Miracle-dz/UniFAR-FTUs huggingface dataset:
Monoclonal Antibody Therapy of T-Cell Leukemia and Lymphoma

T-cell leukemias and lymphomas are a heterogeneous group of uncommon tumors that account for 7-15% of lymphomas. [1] They represent approximately 6,500 new cases annually in the United States. Typically patients with malignant T-cell disorders present with highgrade lesions, advanced stage disease and have systemic or “B” symptoms at diagnosis. Until relatively recently these diseases were treated with the same anthracycline-based chemother‐ apy regimens used to treat B-cell lymphomas. With few exceptions, the outcomes are poorer with lower response rates, shorter times to progression, and shorter median survivals com‐ pared to B-cell lymphomas. A number of new agents have recently entered the clinic for the treatment of T-cell lymphomas. [2] These include the histone deacetylase inhibitors voronistat (Zolinza®) and romidepsin (Istodax®) approved for treatment of previously treated cutaneous T-cell lymphoma (CTCL), the antifolate, pralatrexate (Fotolyn®) indicated for the treatment of relapsed or resistant peripheral T-cell lymphoma (PTCL), and the immunotoxin brentuximab vedotin (Adcetris®) for the treatment of relapsed anaplastic large cell lymphoma (ALCL). These newer agents join a handful of drugs approved for the treatment of T-cell lymphomas including beraxotene (Targretin®) and the interleukin-2-diphtheria toxin fusion protein, denileukin diftitox (Ontak®).
Relationships among Job Stress, Nursing Performance, and Retention Intention of Clinical Nurses

Purpose: This study was aimed to identify the relationships among job stress, nursing performance, and retention intention of clinical nurse. Methods: Data was collected at a hospitals located in Seoul, from October 19 to October 26 in 2010. Total subjects were 270. Data was analyzed by PASW 18.0 program. Results: Job stress of the subjects was 3.69(0.43). Nursing performance of the subjects was 3.69(0.45). Retention intention of the subjects was 3.21(0.78). Job stress and nursing performance were correlated positively (r
Induced hypothermia in severe bacterial meningitis: a randomized clinical trial.

IMPORTANCE Despite advances in care, mortality and morbidity remain high in adults with acute bacterial meningitis, particularly when due to Streptococcus pneumoniae. Induced hypothermia is beneficial in other conditions with global cerebral hypoxia. OBJECTIVE To test the hypothesis that induced hypothermia improves outcome in patients with severe bacterial meningitis. DESIGN, SETTING, AND PATIENTS An open-label, multicenter, randomized clinical trial in 49 intensive care units in France, February 2009-November 2011. In total, 130 patients were assessed for eligibility and 98 comatose adults (Glasgow Coma Scale [GCS] score of ≤8 for <12 hours) with community-acquired bacterial meningitis were randomized. INTERVENTIONS Hypothermia group received a loading dose of 4°C cold saline and were cooled to 32°C to 34°C for 48 hours. The rewarming phase was passive. Controls received standard care. MAIN OUTCOMES AND MEASURES Primary outcome measure was the Glasgow Outcome Scale score at 3 months (a score of 5 [favorable outcome] vs a score of 1-4 [unfavorable outcome]). All patients received appropriate antimicrobial therapy and vital support. Analyses were performed on an intention-to-treat basis. The data and safety monitoring board (DSMB) reviewed severe adverse events and mortality rate every 50 enrolled patients. RESULTS After inclusion of 98 comatose patients, the trial was stopped early at the request of the DSMB because of concerns over excess mortality in the hypothermia group (25 of 49 patients [51%]) vs the control group (15 of 49 patients [31%]; relative risk [RR], 1.99; 95% CI, 1.05-3.77; P = .04). Pneumococcal meningitis was diagnosed in 77% of patients. Mean (SD) temperatures achieved 24 hours after randomization were 33.3°C (0.9°C) and 37.0°C (0.9°C) in the hypothermia and control group, respectively. At 3 months, 86% in the hypothermia group compared with 74% of controls had an unfavorable outcome (RR, 2.17; 95% CI, 0.78-6.01; P = .13). After adjustment for age, score on GCS at inclusion, and the presence of septic shock at inclusion, mortality remained higher, although not significantly, in the hypothermia group (hazard ratio, 1.76; 95% CI, 0.89-3.45; P = .10). Subgroup analysis on patients with pneumococcal meningitis showed similar results. Post hoc analysis showed a low probability to reach statistically significant difference in favor of hypothermia at the end of the 3 planned sequential analyses (probability to conclude in favor of futility, 0.977). CONCLUSIONS AND RELEVANCE Moderate hypothermia did not improve outcome in patients with severe bacterial meningitis and may even be harmful. Careful evaluation of safety issues in future trials on hypothermia are needed and may have important implications in patients presenting with septic shock or stroke. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT00774631.
Switch to an everolimus‐facilitated cyclosporine A sparing immunosuppression improves glycemic control in selected kidney transplant recipients

