Miracle-dz/UniFAR-FTUs huggingface dataset:
Frequent Premature Atrial Contractions in Stroke of Undetermined Etiology

Background: The cause of ischemic stroke is undetermined in 15–40% of patients. We studied the association between frequent premature atrial contractions (PAC) and stroke of undetermined etiology. Methods: We retrospectively studied ischemic stroke patients who were consecutively admitted to our department and underwent 24-hour Holter ECG recording including 163 noncardioembolic stroke patients (group A), 24 stroke patients of undetermined etiology (group B), and 37 cardioembolic stroke patients with prior-diagnosed paroxysmal atrial fibrillation (group C). The number of PAC per 24 h and the prevalence of patients with frequent PAC (200 or more per 24 h) were compared between the groups. Results: The number of PAC was significantly larger in groups B and C than in group A. The proportion of patients with frequent PAC was larger in group B (13/24, 54%) and in group C (18/37, 48%) than in group A (32/163, 20%). Conclusion: Our data suggest that frequent PAC should be regarded as a masked type of paroxysmal atrial fibrillation and should be included in one of the causes of cardioembolic stroke.
What and Where are the Primary Affects? Some Evidence for a Theory

A set of 69 facial photographs of models simulating affective neutrality and the eight primary affects of interest, enjoyment, surprise, distress, fear, shame, contempt, and anger were presented to a group of 24 firemen whose task it was to identify the affect in the photograph. The hypotheses, tested and confirmed were that (a) all Ss would identify primary affects in the photographs with above chance accuracy, (b) groups of Ss would confuse some affects with others in a systematic fashion, and (c) some Ss would show individual biases in their judgments.
Factor V has an anticoagulant cofactor activity that targets the early phase of coagulation

Tissue factor pathway inhibitor (TFPI), the main inhibitor of initiation of coagulation, exerts an important anticoagulant role through the factor Xa (FXa)-dependent inhibition of tissue factor/factor VIIa. Protein S is a TFPI cofactor, enhancing the efficiency of FXa inhibition. TFPI can also inhibit prothrombinase assembly by directly interacting with coagulation factor V (FV), which has been activated by FXa. Because full-length TFPI associates with FV in plasma, we hypothesized that FV may influence TFPI inhibitory function. Using pure component FXa inhibition assays, we found that although FV alone did not influence TFPI-mediated FXa inhibition, it further enhanced TFPI in the presence of protein S, resulting in an ∼8-fold reduction in Ki compared with TFPI alone. A FV variant (R709Q/R1018Q/R1545Q, FVΔIIa) that cannot be cleaved/activated by thrombin or FXa also enhanced TFPI-mediated inhibition of FXa ∼12-fold in the presence of protein S. In contrast, neither activated FV nor recombinant B-domain-deleted FV could enhance TFPI-mediated inhibition of FXa in the presence of protein S, suggesting a functional contribution of the B domain. Using TFPI and protein S variants, we show further that the enhancement of TFPI-mediated FXa inhibition by protein S and FV depends on a direct protein S/TFPI interaction and that the TFPI C-terminal tail is not essential for this enhancement. In FXa-catalyzed prothrombin activation assays, both FV and FVΔIIa (but not activated FV) enhanced TFPI function in the presence of protein S. These results demonstrate a new anticoagulant (cofactor) function of FV that targets the early phase of coagulation before prothrombinase assembly.
Heme oxygenase‐1 potentiates the survival of small‐for‐size liver graft

This study aims to clarify the role of heme oxygenase‐1 (HO‐1) in small‐for‐size liver transplantation. Transplantation was performed using 40% small‐for‐size or 100% whole liver grafts in rats. When no treatment was given, over‐expression of HO‐1 was detected predominantly in the small‐for‐size grafts at 6 hours after reperfusion as compared to whole grafts in both syngeneic and allogeneic combinations. Recombinant adenoviral vector encoding HO‐1 gene (AdHO‐1) administered to donors 48 hours before transplantation enhanced HO‐1 expression in both whole and small‐for‐size allografts, with a predominant augmentation in the small‐for‐size allografts, suggesting favorable conditions for the induction of HO‐1 expression in small‐for‐size allografts. In close relation to the expression level of HO‐1, AdHO‐1 significantly prolonged both whole and small‐for size allograft survivals, with a remarkable effect in the small‐for‐size allograft group. The prolongation of allograft survival was blocked by the HO‐1 inhibitor (zinc protoprophyrin IX). The non‐treated small‐for‐size allografts demonstrated impaired liver function during the early period after reperfusion, which could be improved by over‐expression of HO‐1, but reversed by the HO‐1 inhibitor. The markedly increase expression HO‐1 in small‐for‐size allografts was associated with lower levels of adhesion molecules and pro‐inflammatory cytokines in the early phase after reperfusion. These findings support the beneficial effects of HO‐1 on allograft survival. In conclusion, the ability of small‐for‐size grafts in the induction of HO‐1 expression might facilitate their own survival in liver transplantation. (Liver Transpl 2004;10:784–793.)
Mycobacterium xenopi infection of the spine: a case report and literature review.

