Miracle-dz/UniFAR-FTUs huggingface dataset:
The Influence of Craniotrauma on the Outcome of Polytrauma 1 2

Background : Polytrauma is often associated with poor outcome. This is frequently attributed to head injury which is present in a high proportion of such patients. This study examines the influence of head injury on the outcome of polytrauma in a tertiary health institution in Nigeria. Methodology : A prospective design in which consecutive patients presenting with polytrauma were recruited. They were categorised into those with head injury (A) and those without head injury (B). Out of group A, those in whom head injury was severe (GCS 3 - 8) was extracted and studied ( A1). Data were entered into a proforma and the Epi info 3.2. 1 software was used for the statistical analysis. Specifically, the injury severity score, length of hospital stay, morbidity and mortality were compared in the groups. Results : One hundred and twenty eight patients with polytrauma were studied. There was head injury in 90 patients (A) and no head injury in 38 (B). Of the head injured patients, 13 had severe head injury (A1). There were no statistically significant differences in injury severity score (p=0.7), length of hospital stay (p=0.8), morbidity (p=0.5) or mortality (p=0.48) between the head injured (A) and the non-head injured (B) groups. Severe head injury (A1) was however associated with statistically significant increase in injury severity score (p Conclusion : It is not all polytraumatised patients with head injury that have an adverse outcome but the subset with severe head injury that do. Laid down protocols for neurosurgical referrals and transfers in patients with severe head injury will benefit this category of patients as they do show adverse outcome in polytrauma.
Leukemia inhibitory factor regulates the timing of oligodendrocyte development and myelination in the postnatal optic nerve

Leukemia inhibitory factor (LIF) promotes the survival of oligodendrocytes both in vitro and in an animal model of multiple sclerosis, but the possible role of LIF signaling in myelination during normal development has not been investigated. We find that LIF−/− mice have a pronounced myelination defect in optic nerve at postnatal day 10. Myelin basic protein (MBP)‐ and proteolipid protein (PLP)‐positive myelin was evident throughout the optic nerve in the wild‐type mice, but staining was present only at the chiasmal region in LIF−/− mice of the same age. Further experiments suggest that the myelination defect was a consequence of a delay in maturation of oligodendrocyte precursor cell (OPC) population. The number of Olig2‐positive cells was dramatically decreased in optic nerve of LIF−/− mice, and the distribution of Olig2‐positive cells was restricted to the chiasmal region of the nerve in a steep gradient toward the retina. Gene expression profiling and cell culture experiments revealed that OPCs from P10 optic nerve of LIF−/− mice remained in a highly proliferative immature stage compared with littermate controls. Interestingly, by postnatal day 14, MBP immunostaining in the LIF−/− optic nerve was comparable to that of LIF+/+ mice. These results suggest that, during normal development of mouse optic nerve, there is a defined developmental time window when LIF is required for correct myelination. Myelination seems to recover by postnatal day 14, so LIF is not necessary for the completion of myelination during postnatal development. © 2009 Wiley‐Liss, Inc.
Caffeine and Progression of Parkinson Disease

Objective: Caffeine use is negatively associated with the risk of developing Parkinson disease (PD) and is protective in animal models of PD, but the relationship between caffeine intake and rate of progression of PD is unknown. We assessed this relationship using data from 2 recent clinical trials of PD. Methods: Data were ascertained from 2 recent 1-year clinical trials that together included 413 early PD subjects who did not require symptomatic therapy at the time of study entry. Exploratory analyses compared caffeine intake with rate of progression of PD, as measured by either the likelihood of progression to the point of requiring symptomatic therapy or by change in the total Unified Parkinson Disease Rating Scale score. Results: Rate of progression of PD did not differ significantly between those in the highest and lowest quartiles for caffeine use for either of the primary measures or for secondary analyses of changes in scores on the motor or activities of daily living subsections of the Unified Parkinson Disease Rating Scale. Other secondary analyses yielded variable results. Conclusions: These data do not reveal a consistent relationship between caffeine intake and rate of progression of PD by these measures, although a larger study is required for sufficient power to more fully assess this relationship.
Topiramate in Treatment of Tourette Syndrome

