Miracle-dz/UniFAR-FTUs huggingface dataset:
Saving the Limb in Diabetic Patients With Ischemic Foot Lesions Complicated by Acute Infection

Ischemia and infection are the most important factors affecting the prognosis of foot ulcerations in diabetic patients. To improve the outcome of these patients, it is necessary to aggressively treat 2 important pathologies—namely, occlusive arterial disease affecting the tibial and femoral arteries and infection of the ischemic diabetic foot. Each of these 2 conditions may lead to major limb amputation, and the presence of both critical limb ischemia (CLI) and acute deep infection is a major risk factor for lower-extremity amputation. Thus, the management of diabetic foot ulcers requires specific therapeutic approaches that vary significantly depending on whether foot lesions are complicated by infection and/or ischemia. A multidisciplinary team approach is the key to successful treatment of a diabetic foot ulcer: ischemic diabetic foot ulcers complicated by acute deep infection pose serious treatment challenges because high levels of skill, organization, accuracy, and timing of intervention are required to maximize the chances of limb salvage: these complex issues are better managed by a multidisciplinary clinical group.
Detection of Giardia lamblia antigen in children living in a Peruvian periurban shantytown (Pueblo Joven)

Stool microscopy and an enzyme-linked immunosorbent assay (ELISA) for Giardia lamblia antigen detection were compared for detecting G. lamblia in 30 Peruvian infants. Of 1,131 fecal specimens, G. lamblia was detected by ELISA alone in 44, by microscopy alone in 17, and by both methods in 91. In another group of 17 children negative for G. lamblia by stool microscopy, 6 had G. lamblia detected by ELISA or duodenal aspiration: 2 only by ELISA, 1 only by duodenal aspirate examination, and 3 by both examinations. The ELISA is useful for the detection of G. lamblia in fecal specimens but compared to stool microscopy does not significantly increase the detection of cases.
MHC Class I-Related Neonatal Fc Receptor for IgG Is Functionally Expressed in Monocytes, Intestinal Macrophages, and Dendritic Cells1

The neonatal Fc receptor (FcRn) for IgG, an MHC class I-related molecule, functions to transport IgG across polarized epithelial cells and protect IgG from degradation. However, little is known about whether FcRn is functionally expressed in immune cells. We show here that FcRn mRNA was identifiable in human monocytes, macrophages, and dendritic cells. FcRn heavy chain was detectable as a 45-kDa protein in monocytic U937 and THP-1 cells and in purified human intestinal macrophages, peripheral blood monocytes, and dendritic cells by Western blot analysis. FcRn colocalized in vivo with macrosialin (CD68) and Ncl-Macro, two macrophage markers, in the lamina propria of human small intestine. The heavy chain of FcRn was associated with the β2-microglobulin (β2m) light chain in U937 and THP-1 cells. FcRn bound human IgG at pH 6.0, but not at pH 7.5. This binding could be inhibited by human IgG Fc, but not Fab. FcRn could be detected on the cell surface of activated, but not resting, THP-1 cells. Furthermore, FcRn was uniformly present intracellularly in all blood monocytes and intestinal macrophages. FcRn was detectable on the cell surface of a significant fraction of monocytes at lower levels and on a small subset of tissue macrophages that expressed high levels of FcRn on the cell surface. These data show that FcRn is functionally expressed and its cellular distribution is regulated in monocytes, macrophages, and dendritic cells, suggesting that it may confer novel IgG binding functions upon these cell types relative to typical FcγRs: FcγRI, FcγRII, and FcγRIII.
The bvg‐repressed gene brtA, encoding biofilm‐associated surface adhesin, is expressed during host infection by Bordetella bronchiseptica

Bordetella species display phase modulation between Bvg+ and Bvg− phases. Because expression of known virulence factors is up‐regulated in the Bvg+ phase, bacteria in this phase are considered competent for infection. However, the Bvg− phase is of negligible importance for infection. No studies have shown that bacterial factors specific to the Bvg− phase (bvg‐repressed factors) are expressed in the course of Bordetella infection. In the present study, the gene brtA (Bordetella RTX‐family Adhesin), which is a typical bvg‐repressed gene but is expressed in B. bronchiseptica infecting hosts, was characterized. BrtA is composed of repeated pairs of the VCBS unit and dystroglycan‐type cadherin‐like unit, the von Willebrand Factor A domain, RTX motif and type I secretion target signal. It is herein demonstrated that BrtA is secreted by the type I secretion system and is essential for Ca2+‐dependent bacteria‐to‐substrate adherence, followed by biofilm formation. Although the contribution of BrtA to bacterial colonization of the rat trachea currently remains unclear, this is the first study to present concrete evidence for the expression of a bvg‐repressed gene during infection, which may provide a novel aspect for analyses of Bordetella pathogenesis.
European Organization for Research and Treatment of Cancer and Groupe d'Etude des Lymphomes de l'Adulte very favorable and favorable, lymphocyte‐predominant Hodgkin disease