STUDY DESIGN A case report of Mycobacterium xenopi. OBJECTIVES To present a case report of a vertebral osteomyelitis caused by M. xenopi and to review the world literature on the subject. SUMMARY OF BACKGROUND DATA M. xenopi is most commonly a pulmonary pathogen in immunosuppressed patients or those with underlying lung disease. Infection of the spine is very rare, with only four cases reported. Three of these cases occurred in immunosuppressed patients, and the fourth in a patient with previous tuberculosis osteomyelitis of the spine. METHODS The information was obtained from a review of the patient's clinical notes and follow-up appointments. RESULTS The patient was a 73-year-old woman with an M. xenopi osteomyelitis of T6-T7, confirmed by magnetic resonance imaging and a computed tomography-guided biopsy. She was treated with surgical decompression and stabilization before a 2-year antibiotic regimen was begun. At follow-up assessment 1 year after the antibiotics were finished, she still had some ongoing back pain, but no evidence of relapse. CONCLUSIONS This is the first reported case of an M. xenopi infection of the spine in a patient with no predisposing factors. This type of infection can be difficult to treat, with a high relapse rate reported despite prolonged courses of antibiotics.
Breast-Conserving Therapy for Centrally Located Breast Cancer

Objective:To analyze whether breast-conserving therapy (BCT) may be an oncologically safe approach and result in a good cosmesis in patients with centrally located breast cancer (CLBC). Summary Background Data:Only underpowered, retrospective, single-arm studies have suggested that oncoplastic BCT for CLBC may be oncologically safe and may result in a good cosmesis. Methods:The authors retrospectively analyzed the overall and recurrence-free survival in 1485 patients with breast cancer undergoing BCT comparing CLBC with non-CLBC. Moreover, the authors described 4 different oncoplastic techniques for BCT in patients with CLBC and compared the cosmetic results with simple lumpectomy according to a recently elaborated objective cosmetic evaluation system, the Breast Symmetry Index. Results:Kaplan-Meier curves show no significant difference in a 5-year overall, local, or distant recurrence-free survival between patients with CLBC and non-CLBC after BCT (94% vs. 96%; 100% vs. 98%; 92% vs. 90%; median follow–up, 35.3 months). The cosmetic outcome after oncoplastic BCT compared with simple lumpectomy differed significantly (Breast Symmetry Index: 22 ± 6%d vs. 44 ± 12%d; P < 0.05). Conclusions:The results demonstrate that BCT for CLBC is oncologically safe and that oncoplastic techniques improve cosmesis.
Urinary biochemistry and microscopy in septic acute renal failure: a systematic review.

BACKGROUND Biochemistry and microscopy of urine are widely published diagnostic activities in patients with acute renal failure (ARF). However, their scientific basis in patients with septic ARF has not been assessed systematically. METHODS We performed a systematic review of MEDLINE, EMBASE, CINHAL, and PubMed databases and bibliographies of retrieved articles for all studies describing urinary biochemistry, indices, and microscopy in patients with septic ARF. RESULTS We identified 27 articles (1,432 patients). Because of substantial heterogeneity, no formal quantitative analysis could be performed. Urinary biochemistry or derived indices were reported in 24 articles (89%), and microscopy, in 7 articles (26%). The majority were small single-center reports and had serious limitations. For example, only 52% of patients were septic, only 54% of patients had ARF, many studies failed to include a control group, time from diagnosis of sepsis or ARF to measure of urinary tests was variable, and there were numerous potential confounders. Urinary sodium, fractional excretion of sodium, urinary-plasma creatinine ratio, urinary osmolality, urinary-plasma osmolality ratio, and serum urea-creatinine ratio showed variable and inconsistent results. Low-molecular-weight proteinuria was described in only 22% of articles. A few reports of urinary microscopy described muddy brown/epithelial cell casts and renal tubular cells in patients with septic ARF, whereas others described normal urinary sediment. CONCLUSION The scientific basis for the use of urinary biochemistry, indices, and microscopy in patients with septic ARF is weak. More research is required to describe their accuracy, pattern, and time course in patients with septic ARF.
Emergence of oseltamivir-resistant pandemic H1N1 virus during prophylaxis.