Objectives:To describe the efficacy and safety of topiramate in the treatment of Tourette syndrome (TS). Methods:Charts of subjects whose conditions were diagnosed as tic disorders seen at our clinic from 2003 to 2007 were retrospectively reviewed. Patients who met diagnostic criteria for TS and were started on topiramate at our clinic with at least 1 follow-up visit after beginning topiramate were included. The efficacy of topiramate on a subjective scale, the global impression of response (0 = no response/worse, 1 = mild improvement, 2 = moderate improvement, 3 = marked improvement), and adverse effects were recorded for analysis. Results:Of 453 subjects, 367 met diagnostic criteria for TS and 41 (11.1%; 34 males) were treated with topiramate for tics for 9.43 ± 7.03 months (range, 1-27 months). Mean age at onset of tics was 6.93 ± 2.78 years (range, 2-14 years) and at start of topiramate treatment was 14.83 ± 5.63 years (range, 9-27 years). The average efficacy on tics was 2.15 ± 1.11, and 75.6% (n = 31) of subjects had moderate to marked improvement and adverse effects included cognitive/language problems (24.4%, n = 10) and aggression or mood swings (9.8%, n = 4). Conclusions:This retrospective chart review suggests that topiramate can be used for tics in TS with at least moderate efficacy and typical adverse effects. Randomized controlled trials are needed.
Longitudinal Treatment Effectiveness Outcomes of a Group Intervention for Women and Children Exposed to Domestic Violence

Social support can moderate negative effects of domestic violence for exposed women and children. Also, interventions targeting exposed women and children simultaneously have been shown to be more effective than those focused on children only. Since group interventions can provide such support, our study examined the effectiveness of a 10-week community-based psycho-educational group intervention for women and children. Mothers’ (n = 36) and children’s outcomes (n = 20) were assessed preintervention and 3- and 6-months postintervention. High attrition limited significant findings but maternal outcomes were in the expected direction. Methodological implications and barriers to intervention research are discussed.
Substitution Profile of the Cannabinoid Agonist Nabilone in Human Subjects Discriminating &Dgr;9-Tetrahydrocannabinol

Objectives:The central effects of &Dgr;9-tetrahydrocannabinol (&Dgr;9-THC), the primary active constituent of cannabis, are attributed to cannabinoid CB1 receptor activity, although clinical evidence is limited. Drug discrimination has proven useful for examining the neuropharmacology of drugs, as data are concordant with the actions of a drug at the receptor level. The aim of this study was to determine the profile of behavioral and physiological effects of the cannabinoid agonist nabilone in humans trained to discriminate &Dgr;9-THC. Methods:Six cannabis users learned to identify when they received oral &Dgr;9-THC (25 mg) or placebo and then received a range of doses of the cannabinoid agonists nabilone (1, 2, 3, and 5 mg) and &Dgr;9-THC (5, 10, 15, and 25 mg). The dopamine reuptake inhibitor methylphenidate (5, 10, 20, and 30 mg) was included as a negative control. Subjects completed the Multiple-Choice Procedure, and self-report, task performance, and physiological measures were collected. Results:Nabilone shared discriminative-stimulus effects with the training dose of &Dgr;9-THC, produced subject-rated drug effects that were comparable to those of &Dgr;9-THC, and increased heart rate. Methylphenidate did not engender &Dgr;9-THC-like discriminative-stimulus effects. Conclusions:These data demonstrate that the interoceptive effects of nabilone are similar to &Dgr;9-THC in cannabis users. The overlap in their behavioral effects is likely due to their shared mechanism as CB1 receptor agonists. Given the relative success of agonist replacement therapy to manage opioid, tobacco, and stimulant dependence, these results also support the evaluation of nabilone as a potential medication for cannabis-use disorders.
Thyroid Adverse Effects of Psychotropic Drugs: A Review

