients with GNE myopathy.
ApoA-I deficiency in mice is associated with redistribution of apoA-II and aggravated AApoAII amyloidosis[S]

Apolipoprotein A-II (apoA-II) is the second major apolipoprotein following apolipoprotein A-I (apoA-I) in HDL. ApoA-II has multiple physiological functions and can form senile amyloid fibrils (AApoAII) in mice. Most circulating apoA-II is present in lipoprotein A-I/A-II. To study the influence of apoA-I on apoA-II and AApoAII amyloidosis, apoA-I-deficient (C57BL/6J.Apoa1−/−) mice were used. Apoa1−/− mice showed the expected significant reduction in total cholesterol (TC), HDL cholesterol (HDL-C), and triglyceride (TG) plasma levels. Unexpectedly, we found that apoA-I deficiency led to redistribution of apoA-II in HDL and an age-related increase in apoA-II levels, accompanied by larger HDL particle size and an age-related increase in TC, HDL-C, and TG. Aggravated AApoAII amyloidosis was induced in Apoa1−/− mice systemically, especially in the heart. These results indicate that apoA-I plays key roles in maintaining apoA-II distribution and HDL particle size. Furthermore, apoA-II redistribution may be the main reason for aggravated AApoAII amyloidosis in Apoa1−/− mice. These results may shed new light on the relationship between apoA-I and apoA-II as well as provide new information concerning amyloidosis mechanism and therapy.
Marked accumulation of 27-hydroxycholesterol in the brains of Alzheimer's patients with the Swedish APP 670/671 mutation

There is a significant flux of the neurotoxic oxysterol 27-hydroxycholesterol (27OHC) from the circulation across the blood-brain barrier. Because there is a correlation between 27OHC and cholesterol in the circulation and lipoprotein-bound cholesterol does not pass the blood-brain barrier, we have suggested that 27OHC may mediate the effects of hypercholesterolemia on the brain. We previously demonstrated a modest accumulation of 27OHC in brains of patients with sporadic Alzheimer's disease (AD), consistent with a role of 27OHC as a primary pathogenetic factor. We show here that there is a 4-fold accumulation of 27OHC in different regions of the cortexes of patients carrying the Swedish amyloid precursor protein (APPswe) 670/671 mutation. The brain levels of sitosterol and campesterol were not significantly different in the AD patients compared with the controls, suggesting that the blood-brain barrier was intact in the AD patients. We conclude that accumulation of 27OHC is likely to be secondary to neurodegeneration, possibly a result of reduced activity of CYP7B1, the neuronal enzyme responsible for metabolism of 27OHC. We discuss the possibility of a vicious circle in the brains of the patients with familial AD whereby neurodegenerative changes cause an accumulation of 27OHC that further accelerates neurodegeneration.
Prevalence and Economic Burden of Bronchiectasis

We employed a retrospective cohort design to estimate the prevalence and economic burden of bronchiectasis. Data were obtained from the health-care claims processing systems of more than 30 US health plans (with a combined total of 5.6 million covered lives) and spanned the period January 1, 1999, to December 31, 2001. Study subjects consisted of all persons who were aged ≥18 years in 2001 and had diagnoses of bronchiectasis between 1999 and 2001; those with diagnoses of cystic fibrosis were excluded. For purposes of comparison, a cohort of persons without diagnoses of bronchiectasis was randomly selected and matched on age, sex, geographic region, and comorbid conditions. Prevalence of bronchiectasis ranged from 4.2 per 100,000 persons aged 18–34 years to 271.8 per 100,000 among those aged ≥75 years. Prevalence was higher among women than men at all ages. Persons with bronchiectasis averaged 2.0 (95% confidence interval 1.7–2.3) additional days in hospital, 6.1 (6.0–6.1) additional outpatient encounters, and 27.2 (25.0–29.1) more days of antibiotic therapy than those without the disorder in 2001; average total medical-care expenditures were $5681 ($4862–$6593) higher for bronchiectasis patients. Our findings suggest that over 110,000 persons in the United States may be receiving treatment for bronchiectasis, resulting in additional medical-care expenditures of $630 million annually.