Miracle-dz/UniFAR-FTUs huggingface dataset:
Operational criteria for the classification of chronic alcoholics: identification of Wernicke's encephalopathy.

OBJECTIVES: To establish better operational criteria for the diagnosis of Wernicke's encephalopathy. Current criteria for diagnosing Wernicke's encephalopathy require the presence of three clinical signs (oculomotor abnormalities, cerebellar dysfunction, and an altered mental state), although it has often been reported that most patients do not fulfil all these criteria. METHODS: The clinical histories of 28 alcoholics with neurological and neuropsychological assessments and definitive neuropathological diagnoses were examined to determine clinical signs for use in a screening schedule. Operational criteria were then proposed for differentiating patients with Wernicke's encephalopathy alone or in combination with Korsakoff's psychosis or hepatic encephalopathy. The new criteria for Wernicke's encephalopathy require two of the following four signs; (1) dietary deficiencies, (2) oculomotor abnormalities, (3) cerebellar dysfunction, and (4) either an altered mental state or mild memory impairment. Reproducibility and validity testing of these criteria were performed on 106 alcoholics screened from a large necropsy sample. RESULTS: Despite rater variability with regard to specific symptoms, within and between rater reliability for diagnostic classification using the criteria retrospectively on patient records was 100% for three independent raters. Validity testing showed that Wernicke's encephalopathy was underrecognized only when occurring with hepatic encephalopathy (50% sensitivity). CONCLUSIONS: By contrast with current criteria, the proposed operational criteria show that the antemortem identification of Wernicke's encephalopathy can be achieved with a high degree of specificity.
CEACAM1 in Cervical Cancer and Precursor Lesions: Association With Human Papillomavirus Infection

Carcinoembryonic antigen-related cell adhesion molecule 1 (CEACAM1) is an adhesion molecule expressed in a wide variety of tissues including epithelial cells, leukocytes, and tumors that may establish both homotypic and heterotypic interactions. The aim of this work was to study the protein expression pattern of CEACAM1 in cervical cancer and precursor lesions in the context of human papillomavirus (HPV) infection. We used immunohistochemistry to analyze CEACAM1 expression in formalin-fixed, paraffin-embedded cervical tissues from 15 healthy women, 15 patients with low-grade squamous intraepithelial lesions (SIL), 15 patients with high-grade SIL, and 15 patients with squamous carcinomas. HPV types were identified by PCR. CEACAM1 was either undetectable (13/15) or low (2/15) in normal cervical tissues. By contrast, CEACAM1 expression was increased in high-grade SIL (10 samples staining intermediate/high and 4 samples staining low) as compared with low-grade SIL with undetectable (n=3) or low (n= 12) expression. CEACAM1 expression was undetectable or low in cervical carcinoma. Our results suggest that CEACAM1 may be an interesting progression marker in SIL and cervical cancer, in particular due to reported immunoregulatory properties.
Sex differences in survival after myocardial infarction in Sweden; data from the Swedish National Acute Myocardial Infarction Register.

AIMS Women, particularly younger women, hospitalized with acute myocardial infarction have been found to have poorer prognosis than men. A large proportion of deaths due to myocardial infarction, however, occur in the pre-hospital phase. We set out to analyse age-specific sex differences in survival after myocardial infarction at different time intervals from the onset of acute myocardial infarction, including pre-hospital deaths and 1-year overall survival. METHODS AND RESULTS The National Acute Myocardial Infarction Register in Sweden was used to analyse age-specific sex differences in mortality outside hospital, 28-day mortality and 1-year mortality in 353 905 cases occurring between 1987 and 1995 in Swedish men and women aged 30 to 89 years. Overall, one in four of all myocardial infarction victims died outside hospital. At all ages, except in individuals younger than 50 years, men had higher pre-hospital mortality. The odds of dying within 28 days for women below 50 years of age, compared to men, was 1.84 (1.56--2.18) in hospitalized patients and 1.31 (1.18--1.46) in all infarction patients. Above the age of 65, in the total population with myocardial infarction, women had a better prognosis, with odds ratios ranging from 0.83 to 0.89. In patients surviving the first 28 days, 4.0% of the women and 2.9% of the men below the age of 50 were dead within a year after the infarction, odds ratio 1.37 (1.06--1.76). This excess mortality was mainly due to diabetes and non-cardiac causes. Only women younger than 50 years had a significantly poorer overall 1-year survival than men of the same age. At the age of 70 or more, women had a small survival advantage. CONCLUSION In the total acute myocardial infarction population, only women under 50 years of age have a consistently worse prognosis than men. Much of the excess mortality in young women seems to be associated with diabetes.
Effects of ethanol infusion on the redox state and metabolite levels in rat liver in vivo.

