Miracle-dz/UniFAR-FTUs huggingface dataset:
Managing coeliac disease in patients with diabetes

The association between coeliac disease and type 1 diabetes has long been established. The combination of genetic susceptibility along with a potential role for gluten in the pathogenesis of autoimmunity makes defining gluten's role in type 1 diabetes extremely important. Evidence supporting the role of a gluten‐free diet to improve complications associated with type 1 diabetes is not robust. However there is evidence to support improved growth, bone density and potentially the prevention of additional autoimmune diseases in patients with coeliac disease and type 1 diabetes. The gluten free diet is expensive and challenging to adhere to in people already on a modified diet. Early identification of those who have coeliac disease and would benefit from a gluten‐free diet is of utmost importance to prevent complications associated with type 1 diabetes and coeliac disease.
The interleukin‐1 receptor antagonist anakinra improves first‐phase insulin secretion and insulinogenic index in subjects with impaired glucose tolerance

Inflammation at the level of the β cell appears to be involved in progressive β‐cell dysfunction in type 2 diabetes. We assessed the effect of blocking interleukin‐1 (IL‐1) by anakinra [recombinant human interleukin‐1 receptor antagonist (IL‐1Ra)] on β‐cell function. Sixteen participants with impaired glucose tolerance were treated with 150 mg anakinra daily for 4 weeks in a double blind, randomized, placebo‐controlled cross‐over study with a wash‐out period of 4 weeks. At the end of each treatment period, oral glucose tolerance tests (OGTTs) and hyperglycaemic clamps were performed. First‐phase insulin secretion improved after anakinra treatment compared with placebo, 148 ± 20 versus 123 ± 14 mU/l, respectively (p = 0.03), and the insulinogenic index was higher after anakinra treatment. These results support the concept of involvement of IL‐1β in the (progressive) decrease of insulin secretion capacity associated with type 2 diabetes.
Pharmacological treatment of diabetes in older people

The pharmacological management of diabetes in older people is complex and challenging. It requires a comprehensive understanding of the individual beyond the diabetes itself. Through the ageing years, the older individual presents with diabetes‐related and non‐related comorbidities and complications, develops functional limitations and psychological issues, and may lack social support and access to care. A disturbance in these categories, known as the four geriatric domains, will negatively affect diabetes self‐management and self‐efficacy, leading to poor outcomes and complications. Furthermore, older people with diabetes may be more interested in the management of other chronic conditions such as pain or impaired mobility, and diabetes may be lower in their list of priorities. Proper education must be provided to the older individual and caregivers, with continuous monitoring and counselling, especially when pharmacological interventions offer risks of side effects, adverse reactions and interactions with other medications. Informed shared medical decisions will help to improve adherence to the regimen; however, such discussions ought to be based on the best evidence available, which is unfortunately limited in this age group. We performed a review focused on pharmacological agents and summarize current evidence on their use for the treatment of diabetes in older people. We encourage clinicians to investigate and incorporate the four geriatrics domains in the selection and monitoring of these agents.
Skeletal effects of bariatric surgery: examining bone loss, potential mechanisms and clinical relevance

Bariatric surgery is the most effective therapeutic approach to morbid obesity, resulting in substantial weight loss and improved cardiometabolic profiles; however, a growing body of evidence suggests that bariatric procedures increase both skeletal fragility and the risk of related future fracture secondary to excessive bone loss. Prospective evidence shows that areal bone mineral density (BMD) assessed by dual energy X‐ray absorptiometry (DXA) declines by as much as 14% in the proximal femoral regions, including the femoral neck and total hip, 12 months postoperatively. Lumbar spine areal BMD outcomes show greater 12‐month postoperative variability across surgical procedures (−8 to +6%) and contrast with no change in volumetric BMD outcomes measured by quantitative computed tomography. Diminished mechanical loading, micronutrient deficiency and malabsorption, along with neurohormonal alterations, offer plausible underlying mechanisms to explain these observed post‐bariatric bone changes, but most remain largely unsubstantiated in this population. Importantly, DXA‐based skeletal imaging may have limited utility in accurately detecting bone change in people undergoing bariatric surgery; partly because excessive tissue overlying bone increases the variability of areal BMD outcomes. Moreover, a paucity of fracture and osteoporosis incidence data raises questions about whether marked post‐bariatric surgery bone loss is clinically relevant or a functional adaptation to skeletal unloading. Future studies that use technology which is able to accurately capture the site‐specific volumetric BMD and bone architectural changes that underpin bone strength in people undergoing bariatric surgery, that consider mechanical load, and that better quantify long‐term fracture and osteoporosis incidence are necessary to understand the actual skeletal effects of bariatric surgery.
Pre‐age related maculopathy and the desaturated D‐15 colour vision test

