Miracle-dz/UniFAR-FTUs huggingface dataset:
Genetic factors influencing severe atazanavir-associated hyperbilirubinemia in a population with low UDP-glucuronosyltransferase 1A1*28 allele frequency.

BACKGROUND High prevalence of severe atazanavir-associated hyperbilirubinemia in Asians with low prevalence of the UDP-glucuronosyltransferase (UGT)1A1*28 polymorphism suggests the importance of genetic factors other than UGT1A1*28 for atazanavir-associated hyperbilirubinemia in these populations. METHODS Serum bilirubin levels were measured in 129 Korean human immunodeficiency virus-infected patients 3 months after initiation of atazanavir (400 mg per day) with good adherence to medication. The multidrug resistance gene 1 (MDR1) C3435T and G2677T/A variations and UGT1A1*6 and *28 were examined by direct sequencing of DNA from peripheral whole blood samples. The associations between genetic polymorphisms and severe (grade 3-4) hyperbilirubinemia were evaluated using multivariate logistic regression analysis including demographic and clinical variables. RESULTS The median patient age was 39 years (interquartile range, 34-51 years), and 91% were men. At baseline, the median CD4 cell count was 261 cells/microL (interquartile range, 181-405 cells/microL). Severe hyperbilirubinemia was detected in 27 patients (21%). The independent risk factors for severe hyperbilirubinemia were low baseline CD4 cell count (adjusted odds ratio per 10 cells/microL increase, 0.97; 95% confidence interval, 0.94-0.99), UGT1A1*28 (adjusted odds ratio, 4.15; 95% confidence interval, 1.46-11.84), and MDR1 G2677T/A (adjusted odds ratio, 9.65; 95% confidence interval, 1.09-85.61). Of 19 patients with wild-type alleles for both MDR1 2677 and UGT1A1*28, none developed severe hyperbilirubinemia. CONCLUSION The MDR1 G2677T/A variation and UGT1A1*28 are independent risk factors for severe atazanavir-associated hyperbilirubinemia in Korean human immunodeficiency virus-infected patients.
Atlanto‐axial subluxation in the dog: a review of thirty cases and an evaluation of treatment by lag screw fixation

The clinical and radiological features of atlanto-axial subluxation in the dog are described with reference to a series of 30 cases. Two methods of treatment were evaluated. In 13 dogs, a dorsal approach was used and the atlas and axis stabilised with a wire suture. Four cases had respiratory arrests during surgery; one of these and seven others made full recoveries after wiring. In 10 dogs treated by lag screw fixation of the ventral articular facets there were no complications during surgery and nine of these recovered within two months. Atlanto-axial subluxation was diagnosed in 30 dogs referred to the Department of Veterinary Surgery, University of Bristol between 1977 and 1986. The condition was encountered in six small breeds of dog and was seen most frequently in the Yorkshire
Comparison of 2 different regimens for reactogenicity, safety, and immunogenicity of the live attenuated oral rotavirus vaccine RIX4414 coadministered with oral polio vaccine in South African infants.

BACKGROUND A phase II, randomized, double-blind, placebo-controlled study was conducted in South Africa during 2003-2004 to evaluate the safety, reactogenicity, and immunogenicity of 2 regimens of the live attenuated oral human rotavirus vaccine RIX4414 when coadministered with the Expanded Program on Immunization childhood vaccines, including oral polio vaccine. METHODS Healthy infants were randomized (2:2:1) to receive either 2 doses of RIX4414 (n = 190; at 10 and 14 weeks, with placebo at 6 weeks), 3 doses of RIX4414 (n = 189; at 6, 10, and 14 weeks), or 3 doses of placebo (n = 96), all with concomitant routine vaccinations. The antirotavirus IgA seroconversion rate was assessed using enzyme-linked immunosorbent assay at 2 months after the last dose of RIX4414 or placebo. Antipolio types 1, 2, and 3 antibodies were measured using a virus neutralization assay. Solicited symptoms were recorded for 15 days after each dose. RESULTS The antirotavirus IgA seroconversion rates were similar in the RIX4414 2- and 3-dose groups (44.3% and 44.4%, respectively; P = .544, by 1-sided Fisher exact test) and antirotavirus IgA geometric mean concentrations were also comparable. Seroprotection rates for antipolio types 1, 2, and 3 antibodies were high (93%-100%) and were not significantly different among groups. Solicited symptoms reported within 15 days after vaccination were similar in all groups. CONCLUSIONS The immune seroconversion response to the RIX4414 vaccine with 3 doses was not superior to the 2-dose regimen. There was no interference by either regimen with antibody response to oral polio vaccine, and RIX4414 was well tolerated when given with routine vaccinations.
Child-headed households as contested spaces: Challenges and opportunities in children's decision-making