Lymphocyte‐predominant Hodgkin disease (LPHD) is rare and has a natural history different from that of classic Hodgkin disease. There is little information in the literature regarding the role of chemotherapy in patients with early‐stage LPHD. The objective of this study was to examine recurrence free survival (RFS), overall survival (OS), and patterns of first recurrence in patients with LPHD who were treated with radiotherapy alone or with chemotherapy followed by radiotherapy.
A polyarticular onset and diabetes could be the main predictors of cardiovascular events in psoriatic arthritis.

OBJECTIVES We aimed to determine which disease features could be associated to the risk of cardiovascular (CV) events in a PsA cohort from a tertiary care institution. METHODS We conducted an age- and sex-matched case-control study in which the cases were all PsA patients who developed cardiovascular (CV) events during the study period (2010-14). The control group was free of CV events during the same period. Univariate analysis was performed to examine unadjusted associations of potential risk factors. Significant variables in the univariate analysis were then introduced in a multivariate analysis with a backward stepwise approach. RESULTS Of the 206 patients enrolled, 17 (8.3%) patients developed a total of 25 CV events (10 stroke, 9 acute coronary events and 6 ischaemic peripheral vascular events). In univariate analysis these patients showed more pustular psoriasis (OR 5.5, p=0.02), polyarticular onset (OR 3.2, p=0.03), polyarthritis during follow-up (OR 2.9, p=0.04), arthritis onset after 40 yr (OR 3.7, p=0.02), high lipid levels (OR 2.8, p=0.04), hypertension (OR 6.4, p=0.0008), diabetes (OR 12.1, p<0.0001) and lower educational level (OR 3.2, p=0.05). After controlling for age and other confounders, a polyarticular onset of PsA (OR 3.7, p=0.043) and diabetes (OR 8.1, p=0.001) remained as independently related to the risk of CV events. CONCLUSIONS Traditional CV risk factors as well as factors related to the inflammatory nature of the disease were the main predictors of CV complications in this PsA population.
Pancreatic islet blood flow in normal and obese-hyperglycemic (ob/ob) mice.

The present study evaluated whether a microsphere technique could be used for islet blood flow measurements in anesthetized mice. When this was confirmed, we applied the technique in different strains of mice. Approximately 9 x 10(4) microspheres could be given without interfering with mean arterial blood pressure. Mixing of the microspheres with arterial blood was adequate, and the extraction of microspheres in capillary beds was nearly 100%. In NMRI mice whole pancreatic blood flow was estimated to be 0.54 +/- 0.11 ml.min-1.g pancreatic tissue-1 and islet blood flow to be 18 +/- 4 microliters.min-1.g pancreas-1 (n = 12 animals per experiment), whereas corresponding values in lean C57Bl/6 mice were twice as high. In C57Bl/6 mice glucose (3 g/kg iv) doubled islet blood flow without affecting whole pancreatic blood flow, whereas no effect was seen after an equimolar dose of 3-O-methylglucose. In obese-hyperglycemic C57Bl/6 mice, islet blood flow was more than five times higher than in the lean C57Bl/6 mice when expressed as blood flow per gram pancreas. However, when islet blood perfusion was corrected for islet weight, it was lower in the obese than in the lean mice, suggesting an impaired ability in obese mice to increase blood flow in concert with the increased islet mass. This may contribute to the insufficient insulin secretion and resulting hyperglycemia seen in these animals.
Comparing inequalities in health outcomes in European countries

Quality healthcare system is a priority for citizens of any country. Citizens’ health is also a core EU priority. The objective of this article is application of multidimensional statistical techniques as a tool for information value added on health outcomes data in European countries and their further comparison. To achieve this objective, factor analysis and multidimensional comparison methods have been applied to the matrix of 16 healthcare indicators on 25 selected European countries. The synthetic variable allows transforming the countries described by a variety of healthcare indicators into one-dimensional space that considerably simplify monitoring of healthcare inequalities. The obtained results are compared with the results on the self-perceived health status provided by the citizens of the same countries. The results of this comparison have demonstrated significant similarity between self-reported statuses and objectively measured healthcare statuses. The results are presented in a visual form using tables and graphs.
The Sustainable Development Goals (SDGs) and Indigenous Peoples: Another Missed Opportunity?

