Miracle-dz/UniFAR-FTUs huggingface dataset:
Improvement of Blood Pressure Control in a Hypertension Clinic in Japan: A 15-Year Follow-Up Study

Many guidelines recommended strict blood pressure (BP) control to prevent cardiovascular events. However, BP control in a substantial majority of hypertensives remains to be insufficient. We have determined the trends of BP control of the same patients during 15 years in a hypertension clinic. One hundred three patients (age 32–91, mean 68 ± 11 years in 2006), who were followed at our hypertension clinic between 1991–2006, were retrospectively investigated. We compared the clinical characteristics of the patients in 2006 to those in 1991, 1996, and 2001, using the averaged BP determined at two occasions of each year for our analysis. The average BP decreased from 144 ± 17/87 ± 10 mmHg to 132 ± 12/75 ± 10 mmHg (p < 0.01) during the 15 years between 1991 and 2006. When good BP control was defined as < 140/90 mmHg, the rate of patients with good BP control increased from 35% in 1991 to 45% in 1996, to 54% in 2001 (p < 0.01 vs. 1991), and to 72% in 2006 (p < 0.01 vs. 1991). The number of anti-hypertensive drugs used in 2006 significantly increased compared to those in 1991, 1996, and 2001. More specifically, the use of diuretics and α-blockers increased significantly during this period. Results suggest that BP control improved in the 15 years studied, and the increased use of the anti-hypertensive drugs, as well as the increased awareness of the importance of strict BP control, seems to have contributed to improve the BP control.
Prevalence of hypertension and diabetes mellitus in adults from a rural community in Ghana.

OBJECTIVES The aim of this study was to determine the prevalence of hypertension and diabetes mellitus (DM) in the Adankwame community of Ghana. DESIGN This was a cross-sectional, observational study. SETTING This study took place in the rural Adankwame community of Ghana, approximately 12 km from Kumasi, Ghana. PARTICIPANTS Study subjects were adults (older than aged 18 years). A two-tier random sampling approach was taken to recruit study participants to achieve a sample size of 326 adults, 94 males and 232 females. MAIN OUTCOME MEASURES The subjects' height, weight, abdominal circumference, demographic and risk factor information, blood pressure measurements, and blood glucose levels were measured and recorded. RESULTS The mean systolic and diastolic blood pressures in the population were 131 (SD 26.61) and 78 mmHg (SD 15.24), respectively. The prevalence of hypertension was 0.35 (95% CI 0.30-0.40). The prevalence of pre-hypertension, Stage 1 hypertension, and Stage 2 hypertension were approximately 0.248, 0.19, and 0.16, respectively. Mean fasting blood sugar and random blood sugar in the study population were 108 mg/dL (SD 35.33) and 131 mg/dL (SD 41.35), respectively. The overall prevalence of DM in this sample population was 0.077 (95% Cl 0.05-0.11). CONCLUSIONS Hypertension and diabetes mellitus are rising as diseases of public health importance in the Adankwame community. Research to provide substantial data on the prevalence of these two diseases in Ghana is needed to inform national non-communicable disease policy.
The Epidemiology of Shoulder Injuries in English Professional Rugby Union

Background Shoulder injuries constitute a considerable risk to professional rugby union players; however, there is a shortage of detailed epidemiologic information about injuries in this population. Purpose To describe the incidence, severity, and risk factors associated with shoulder injuries in professional rugby union. Study Design Descriptive epidemiology study. Method Medical personnel prospectively reported time-loss injuries in professional rugby union in England, and the shoulder injuries were evaluated. Results The incidence of shoulder injuries was significantly lower during training (0.10/1000 player—training hours) compared with matches (8.9/1000 player—match hours). The most common match injury was acromioclavicular joint injury (32%); the most severe was shoulder dislocation and instability (mean severity, 81 days absent), which also caused the greatest proportion of absence (42%) and had the highest rate of recurrence (62%). The majority of match shoulder injuries were sustained in the tackle (65%), and outside backs were the most likely to sustain an injury from tackling (2.4/1000 player-tackles). Injuries sustained during training were significantly more severe (61 days) than were those sustained during match play (27 days), and defensive training sessions carried the highest risk of injury (0.45/1000 player-hours; mean severity, 67 days). A mean of 241 player-days per club per season were lost to shoulder injuries. Conclusion Results suggest the potential to reduce this injury burden by modifying training activities and implementing “prehabilitation” strategies in an effort to minimize the risk of shoulder dislocation/instability.
Is there evidence for an increase in the death rate from liver-related disease in patients with HIV?