To the Editor: Neuraminidase inhibitors (oseltamivir and zanamivir) are recommended for treatment of severe illness caused by the 2009 pandemic influenza A (H1N1) virus, and their use has also been advocated for postexposure prophylaxis in high-risk persons.1 We report the emergence of an oseltamivir-resistant virus in a familial cluster of infections with the 2009 H1N1 virus. In a 13-year-old boy with asthma, infection with the 2009 H1N1 virus developed and was confirmed by reverse-transcriptase polymerase-chain-reaction (RT-PCR) testing of a nasopharyngeal aspirate. Administration of oseltamivir (60 mg twice a day for 5 days for this boy who weighed 32 kg) was .
INTRAOCULAR FOREIGN BODIES IN YOUNG PEOPLE

&NA; The authors examined 104 patients with penetrating ocular injuries and retained intraocular foreign bodies. Nineteen patients (18%), with 20 injured eyes, were aged 18 years or younger. Fifty percent of eyes in the young people (10/20) achieved a final visual acuity of 20/30 or better and 65% (13/20) achieved 20/100 or better. Young people were significantly more likely than adults to be injured as a result of a projectile weapon or explosion (P < 0.001). They also had a greater incidence of an initial visual acuity worse than 5/200 (P < 0.001), which was statistically associated with a greater incidence of hyphema (P = 0.002), retinal detachment (P = 0.022), and uveal prolapse (P = 0.082). Although the distribution of final visual acuity was not significantly different between young people and adults, the latter tended to have poorer visual outcome after adjusting for initial visual acuity (P = 0.01).
Symptom Occurrence, Symptom Intensity, and Symptom Distress in Patients Undergoing High‐dose Chemotherapy With Stem‐cell Transplantation

The main aim of this study was to investigate the patients' self-reported symptom occurrence, symptom intensity (SI), and symptom distress (SD) from admission for stem-cell transplantation (SCT) until discharge from the ward. Forty-three patients participated and data were collected at 7 different time-points by using the self-administered Symptom Frequency, Intensity, and Distress questionnaire for SCT (SFID-SCT). The results showed that symptom occurrence followed a curve on which the highest frequencies of symptoms were reported from the day of the SCT (T2) until the end of the protective care period (T5). The mean SI and SD scores became higher when the number of reported symptoms increased. Between T2 and T5, 33% to 54% of the patients reported >10 simultaneous symptoms. Symptoms reported by more than 50% of the patients during T2–T5 were tiredness, loss of appetite, mouth dryness, nausea, sleeping disturbances, diarrhea, and changes of taste. Loss of appetite, tiredness, and mouth dryness were, in descending order, the 3 symptoms reported as most intense and distressing. A statistically significantly higher SD-score was found for the patients undergoing allogeneic SCT on the day before start of the conditioning regimen, as compared to the patients undergoing autologous SCT. Patients reporting no anxiety on admission were found to have higher, mean SD-scores at the end of the hospital stay than anxious patients. The SFID-SCT questionnaire was found to give useful information not only about symptom occurrence but also about SI and SD. To use an instrument that distinguishes between these aspects of the symptom experience may help health care professionals to support the patients through the SCT-process.
Conjugated Linoleic Acid Inhibits Proliferation and Modulates Protein Kinase C Isoforms in Human Prostate Cancer Cells

Abstract: Prostate cancer is the second most common cancer in men. The disease etiology is poorly understood, but diet and lifestyle are contributory factors. Conjugated linoleic acids (CLAs), naturally occurring fatty acids in ruminant food products, have antitumor properties in animal models of cancer and antiproliferative effects on cancer cells in vitro. The cellular mechanisms by which CLAs elicit these effects are unclear, particularly for prostate cancer cells. We have previously identified protein kinase C (PKC) isoforms α, δ, ι, μ, and ζ in LNCaP prostate cancer cells. The objective of this study was to determine the effects of CLAs (individual cis-9, trans-11 and trans-10, cis-12 isoforms and a 50:50 mixture) on PKC isoform abundance in LNCaP cells. Confluent cells were treated with 6, 25, and 50 μM CLA for 0.5, 6, and 24 h. Cytosol and membrane protein fractions were assayed for PKC isoforms (mainly α and δ but also ι, μ, and ζ) by Western blot analysis using specific antibodies. CLAs clearly modulated the abundance of these PKC isoforms, both positively and negatively, depending on the isoform, concentration of CLAs, and period of treatment. Increased PKC-δ and decreased PKC-ι membrane abundance was consistent with CLAs eliciting increased apoptosis and, in part, with their antitumor effects.
Optimizing Patient-Ventilator Synchrony During Invasive Ventilator Assist in Children and Infants Remains a Difficult Task*