This article explores the constraints and opportunities in children's decision-making in child-headed households (CHHs). It draws from the findings of an explorative study of 30 CHHs carried out in Harare, Zimbabwe in 2007. Relatively little is known about how children make decisions in CHHs, notwithstanding the fact that understanding this process can be an entry way into their lifeworlds. Situated semi-structured interviews were used with older children from the ages of 11–17 years and participatory methods with children from the ages of 5–10 years to investigate decision-making in CHHs. The findings seem to reveal that some of the children in CHHs are active agents who try in their own way to make sense of their situations and to act within their capacities to improve their experiences. Initiatives to assist them should therefore be planned, taking into account the fact that they can contribute solutions to the challenges they encounter in their daily lives.
The effect of high-dose vitamin A supplementation given with bacille Calmette-Guérin vaccine at birth on infant rotavirus infection and diarrhea: a randomized prospective study from Guinea-Bissau.

BACKGROUND Prophylactic vitamin A supplementation (VAS) reduces mortality and may reduce morbidity associated with diarrhea in children >6 months of age. Rotavirus is the most common cause of acute dehydrating diarrhea among children worldwide. METHODS In a randomized placebo-controlled study of 50,000 IU of vitamin A versus placebo given with bacille Calmette-Guérin vaccine at birth, 287 infants were followed up with weekly interviews and stool sample obtainment to test the hypothesis that VAS reduced the risk of rotavirus infection. RESULTS VAS was associated with increased risk of rotavirus infection and diarrhea (incidence rate ratio [IRR] of infection, 1.72 [95% confidence interval (CI), 1.04-2.85]; IRR of diarrhea, 3.74 [95% CI, 1.40-9.98]) among children <6 months of age. There was no effect in older children. VAS had a beneficial effect on nonrotavirus diarrhea in boys <6 months of age (IRR, 0.51; 95% CI, 0.27-0.95) and a detrimental effect in girls >6 months of age (IRR, 1.84; 95% CI, 0.96-3.55). CONCLUSION VAS at birth did not reduce rotavirus morbidity. The effect of VAS on nonrotavirus diarrhea may differ by sex, being more beneficial in boys. Clinical trials registration. NCT00168597 .
Factors associated with seropositivity of 2009 H1N1 influenza in Beijing, China.

sulatum. Multiple shallow ulcers on the distal ileum and throughout the colon were observed during colonoscopy. Yeast forms of P. brasiliensis (Figure 1B) and H. capsulatum (Figure 1C) were identified in a colonic tissue sample. Intravenous amphotericin B deoxycholate was started and was followed by oral itraconazole, with good clinical response. The third patient was a 40-year-old woman admitted with a 1-year history of diarrhea and weight loss. Physical examination showed a debilitated patient with mild hepatomegaly. Sputum, stool, and colonic tissue samples obtained via colonoscopy were positive for P. brasiliensis (Figure 1D). Amphotericin B deoxycholate was started, but the patient died of sepsis due to Listeria monocytogenes. The fourth patient was a 79-year-old woman admitted with a 1-month history of dyspnea and weight loss. HTLV-1 infection had been diagnosed 12 years previously. A 5-year history of recurrent episodes of fever and cough was elicited. Physical examination revealed a chronically ill patient in respiratory distress with diffuse inspiratory rales. Bronchial washing revealed yeast forms of P. brasiliensis, which were also observed in a lung tissue sample obtained via transbronchial biopsy. A chest computed tomographic image showed extensive pulmonary disease with bronchiectasis and cavitary lesions (Figure 1E). Amphotericin B deoxycholate and broad-spectrum antibiotics were started, but the patient did not recover and died a few days later. To our knowledge, this is the first description of coinfection with P. brasiliensis and HTLV-1. Complex host-pathogen interactions modulate the clinical presentation of paracoccidioidomycosis. Patients with the juvenile or subacute form display a predominant type 2 T helper (Th2) cytokine pattern, whereas patients with more chronic forms display a predominant type 1 T helper response [2–4]. HTLV-1 blunts the Th2 cytokine pattern and predisposes to disseminated strongyloidiasis, and there is evidence from observational studies that it increases mortality among patients with tuberculosis [5, 6]. We could not confirm that the widespread paracoccidioidomycosis resulted from HTLV-1–induced cellular immunosuppression. However, the aberrant clinical picture with documented coinfection with multiple pathogens observed in patients 2 and 3 and the severe chronic multifocal presentation observed in patients 1 and 4 suggests the presence of an underlying immunosuppressive condition. Additional studies are needed to evaluate the true association between these 2 conditions, with a focus on the prevalence of the coinfection and the host immunologic response. Clinicians should be aware of this potentially lethal association.
A Randomized Comparative Trial of Continued Zidovudine/Lamivudine or Replacement With Tenofovir Disoproxil Fumarate/Emtricitabine in Efavirenz-Treated HIV-1-Infected Individuals