Background:Increases in deaths due to liver-related disease (LRD) among HIV-infected individuals have been reported although the influence of combination antiretroviral therapy (cART) on LRD is controversial. Aims:To determine changes over time in the death rate from LRD and if longer exposure to cART was associated with an increased death rate from LRD in 10 937 patients from EuroSIDA, an observational longitudinal cohort study. Results:A total of 184 (1.7%) died from LRD during 52 236 person-years of follow-up (PYFU). The death rate from LRD declined from 6.9 per 1000 PYFU before 1995 [95% confidence interval (CI), 3.9–9.9] to 2.6 at/after 2004 (95% CI, 1.6–4.0). When the current CD4 cell count and other factors were taken into account, there was a 13% increase in the death rate from LRD per year (95% CI, 5–20%, P = 0.0008). In patients who had started cART, there was a 12% increase in the death rate from LRD per additional year exposure to cART (95% CI, 4–20%, P = 0.022) after adjustment for current CD4 cell count and other factors. Conclusions:Death rates from LRD appeared to decrease across Europe. However after adjustment for the current CD4 cell count, and therefore increases in CD4 cell counts in patients taking cART, there was a significant increase over time in death rates from LRD. In patients with similar CD4 cell counts, longer exposure to cART was associated with an increased death rate from LRD. This may be due to direct liver toxicity of antiretrovirals, progression of liver disease due to hepatitis B virus or hepatitis C virus over time as patients survive longer, or some other factor.
Radiation exposure of the spinal interventionalist performing fluoroscopically guided lumbar transforaminal epidural steroid injections.

OBJECTIVE To evaluate radiation exposure to spinal interventionalists while performing transforaminal epidural steroid injections (TFESIs). DESIGN Prospective study. SETTING Multidisciplinary spine center. PARTICIPANTS One hundred consecutive patients with either herniated nucleus pulposus (HNP) or lumbar spinal stenosis (LSS). INTERVENTION Fluroscopically guided lumbar TFESIs. MAIN OUTCOME MEASURE Radiation exposure was monitored by radiography technologists who allocated 4 dosimetry badges to all spinal interventionalists performing fluroscopically guided lumbar TFESIs on patients being treated for radicular pain. Badges were placed on the ring finger, glasses, and the inside and outside of the lead apron worn by the interventionalists. The radiography technologists also wore marked badges outside their lead aprons. One control badge was placed 67in away from the fluoroscopy table and a second badge was placed in a desk more than 500ft away from the procedure to monitor ambient radiation. RESULTS The average fluoroscopy time per procedure was 15.16 seconds. The average exposure per procedure was 0.7mrem at the ring badge, 0.4mrem at the glasses badge, and 0.3mrem at the outside apron badge. No radiation was detectable at the inside apron or at the outside room control badge. The cumulative exposure to the interventionalists from all 100 procedures was 70mrem at the ring badge, 40mrem at the glasses badge, and 30mrem at the outside apron badge. The radiography technologists' average exposure during these procedures was below the limit of detectablility. Radiation time under fluoroscopy ranged from 5 to 38 seconds. The interventionalist's exposure to radiation was significantly greater during procedures conducted on patients with LSS then during procedures on patients with HNP. CONCLUSION Adhering to a radiation safety program that includes maximizing the distance the spinal interventionalist is from the radiation source, decreasing exposure time, and proper shielding is essential when performing fluoroscopically guided lumbar TFESIs. Our study shows that exposure to radiation of the spinal interventionalist performing fluoroscopically guided lumbar TFESIs was well within safety limits when proper techniques were followed.
Diagnostic efficiency of home pregnancy test kits. A meta-analysis.