Mammalian target of rapamycin inhibitors (mToRi) allow calcineurin inhibitor (CNI) sparing therapy in renal transplant recipients with possible beneficial effects on the long‐term allograft function and cardiovascular risk. The influence of mToRi on glucose metabolism is still under discussion.
Detection of undiagnosed HIV among state prison entrants.

A substantial proportion of individuals infected with the human immunodeficiency virus (HIV) in the United States enter a correctional facility annually.1,2 Therefore, incarceration presents an opportunity for HIV detection. Even though many states have adopted policies of mass HIV screening of inmates,2–4 the extent to which HIV testing on prison entry detects new infections is unclear. We examined HIV prevalence among inmates entering a state prison system and the proportion known to state public health authorities as having previously tested HIV seropositive.
Liver fat content, non-alcoholic fatty liver disease, and ischaemic heart disease: Mendelian randomization and meta-analysis of 279 013 individuals

Aims In observational studies, non-alcoholic fatty liver disease (NAFLD) is associated with high risk of ischaemic heart disease (IHD). We tested the hypothesis that a high liver fat content or a diagnosis of NAFLD is a causal risk factor for IHD. Methods and results In a cohort study of the Danish general population (n = 94 708/IHD = 10 897), we first tested whether a high liver fat content or a diagnosis of NAFLD was associated observationally with IHD. Subsequently, using Mendelian randomization, we tested whether a genetic variant in the gene encoding the protein patatin-like phospholipase domain containing 3 protein (PNPLA3), I148M (rs738409), a strong and specific cause of high liver fat content and NAFLD, was causally associated with the risk of IHD. We found that the risk of IHD increased stepwise with increasing liver fat content (in quartiles) up to an odds ratio (OR) of 2.41 (1.28-4.51)(P-trend = 0.004). The corresponding OR for IHD in individuals with vs. without NAFLD was 1.65 (1.34-2.04)(P = 3×10-6). PNPLA3 I148M was associated with a stepwise increase in liver fat content of up to 28% in MM vs. II-homozygotes (P-trend = 0.0001) and with ORs of 2.03 (1.52-2.70) for NAFLD (P = 3×10-7), 3.28 (2.37-4.54) for cirrhosis (P = 4×10-12), and 0.95 (0.86-1.04) for IHD (P = 0.46). In agreement, in meta-analysis (N = 279 013/IHD = 71 698), the OR for IHD was 0.98 (0.96-1.00) per M-allele vs. I-allele. The OR for IHD per M-allele higher genetically determined liver fat content was 0.98 (0.94-1.03) vs. an observational estimate of 1.05 (1.02-1.09)(P for comparison = 0.02). Conclusion Despite confirming the known observational association of liver fat content and NAFLD with IHD, lifelong, genetically high liver fat content was not causally associated with risk of IHD. These results suggest that the observational association is due to confounding or reverse causation.
Human parvovirus B19-associated myocarditis.