Objectives Because many patients with mental illness take more than one psychotropic drug, an understanding of the effects of every class of these drugs is very important to manage any thyroid abnormalities that can happen with these patients. Methods A systematic review of all the published literature was made via Medline. Keywords used for the search were “thyroid side effects” in association with one of the following: “antipsychotics,” “antidepressants,” “lithium,” “anticonvulsants,” “benzodiazepines,” “anticholinergics,” “antihistaminergics,” “cholinesterase inhibitors,” “stimulants,” “methadone,” and “naltrexone. ” Results Phenothiazines, which are antipsychotics, mainly alter iodine capture, complex and deactivate it, as well as decrease thyroid-stimulating hormone’s (TSH’s) response to thyroid-releasing hormone (TRH). Nonphenothiazines, typical antipsychotics, can induce the formation of thyroid autoantibodies and can elevate TSH levels. Atypical antipsychotics may decrease TRH-stimulated TSH. Tricyclic antidepressant drugs complex with iodine and thyroid peroxidase and deactivate them, induce deiodinase activity and interfere with the hypothalamo-pituitary-thyroid (HPT) axis by decreasing TSH response to TRH. The main effect with other antidepressant drugs is a decrease in circulating thyroid hormone levels. Lithium inhibits thyroid hormone release and increases TRH-stimulated TSH, inducing goiter, clinical and subclinical hypothyroidism, and hyperthyroidism. Carbamazepine mainly reversibly decreases serum thyroid hormone levels. Other psychotropic drugs such as valproic acid, benzodiazepines, opiates, anticholinergic and antihistaminergic drugs, and stimulants have minor interferences with thyroid functions. Conclusion Patients receiving lithium, phenothiazines, and tricyclic antidepressants TCA should be closely monitored for the development of thyroid function abnormalities. Only patients at risk for developing thyroid function abnormalities should be monitored when they receive typical and/or atypical antipsychotic drugs, nontricyclic antidepressant drugs, and carbamazepine. No specific recommendations are proposed as toward thyroid function monitoring for patients receiving any other psychopharmacologic drug.
Uncaria tomentosa Gel against Denture Stomatitis: Clinical Report.

The objective of this study is to report the clinical use of 2% Uncaria tomentosa gel against denture stomatitis (DS) as an alternative treatment. The patient was a 65-year-old, denture-wearing woman. At the clinical examination, her palate showed hyperplasic and erythematous mucosa indicating DS type II. DS is a chronic oral disease that affects denture wearers. It occurs as an inflammatory reaction in denture-wearing patients under maxillary prostheses. Candida albicans has been reported as the principal etiological agent. An alternative treatment, the topical application of a gel of 2% U. tomentosa three times a day for 1 week was given to the patient. After 1 week of this treatment, she had significantly reduced signs of the disease. Despite the existence of a great number of antifungal agents, treatment failure is observed frequently. Phytotherapy is becoming more popular worldwide. Currently, the most promising medicinal Amazonian herb is U. tomentosa (Willd.) DC. , known as Cat's Claw. Studies of the chemical and pharmacological properties of this medicinal plant have allowed researchers to develop indications for its use. This report demonstrates the effectiveness of U. tomentosa against DS.
Mercado de trabajo, salud laboral e inmigración

El proceso de cambio economico y social que esta experimentando Navarra en las ultimas decadas esta asociado con la llegada de un flujo de inmigrantes creciente a partir del nuevo siglo. Su influencia ha sido decisiva como factor de cambio economico en terminos de crecimiento de produccion y demanda interna. Se esta construyendo una Navarra diferente gracias al fenomeno migratorio. Analizaremos en primer lugar su impacto en el crecimiento demografico. Se valora su influencia en el mercado de trabajo con sus luces y sus sombras. El colectivo de extranjeros supone ya el 10% de la poblacion activa y su presencia en algunos sectores productivos es decisiva para la viabilidad de los mismos. Se revisan las disfunciones y los problemas del mercado de trabajo, especialmente el tema de la siniestralidad. Para finalizar se expone el comportamiento de los indicadores de incapacidad temporal en dicho colectivo. Aunque este fenomeno ha supuesto un desequilibrio en algunos ambitos de la politica social (educacion, vivienda, sanidad) se puede afirmar que el modelo de integracion en Navarra se basa en un sistema de bienestar generoso, un clima social en general tolerante y un crecimiento economico sostenido.
Immunodeficiency reduces neural stem/progenitor cell apoptosis and enhances neurogenesis in the cerebral cortex after stroke