OBJECTIVE To assess the diagnostic efficiency of home pregnancy test (HPT) kits. DATA SOURCES A literature search of English-language studies was performed with MEDLINE and a review of bibliographies. STUDY SELECTION Studies were included if HPT kits were compared with a criterion standard (laboratory testing), if they used appropriate controls, and if data were available to determine sensitivity and specificity. DATA EXTRACTION Two investigators independently extracted data, and disagreement was resolved by consensus. Sensitivity, specificity, and an effectiveness score (a measure of the discriminatory power of the test, with higher scores implying greater effectiveness) were calculated. DATA SYNTHESIS Five studies evaluating 16 HPT kits met the inclusion criteria. The range of sensitivities for HPT kits was 0.52 to 1.0. In studies where urine samples obtained by the investigators were tested by volunteers, sensitivity was 0.91 (95% confidence interval [CI], 0.84-0.96). However, the sensitivity was less in studies where subjects were actual patients who performed the test on their own urine samples (sensitivity, 0.75 [95% CI, 0.64-0.85]). The test effectiveness score was 2.75 (95% CI, 2.3-3.2) for studies where subjects were volunteers but deteriorated to 0.82 (95% CI, 0.4-1.2) for studies with actual patients. CONCLUSIONS The diagnostic efficiency of HPT kits is greatly affected by characteristics of the users. Despite the popularity of these kits, the relatively low effectiveness scores of these kits when used by actual patients are of concern. We suggest that manufacturers of HPT kits publish results of trials in actual patients before marketing them to the general public.
IL13 promoter polymorphism 1112C/T modulates the adverse effect of tobacco smoking on lung function.

RATIONALE Although the duration and amount of cigarette smoking correlate with reduction in pulmonary function, there is still variation among individual responses. IL-13 is involved in pulmonary inflammation, remodeling, and susceptibility to chronic obstructive pulmonary disease (COPD). OBJECTIVES We investigated whether the relationships between smoking and the lung function measures FEV(1) and FEV(1)/FVC ratio are modulated by IL13 polymorphisms. METHODS Smokers (>or=20 pack-years), aged at least 40 years old (n = 1,073), were genotyped for three single nucleotide polymorphisms (SNPs; -1112C/T [rs1800925], +2044G/A [rs20541, R130Q], and +2525G/A [rs1295685]) in the IL13 gene. Linear, quantile, and logistic regression methods were used to assess the effect of cigarette smoking (pack-years), IL13 polymorphisms, and their interaction on %predicted FEV(1) and FEV(1)/FVC ratio. Age, sex, and current smoking status were included as confounders. MEASUREMENTS AND MAIN RESULTS The number of pack-years smoked was associated with a lower value for both %predicted FEV(1) and FEV(1)/FVC (P < 0.001). The three SNPs were not associated with lung function measures; however, there was a significant combined effect between smoking and the promoter polymorphism -1112C/T on %predicted FEV(1) (P for interaction < 0.03 for mean %predicted FEV(1) and < 0.0001 for 90th percentile %predicted FEV(1)). Every 20-pack-year increment in smoking was associated with a 2.4% reduction in mean %predicted FEV(1) in the common homozygous (CC) or heterozygous (CT) promoter genotypes, and an 8.2% reduction in mean %predicted FEV(1) in minor allele homozygotes (TT, recessive model). CONCLUSIONS An IL13 polymorphism in the promoter region may modulate the adverse effects of cigarette smoking on pulmonary function in long-term cigarette smokers.
A review of barriers and facilitators of HIV treatment among injection drug users

Globally, injection drug use continues to account for a substantial proportion of HIV infections. There have not, however, been any evidence-based reviews of the barriers and facilitators of HIV treatment among injection drug users. For this review, published studies were extracted from nine academic databases, with no language or date specified in the search criteria. Existing evidence demonstrates that, although injection drug users often have worse outcomes from HIV treatment than non-injection drug users, major antiretroviral-associated survival gains still have been observed among this population. Inferior outcomes are explained by a range of barriers to antiretroviral access and adherence, which often stem from the negative influences of illicit drug policies, as well as issues within medical systems, including lack of physician education about substance abuse. Evidence demonstrates that several under-utilized interventions and novel antiretroviral delivery modalities have helped to greatly address these barriers in several settings, and there is sufficient evidence to support immediate scale-up of these programmes. These interventions include coupling antiretroviral therapy with opioid substitution therapies as well as directly administered antiretroviral therapy programmes. Of particular interest for future evaluation is the coupling of HIV treatment programmes within comprehensive services, which also provide low-threshold (harm reduction) HIV prevention programmes. Scale-up of evidence-based HIV treatment and prevention to injection drug users, however, will require increasing political will among both national policy-makers and international public health agencies.
Characterization of the oxidative stress initiated in cultured human keratinocytes by treatment with peroxides.