Abstract Indicators have emerged as a powerful communication tool for complex phenomena in the shift towards quantitative measurement. Indigenous peoples have not been immune to the representation and monitoring of their lives using indicators. Across many of these standard metrics, they consistently underperform. As a result, resources globally and nationally are often targeted at improving these metrics of indigenous populations. Indigenous peoples have not been silent on this matter. In challenging these universal frameworks, they mobilised a self-determination movement which is centred on their worldviews and priorities. The endorsement and ratification of the United Nations Declaration on the Rights of Indigenous Peoples (UNDRIP) have further created a space and impetus to ask how the UNDRIP can be implemented to support indigenous groups around the world to drive their own development agenda. Using a framework informed by UNDRIP and Indigenous knowledge this paper has two aims: 1) to explore if and how the SDGs have reframed policy relating to Indigenous peoples in Australia and Aotearoa New Zealand and 2) to explore how indigenous communities are developing their own indicators to inform their development needs and in the process mitigate the negative governance effects of national goal and target setting.
Alveolar soft part sarcoma ‘revisited’: clinicopathological review of 47 cases from a tertiary cancer referral centre, including immunohistochemical expression of TFE3 in 22 cases and 21 other tumours

Background: Alveolar soft part sarcoma accounts for 0.5–1.0% of soft tissue sarcomas in the United States. At our Hospital, it constitutes 1.8% of the newly diagnosed soft tissue sarcomas. Lately, TFE3 has been found to be a useful immunohistochemical marker for diagnosing this sarcoma. Methods: We reviewed 47 cases of alveolar soft part sarcoma that were either treated at Tata Memorial Hospital, Mumbai, India, or were referred in consultation from various parts of India. TFE3 immunohistochemical staining was performed on 22 alveolar soft part sarcomas and on 21 other tumours. Results: Unlike most other large series, 58% of patients were males and 40% were females. The ages ranged from 2 to 54 years (median 24 years). Tumours were located in the deep soft tissues of lower extremities (54%), upper extremities (13%), head and neck (11%), retroperitoneum (10%), chest wall (6%), pelvis (4%), and were positive for TFE3 (20/22, 91%), desmin (3/18, 16%), myoglobin (1/6, 17%) and smooth muscle actin (1/9, 11%). TFE3 was positive in tumour controls that comprised paragangliomas (3/4), translocation related renal cell carcinoma (1/1), adrenocortical carcinoma (1/3) and granular cell tumour (1/3). Treatment consisted of primary surgical excision, metastatectomy, chemotherapy and radiotherapy. Seven tumours (24%) recurred locally and 21 of 29 (72%) metastasised, mainly to the lungs. Follow-up information (5–108 months, median 27.5 months) was available for 22 patients. No patients died in the relatively short follow-up period. Conclusions: TFE3 is a useful immunohistochemical marker for diagnosis of an alveolar soft part sarcoma. Awareness of other tumours expressing TFE3 is vital. Alveolar soft part sarcoma has a high metastasis rate but relatively good short-term survival. Surgical excision with follow-up forms the present management.
Regulation of baboon fetal adrenal androgen production by adrenocorticotropic hormone, prolactin, and growth hormone.

Factors other than adrenocorticotropic hormone (ACTH) are thought to influence fetal adrenal steroidogenesis during primate pregnancy. Therefore, we determined the effects of prolactin (Prl), growth hormone (GH), and human chorionic gonadotropin (hCG) as well as ACTH on steroid secretion by collagenase-dispersed baboon fetal adrenal cells. Adrenal glands were obtained from seven baboon (Papio anubis) fetuses following cesarean section at Day 100-107 of gestation (term = Day 184). Tissue was minced with a fine scissors and cells were dispersed with 0.2% collagenase, then washed with Medium 199 containing penicillin/streptomycin. Cells (0.5 X 10(4)) were placed in 4 ml Medium 199 with or without 10 nmol ovine Prl, ovine GH, or ACTH, or 50 nmol hCG. After 18 h incubation (37 degrees C), cells were separated by centrifugation and the quantities of cortisol (F), dehydroepiandrosterone (DHA), and DHA-sulfate (DHAS) secreted into the medium were determined. In controls, DHA secretion [224 +/- 96 ng/(24 h X 10(5) cells] was greater (P less than 0.05) than that of DHAS (20 +/- 12) and F (14 +/- 12). Adrenocorticotropic hormone, Prl, and GH stimulated (P less than 0.05) DHA secretion by 370% +/- 71%, 215% +/- 61%, and 292% +/- 73%, respectively; hCG was not effective. Due primarily to the relatively low secretion rates, DHAS and F secretion were not altered by hormonal treatment. Moreover, addition of 20 nmol progesterone to the medium in the presence or absence of ACTH did not influence F production. These findings indicate that the baboon fetal adrenal at midgestation does not utilize placental progesterone for F synthesis. (ABSTRACT TRUNCATED AT 250 WORDS)
Can Frequency-doubling Technology and Short-wavelength Automated Perimetries Detect Visual Field Defects Before Standard Automated Perimetry in Patients With Preperimetric Glaucoma?

