Miracle-dz/UniFAR-FTUs huggingface dataset:
Lifestyle modifications in the prevention and treatment of hypertension.

OBJECTIVE To present an objective, evidence-based review of the current literature on the role of lifestyle factors in hypertension. METHODS We discuss the reported roles of obesity and overweight, nutritional factors, alcohol, physical activity, and smoking in the prevention and treatment of hypertension. RESULTS For all age-groups and in both sexes, cross-sectional and prospective studies have shown a direct strong relationship between weight and blood pressure. In general, overweight is associated with a twofold to sixfold increase in the risk of developing hypertension. Clinical trials have proved that weight loss is effective in the primary prevention of hypertension as well as in the reduction of both systolic and diastolic blood pressure in patients with normal or high blood pressure. A decreased intake of dietary sodium has been demonstrated to have a hypotensive effect, both alone and as an adjunctive measure to pharmacologic therapy. Although no consensus currently exists about the role of potassium intake in prevention or control of hypertension, some studies support the protective value of high intake of potassium. A consistent relationship has been noted between consumption of alcohol and increased blood pressure, and reduced intake of alcohol has been shown to decrease blood pressure significantly. An inverse relationship exists between blood pressure and physical activity, independent of overweight or obesity. Moreover, increased physical activity helps lower both systolic and diastolic blood pressure. In a study of the effect of smoking and use of smokeless tobacco in healthy middle-aged men, ambulatory diastolic blood pressures were increased in both smokers and smokeless tobacco users in comparison with nonusers. CONCLUSION Ample evidence supports the beneficial effects of healthful lifestyle modifications in the prevention and management of hypertension. Therefore, physicians should be motivated to provide guidance to the population relative to lifestyle practices that can help prevent and control hypertension.
Aetiology of Bacterial Pathogens from Adult Patients with Community-Acquired Pneumonia in Arba Minch Hospital, South Ethiopia

Background: Community-acquired pneumonia (CAP) is major causes of morbidity and mortality. The etiology of CAP varies by geographic region; knowing the etiology might help for the management of the case in case of emergency and to guide treatment. So, in resource limited countries it is wise to identify the most common pathogens of CAP. The objective of this study was to determine bacterial etiology of CAP among adult patients visiting Arba Minch Hospital. Methods: A cross sectional study was conducted in Arba Minch Hospital, Southern Ethiopia from March 01 to June 01, 2013. Data was collected from adult patients with CAP visiting Arba Minch Hospital using face to face interviews, observation using checklist and laboratory examinations. Sputum specimens were collected and microbiological investigations were performed using standard procedures. Data was processed and analyzed with SPSS version16.0 and Excel 2007. Results: Out of 170 cases, only 68 (40%) were culture positive. One pathogen was demonstrated in 63 (92.6%) patients and 6 (7.4%) had mixed infection. The common isolates of single bacterial pathogens from sputum specimens were S. pneumoniae 20 (11.8%), S. aureus 15 (8.8%), P. aeruginosa 10 (5.8%), K. pneumoniae 8 (4.7%), E. coli 4 (2.4%), H. influenzae 4 (2.4%), P. mirabilis 1 (0.6%), and P. vulgaris 1 (0.6%). The commonest mixed bacterial isolate was K. pneumoniae and P. aeruginosa 2(1.2%). Conclusion: In this study, common bacteria isolated were S. pneumoniae, S. aureus and gram negative bacteria. Significant numbers of Gram negative bacteria were isolated which may indicate a shift of infection trend to Gram negative bacteria. Hence, periodic monitoring of etiologic agents with their drug resistant pattern is essential for better management of CAP and treatment strategies.
Pathophysiological roles of endogenous endothelin-1 in dogs with chronic heart failure produced by rapid right ventricular pacing.