Cultured human keratinocytes were treated with H2O2, Fe++/Fe , H2O2 + Fe++/Fe , t-butylhydroperoxide (tBHP), or cumene hydroperoxide (CHP). Fe++ +/- Fe was without effect on cell viability. Neither CHP, tBHP, nor H2O2 at 200 microM led to alteration of trypan blue exclusion, but with 700 microM CHP or tBHP there was uptake of trypan blue after 20 min and lysis of cells beginning at 4 h of treatment. Lysis occurred even if the organic hydroperoxide was removed from the media after 1 h. Treatment with 700 microM H2O2 resulted in half of the cells becoming permeable to trypan blue by 60 min, but > 80% of the cells remained intact and functional, and eventually recovered their impermeability to trypan blue. No concentration of H2O2, tBHP, or CHP produced significant thiobarbituric acid (TBA)-reactive material, and Fe++/Fe , H2O2 + Fe++/Fe , and CHP + Fe++/Fe led to the formation of only small amounts of TBA-reactive material. This was attributed to a lack of polyunsaturated lipid in cells cultured in synthetic media. The activity of glyceraldehyde 3-phosphate dehydrogenase (GAPDH) is sensitive to oxidative damage and thus was used as an indicator of oxidative stress along with the ratio of reduced/oxidized glutathione (GSH/GSSG). Using these two criteria, we found that CHP or tBHP treatment led to an oxidative stress that was more protracted as compared with the effect of H2O2. The organic peroxides also led to depletion of total glutathione, an effect not found with H2O2. It was also found that H2O2 was more rapidly metabolized than the organic peroxides. In summary, cultured human keratinocytes treated with peroxides underwent a number of changes, which included inactivation of GAPDH, a decrease in the ratio GSH/GSSG, and a loss of trypan blue exclusion. However, as long as the duration of this oxidative stress was short, these changes were reversible and the cells survived. Prolonged oxidative stress led to irreversible damage and cell death. H2O2 was rapidly metabolized and relatively well tolerated by keratinocytes. On the other hand, organic hydroperoxides were metabolized more slowly and were lethal at sub-millimolar concentrations. The relative toxicity of organic hydroperoxides is hypothesized to be related to their non-polar nature.
Baclofen blocks expression and sensitization of anxiety-like behavior in an animal model of repeated stress and ethanol withdrawal.

BACKGROUND Repeated exposures to forced ethanol diets (EDs) or restraint stress sensitize anxiety-like behavior during a future ethanol withdrawal. The present investigation assessed whether pretreatment of rats with agents targeting receptor systems thought to be important in treating relapse in alcoholic patients would prevent sensitization of anxiety-like behavior. METHODS Groups of rats were exposed to either (1) three 5-day cycles of ED with 2 days of withdrawal between cycles, (2) continuous ED, or (3) 5 days of ED in a single cycle preceded by 2 episodes of restraint stress 6 days apart. Drugs [baclofen, acamprosate, naloxone, lamotrigine, ifenprodil, dizocilpine (MK-801), CGS19755, diazepam, flumazenil, or 6-methyl-2-(phenylethynyl)pyridine] were given prophylactically during the first and second withdrawal periods only or, in separate baclofen experiments, acutely during the third withdrawal or during withdrawal from continuous ED. Baclofen administration preceded each stress session in the stress-withdrawal protocols. Anxiety-like behavior was assessed in the social interaction (SI) test 5 hours after the ethanol was removed or after 3 days of abstinence. RESULTS Baclofen (1.25, 2.5, and 5 mg/kg), flumazenil (5 mg/kg), and diazepam (1 mg/kg) blocked the reduction in SI induced by ethanol withdrawal. Among the drugs that alter glutamate function, only acamprosate (300 mg/kg) was effective. In the stress protocols, baclofen (5 mg/kg) given before each of the 2 restraint stress sessions before ethanol exposure or before stress during abstinence also attenuated SI deficits. CONCLUSIONS These findings suggest that GABAB and GABAA, but not glutamate or opioid mechanisms, are involved in adaptive changes associated with anxiety-like behavior induced by these repeated ethanol-withdrawal and stress-withdrawal paradigms. The lack of action of agents attenuating different aspects of glutamate function suggests that acamprosate's action is related to some other, as yet undetermined, mechanism.
Feasibility and Initial Effectiveness of Home Exercise During Maintenance Therapy for Childhood Acute Lymphoblastic Leukemia