The Desaturated D‐15 colour vision test was used to investigate the colour discrimination of aged normal subjects, subjects with age‐related maculopathy RM), and subjects designated as pre‐age related maculopathy (pre‐ARM). subjects classified as pre‐ARM had normal visual acuity but showed ophthalmoscopically visible pigmentary disturbance at the macula. There were significant losses of colour vision in the pre‐ARM subjects and the ARM subjects compared to the aged normals on the Desaturated D‐15 colour vision test. This decrement in colour discrimination was predominantly a blue‐yellow (tritan) hue confusion. The results indicate that functional changes are occurring in subjects with pigmentary disturbance at the macula before ARM can be diagnosed by conventional clinical criteria.
Cellular and molecular mechanisms of viral infection in the human placenta

Abstract The placenta is a highly specialized organ that is formed during human gestation for conferring protection and generating an optimal microenvironment to maintain the equilibrium between immunological and biochemical factors for fetal development. Diverse pathogens, including viruses, can infect several cellular components of the placenta, such as trophoblasts, syncytiotrophoblasts and other hematopoietic cells. Viral infections during pregnancy have been associated with fetal malformation and pregnancy complications such as preterm labor. In this minireview, we describe the most recent findings regarding virus–host interactions at the placental interface and investigate the mechanisms through which viruses may access trophoblasts and the pathogenic processes involved in viral dissemination at the maternal–fetal interface.
Reticulócitos e hematócrito de cães pré e pós esplenectomia parcial

ABSTRACT The reticulocytes are erythroid cells that exhibitresidual RNA, being released from bone marrow byerythropoietin stimulus in response to tissue hypoxia. After itsrelease from bone marrow, they are temporarily sequestred inthe spleen, where they acquire form of mature erythrocytes.Besides, the spleen is also responsible for storage of the bloodand their elements. The splenectomy is indicated in cases ofsplenic torsion or rupture, symptomatic splenomegaly, andsplenic masses. This study aimed to evaluate the response ofreticulocytes and of hematocrit in dogs submitted to partialsplenectomy. Nine mongrel males and female dogs were used.The samples were obtained one hour before the surgery and48, 96, 144 and 168 hours after this procedure. The findingsdemonstrated that the hematocrit decreases significantly afterthe partial splenectomy. Highest values reticulocytes werereached 96 h after the surgery, followed by a decline in number,nevertheless, the counting was higher than moments before ofthe partial splenectomy.
HUBUNGAN ANTARA OBESITAS DENGAN KEJADIAN HERNIA INGUINALIS

Obesitas atau kelebihan berat badan secara alami akan memiliki tekanan internal yang lebih besar. Tekanan internal tersebut dengan mudah dapat mendorong jaringan lemak dan organ internal menjadi hernia. Data rekam medik RSUD Kabupaten Kudus tahun 2011 terdapat 321 pasien hernia inguinalis dan termasuk dalam 20 besar penyakit. Tujuan dari penelitian ini adalah untuk mengetahui hubungan antara obesitas dengan kejadian hernia inguinalis di Kabupaten kudus tahun 2012. Jenis penelitian ini adalah survei analitik dengan pendekatan kasus kontrol (case control). Kelompok kasus adalah penderita penderita hernia inguinalis di Kabupaten Kudus berjumlah 90 orang. Kelompok kontrol adalah penderita demam thypoid di Kabupaten Kudus berjumlah 90 orang. Tehnik pengambilan sampel dengan cara simple random sampling. Instrumen yang digunakan dalam penelitian ini adalah kuesioner. Analisis data dilakukan secara univariat, bivariat (menggunakan uji chi square dengan α=0,05) dan stratifikasi (menggunakan uji Mantel Heanszel). Hasil penelitian didapatkan bahwa ada hubungan antara obesitas dengan kejadian hernia inguinalis (p value=0,002, OR=0,292, CI=0,131-0,674). Jenis kelamin merupakan variabel perancu dalam hubungan antara obesitas dengan kejadian hernia inguinalis (p value Mantel Haenszel 0,051).
Antiretroviral treatment as prevention.