This study was designed to analyze the pathophysiological role of the endogenous endothelin (ET) system and the therapeutic approach to congestive heart failure (CHF) with ET(A)/ET(B) receptor antagonists in a canine CHF model. After 3 weeks of rapid right ventricular pacing (240 beats/min), concentrations of immunoreactive ET-1 in dogs increased approximately 2-fold in plasma and in the left and right ventricles but not in the lung. There were no meaningful changes in the density and affinity of total ET receptors, or in the ratio of ET(A) to ET(B) receptors. To clarify the functional role of endogenous ET, we examined the effects of acute injection of J-104132 (1 and 3 mg/kg i.v.), an ET(A)/ET(B) receptor antagonist, on cardiovascular and renal function in dogs with CHF. Compared with vehicle, J-104132 at both doses significantly decreased pulmonary artery pressure (PAP), pulmonary capillary wedge pressure (PCWP), and mean arterial pressure (MAP), and increased cardiac output (CO) and renal blood flow. J-104132 had no effects on heart rate and cardiac contractility. In addition, we examined whether J-104132 has an additive effect in the presence of enalaprilat. J-104132 (1 mg/kg i.v.) administered after enalaprilat (0.05 mg/kg i.v.) induced further decreases in MAP, PCWP and PAP, and further increases in CO, resulting in further decreases in total peripheral resistance. These results indicate that the endogenous ET system is exaggerated in CHF and has a detrimental effect on cardiac function. Therefore, J-104132 given alone or as combination therapy may play a beneficial role in the treatment of CHF in humans.
Splenectomy correlates with increased risk of pulmonary tuberculosis: a case-control study in Taiwan.

This study investigated whether there was an association between splenectomy and pulmonary tuberculosis. This was a case-control study using the database of the Taiwan National Health Insurance Programme. We identified 18 960 patients (aged 20 years or older) with newly diagnosed pulmonary tuberculosis as the case group and 73 988 participants without pulmonary tuberculosis as the control group from 1998 to 2011. Both groups were matched for sex, age (per 5 years) and index year of pulmonary tuberculosis diagnosis. The risk of pulmonary tuberculosis associated with splenectomy and other co-morbidities was estimated. After controlling for confounders, multivariable logistic regression analysis showed that the odds of pulmonary tuberculosis were 1.91 in patients with splenectomy (95% CI 1.06-3.44), compared with the participants without splenectomy. Chronic obstructive pulmonary diseases (OR 3.07, 95% CI 2.94-3.21), pneumoconiosis (OR 2.20, 95% CI 1.90-2.56), chronic kidney diseases (OR 1.49, 95% CI 1.33-1.67), diabetes mellitus (OR 1.57, 95% CI 1.50-1.64) and chronic liver diseases (OR 1.31, 95% CI 1.25-1.37) were associated with an increased risk of pulmonary tuberculosis. The sub-analysis demonstrated that the odds of pulmonary tuberculosis were 4.81 (95% CI 2.31-10.0) for patients co-morbid with splenectomy and any of the above diseases. Splenectomy is associated with a 1.9-fold increased risk of pulmonary tuberculosis in Taiwan. There is a synergistic effect between splenectomy and other co-morbidities on the risk of pulmonary tuberculosis.
Non‐invasive bronchial epithelial papillary tumors

Nineteen papillary, non‐invasive tumors arising from the bronchial epithelium but excluding carcinoid tumors are reviewed. Eight were solitary papillomas of which three were covered with a mixture of epithelial types. Seven were benign but one had a focus of carcinoma in situ. A similar change was seen in bronchial epithelium adjacent to a papilloma. Two cases of recurrent papillomas were seen and in one, carcinomatous changes eventually occurred. Two combined benign bronchial cystadenomas with papillomas are described. One transitional celled papillary carcinoma in situ and five other papillary carcinomas in situ are described. One bronchial papilioma covered with dysplastic epithelium was considered an intermediate stage in the development of carcinoma in situ. Two papillary tumors may have arisen from peripheral bronchi or bronchioles. Their lining cells resembled Clara cells, they grew by local expansion, and there was an absence of malignant features. The differential characteristics of two secondary carcinomatous polypoidal tumors are described.
The diversity of seizures related to alcohol use. A study of consecutive patients