1 Hepatic levels of several metabolites of the Embden-Meyerhof pathway, the citric acid cycle and oxidized and reduced substrate pairs of the lactate, α-glycerophosphate, β-hydroxybutyrate, malate, and glutamate dehydrogenase systems were measured in freeze clamped livers from fed male rats, before and after ethanol infusion. 2 Ethanol infusion in fed male rats after 30 min resulted in an increase in the levels of hexosemonophosphates, triosephosphates, fructose 1,6 diphosphate, lactate, α-glycerophosphate, malate, β-hydroxybutyrate, and glutamate. [Lactate]/[pyruvate] ratio increased about 3 fold, [α-glycerophosphate]/[dihydroxyacetonephosphate] 1.5 fold, [malate]/[oxaloacetate], [β-hydroxybutyrate]/[acetoacetate], and [glutamate]/[2-oxoglutarate] × [NH4+] about 2 fold. 3 The levels of pyruvate, acetyl CoA, citrate, and ATP were decreased during ethanol treatment. 4 The hepatic levels of glycogen, oxaloacetate, 2-oxoglutarate, ammonia, aspartate, and acetoacetate remained unchanged, 30 min after ethanol infusion, as compared to values before ethanol infusion. 5 Hepatic glucose 6-phosphatase activity was significantly increased after 15 min of ethanol infusion (1.5 g/kg body weight). The glucose 6-phosphatase activity showed a maximum 15 min after ethanol infusion, the fructose 1,6 diphosphatase activity did not change significantly 15 and 30 min after ethanol infusion. Hepatic acid and alkaline phosphatase activities measured with β-glycerophosphate as substrate showed no significant changes compared to values from normal rat livers. 6 The presence of ethanol (8 mM) in the incubation medium showed no significant effect on the [6-14C]glucose incorporation into glycogen by the liver slices.
Pattern of Medical Admissions in a Tertiary Health Centre in Abakaliki South-East Nigeria

The pattern of medical admissions varies amongst different regions of the world and this depends on many factors including the prevalent medical diseases in the region. This study determined the pattern of medical admissions in a tertiary health centre in Abakaliki South Eastern Nigeria and compared it with that from other parts of the country. It was a retrospective, descriptive and hospital based study. The admission and discharge registers of the medical wards of the Federal Teaching Hospital Abakaliki south-east Nigeria from July 2012 to June 2013 were reviewed and relevant data extracted and analyzed using Statistical Package for Social Sciences (SPSS) version 19 software. The patients admitted during the period numbered 1247, with age range of 15 to 99 years. There were 643(51.56%) males and 604 (48.44%) females, with a male to female ratio of 1.06:1. Seventy per cent of the patients were between 30 and 69years. Infectious diseases accounted for 255 (20.45%) of the admissions, while cardiovascular disorders and neurological disorders accounted for 251 (20.13%) and 233 (18.68%) respectively. Non-communicable diseases accounted for 711 (57.02%) of the cases while communicable diseases accounted for 536 (42.98%). There was male predilection for neurological and chronic liver diseases while female patients had predilection for infectious diseases. The study showed that majority of the patients was in the productive age. There was also double burden of both communicable and non-communicable diseases in Abakaliki with higher female prevalence of infectious diseases. Health planning towards prevention of the identified diseases should be instituted. Keywords: pattern, medical, admissions, Abakaliki, Nigeria
Non‐invasive tear film break‐uptime: sensitivity and specificity