Background:Long-term antiretroviral therapy dramatically reduces HIV-related morbidity and mortality but is also associated with metabolic and morphological changes and requires high levels of adherence. Methods:A randomized, 48-week, open-label, comparative study of continuation of twice-daily zidovudine/lamivudine or replacement with once-daily tenofovir disoproxil fumarate/emtricitabine in individuals on successful efavirenz-based antiretroviral therapy. Limb fat mass was assessed by dual x-ray absorptiometry in a subset of participants through week 48. Results:Two hundred thirty-four individuals were randomized and treated (117 each to continue or switch) with 206 subjects completing 48 weeks of study. Five percent subjects in the continue group and 3% subjects in the switch group discontinued due to adverse events. By intent-to-treat, missing = failure analysis, no differences in virological efficacy were observed at any time point (week 48 <50 copies/mL continue 85%, switch 88%). At week 24, switching was associated with significant increases in hemoglobin (mean difference 0.37 g/dL, 95% confidence interval: 0.15 to 0.58 g/dL, P < 0.001) and significant declines in total cholesterol and triglycerides. In the dual x-ray absorptiometry substudy (n = 100), fat was preserved or increased in the switch group but declined in the continue group (mean difference 448 g, 95% confidence interval: 57 to 839 g, P = 0.025). Individuals with longer exposure to zidovudine and lower baseline limb fat experienced less limb fat increase after switching. No differences in renal adverse events were observed between groups. Conclusions:Switching from zidovudine/lamivudine to tenofovir disoproxil fumarate/emtricitabine in persons on efavirenz therapy maintains virological control, establishes a once-daily regimen, results in improvements in hemoglobin and key lipid parameters, and preserves and restores limb fat relative to continuation of zidovudine/lamivudine.
The Acute Effects of HIV Protease Inhibitors on Insulin Suppression of Glucose Production in Healthy HIV-Negative Men

Background:The effects of different HIV protease inhibitors (PIs) on peripheral insulin resistance have been described, but less is known about their effects on insulin suppression of endogenous glucose production (EGP). Methods:We tested the acute effects of 3 PIs, indinavir, ritonavir, and amprenavir, on EGP quantified by stable isotope techniques during the hyperinsulinemic, euglycemic clamp in 3 similar placebo-controlled protocols. Results:EGP was higher with indinavir in the hyperinsulinemic state than with placebo (4.1 ± 1.3 vs. 2.2 ± 0.8 μg·kg−1·min−1, P = 0.04). A trend toward higher EGP was seen with ritonavir (3.6 ± 0.3 vs. 3.0 ± 0.5 μg·kg−1·min−1, P = 0.08). There was no evidence that amprenavir blunted insulin suppression of EGP compared with placebo (2.9 ± 0.04 vs. 3.2 ± 0.7 μg·kg−1·min−1, P = 0.63). Conclusions:Some PIs can acutely blunt the ability of insulin to suppress EGP, but, as with insulin resistance, the effects of PIs on EGP are drug-specific, not class-specific.
A Meta-Analysis of the Incidence of Non-AIDS Cancers in HIV-Infected Individuals