The aim of the sudy was to investigate the influence of hazardous alcohol drinking on the occurrence of epileptic seizures, the semiology of such seizures, and the extent of the problem. A consecutive sample of 142 acute seizure patients (78 male and 64 female, mean age 46 (16–79) years) was studied. Control groups were 185 consecutive sciatica patients and 254 healthy individuals. Subjects with a hazardous alcohol drinking level were identified by a score>8 in the Alcohol Use Disorders Identification Test (AUDIT). Seizures in AUDIT‐positive individuals occurring withing 72 h of the last drink were considered to be related to alcohol withdrawal. Generalized or partial onset seizures were classified on the basis of history, electroencephalographic (EEG) and neuroradiological findings. Thirty‐five percent of seizure patients were AUDIT‐positive, whereas conversely 27% were abstainers. Two‐thirds of AUDIT‐positive seizure patients met the criteria for withdrawal seizures. Indications of partial onset seizures were found in 25 (51%) of AUDIT‐positive patients, all secondarily generalized seizures. Sixty percent of generalized onset sizure patients were AUDIT‐positive. In conclusion, seizure patients included significantly more AUDIT‐positive subjects, as well as abstainers, than healthy Norwegian controls and consecutive sciatica patients from our hospital. Partial onset seizures are more frequent among hazardous drinkers than hitherto recognized. A generalized onset seizure in adults warrants a high suspicion of alcohol as a provoking factor. Routine screening of acute seizure admission with the Alcohol Use Disorders Identification Test is recommended.
Two Cases of Keratoconus Diagnosed After Pregnancy

Purpose. This case report aims to demonstrate that pregnancy-induced biomechanical corneal changes in combination with risk factors for ectasia can develop into (the exacerbation of) keratoconus. Case Report. We describe two women who were clinically diagnosed with keratoconus after their second pregnancy. Both women were myopic and had a history of allergies and contact lens wear. It is unclear whether these two women had a newly diagnosed keratoconus that developed during pregnancy or had experienced an exacerbation of an unrecognized, subclinical keratoconus. Conclusions. Nowadays, documented progression of keratoconus can be treated by corneal crosslinking to stabilize the weakened cornea. Therefore, it is important to understand the effects of hormonal changes in (keratoconic) eyes during pregnancy and to include topographic imaging in unexplained visual deterioration in young individuals, especially during or after a pregnancy.
Dialysis Unmasks the Fungicidal Properties of Glandular Salivary Secretions

ABSTRACT Several salivary proteins exhibit fungicidal activity against the opportunistic oral pathogen Candida albicans when they are tested as pure proteins in vitro. However, salivary secretions that are examined by the same assays either lack or exhibit very low candidacidal activity. Since ionic strength is known to have an inhibitory effect on the fungicidal activities of some proteins, parotid secretion was subjected to dialysis with membranes having molecular weight cutoffs (MWCOs) of 500, 1,000, 10,000, and 25,000. Dialysis with membranes with MWCOs of ≥1,000 promoted fungicidal activity of parotid secretion, and this activity was dose dependent. The addition of sodium chloride to dialyzed, fungicidal parotid secretion abolished this activity, indicating that the fungicidal component was salt sensitive. Similar results were obtained with submandibular and sublingual secretions. Polyacrylamide gel electrophoresis under native and denaturing conditions was used to analyze the composition of the dialysate. Unexpectedly, proteins with MWs much lower than the nominal MWCOs of the membranes were not lost during dialysis. Among the retained proteins, the two fractions with MWs of approximately 17,000 and 4,000 exhibited fungicidal activity. These results are consistent with the presence of lysozyme and histatins, respectively, which may represent the major candidacidal capacity of dialyzed parotid secretion.
Correlation between Antifungal Susceptibilities ofCoccidioides immitis In Vitro and Antifungal Treatment with Caspofungin in a Mouse Model

ABSTRACT Caspofungin (Merck Pharmaceuticals) was tested in vitro against 25 clinical isolates of Coccidoides immitis. In vitro susceptibility testing was performed in accordance with the National Committee for Clinical Laboratory Standards document M38-P guidelines. Two C. immitis isolates for which the caspofungin MICs were different were selected for determination of the minimum effective concentration (MEC), and these same strains were used for animal studies. Survival and tissue burdens of the spleens, livers, and lungs were used as antifungal response markers. Mice infected with strain 98-449 (48-h MIC, 8 μg/ml; 48-h MEC, 0.125 μg/ml) showed 100% survival to day 50 when treated with caspofungin at ≥1 mg/kg. Mice infected with strain 98-571 (48-h MIC, 64 μg/ml; 48-h MEC, 0.125 μg/ml) displayed ≥80% survival when the treatment was caspofungin at ≥5 mg/kg. Treatment with caspofungin at 0.5, 1, 5, or 10 mg/kg was effective in reducing the tissue fungal burdens of mice infected with either isolate. When tissue fungal burden study results were compared between strains, caspofungin showed no statistically significant difference in efficacy in the organs of the mice treated with both strains. A better in vitro-in vivo correlation was noted when we used the MEC instead of the MIC as the endpoint for antifungal susceptibility testing. Caspofungin may have a role in the treatment of coccidioidomycosis.
Analysis of Foramen Ovale Electrode‐Recorded Seizures and Correlation with Outcome Following Amygdalohippocampectomy