To the Editor: Viral and postviral myocarditis are the major causes of acute and chronic dilated cardiomyopathy.1 To gain insight into the pathogenesis of parvovirus B19–associated myocarditis as an endothelial-cell–mediated disease (Figure 1A), we measured viral loads in endomyocardial biopsy specimens obtained from 498 patients (341 men and 157 women; mean [±SD] age, 46.93±15.85 years) with myocarditis2 or chronic dilated cardiomyopathy who were positive for parvovirus B19 on immunohistologic analysis. A total of 91 noninflamed normal hearts obtained from autopsies served as controls. We found that parvovirus B19 genomes were significantly more likely to be detected in the endomyocardial biopsy .
Clinical trial evidence supporting FDA approval of novel therapeutic agents, 2005-2012.

IMPORTANCE Many patients and physicians assume that the safety and effectiveness of newly approved therapeutic agents is well understood; however, the strength of the clinical trial evidence supporting approval decisions by the US Food and Drug Administration (FDA) has not been evaluated. OBJECTIVES To characterize pivotal efficacy trials (clinical trials that serve as the basis of FDA approval) for newly approved novel therapeutic agents. DESIGN AND SETTING Cross-sectional analysis using publicly available FDA documents for all novel therapeutic agents approved between 2005 and 2012. MAIN OUTCOMES AND MEASURES Pivotal efficacy trials were classified according to the following design features: randomization, blinding, comparator, and trial end point. Surrogate outcomes were defined as any end point using a biomarker expected to predict clinical benefit. The number of patients, trial duration, and trial completion rates were also determined. RESULTS Between 2005 and 2012, the FDA approved 188 novel therapeutic agents for 206 indications on the basis of 448 pivotal efficacy trials. The median number of pivotal trials per indication was 2 (interquartile range, 1-2.5), although 74 indications (36.8%) were approved on the basis of a single pivotal trial. Nearly all trials were randomized (89.3% [95% CI, 86.4%-92.2%]), double-blinded (79.5% [95% CI, 75.7%-83.2%]), and used either an active or placebo comparator (87.1% [95% CI, 83.9%-90.2%]). The median number of patients enrolled per indication among all pivotal trials was 760 (interquartile range, 270-1550). At least 1 pivotal trial with a duration of 6 months or greater supported the approval of 68 indications (33.8% [95% CI, 27.2%-40.4%]). Pivotal trials using surrogate end points as their primary outcome formed the exclusive basis of approval for 91 indications (45.3% [95% CI, 38.3%-52.2%]), clinical outcomes for 67 (33.3% [95% CI, 26.8%-39.9%]), and clinical scales for 36 (17.9% [95% CI, 12.6%-23.3%]). Trial features differed by therapeutic and indication characteristics, such as therapeutic area, expected length of treatment, orphan status, and accelerated approval. CONCLUSIONS AND RELEVANCE The quality of clinical trial evidence used by the FDA as the basis for recent approvals of novel therapeutic agents varied widely across indications. This variation has important implications for patients and physicians as they make decisions about the use of newly approved therapeutic agents.
Serological and pathological investigation of brucellosis in dairy cows of Mymensingh district, Bangladesh

Brucellosis is a widespread and economically important infectious disease of animals and humans caused by the members of the genus Brucella . The disease is manifested by abortion, birth of unthrifty calves and retained placentae in female animals. The correct and prompt diagnosis is important for controlling and eradicating the disease from animals. This experiment was carried out in the Department of Pathology, Faculty of Veterinary Science, Bangladesh Agricultural University, Mymensingh to detect Brucella antibody in dairy cows using Rose Bengal Plate Test (RBPT), indirect Enzyme Linked Immunosorbent Assay (i-ELISA) and histopathology. The study was carried out between the periods of January 2012 to September 2012. Placental tissue obtained from aborted cow and internal organs of aborted fetus were used in histopathological study. A total of 190 sera sample were collected with the history of reproductive disorders, like late abortion, retained placenta and anestrous from Veterinary Hospital, Bangladesh Agricultural University (BAU) and meat market Kewatkhali, Mymensingh. The seroprevalance of brucellosis using RBPT and iELISA were 2.63% and 1.05% respectively. Histopathological study revealed multifocal necrosis in hepatic parenchyma, depletion of lymphocytes in spleen and lymphnodes and distended trabeculi in spleen and lymphnodes in aborted calf, diffuse fibrosis around the placental epithelia and in placental tissues. Distinct histopathological lesions in the liver and spleen of Brucella suspected calf were not evident but the retained fetal membrane showed characteristics fibrosis and reactive cellular infiltration. It needs to adopt nucleic acid based technologies in order to confirm the species of Brucella involved and as well as to avoid cross reactivity of antibodies as seen in RBPT and iELISA. DOI: http://dx.doi. org/10.3329/bjvm.v11i2. 19124 Bangl. J. Vet. Med . (2013). 11 (2): 107-112
Use of sentinel practices to obtain data regarding common clinical conditions and presentations in small animal consultations