Acute inflammation in the poststroke period exacerbates neuronal damage and stimulates reparative mechanisms, including neurogenesis. However, only a small fraction of neural stem/progenitor cells survives. In this report, by using a highly reproducible model of cortical infarction in SCID mice, we examined the effects of immunodeficiency on reduction of brain injury, survival of neural stem/progenitor cells, and functional recovery. Subsequently, the contribution of T lymphocytes to neurogenesis was evaluated in mice depleted for each subset of T lymphocyte. SCID mice revealed the reduced apoptosis and enhanced proliferation of neural stem/progenitor cells induced by cerebral cortex after stroke compared with the immunocompetent wild‐type mice. Removal of T lymphocytes, especially the CD4+ T‐cell population, enhanced generation of neural stem/progenitor cells, followed by accelerated functional recovery. In contrast, removal of CD25+ T cells, a cell population including regulatory T lymphocytes, impaired functional recovery through, at least in part, suppression of neurogenesis. Our findings demonstrate a key role of T lymphocytes in regulation of poststroke neurogenesis and indicate a potential novel strategy for cell therapy in repair of the central nervous system. © 2010 Wiley‐Liss, Inc.
Expression of plasminogen activator inhibitor‐1 and protease nexin‐1 in human astrocytes: Response to injury‐related factors

Astrocytes play a diverse role in central nervous system (CNS) injury. Production of the serine protease inhibitors (serpins) plasminogen activator inhibitor‐1 (PAI‐1) and protease nexin‐1 (PN‐1) by astrocytes may counterbalance excessive serine protease activity associated with CNS pathologies such as ischemic stroke. Knowledge regarding the regulation of these genes in the brain is limited, so the objective of the present study was to characterize the effects of injury‐related factors on serpin expression in human astrocytes. Native human astrocytes were exposed to hypoxia or cytokines, including interleukin‐6 (IL‐6), IL‐1β, tumor necrosis factor‐α (TNF‐α), IL‐10, transforming growth factor‐α (TGF‐α), and TGF‐β for 0–20 hr. Serpin mRNA expression and protein secretion were determined by real‐time RT‐PCR and ELISA, respectively. Localization of PAI‐1 and PN‐1 in human brain tissue was examined by immunohistochemistry. Hypoxia and all assayed cytokines induced a significant increase in PAI‐1 expression, whereas prolonged treatment with IL‐1β or TNF‐α resulted in a significant down‐regulation. The most pronounced induction of both PAI‐1 and PN‐1 was observed following early treatment with TGF‐α. In contrast to PAI‐1, the PN‐1 gene did not respond to hypoxia. Positive immunoreactivity for PAI‐1 in human brain tissue was demonstrated in reactive astrocytes within gliotic areas of temporal cortex. We show here that human astrocytes express PAI‐1 and PN‐1 and demonstrate that this astrocytic expression is regulated in a dynamic manner by injury‐related factors. © 2010 Wiley‐Liss, Inc.
Snoring and Obstructive Sleep Apnea: Objective Efficacy and Impact of a Chairside Fabricated Mandibular Advancement Device

PURPOSE Obstructive sleep apnea (OSA) has been described as a common sleep respiratory disorder. Its prevalence in the adult population has been reported to be high, varying from 3% to 28%. Dental practitioners play a key role in the treatment of this disease, using tailor-made mandibular advancement devices (MADs). This pilot study assessed the efficacy and compliance of a custom-fitted thermoplastic MAD for the treatment of moderate to severe OSA syndrome. MATERIALS AND METHODS In this open study without a control group, OSA syndrome sufferers were enrolled by four centers. One specific MAD was custom fitted to the patients. Polysomnography, Epworth, and snoring scales were administered from inclusion to 45 days postinclusion. RESULTS The study population consisted of 33 men and 8 women; 35 patients completed the study. Patient response was high with 69% of them considered as responders, and 60% showing a complete response. Also, 77.3% of patients with moderate OSA syndrome presented a complete response. An improvement was observed in the apnea hypopnea index, which decreased from 34.1 ± 18.9 to 12.8 ± 14.1. The Epworth Sleepiness Scale score, snoring, and quality of sleep scores decreased with the device (p < 0.0001). Compliance rates were high, with patients wearing the device 6.5 nights a week. Side effects and patient complaints were minor and transient. CONCLUSION This custom-fitted MAD improved respiratory and somnolence parameters, with response rates similar to those published in the literature with other devices.
Disruption of neurovascular unit prior to motor neuron degeneration in amyotrophic lateral sclerosis