PurposeTo assess the ability of frequency-doubling technology (FDT) perimetry and short-wavelength automated perimetry (SWAP) to detect glaucomatous damage in preperimetric glaucoma subjects. ParticipantsTwo hundred seventy-eight eyes of 278 subjects categorized as normal eyes [n=98; intraocular pressure <20 mm Hg, normal optic disc appearance, and standard automated perimetry (SAP)]; preperimetric glaucoma eyes (n=109; normal SAP and retinal nerve fiber layer defects or localized optic disc notching and thinning); and glaucoma patients (n=71; intraocular pressure >21 mm Hg, optic disc compatible with glaucoma, and abnormal SAP). MethodsThe preperimetric glaucoma group underwent at least 2 reliable full-threshold 24-2 Humphrey SAPs, full-threshold C-20 FDT, full-threshold 24-2 SWAP, optic disc topography using the Heidelberg Retina Tomograph II, laser polarimetry using the GDx VCC, and Optical Coherence Tomography (Zeiss Stratus OCT 3000). Receiver operating characteristic curves were plotted for the main Heidelberg Retina Tomograph, Optical Coherence Tomography, and GDx VCC parameters for the normal and glaucoma patients. The area under the receiver operating characteristic curve was used to determine the parameters indicating glaucomatous damage in the optic disc or retinal nerve fiber layer, which were used to establish additional subgroups of patients with preperimetric glaucoma. FDT and SWAP sensitivities were calculated for the patient subsets with structural damage and normal SAP. ResultsAt least 20% of the patients with preperimetric glaucoma demonstrated functional losses in FDT and SWAP. The more severe the structural damage, the greater the sensitivity for detecting glaucomatous visual field losses. ConclusionsFDT and SWAP detect functional losses in cases of suspected glaucoma before glaucomatous losses detected by SAP.
Lower sex hormone levels are associated with more chronic musculoskeletal pain in community-dwelling elderly women

Abstract Chronic pain is more prevalent in women than in men, with increasing differences between sexes in advanced age. This could be caused by differences in sex hormone levels. We therefore studied the relationship between sex hormones and the prevalence and incidence of chronic pain. The association between sex hormone levels and chronic pain was examined in 9717 participants aged 45 years and older from the Rotterdam Study, a population-based study. Chronic pain was defined as pain in the lower back, hands, knees and/or hips for at least 3 months. Sex hormone levels included estrogen, testosterone, androstenedione, and 17-hydroxyprogesterone. Relationships between hormones and prevalent and new onset chronic pain were analyzed using linear and logistic regression, stratified by gender. Women with androstenedione or estradiol levels in the lowest tertile had more chronic pain (odds ratio, 1.20; 95% CI, 1.03-1.39 and odds ratio, 1.27; 95% CI, 1.10-1.48, respectively). Mean estradiol levels were lower among men with chronic pain (mean difference −3.88 pmol/L; P = 0.005). Lowest tertile 17-hydroxyprogesterone in women was associated with 38% more new onset pain. All these associations were independent from age, body mass index, health and lifestyle factors, and osteoarthritis. Lower sex hormone levels are associated with chronic musculoskeletal pain, independent from lifestyle and health-related factors, in community-dwelling elderly women. These results suggest that sex hormones play a role in chronic pain and should be taken into account when a patient presents with chronic pain. Therefore, sex hormones may be a potential treatment target for these patients.
Report on childhood obesity in China (4) prevalence and trends of overweight and obesity in Chinese urban school-age children and adolescents, 1985-2000.