The numbers that define the scope of the HIV–AIDS pandemic are staggering: 30 years, 60 million infections, 30 million deaths. We have not been defenseless in this fight, however. The introduction of potent combination antiretroviral therapy in 1996 and the public health approach to HIV treatment in resource-limited settings in 2002 have changed the course of the epidemic.1,2 In parallel with treatment, the use of antiretroviral drugs as a prevention tool has been a focus from the beginning of the antiretroviral-therapy era, with the hallmark achievement being the prevention of mother-to-child transmission of the virus. The result has been .
Transplantation for alcoholic hepatitis--time to rethink the 6-month "rule".

Liver transplantation for alcoholic liver disease has been controversial since the advent of the procedure. The perception that alcohol-related liver disease is self-inflicted, combined with concerns about recidivism to alcohol use and poor adherence to post-transplantation care, has led the public and physicians to not support transplantation in patients with alcoholism. After initially avoiding transplantations in this group of patients, the majority of programs now restrict the procedure to those meeting a requirement of a 6-month period of abstinence from alcohol. Unfortunately, a subgroup of patients with severe, acute alcoholic hepatitis has little or no chance of surviving 6 months, .
Single nucleotide polymorphisms of the IL28B and sustained virologic response of patients with chronic hepatitis C to PEG-interferon/ribavirin therapy: A meta-analysis

Background Hepatitis C is a global health problem and represents a major cause of liver disease and socioeconomic burden. Effective antiviral therapy may prevent these complications, but the current treatment for patients with chronic hepatitis C virus (HCV) infection does not produce sustained virologic response. Therefore, identification of the determinants of response to treatment is a high priority. A number of host and viral factors have been associated with treatment outcomes. Objectives To assess the associations of single nucleotide polymorphisms (SNP) of the IL28B and sustained virologic response (SVR) of patients with chronic hepatitis C to PEG-interferon/ribavirin therapy. Materials and Methods We searched PubMed, Medline and Cochrane Library, and found 7 eligible papers involved in this study. Then we performed a meta-analysis comparing the SVR rate at SNP of the IL28B in individuals with PEG-interferon/ribavirin therapy. Meanwhile, the SVR rate between different races and HCV genotypes was studied. Results The sustained virologic response rate was higher in patients with the rs12979860 CC and rs8099917 TT alleles in the IL28B SNP, comparing with the rs12979860 CT, or TT and rs8099917 TG or GG. Furthermore, a higher SVR was observed in the Caucasians than in Afro-Americans (OR = 3.85, 95% CI: 3.06-4.83); the percentage of rs12979860 TT genotype was lower in Caucasians (OR = 0.25, 95% CI: 0.20-0.31) and the percentage of rs12979860 CC genotype was higher in Caucasians than that of Afro-Americans (OR = 3.45, 95% CI = 2.68-4.44). Between different HCV genotypes, the SVR was much lower in those with HCV genotype 1 than those with genotype 2/3 (OR = 0.16, 95% CI: 0.11-0.24). Conclusions IL28B is significantly associated with response to PEG-interferon/ribavirin therapy of patients with chronic HCV infection. Both the rs12979860 and rs8099917 alleles could be used as independent predictors of the treatment response. The rs12979860 allele in particular, is more important from our study. The polymorphism even explains part the difference in response rate between different ethnic groups and HCV genotypes.
NaCl-saturated brines are thermodynamically moderate, rather than extreme, microbial habitats.