Abstract The accuracy of a diagnostic technique; non‐invasive tear film break‐up time (NIBUT) was determined by calculating the sensitivity and specificity of the test. Thirty‐three dry eye patients (65 eyes) of varying severity (mild, moderate and severe) and 66 age and sex matched normal subjects (132 eyes) were examined. The results indicate that the critical value of 10 seconds for the NIBUT provides sensitivity of 82% and specificity of 86%.
Nightmares Associated with the Eveningness Chronotype

Relations between common nightmares and chronobiological factors remain poorly understood. The possibility that nightmare frequency and distress are associated with chronotype (“morningness-eveningness”) was investigated in a sample of respondents to an Internet questionnaire. Over a 4½-year period, a total of 3978 subjects (mean age = 26.5 ± 11.6 yrs; age range = 10-69; 2933 female, 1045 male) submitted responses to single items about chronotype and nightmares as well as to other demographic variables. Analyses of chronotype and nightmares items by age and gender replicated most previous findings for these measures—validating their further assessment—and uncovered abrupt increases in nightmare distress between ages 10-19 and 20-29 for females and ages 30-39 and 40-49 for males. Most important, there was a strong association between nightmares and eveningness for female subjects. The latter was expressed as a linear association between nightmare frequency and increasing eveningness and a cubic association between nightmare distress and increasing eveningness; the definite evening types displayed the most severe nightmares. The effect for nightmare frequency was independent of age and sleep duration but was eliminated when nightmare distress was covaried. For females, the nightmare/eveningness association appeared at ages 20 to 29 for the definite evening type and only later, at ages 30 to 39, for the moderate evening type. Findings are consistent with the possibility that nightmares are the expression of a more general pathological factor that is characteristic of eveningness and that is responsible for affective symptoms such as neuroticism and depression. This pathological factor appears to be expressed in late adolescence/ early adulthood, and relative morningness may be a protective factor delaying its onset. The well-established circadian modulations of cognitive, social, and affective tasks that are influenced by chronotype may extend to the memory and affective processes of sleep—including dreaming. This chronotypic influence, together with a likely gender difference in the neurophysiological substrate of emotional processing, may result in the differential occurrence of nightmares for female evening types.
Diet Quality and Cancer Incidence in Nova Scotia, Canada

Cancer rates in the province of Nova Scotia, Canada, are among the highest in the country and coincide with elevated rates of risk factors such as smoking, poor diet, and obesity. To investigate the importance of diet on cancer, using data from the 1990 Nova Scotia Nutrition Survey, we developed a diet quality score reflecting compliance with 17 nutrient recommendations. The survey data were subsequently linked with the provincial cancer registry, and the relationship between diet quality and cancer was quantified using logistic regression. Our results support an inverse relationship between diet quality and cancer, although limited statistical power resulting from our small study sample did not reveal any statistically significant relationships. We estimated that cancer incidence could potentially be reduced by ~35% through improved diet quality. On the basis of poor diet, nutrition-related factors (high body mass index), our estimates of the preventable fraction of cancer, and the high provincial cancer rates, we recommend health promotion strategies aimed at improving diet quality in Nova Scotia.
Surgery for cervical intraepithelial neoplasia.

BACKGROUND Cervical intraepithelial neoplasia (CIN) is the most common pre-malignant lesion. Atypical squamous changes occur in the transformation zone of the cervix with mild, moderate or severe changes described by their depth (CIN 1, 2 or 3). Cervical intraepithelial neoplasia is treated by local ablation or lower morbidity excision techniques. Choice of treatment depends on the grade and extent of the disease. OBJECTIVES To assess the effectiveness and safety of alternative surgical treatments for CIN. SEARCH STRATEGY We searched the Cochrane Gynaecological Cancer Group Trials Register, Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library), MEDLINE and EMBASE (up to April 2009). We also searched registers of clinical trials, abstracts of scientific meetings and reference lists of included studies. SELECTION CRITERIA Randomised controlled trials (RCTs) of alternative surgical treatments in women with cervical intraepithelial neoplasia. DATA COLLECTION AND ANALYSIS Two review authors independently abstracted data and assessed risks of bias. Risk ratios that compared residual disease after the follow-up examination and adverse events in women who received one of either laser ablation, laser conisation, large loop excision of the transformation zone (LLETZ), knife conisation or cryotherapy were pooled in random-effects model meta-analyses. MAIN RESULTS Twenty-nine trials were included. Seven surgical techniques were tested in various comparisons. No significant differences in treatment failures were demonstrated in terms of persistent disease after treatment. Large loop excision of the transformation zone appeared to provide the most reliable specimens for histology with the least morbidity. Morbidity was lower than with laser conisation, although the trials did not provide data for every outcome measure. There were not enough data to assess the effect on morbidity when compared with laser ablation. AUTHORS' CONCLUSIONS The evidence suggests that there is no obvious superior surgical technique for treating cervical intraepithelial neoplasia in terms of treatment failures or operative morbidity.
Will the elderly of the future be healthier?