Gathering data on the veterinary caseload will be useful in directing both future research and the veterinary curriculum. Previous studies have used clinical records to gather this data, but the validity of these methods remains unclear. Direct observation has been used to collect similar data in medicine and may be better able to capture the complexities of the consultation. The aim of the study was to determine the common patients, presentations, diagnoses and interventions during small animal veterinary consultations using direct observation. A network of 8 sentinel practices in England and Scotland was recruited. A tool allowing collection of data during direct observation of consultations was developed and piloted. The tool was used to gather data on patient characteristics, problems discussed, diagnoses made and outcomes selected. Practice visits were conducted to feedback results and stimulate discussion. Consultations were highly complex, with discussion of multiple problems, leading to a wide range of diagnoses and outcomes. Discussion of several problems appeared to be associated with increased consultation length. Preventive medicine was a common reason for presentation, and these consultations were amongst the most complex. A definitive diagnosis was not reached for most problems, yet actions were frequently taken. Feedback from the practices involved was positive, and discussions surrounding priorities for future research echoed the findings of the study. Direct observation of consultations allows caseload to be recorded in great detail, which may not be possible with other collection methods. The results are the first step in directing future research towards areas relevant to practitioners and will also be useful in guiding the veterinary curriculum. The way in which future research is conducted should take into account the realities of first opinion practice, such as the high frequency of comorbidity and polypharmacy, and low frequency of definitive diagnosis.
Effects of BMI changes on lung function in COPD subjects from two longitudinal general population studies

Background. Longitudinal studies have shown that increases in BMI can lead to a reduction in pulmonary function, and the nature of this association remains under investigation in COPD. Aim. To evaluate the effects of BMI changes over an 8.2-17.5 year follow-up on, FEV1and FVC in COPD subjects from a longitudinal general population study. Methods. Subjects (n = 1472, >24years of age) participating in both baseline and follow-up survey from two different longitudinal general population studies in Italy (Po river delta and Pisa) were investigated. COPD subjects (n=230) were defined those with FEV1/FVC<0.70 at baseline. Longitudinal changes (Δ) in BMI, FVC, and FEV1 were computed as absolute differences between the values at follow-up and those at baseline. Linear regression models for ΔFEV1, ΔFVC, and with ΔBMI, gender, baseline age, baseline smoking habits, and baseline BMI as covariates were applied. Results. ΔBMI varied from -3.91 to 8.65 kg/m2 in subjects with COPD, and from -12.76 to 14.54 kg/m2 in subjects without COPD. In COPD subjects, longitudinal changes in BMI were significantly associated with reduction in lung function parameters. Estimated coefficients of ΔBMI were -0.142, p = 0.024, and -0.184, p = 0.004, for ΔFEV1 and ΔFVC, respectively. These associations were independent from gender, baseline smoking habit and baseline BMI, while were affected by baseline age. Analogous results were observed in subjects without COPD. Conclusions. Longitudinal BMI changes affect lung function in subjects with and without COPD. On average an accelerated decline of lung function is observed in those COPD subjects with higher increase of BMI over follow-up.
FREQUENCY OF VARIOUS NEONATAL COMPLICATIONS IN INFANTS BORN TO DIABETIC MOTHERS - A HOSPITAL BASE STUDY