Objectives: To document and compare the prevalence of asynchrony events during invasive-assisted mechanical ventilation in pressure support mode and in neurally adjusted ventilatory assist in children. Design: Prospective, randomized, and crossover study. Setting: Pediatric and Neonatal Intensive Care Unit, University Hospital of Geneva, Switzerland. Patients: Intubated and mechanically ventilated children, between 4 weeks and 5 years old. Interventions: Two consecutive ventilation periods (pressure support and neurally adjusted ventilatory assist) were applied in random order. During pressure support, three levels of expiratory trigger setting were compared: expiratory trigger setting as set by the clinician in charge (PSinit), followed by a 10% (in absolute values) increase and decrease of the clinician’s expiratory trigger setting. The pressure support session with the least number of asynchrony events was defined as PSbest. Therefore, three periods were compared: PSinit, PSbest, and neurally adjusted ventilatory assist. Asynchrony events, trigger delay, and inspiratory time in excess were quantified for each of them. Measurements and Main Results: Data from 19 children were analyzed. Main asynchrony events during PSinit were autotriggering (3.6 events/min [0.7–8.2]), ineffective efforts (1.2/min [0.6–5]), and premature cycling (3.5/min [1.3–4.9]). Their number was significantly reduced with PSbest: autotriggering 1.6/min (0.2–4.9), ineffective efforts 0.7/min (0–2.6), and premature cycling 2/min (0.1–3.1), p < 0.005 for each comparison. The median asynchrony index (total number of asynchronies/triggered and not triggered breaths ×100) was significantly different between PSinit and PSbest: 37.3% [19–47%] and 29% [24–43%], respectively, p < 0.005). With neurally adjusted ventilatory assist, all types of asynchrony events except double-triggering and inspiratory time in excess were significantly reduced resulting in an asynchrony index of 3.8% (2.4–15%) (p < 0.005 compared to PSbest). Conclusions: Asynchrony events are frequent during pressure support in children despite adjusting the cycling off criteria. Neurally adjusted ventilatory assist allowed for an almost ten-fold reduction in asynchrony events. Further studies should determine the clinical impact of these findings.
Everolimus as Primary Immunosuppression in Kidney Transplantation: Experience in Conversion From Calcineurin Inhibitors

Background. We analyzed our clinical experience with everolimus (EVL) and identified prognostic factors for a successful conversion. Methods. Retrospective study of 220 kidney recipients consecutively converted to EVL with calcineurin inhibitor elimination. We studied risk factors for proteinuria at 1 year after conversion, decline in renal function, and graft survival. Results. Baseline creatinine clearance was 52.4±17.8 mL/min vs. 53.4±20.1 mL/min 1 year after conversion (P=0.150). Median proteinuria increased from 304 mg/day (interquartile range 160–507) to 458 mg/day (interquartile range 238–892; P<0.001). Risk factors for development of proteinuria ≥900 mg/day (P75) at 1-year postconversion were creatinine clearance less than 60 mL/min (odds ratio [OR] 3.37; 95% confidence interval [CI]: 1.15–9.89), serum triglycerides ≥150 mg/day (OR 4.35; 95% CI: 1.70–11.17), no treatment with prednisone (OR 3.04; 95% CI: 1.22–7.59), baseline proteinuria ≥550 mg/day (OR 10.37; 95% CI: 3.99–26.99), and conversion ≥3 years after transplant (OR 5.77; 95% CI: 1.89–17.59). An interaction was observed between baseline proteinuria and time to conversion: in patients with baseline proteinuria ≥550 mg/day, the risk of developing proteinuria ≥900 mg/day was 77.1% if they were converted after ≥3 years posttransplant. However, this risk was 29.8% in the subgroup converted before (P=0.02). Actuarial graft survival at 1 and 4 years postconversion was 98.2% and 86.5%, respectively. Baseline proteinuria ≥550 mg/day was a risk factor for graft loss in patients converted after the third year but not in patients converted before this time. EVL discontinuation rate was 24% in the first year postconversion. Conclusions. Conversion to EVL and elimination of calcineurin inhibitors is safe. Success depends on not making late conversions and not converting patients with high baseline proteinuria.
Numerical simulation of the dense random packing of a binary mixture of hard spheres: Amorphous metals.