NaCl-saturated brines such as saltern crystalliser ponds, inland salt lakes, deep-sea brines and liquids-of-deliquescence on halite are commonly regarded as a paradigm for the limit of life on Earth. There are, however, other habitats that are thermodynamically more extreme. Typically, NaCl-saturated environments contain all domains of life and perform complete biogeochemical cycling. Despite their reduced water activity, ∼0.755 at 5 M NaCl, some halophiles belonging to the Archaea and Bacteria exhibit optimum growth/metabolism in these brines. Furthermore, the recognised water-activity limit for microbial function, ∼0.585 for some strains of fungi, lies far below 0.755. Other biophysical constraints on the microbial biosphere (temperatures of >121°C; pH > 12; and high chaotropicity; e.g. ethanol at >18.9% w/v (24% v/v) and MgCl2 at >3.03 M) can prevent any cellular metabolism or ecosystem function. By contrast, NaCl-saturated environments contain biomass-dense, metabolically diverse, highly active and complex microbial ecosystems; and this underscores their moderate character. Here, we survey the evidence that NaCl-saturated brines are biologically permissive, fertile habitats that are thermodynamically mid-range rather than extreme. Indeed, were NaCl sufficiently soluble, some halophiles might grow at concentrations of up to 8 M. It may be that the finite solubility of NaCl has stabilised the genetic composition of halophile populations and limited the action of natural selection in driving halophile evolution towards greater xerophilicity. Further implications are considered for the origin(s) of life and other aspects of astrobiology.
Vitamin D--baseline status and effective dose.

There has been more ink spilled over the efficacy of vitamin D than over that of most nutrients, with the possible exception of sodium. Why is this? Dozens of randomized, controlled trials have been conducted — some large, and many small. Unfortunately, their results have been inconsistent — some positive, some null, and the odd one or two actually negative. Even the many available meta-analyses on the topic have yielded inconsistent results. If vitamin D is actually efficacious, why is there this inconsistency? In this issue of the Journal, in yet another meta-analysis, Bischoff-Ferrari et al.1 suggest several explanations, including .
Effect of a Primary Care-Based Psychological Intervention on Symptoms of Common Mental Disorders in Zimbabwe: A Randomized Clinical Trial.

Importance Depression and anxiety are common mental disorders globally but are rarely recognized or treated in low-income settings. Task-shifting of mental health care to lay health workers (LHWs) might decrease the treatment gap. Objective To evaluate the effectiveness of a culturally adapted psychological intervention for common mental disorders delivered by LHWs in primary care. Design, Setting, and Participants Cluster randomized clinical trial with 6 months' follow-up conducted from September 1, 2014, to May 25, 2015, in Harare, Zimbabwe. Twenty-four clinics were randomized 1:1 to the intervention or enhanced usual care (control). Participants were clinic attenders 18 years or older who screened positive for common mental disorders on the locally validated Shona Symptom Questionnaire (SSQ-14). Interventions The Friendship Bench intervention comprised 6 sessions of individual problem-solving therapy delivered by trained, supervised LHWs plus an optional 6-session peer support program. The control group received standard care plus information, education, and support on common mental disorders. Main Outcomes and Measures Primary outcome was common mental disorder measured at 6 months as a continuous variable via the SSQ-14 score, with a range of 0 (best) to 14 and a cutpoint of 9. The secondary outcome was depression symptoms measured as a binary variable via the 9-item Patient Health Questionnaire, with a range of 0 (best) to 27 and a cutpoint of 11. Outcomes were analyzed by modified intention-to-treat. Results Among 573 randomized patients (286 in the intervention group and 287 in the control group), 495 (86.4%) were women, median age was 33 years (interquartile range, 27-41 years), 238 (41.7%) were human immunodeficiency virus positive, and 521 (90.9%) completed follow-up at 6 months. Intervention group participants had fewer symptoms than control group participants on the SSQ-14 (3.81; 95% CI, 3.28 to 4.34 vs 8.90; 95% CI, 8.33 to 9.47; adjusted mean difference, -4.86; 95% CI, -5.63 to -4.10; P < .001; adjusted risk ratio [ARR], 0.21; 95% CI, 0.15 to 0.29; P < .001). Intervention group participants also had lower risk of symptoms of depression (13.7% vs 49.9%; ARR, 0.28; 95% CI, 0.22 to 0.34; P < .001). Conclusions and Relevance Among individuals screening positive for common mental disorders in Zimbabwe, LHW-administered, primary care-based problem-solving therapy with education and support compared with standard care plus education and support resulted in improved symptoms at 6 months. Scaled-up primary care integration of this intervention should be evaluated. Trial Registration pactr.org Identifier: PACTR201410000876178.
Dry powder inhalation: technical and physiological aspects, prescribing and use

Inhalation is a convenient way to deliver drugs to the respiratory tract in the treatment of respiratory diseases. Different types of devices, such as pressurised metered dose inhalers (p-MDI's), nebulizers or dry powder inhalers (DPI's) are used for the pulmonary delivery of drugs. The present thesis focuses on dry powder inhalation. Inhalation technology of inhalation therapy with DPI's is not just the administration of powder to the patient, resulting in a clinical effect. Zie: Summary
Aquaretic treatment in polycystic kidney disease.