Summary: We report a detailed electroclinical analysis of 320 seizures recorded by foramen ovale electrodes in 77 potential candidates for selective temporal lobe surgery because of antiepileptic drug‐resistant seizures. The exact localization of the origin of seizure discharges, the electroencephalographic (EEG) seizure onset patterns, transhemispheric propagation, propagation time, duration of discharge, laterality of discharge termination, postictal focal slowing, correspondence between foramen ovale recordings and the scalp EEG, and the influence of antiepileptic drug modifications were studied and correlated with the clinical seizure semiology and with postoperative outcome following selective amygdalohippocampectomy. In general, the foramen ovale electrode technique provided good neurophysiological information in candidates for selective amygdalohippocampectomy. The following ictal signs predicted a good surgical outcome: (a) unilateral and anterior mediobasal temporal lobe seizure onset, (b) short seizure duration, (c) no or infrequent contralateral seizure discharge propagation, and (d) if propagation to the contralateral mediobasal temporal lobe occurred, the postoperative outcome was better the later the contralateral mediobasal temporal lobe was affected. Postoperative outcome was also better the less frequently contralateral interictal spikes occurred. No direct predictive value could be attributed to the presence of an initial arrest reaction.
Non-epithelial lesions of the larynx: review of the 10-year experience in a tertiary Spanish hospital

Conclusion. In this report we review the diagnosis, therapy, and outcome of laryngeal non-epìthelial tumors and comment on the literature on these rare lesions. Objectives. Non-epithelial tumors of the larynx are rather rare and most cases have been reported as isolated or short series of cases from different centers all over the world. The aim of the present study was to review the 10-year experience with non-epithelial lesions in a 400-bed tertiary hospital covering a population of almost 250 000 people in Madrid, Spain. Patients and methods. We reviewed 2631 laryngeal samples corresponding to this time period. Results. In all, 737 corresponded to carcinomas (726 squamous cell carcinomas). We had two cases of chondrosarcoma, one case of liposarcoma, one case of synovial sarcoma, and one neural benign tumor, suggestive of neurinoma. In this period we also had an inflammatory pseudotumor affecting the vocal cord, a case of primary laryngeal extramedullary plasmocytoma, and one case of high grade diffuse malignant lymphoma with exclusive involvement of the larynx. In our series most patients were women (five vs three patients) and ages ranged between 12 and 92 years.
Zebrafish Cxcr4a determines the proliferative response to Hedgehog signalling

The Hedgehog (Hh) pathway plays dual roles in proliferation and patterning during embryonic development, but the mechanism(s) that distinguish the mitogenic and patterning activities of Hh signalling are not fully understood. An additional level of complexity is provided by the observation that Hh signalling can both promote and inhibit cell proliferation. One model to account for this apparent paradox is that Hh signalling primarily regulates cell cycle kinetics, such that activation of Hh signalling promotes fast cycling and an earlier cell cycle exit. Here we report that activation of Hh signalling promotes endodermal cell proliferation but inhibits proliferation in neighbouring non-endodermal cells, suggesting that the cell cycle kinetics model is insufficient to account for the opposing proliferative responses to Hh signalling. We show that expression of the chemokine receptor Cxcr4a is a critical parameter that determines the proliferative response to Hh signalling, and that loss of Cxcr4a function attenuates the transcription of cell cycle regulator targets of Hh signalling without affecting general transcriptional targets. We show that Cxcr4a inhibits PKA activity independently of Hh signalling, and propose that Cxcr4a enhances Hh-dependent proliferation by promoting the activity of Gli1. Our results indicate that Cxcr4a is required for Hh-dependent cell proliferation but not for Hh-dependent patterning, and suggest that the parallel activation of Cxcr4a is required to modulate the Hh pathway to distinguish between patterning and proliferation.
Proton Pump Inhibitor Resistance in the Treatment of Laryngopharyngeal Reflux