Recent reports suggest that functional or structural defect of vascular components are implicated in amyotrophic lateral sclerosis (ALS) pathology. In the present study, we examined a possible change of the neurovascular unit consisting of endothelium (PCAM‐1), tight junction (occludin), and basement membrane (collagen IV) in relation to a possible activation of MMP‐9 in ALS patients and ALS model mice. We found that the damage in the neurovascular unit was more prominent in the outer side and preferentially in the anterior horn of ALS model mice. This damage occurred prior to motor neuron degeneration and was accompanied by MMP‐9 up‐regulation. We also found the dissociation between the PCAM‐1‐positive endothelium and GFAP‐positive astrocyte foot processes in both humans and the animal model of ALS. The present results indicate that perivascular damage precedes the sequential changes of the disease, which are held in common between humans and the animal model of ALS, suggesting that the neurovascular unit is a potential target for therapeutic intervention in ALS. © 2011 Wiley‐Liss, Inc.
Making Decisions and Advising Decisions in Traumatic Brain Injury

Objective and BackgroundDecision under ambiguity and decision under risk are fundamental in every-day life. MethodsWe investigated these 2 types of decision in traumatic brain injury (TBI) patients through the Iowa Gambling Task (IGT), the Probability-Associated Gambling (PAG) task, and a counsel version of the PAG task. Although in the IGT rules for gain and losses are implicit and probability information is missing, in the PAG task and the counsel task rules are explicit and probabilities are well-defined. ResultsIn the IGT, TBI patients selected more disadvantageously than healthy controls and failed to develop an advantageous strategy over time. Patients also made less advantageous choices than controls in the PAG task and the counsel task. Compared with controls, TBI patients gambled more frequently with low probabilities and less frequently with high probabilities. Overall, participants decided more advantageously in the counsel task, which does not provide feedback, than in the PAG task. Importantly, our results indicate that TBI patients' performance on all decision tasks correlated with executive functions. ConclusionsOur study shows that TBI patients have difficulties in decision under risk and decision under ambiguity. Difficulties may be attributed to deficient learning from feedback and to reduced risk estimation, but not to impulsive risk taking behavior.
Regulation of tissue plasminogen activator/plasminogen activator inhibitor‐1 by hydrocortisone in rat primary astrocytes

Although originally known as a plasma serine protease involved in clot dissolution, tPA and its primary inhibitor, PAI‐1, play crucial roles in synaptic reorganization and plasticity in the central nervous system. In contrast to the wide array of work conducted in neural cells, relatively little is known about the regulatory mechanism governing tPA/PAI‐1 expression in astrocytes. Glucocorticoids (GCs) such as hydrocortisone regulate the expression of tPA/PAI‐1 in various biological systems in a tissue‐specific manner. However, little is known about GC‐mediated regulation of tPA/PAI‐1 system in CNS. The aims of the present study were to investigate whether tPA/PAI‐1 expression is regulated by hydrocortisone in rat primary astrocytes. Enzyme activity of tPA was decreased in a concentration‐dependent manner by hydrocortisone treatment, and the activity of PAI‐1 was increased by hydrocortisone. Hydrocortisone did not affect the level of tPA mRNA, which suggests that transcriptional down‐regulation of tPA mRNA is not involved in the down‐regulation of tPA enzyme activity in astrocytes. However, the level of PAI‐1 mRNA and protein was increased. Both hydrocortisone and a tPA‐Stop treatment prevented glutamate‐induced neurotoxicity in rat cortical primary mixed astrocyte–neuron culture, which suggests a neurotoxic role for tPA in our culture system. Interestingly, hydrocortisone further increased LPS‐induced up‐regulation of PAI‐1 while inhibiting the up‐regulation of iNOS and COX‐2 expression. Our data show that hydrocortisone up‐regulated PAI‐1 expression along with down‐regulation of tPA activity in both normal and inflammatory conditions. © 2011 Wiley‐Liss, Inc.