Autosomal dominant polycystic kidney disease (ADPKD), the most common hereditary kidney disease, progresses relentlessly to end-stage kidney disease before the age of 60 years in half the affected patients. One in 10 patients undergoing dialysis has ADPKD. The disease is characterized by prominent cystic enlargement of the kidneys, which is often associated with episodes of pain, hematuria, and cyst infection. An effective therapy to slow the progression of this disease does not exist, although several promising drug candidates are being tested.1 Vasopressin-mediated cyclic AMP (cAMP) generation is enhanced in polycystic kidneys, driving the proliferation of cyst epithelial cells and the .
Bacteriological and immunological study associated with patients of Urinary Bladder carcinoma

The blood, serum & urine samples are collected from (22) patients with urinary bladder cancer were admitted to Al-Hilla general teaching hospital after diagnosis by helping urology physician. The result appeared that E.coli with high percentage (22.7% ,27.2%)in nixed &single infection respectively followed by Ps.aeuroginosa (22.7% , 13.6%) and S.aureus (18.8% , 9.09%). Interleukin 2 &Interleukin 8 concentration level was detected in serum by enzyme-linked immunosorbent assay(ELISA) and data were compared with control to compare the performance of each cytokins & results show no elevated , no significant decrease in level in two cytokins, this leads to an independent factors for the detection of urinary bladder cancer.
Still no closure on the question of PFO closure.

In approximately 30% of young survivors of stroke, no clear cause is identified despite a thorough evaluation.1 Patent foramen ovale is found on transesophageal echocardiography in about half of these patients, as compared with approximately 25% of the general population. Clinicians, then, often assume that the patent foramen ovale was the cause of the stroke, although it may be incidental in some patients.2–4 The most effective strategy for the prevention of stroke recurrence in such patients is uncertain, and some experts recommend closure of the patent foramen ovale to prevent future embolic events, although high-level data have been lacking.
A novel GIP analogue, ZP4165, enhances glucagon‐like peptide‐1‐induced body weight loss and improves glycaemic control in rodents

To investigate the effects of the novel glucose‐dependent insulinotropic polypeptide (GIP) analogue, ZP4165, on body weight and glycaemic control in rodents, and to investigate if ZP4165 modulates the anti‐obesity and anti‐hyperglycaemic effects of a glucagon‐like peptide‐1 (GLP‐1) agonist (liraglutide).
Clinical profile and seasonality of rotavirus infection in children of Bangladesh

Abstract Rotavirus (RV) is the single most important causative agent for severe dehydrating childhood diarrhea worldwide. RV diarrhea is a tremendous social and economic burden upon the people in developing countries. In Bangladesh, the proportion of RV diarrhea in children is increasing compared to other infectious diarrheal agents primarily because of improvements in water sanitation. This hospital-based cross sectional study was carried out in a children’s hospital of Bangladesh to highlight the clinical presentations and seasonal predilection of RV diarrhea. A total of 601 children under the age of 5 years presenting with acute watery diarrhea were enrolled, with collected stools tested for presence or absence of RV antigen by enzyme linked immunosorbent assay (ELISA). Forty-two percent of the samples were ELISA positive for RV antigen; 72% of those RV+ children were under 12 months of age and 92% were under 24 months. Nausea, vomiting and large families (≥ 5 members) showed significant association with RV+ diarrhea compared to RV- diarrhea (P = 0.004, 0.001 and P = 00.006 respectively). In RV+ diarrhea, the purging rate was also significantly higher (P = 0.043). Mild to moderate fever and dehydration were noted in 82% and 84% cases of RV+ diarrhea respectively. RV+ diarrhea peaked during winter months (January through March). The vulnerable age group, seasonality and clinical presentations of childhood RV diarrhea observed in our study are expected to assist the Bangladeshi health care professionals confidently dealing with this health problem; even if there is little or no laboratory support.