https://doi.org/10.1177/1403494816683874 © Author(s) 2016 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav DOI: 10.1177/ 403 9 816 8 4 journals.sagepub.com/home/sjp Research on the health of elderly people yields divergent findings. A longer life is not necessarily a longer, healthy life. We live longer than before, but what can we expect our state of health to be in our additional years [1,2]? It is surprisingly difficult to find an unequivocal answer to this question [3,4]. This is paradoxical because knowledge on health trends among elderly people is crucial for health policy design, for the estimation of future costs and needs in the health and care sector, and for the planning and facilitation of health services and treatment.
White matter abnormalities in bipolar disorder and schizophrenia detected using diffusion tensor magnetic resonance imaging.

OBJECTIVES Strong qualitative and quantitative evidence exists of white matter abnormalities in both schizophrenia and bipolar disorder (BD). Diffusion tensor imaging (DTI) studies suggest altered connectivity in both disorders. We aim to address the diagnostic specificity of white matter abnormalities in these disorders. METHODS DTI was used to assess white matter integrity in clinically stable patients with familial BD (n = 42) and familial schizophrenia (n = 28), and in controls (n = 38). Differences in fractional anisotropy (FA) were measured using voxel-based morphometry and automated region of interest analysis. RESULTS Reduced FA was found in the anterior limb of the internal capsule (ALIC), anterior thalamic radiation (ATR), and in the region of the uncinate fasciculus in patients with BD and those with schizophrenia compared with controls. A direct comparison between patient groups found no significant differences in these regions. None of the findings were associated with psychotropic medication. CONCLUSIONS Reduced integrity of the ALIC, uncinate fasciculus, and ATR regions is common to both schizophrenia and BD. These results imply an overlap in white matter pathology, possibly relating to risk factors common to both disorders.
The ST2/IL-33 Axis in Immune Cells during Inflammatory Diseases

Il1rl1 (also known as ST2) is a member of the IL-1 superfamily, and its only known ligand is IL-33. ST2 exists in two forms as splice variants: a soluble form (sST2), which acts as a decoy receptor, sequesters free IL-33, and does not signal, and a membrane-bound form (ST2), which activates the MyD88/NF-κB signaling pathway to enhance mast cell, Th2, regulatory T cell (Treg), and innate lymphoid cell type 2 functions. sST2 levels are increased in patients with active inflammatory bowel disease, acute cardiac and small bowel transplant allograft rejection, colon and gastric cancers, gut mucosal damage during viral infection, pulmonary disease, heart disease, and graft-versus-host disease. Recently, sST2 has been shown to be secreted by intestinal pro-inflammatory T cells during gut inflammation; on the contrary, protective ST2-expressing Tregs are decreased, implicating that ST2/IL-33 signaling may play an important role in intestinal disease. This review will focus on what is known on its signaling during various inflammatory disease states and highlight potential avenues to intervene in ST2/IL-33 signaling as treatment options.
Factors predicting long-term survival after T-cell depleted reduced intensity allogeneic stem cell transplantation for acute myeloid leukemia