Objective:To estimate summary standardized incidence ratios (SIRs) of non-AIDS cancers among HIV-infected individuals compared with general population rates overall and stratified by gender, AIDS, and highly active antiretroviral therapy (HAART) era. Design:A meta-analysis using SIRs from 18 studies of non-AIDS cancer in HIV-infected individuals. Methods:SIRs for non-AIDS cancers in HIV-infected individuals and 95% confidence limits (CLs) were abstracted from each study. Random effects meta-analyses were used to estimate summary SIRs. Modifications by gender, AIDS, and HAART era were estimated with meta-regression. Results:Four thousand seven hundred ninety-seven non-AIDS cancers occurred among 625,716 HIV-infected individuals. SIRs for several cancers were elevated. In particular, cancers associated with infections, such as anal (SIR = 28; 95% CL 21 to 35), liver (SIR = 5.6; 95% CL 4.0 to 7.7), and Hodgkin lymphoma (SIR = 11; 95% CL 8.8 to 15) and smoking, such as lung (SIR = 2.6; 95% CL 2.1 to 3.1), kidney (SIR = 1.7; 95% CL 1.3 to 2.2), and laryngeal (SIR = 1.5; 95% CL 1.1 to 2.0). AIDS was associated with greater SIRs for Hodgkin lymphoma, leukemia, lung, brain, and all non-AIDS cancers combined. Conclusions:HIV-infected individuals may be at an increased risk of developing non-AIDS cancers, particularly those associated with infections and smoking. An association with advanced immune suppression was suggested for certain cancers.
Telehealth with 3D games for stroke rehabilitation

Abstract This study explores the feasibility of a novel telehealth system for stroke rehabilitation in a rural area in Sweden. It addresses two major problems of home-based rehabilitation: training motivation and frequent meetings. Three stroke subjects were equipped with 3D computer games workbenches, and were instructed to play with the hemiplegic upper extremity. On-line coaching meetings were performed using bidirectional audiovisual communication. The intervention led to clinical changes for all subjects. On-line coaching is promising, but not yet as effective as desired. However, a distance based approach using 3D games for upper extremity rehabilitation after stroke is feasible.
Diagnostic utility of abdominal ultrasonography in dogs with chronic vomiting.

BACKGROUND Chronic vomiting is a common problem in dogs that has many causes. Ultrasonographic descriptions of many gastrointestinal (GI) diseases have been published. However, diagnostic utility of ultrasonography in dogs with chronic vomiting has not been investigated. HYPOTHESIS Diagnostic utility of abdominal ultrasound will be highest in dogs with GI neoplasia and lowest in those with inflammatory disorders. ANIMALS Eighty-nine pet dogs with chronic vomiting. METHODS Medical records were reviewed and the contribution of abdominal ultrasound to the clinical diagnosis was subjectively scored. RESULTS In 68.5% of dogs, the reviewers thought that the same diagnosis would have been reached without performing ultrasonography. In 22.5% of dogs, the ultrasound examination was considered to be vital or beneficial to the diagnosis. Univariable analysis identified that increased diagnostic utility was associated with increasing age, a greater number of vomiting episodes per week, presence of weight loss, a greater percentage of lost body weight, and a final diagnosis of GI lymphoma or gastric adenocarcinoma. However, multivariate analysis only identified increasing age and a final diagnosis of gastric adenocarcinoma or GI lymphoma to be associated with increased diagnostic utility. In 12.4% of dogs, additional benefits of ultrasonography to case management, excluding the contribution to the vomiting problem, were identified. CONCLUSIONS AND CLINICAL IMPORTANCE The diagnostic utility of abdominal ultrasonography was high in 27% of dogs. The presence of factors that are associated with high diagnostic utility is an indication to perform abdominal ultrasonography in dogs with chronic vomiting.
Survival and the development of azotemia after treatment of hyperthyroid cats.

BACKGROUND Hyperthyroidism complicates the diagnosis of chronic kidney disease (CKD) as it increases glomerular filtration rate. No practical and reliable means for identifying those cats that will develop azotemia after treatment for hyperthyroidism has been identified. Hyperthyroidism is associated with proteinuria. Proteinuria has been correlated with decreased survival of cats with CKD and with progression of CKD. HYPOTHESIS Proteinuria and other clinical parameters measured at diagnosis of hyperthyroidism will be associated with the development of azotemia and survival time. ANIMALS Three hundred client owned hyperthyroid cats treated in first opinion practice. METHODS Retrospective, cohort study relating clinical parameters in hyperthyroid cats at diagnosis to the development of azotemia within 240 days of diagnosis and survival time (all cause mortality). Multivariable logistic regression analysis was used to identify factors that were predictive of the development of azotemia. Multivariable Cox regression analysis was used to identify factors associated with survival. RESULTS Three hundred cats were eligible for survival analysis and 216 cats for analysis of factors associated with the development of azotemia. The median survival time was 417 days, and 15.3% (41/268) cats developed azotemia within 240 days of diagnosis of hyperthyroidism. Plasma concentrations of urea and creatinine were positively correlated with the development of azotemia. Plasma globulin concentration was negatively correlated with the development of azotemia. Age, urine protein:creatinine ratio, and the presence of hypertension were significantly correlated with decreased survival time. Urine specific gravity and PCV were significantly correlated with increased survival time. CONCLUSIONS AND CLINICAL IMPORTANCE The proteinuria associated with hyperthyroidism is not a mediator of progression of CKD; however, it does correlate with all cause mortality.
Plasma Rico en Plaquetas y su utilización en implantología dental