OBJECTIVE To describe the nationwide prevalence of childhood overweight/obesity, and their group variations and trends over the past 20 years in the Chinese urban population. METHODS Data sets of boys and girls at the age of 7-18 years collected from the series of Chinese national surveillance on students' constitution and health (CNSSCH) between 1985 and 2000 were divided into five socioeconomic and demographic groups, while BMI classification reference proposed by Working Group on Obesity in China (WGOC) was used as screening reference to calculate the prevalence and trends of overweight/obesity in these groups. RESULTS In 2000, the prevalence of obesity and overweight in boys aged 7-18 years was 11.3% and 6.5% in Beijing, 13.2% and 4.9% in Shanghai, 9.9% and 4.5% in coastal big cities, and 5.8% and 2.0% in coastal medium/small-sized cities, respectively, while the prevalence of of obesity and overweight in girls of the same age group was 8.2% and 3.7% in Beijing, 7.3% and 2.6% in Shanghai, 5.9% and 2.8% in coastal big cities, and 4.8% and 1.7% in coastal medium/small-sized cities, respectively. The prevalence of obesity was low in most of the inland cities at an early stage of epidemic overweight. The epidemic manifested a gradient distribution in groups, which was closely related to socioeconomic status (SES) of the study population. However, a dramatic and steady increasing trend was witnessed among all sex-age subgroups in the five urban groups, and such a trend was stronger in boys than in girls, and much stronger in children than in adolescents. CONCLUSION Although China is at an early stage of epidemic obesity by and large, the prevalence of obesity in her urban population, particularly in coastal big cities has reached the average level of developed countries. The increasing trend has been rapid since early 1990s, and the increments in obesity and overweight are exceptionally high. The prospect of epidemic obesity in China is in no way optimistic. Therefore, preventive program should be focused on the improvement of the balance between caloric intake and energy expenditure, and interventions aimed at changing children's life styles.
Physical workload and the risk of severe knee osteoarthritis.

OBJECTIVES This study investigated the impact of physical workload on the risk of severe knee osteoarthritis (OA) leading to knee arthroplasty. METHODS In this case-referent study, the cases were 55- to 75-year-old men (N=55) and women (N=226) who had undergone their first knee arthroplasty operation for primary knee OA in the Kuopio University Hospital in 1992-1993. The referents (N=524) were from the same source population and were matched with the cases for age and gender. Information on explanatory variables was obtained by a computer-assisted telephone interview. Exposure was assessed up to 49 years of age. RESULTS After adjustment for body mass index, knee injury and leisure-time physical activity, an increased relative risk of knee OA was found for a history of high physical workload. The odds ratio (OR) was 1.53 [95% confidence interval (95% CI) 0.42-5.56] for the men and 2.03 (95% CI 1.03-3.99) for the women as compared with those with low physical workload. With respect to generic risk factors, climbing already at a medium level of exposure was associated with an increased risk of knee OA among the men (OR 3.06, 95% CI 1.25-7.46) and kneeling and squatting was a risk factor for both genders. Of the different trades, agriculture, forestry, fishing, transportation, and traffic showed the highest risks of knee OA. CONCLUSIONS The results of this study agree with the hypotheses that heavy physical loading increases the risk of knee OA and that cumulative physical stress has a deleterious effect on the knee joint.
Medial patellar ligament splitting for the treatment of upward fixation of the patella in 7 equids.

OBJECTIVE To describe a surgical technique for splitting the proximal third of the medial patellar ligament (MPL) in horses and ponies with upward fixation of the patella (UFP), and to report outcome. STUDY DESIGN Prospective clinical study. SAMPLE POPULATION Four horses and 3 Shetland ponies. METHODS With ultrasound guidance, the proximal third of the MPL was split by percutaneous use of a no. 15 scalpel blade. The rationale for this surgical procedure was to induce a localized desmitis with subsequent ligament thickening. No anti-inflammatory drugs were administered, and horses and ponies were exercised the day after surgery. Clinical, radiographic and ultrasonographic follow-up evaluation was obtained. RESULTS No short-term or long-term complications were observed, and no patients had clinical signs of UFP after surgery. This clinical effect was attributed to a 2- to 3-fold increase in size of the proximal part the MPL from an induced localized desmitis. CONCLUSIONS-Percutaneous splitting of the proximal third of the MPL resolved UFP in equids. CLINICAL RELEVANCE Splitting of the proximal third of the MPL is effective for treatment of UFP and allows rapid return to normal activity.