Background Reduced intensity conditioning regimens permit the delivery of a potentially curative graft-versus-leukemia effect in older patients with acute myeloid leukemia. Although T-cell depletion is increasingly used to reduce the risk of graft-versus-host disease its impact on the graft-versus-leukemia effect and long-term outcome post-transplant is unknown. Design and Methods We have characterized pre- and post-transplant factors determining overall survival in 168 patients with acute myeloid leukemia transplanted using an alemtuzumab based reduced intensity conditioning regimen with a median duration of follow-up of 37 months. Results The 3-year overall survival for patients transplanted in CR1 or CR2/CR3 was 50% (95% CI, 38% to 62%) and 44% (95% CI, 31% to 56%), respectively compared to 15% (95% CI, 2% to 36%) for patients with relapsed/refractory disease. Multivariate analysis demonstrated that both survival and disease relapse were influenced by status at transplant (P=0.008) and presentation cytogenetics (P=0.01). Increased exposure to cyclosporine A (CsA) in the first 21 days post-transplant was associated with an increased relapse risk (P<0.0001) and decreased overall survival (P<0.0001). Conclusions Disease stage, presentation karyotype and post-transplant CsA exposure are important predictors of outcome in patients undergoing a T-cell depleted reduced intensity conditioning allograft for acute myeloid leukemia. These data confirm the presence of a potent graft-versus-leukemia effect after a T-cell depleted reduced intensity conditioning allograft in acute myeloid leukemia and identify CsA exposure as a manipulable determinant of outcome in this setting.
Investigation of Myotonic Dystrophy Kinase Isoform Translocation and Membrane Association*

Myotonic dystrophy is caused by the expansion of a CTG repeat found in the 3′-untranslated region of the myotonic dystrophy kinase. The mechanism of disease and the role of the kinase are currently obscure. Here we begin the investigation of domain structure/function correlations to aid in determining its normal function. Expressed full-length protein and protein truncated before a C-terminal hydrophobic domain were compared. In vitro, signal peptide function and protection of kinase by microsomal membranes were absent; thus, it is not translocated, as previously proposed. However, full-length kinase expressed in insect cells was found in fractions enriched for membranes and decorated mitochondria. The truncated form was found primarily in the cytosol. The kinase was present as two self-associated, disulfide-linked complexes. The majority of full-length kinase was found in the larger of the two complexes, while almost all of the truncated form was found in the smaller. Thus, the C-terminal region confers a higher order of self-association. Furthermore, full-length kinase expressed in COS-1 cells was present as high molecular weight complex, while the truncated form was present as monomer species. These experiments indicate that the myotonic dystrophy kinase is not membrane-integrated, but that it may have a molecular organization which favors peripheral association with membranes.
[The cellular plasticity of human adipocytes].

OBJECTIVE To explore the dedifferentiation phenomenon of human mature adipocytes cultured in vitro and to discuss the possibility of using dedifferentiation adipocytes (DA) as seed cells. METHODS Mature adipocytes and ASCs were harvested from human fat aspirates. Mature adipocytes were cultured and induced to DA by ceiling adherent culture method. Cell morphology were observed during the whole process. Viabilities of DA and ASCs were compared by MTT chromatometry and cell growth curves were drawn based on it. Cell surface markers of DA and ASCs were detected by flow cytometry. The adipogenic, osteogenic and chondrogenic ability of DA and ASCs were assessed by oil red O staining, alizarin bordeaux staining and alcian blue staining, respectively. RESULTS Human mature adipocytes can dedifferentiate into fibroblast-shaped DA. MTT chromatometry assay demonstrated that DA and ASCs both had strong reproductive activity, with no significant difference between them. Flow cytometry assay demonstrated that both DA and ASCs expressed HLA-ABC, CD29 and CD44, while didn't express CD45, CD34 and CD106. After two weeks of adipogenic differentiation, lipid droplets could be displayed by oil red O staining in both DA and ASCs. After two weeks of osteogenic differentiation, calcium salts mineralization in DA and ASCs could be detected by alizarin bordeaux staining. After two weeks of chondrogenic differentiation, matrix of cartilage cells in DA and ASCs could be detected by alcian blue staining. CONCLUSIONS Mature adipocytes can be dedifferentiated into DA in vitro. DA has strong reproductive activity, as well as osteogenic, chondrogenic ability and strong adipogenic ability. It expresses some of the stem cell-related cell surface proteins and is a promising seed cell for adipose tissue engineering.