Purpose: Children with acute lymphoblastic leukemia (ALL) are at increased risk of obesity and deconditioning from cancer therapy. This pilot study assessed feasibility/initial efficacy of an exercise intervention for patients with ALL undergoing maintenance therapy. Methods: Participants were aged 5 to 10 years, receiving maintenance therapy, in first remission. A 6-month home-based intervention, with written and video instruction, was supervised with weekly calls from an exercise coach. Pre- and poststudy testing addressed strength, flexibility, fitness, and motor function. Results: Seventeen patients enrolled (participation 63%). Twelve (71%) finished the intervention, completing 81.7 ± 7.2% of prescribed sessions. Improvements of 5% or more occurred in 67% for knee and 75% for grip strength, 58% for hamstring/low-back and 83% for ankle flexibility, 75% for the 6-Minute Walk Test, and 33% for performance on the Bruininks-Oseretsky Test of Motor Proficiency Version 2. Conclusions: This pilot study demonstrated that exercise intervention during ALL therapy is feasible and has promise for efficacy.
Impact of arsenic in foodstuffs on the people living in the arsenic-affected areas of West Bengal, India

Although the accumulation of arsenic (As) in human blood is linked with some diseases and with occupational exposure, there are few reports on speciation of As in blood. On the basis of our earlier article,[ 1 ] elevated level of arsenicals in human urine and blood were found in the ex-exposed population via As-containing drinking water. The aim of the present study was to get an insight on impact of As in foodstuffs on the people living in the As-affected areas. Moreover, speciation of arsenicals in urine, and water-samples found in arsenobetaine (AsB). Since sampling population (n = 25) was not taking any seafood, As in foodstuffs was thought to be the prime source for this discrepancy. So, speciation of methanol extract of freeze-dried red blood cells (RBCs) and foodstuffs, and trichloro acetic acid (TCA) treated plasma by high performance liquid chromatography-inductively coupled argon plasma mass spectrometer (HPLC-ICP MS) collected from the study population (n = 33) was carried out to support our hypothesis. Results showed that urine contained AsB (1.7%), arsenite (iAsIII) (14.3), arsenate (iAsV) (4.9), monomethylarsonous acid (MMAIII) (0.64), monomethylarsonic acid (MMAV) (13.6), dimethylarsinous acid (DMAIII) (7.7), and dimethylarsinic acid (DMAV) (65.4). Blood contained 21.3 μ g L− 1 (mean) As and of which 27.3% was in plasma and 72.7% in RBCs. RBCs contained AsB (21.6%) and DMAV (78.4) and blood plasma contained AsB (12.4%), iAsIII (25.9), MMAV (30.3), and DMAV (31.4). Furthermore, speciation of As in foodstuffs showed that most of them contained AsB (3.54–25.81 μ g kg− 1) (25.81–312.44 μ g kg− 1) along with iAsIII (9.62–194.93), iAsV (17.63–78.33), MMAV (9.47–73.22) and DMAV (13.43–101.15) that supported the presence of AsB and elevated As in urine and blood samples of the present study group. Inorganic As (iAs) predominates in rice (67.17–86.62%) and in spices (40–90.35%), respectively over organic As. So, As in the food chain is a real threat to human health.
Rapid Diagnosis of Pulmonary Tuberculosis with the LCx Mycobacterium tuberculosis Assay and Comparison with Conventional Diagnostic Techniques

ABSTRACT The LCx MTB amplification assay is a nucleic acid amplification test intended for the direct detection ofMycobacterium tuberculosis complex in respiratory specimens. We evaluated its performance on 2,001 consecutive respiratory specimens; 78 were culture positive for M. tuberculosis. Sensitivity, specificity, and positive and negative predictive values of this assay for all specimens compared to culture results were 88.5, 97.7, 60.5, and 99.5%, respectively. When referred to resolved clinical diagnosis of active tuberculosis, these values improved to 90.2, 98.4, 72.8, and 99.5%, respectively.