OBJECTIVE: To describe the occurrence of relative proton pump inhibitor (PPI) drug resistance in the treatment of laryngopharyngeal reflux (LPR). STUDY DESIGN AND SETTING: A retrospective review was performed for 1053 consecutive adults undergoing double-probe (simultaneous esophageal and pharyngeal) pH testing in our laboratory. Two hundred five patients who had pH studies performed while taking at least a daily dose of PPI therapy were identified; 167 qualified for further analysis. The pH data was reviewed for the presence of abnormalities in either esophageal or pharyngeal acid exposure to evaluate drug efficacy. RESULTS: Forty-four percent (74/167) of the study patients demonstrated abnormal levels of acid exposure. Results were further analyzed to compare failure rates based on different dosage regimens. Patients on once daily doses of PPI failed at a rate of 56%, with lower failure rates for higher-dose regimens. CONCLUSIONS: A significant number of LPR patients on PPI therapy demonstrate relative drug resistance.
Cloning and immunoreactivity of the 5‐HT1Mac and 5‐HT2Mac receptors in the central nervous system of the freshwater prawn Macrobrachium rosenbergii

Biogenic amines are implicated in several mental disorders, many of which involve social interactions. Simple model systems, such as crustaceans, are often more amenable than vertebrates for studying mechanisms underlying behaviors. Although various cellular responses of biogenic amines have been characterized in crustaceans, the mechanisms linking these molecules to behavior remain largely unknown. Observed effects of serotonin receptor agonists and antagonists in abdomen posture, escape responses, and fighting have led to the suggestion that biogenic amine receptors may play a role in modulating interactive behaviors. As a first step in understanding this potential role of such receptors, we have cloned and fully sequenced two serotonin receptors, 5‐HT1Mac and 5‐HT2Mac, from the CNS of the freshwater prawn Macrobrachium rosenbergii and have mapped their CNS immunohistochemical distribution. 5‐HT1Mac was found primarily on the membranes of subsets of cells in all CNS ganglia, in fibers that traverse all CNS regions, and in the cytoplasm of a small number of cells in the brain and circum‐ and subesophageal ganglia (SEG), most of which also appear to contain dopamine. The pattern of 5‐HT2Mac immunoreactivity was found to differ significantly; it was found mostly in the central neuropil area of all ganglia, in glomeruli of the brain's olfactory lobes, and in the cytoplasm of a small number of neurons in the SEG, thoracic, and some abdominal ganglia. The observed differences in terms of localization, distribution within cells, and intensity of immunoreactive staining throughout the prawn's CNS suggest that these receptors are likely to play different roles. J. Comp. Neurol. 513:399–416, 2009. © 2009 Wiley‐Liss, Inc.
Statistical analysis with missing exposure data measured by proxy respondents: a misclassification problem within a missing‐data problem

In studies of older adults, researchers often recruit proxy respondents, such as relatives or caregivers, when study participants cannot provide self‐reports (e.g., because of illness). Proxies are usually only sought to report on behalf of participants with missing self‐reports; thus, either a participant self‐report or proxy report, but not both, is available for each participant. Furthermore, the missing‐data mechanism for participant self‐reports is not identifiable and may be nonignorable. When exposures are binary and participant self‐reports are conceptualized as the gold standard, substituting error‐prone proxy reports for missing participant self‐reports may produce biased estimates of outcome means. Researchers can handle this data structure by treating the problem as one of misclassification within the stratum of participants with missing self‐reports. Most methods for addressing exposure misclassification require validation data, replicate data, or an assumption of nondifferential misclassification; other methods may result in an exposure misclassification model that is incompatible with the analysis model. We propose a model that makes none of the aforementioned requirements and still preserves model compatibility. Two user‐specified tuning parameters encode the exposure misclassification model. Two proposed approaches estimate outcome means standardized for (potentially) high‐dimensional covariates using multiple imputation followed by propensity score methods. The first method is parametric and uses maximum likelihood to estimate the exposure misclassification model (i.e., the imputation model) and the propensity score model (i.e., the analysis model); the second method is nonparametric and uses boosted classification and regression trees to estimate both models. We apply both methods to a study of elderly hip fracture patients. Copyright © 2014 John Wiley & Sons, Ltd.