A new algorithm for the construction of a dense random packing of a binary mixture of hard spheres is presented. The algorithm uses periodic boundary conditions and is capable of handling any binary composition with radius ratio between 1.0 and 2.0. Computed results are relatively insensitive to variations in program parameters. The resulting packings are extremely homogeneous and isotropic. The packing fraction, the radial distribution function, and the Voronoi-cell statistics are all calculated for equal spheres. The packing fraction is also calculated as a function of composition fraction and size ratio for unequal sphere mixtures. For all cases the packing fraction is between 0.64 and 0.68. This contradicts the popular notion that the packing fraction increases rapidly as a function of size ratio for a given composition fraction for dense random packings. Since the mass density scales linearly with packing fraction and amorphous metals have mass densities very close to those of the corresponding crystal, the dense random packing of hard spheres predicts mass densities that are 8--14 % lower than in the crystalline metal. The unlikelihood of this implies that the atoms in an amorphous metal cannot act like hard spheres. Rather they deform in such a way asmore » to pack together more efficiently than a dense random packing of hard spheres. « less
Effects of hydroxyurea and 1-beta-D-arabinofuranosyl-cytosine on deoxyribonucleotide pools in mouse embryo cells.

Mouse embryo cells incubated in medium with 0.5% serum contain only few cells which synthesize DNA. When the serum concentration was raised, DNA synthesis was induced and the pools of the deoxyribonucleoside triphosphates expanded. In such cultures the pool of dGTP was the smallest of the deoxyribonucleoside triphosphate pools and its size corresponded to only approximately 30 sec of DNA synthesis. The dCTP pool was 10–20 times larger than the dGTP pool. Addition of hydroxyurea resulted in an almost instantaneous loss of the pool of dGTP and also in a decrease in the size of the dATP pool. In contrast the pools of dCTP and dTTP increased. However, the turnover of the dTTP pool was greatly diminished. Removal of hydroxyurea from the medium resulted in a rapid normalization of the triphosphate pools but only in a more gradual restoration of DNA synthesis. During incubation in 1-β-D-arabinofuranosyl-cytosine (arabinosyl-cytosine), the pools of dATP, dGTP and dTTP expanded, while the pool of dCTP showed an initial decrease. The turnover of the dTTP pool was not markedly affected in spite of the fact that DNA synthesis was greatly reduced. When arabinosyl-cytosine was removed the pools were normalized and DNA synthesis was slowly restored. Our results thus show that the inhibition of DNA synthesis by hydroxyurea is correlated with diminishing pools of dGTP and dATP and a decreased turnover of dTTP, indicating a generally decreased deoxyribonucleotide formation presumably due to the inhibition of the enzyme ribonucleoside-diphosphate reductase. The inhibition of DNA synthesis by arabinosyl-cytosine is not correlated with a similar depletion of deoxyribonucleoside triphosphate pools.
Stem cell therapy for severe autoimmune diseases

A Imunossupressao intensa seguida do transplante de celulas precursoras hematopoieticas (TCPH), alogenicas ou autogenicas e um procedimento relativamente recente e que foi utilizado pela primeira vez em casos dramaticos de lupus eritematoso sistemico. Atualmente tres procedimentos agressivos sao utilizados nas doencas autoimunes: Altas doses de quimioterapia sem o resgate de celulas precursoras, imunossupressao intensa com impulsao subsequente de celulas precursoras hematopoieticas alogenicas combinadas ou nao a selecao de celulas CD34+, e o transplante autogenico de celulas precursoras hematopoieticas. A comprovacao do efeito enxerto contra a leucemia observado e comprovado, define o TCPH como forma de imunoterapia, existindo evidencias tambem do efeito contra a imunidade o qual propiciaria a cura das doencas autoimunes nesta forma de terapia. O uso do TCPH autogenico teve seu avanco baseado na seguranca do mesmo em relacao aos TCPHs alogenicos. No relato sao apresentados dados em esclerose multipla e lupus eritematoso sistemico sendo nossa conclusao de que as TCPHs nas suas modalidades tem indicacao a luz dos resultados na literatura.