Objective: To determine the frequency of various complications occurring in infants of diabetic mothers.Methodology: This descriptive study was conducted in the neonatal unit and obstetric units of LadyReading Hospital, Peshawar from January to July 2010. Forty two consecutive cases of infants of diabeticmothers were enrolled in the study. Maternal history especially obstetric history and history regardingdiabetes mellitus was obtained and complete neonatal examination was performed. The physical findingsand anthropometric measurements were recorded into a printed Proforma. Serum glucose, serum calcium,hematocrit and echocardiography was performed in all enrolled babies.Results: Out of 42 diabetic mothers, gestation diabetes was seen in 71.4% while pre-conceptional diabeteswas seen in 28.5%. The male Infants of Diabetic Mothers in this study were 69%. Infant of DiabeticMothers delivered by C-section were 45%. Macrosomia 40.4% (n=42) was found to be the most commoncomplication followed by hypoglycaemia 23.8%. The mortality rate in our study was 4.7% (n=2). Conclusion: This study confirms the high occurrence of complications in newborns, born to diabeticmothers. Large for gestational age and hypoglycemia were the commonest complications.
Newly identified events in the RE-LY trial.

To the Editor: We wish to update our article about the Randomized Evaluation of Long-Term Anticoagulation Therapy (RE-LY) trial (Sept. 17, 2009, issue). 1 After the database was locked on August 15, 2009, we identified several additional primary efficacy and safety outcome events during routine clinical site closure visits. These events included two systemic embolic events and nine major hemorrhages. Subsequently, after discussions with the Food and Drug Administration, the primary and secondary efficacy and safety data were checked for consistency, and the study database was reevaluated for possible underreporting of events. To achieve this, all free text, outcomes, and adverse .
Seroprevalence of Cytomegalovirus Infection amongst Pregnant Women in Kaduna State, Nigeria

Cytomegalovirus (CMV) is a major public health problem throughout the world. It is the leading cause of congenital infections leading to neurological disabilities in children that result to severe sequelae such as sensor neural hearing loss, neuro-developmental delay and blindness. This study was conducted to determine the seroprevalence of human cytomegalovirus among pregnant women in Kaduna State, Nigeria. Three hundred and sixty three (363) blood samples were collected from 330 pregnant women attending antenatal clinics and 33 non pregnant women attending the Outpatient Department in three selected General Hospitals in Kaduna State. Serum obtained from the blood samples were examined for the presence of CMV IgG antibodies by IFA method. About 94.8% of pregnant women tested positive to CMV IgG antibodies while all (100%) of the non pregnant women tested positive. There was no statistically significant association between CMV and pregnancy (÷2=1.784, df=2, p=0.182). Infection with CMV was strongly associated with zone location (÷2=15.381, df,=2, p=0.000) and employment status of the women (÷2=5.519, df=1, p=0.018). There was no significant association between CMV infection and age, gravida, gestation age, education, number of marriages and history of previous transfusion. The high prevalence of CMV infection observed in this study indicates that the virus is prevalent in the study area and it is therefore advisable that routine screening of CMV infection be implemented for all antenatal women in the State. Keywords : Seroprevalence, Cytomegalovirus, IgG, Pregnant women, Kaduna, Nigeria
Management of Cervical Erosion

Cervical erosion, a benign lesion is sometimes much troublesome due to its chronicity and nature of recurrence. It is the replacement of the stratified squamous epithelium of the portio-vaginalis by the columnar epithelium of endocervix. Considering the feature of cervical erosion, it can be correlated with Garbhashayagrivagata Vrana. The treatment is designed to destruct overgrowth columnar epithelium either by chemical substances or cryosurgery or electric cautery. In Ayurvedic classics for destruction of any such lesion kshara is prescribed. Keeping these points in view, the present work a clinical comparative study has been made to assess the effect of Snuhi Kshara cauterization and electric cautery cauterization in cervical erosion cases. The Kshara and Electric cautery were applied locally on eroded cervix and results were assessed on the basis of epithelization of erosion and improvement in symptoms. The study reveals that Snuhi Kshara ( Euphorbia neriefolia ) cauterization showed better results than electric cautery cauterization.