Se presenta una revision sobre la utilizacion del Plasma Rico en Plaquetas en el ambito de la implantologia. El trabajo comienza con la definicion de varios conceptos basicos sobre Regeneracion Tisular Guiada. Acontinuacion se explican los factores de crecimiento y su participacion en los concentrados de plaquetas. Se hace hincapie en los estudios realizados con PRPe implantes y se describe la aparicion de unos posibles efectos negativos con el empleo de esta tecnica. Por ultimo se exponen las conclusiones del trabajo.
Multicenter evaluation of plasma N-terminal probrain natriuretic peptide (NT-pro BNP) as a biochemical screening test for asymptomatic (occult) cardiomyopathy in cats.

BACKGROUND B-type natriuretic peptide concentrations reliably distinguish between cardiac and respiratory causes of dyspnea, but its utility to detect asymptomatic cats with occult cardiomyopathy (OCM) is unresolved. HYPOTHESIS/OBJECTIVES Determine whether plasma N terminal probrain natriuretic peptide (NT-proBNP) concentration can discriminate asymptomatic cats with OCM from normal cats, and whether NT-proBNP concentration correlates with clinical, biochemical, and echocardiographic parameters. ANIMALS One hundred and fourteen normal, healthy cats; 113 OCM cats. METHODS Prospective, multicenter, case-controlled study. NT-proBNP was prospectively measured and cardiac status was determined from history, physical examination, and M-mode/2D/Doppler echocardiography. Optimal cut-off values were derived using receiver operating characteristic (ROC) curve analysis. RESULTS NT-proBNP was higher (median, interquartile range [25th and 75th percentiles]) in (1) OCM (186 pmol/L; 79, 478 pmol/L) versus normal (24 pmol/L; 24, 32 pmol/L) (P < .001); and (2) hypertrophic obstructive cardiomyopathy (396 pmol/L; 205, 685 pmol/L) versus hypertrophic cardiomyopathy (112 pmol/L; 48, 318 pmol/L) (P < .001). In OCM, NT-proBNP correlated (1) positively with LVPWd (ρ = 0.23; P = .01), LA/Ao ratio (ρ = 0.31; P < .001), LVs (ρ = 0.33; P < .001), and troponin-I (ρ = 0.64; P < .001), and (2) negatively with %FS (ρ = -0.27; P = .004). Area under ROC curve was 0.92; >46 pmol/L cut-off distinguished normal from OCM (91.2% specificity, 85.8% sensitivity); >99 pmol/L cut-off was 100% specific, 70.8% sensitive. CONCLUSIONS AND CLINICAL IMPORTANCE Plasma NT-proBNP concentration reliably discriminated normal from OCM cats, and was associated with several echocardiographic markers of disease severity. Further studies are needed to assess test performance in unselected, general feline populations, and evaluate relationships between NT-proBNP concentrations and disease progression.
Miíases humanas por Cochliomyia Hominivorax (Coquerel, 1858) (Diptera, Calliphoridae) em hospitais públicos na cidade do Recife, Pernambuco, Brasil

The occurence of human myiasis caused by larvae of Cochliomyia hominivorax was registered for the first time in Recife, State of Pernambuco, Brazil. From November, 1999 to October, 2002 were registered, in three public hospitals 24 cases of myiasis in human beings, of both sexes, with age varying from 08 to 93 years old. The wounds infested with screwworms observed in these patients were classified as cutaneous, oral, anal, aureal and ocular myiasis. The inferior members were more frequently attacked (10/24) (41.7%) than the other anatomic areas. In all of the cases, the myiasis were established in pre-existent lesions, and the factors that predispose to this disease were: excoriations of varied nature (10/24) (41.7%); no identified lesions (05/24) (20.8%); diseases of the circulatory system (03/24) (12.5%); tumors (02/24) (8.3%); conjunctivitis, auricular infections, dermatitis and surgical wound (01/24) (4.2%). The factors that predispose to be infested by C. hominivoraxwere the physical and mental weakness, dehydration, inadequate corporal hygiene, diabetes, malnutrition, elephantiasis, schizophrenia, alcoholism, anemia, lice infestation and fundamentally accidental wounds.