Miracle-dz/UniFAR-FTUs huggingface dataset:
Management of Antiplatelet Therapy in Patients With Coronary Artery Disease Requiring Cardiac and Noncardiac Surgery

Approximately 5% to 15% of patients undergoing coronary stent implantation are estimated to undergo a surgical procedure within 2 years.1–7 In the largest (N=126 773) cohort study to date describing the incidence and timing of noncardiac surgery after coronary stent placement, 12% of patients who received bare metal stents (BMSs) and 47% of patients who received drug-eluting stents (DESs) had early surgery, defined as surgical procedures occurring within 6 weeks in patients treated with BMSs or within 12 months in those treated with DESs.8 Although the majority were minor procedures, major surgical procedures were more likely to occur within 12 months of stent placement in comparison with 12 to 24 months. Interestingly, a decline in surgical procedures was noted after publication of the American College of Cardiology/American Heart Association Guidelines on Perioperative Cardiovascular Evaluation and Care for Noncardiac Surgery in 2007 (preguidelines 25% versus postguidelines 13%, P =0.001). 8 Stented patients undergoing surgery are likely to discontinue dual-antiplatelet therapy (DAPT), composed of aspirin and a P2Y12 receptor antagonist (mostly clopidogrel, but may also include prasugrel or ticagrelor), thereby being exposed to a withdrawal of protection with subsequent risk for stent thrombosis or other ischemic events. In a survey of 1358 consecutive patients treated with DESs and discharged on aspirin and clopidogrel, surgery was identified as the second cause of early discontinuation within 1 year (21%) and the first cause of late discontinuation thereafter (49%). 9 Defining the fine balance between ischemic and bleeding risk remains a challenge in stented patients undergoing surgery treated with antiplatelet therapy. Understanding whether an antithrombotic drug should or should not be discontinued and tailoring treatment strategies based on the type of intervention are key to balancing the safety and efficacy profiles of antithrombotic medications in this particular scenario. Importantly, such …
Evaluation of Social Nicotine Dependence Using the Kano Test for Social Nicotine Dependence (KTSND-K) Questionnaire in Korea

Background: Smoking is one of the most important leading causes of morbidity and mortality. Smoking habit is recognized as nicotine dependence, which consists of physical and psychosocial dependence. To evaluate social nicotine dependence, the Kano Test for Social Nicotine Dependence (KTSND) working group developed a new questionnaire, which consists of 10 questions with a total score of 30 in Japan. We examined the social nicotine dependence among healthy adults using the new KTSND questionnaire and evaluated validity of the KTSND questionnaire in Korea. Method: We applied Korean KTSND questionnaire version 2 to employees of hospital, university students and people for medical examination and promotion test. Complete data obtained from the 741 responders were analyzed. Result: The mean age of responders was 31.8 years. Among them, males were 57.8%. Current smokers, ex-smokers, and non-smokers were 13.8%, 12.8%, and 73.4% respectively. According to smoking status, the total KTSND scores of current smokers were significantly higher than those of ex-smokers, and of non-smokers (17.1±5.4 versus 14.3±5.5, and 12.3±5.5, p ≤0.001). The total KTSND scores of males were higher than those of females, suggesting that males have a propensity for depending nicotine socially much more than females (14.3±5.7 and 11.7±5.4 respectively, p<0.001). Eight of ten questions produced significantly different scores among three different smoking groups. When current smokers were sub-classified by heavy smoking index (HSI) that represented physical nicotine dependence, we did not find a significant difference of KTSND score between low HSI group (<4 ) and high HSI group (≥ 4), This finding suggested that the psychosocial dependence might play a different role from physical nicotine dependence in smoking. Most of the non-smokers (62.5%) had an experience of harmful passive smoking especially in public place. Conclusion: Our study suggested that the KTSND questionnaire could be a useful method to evaluate psychosocial aspects of smoking. (Tuberc Respir Dis 2007; 62: 365-373)
Prevalence of intestinal parasites at Ujjain, Madhya Pradesh, India: Five-year study

This study was conducted to determine the prevalence of intestinal parasites in hospitals at Ujjain. A total of 5990 samples were collected in five years: 3580 from Ujjain Charitable Trust Hospital (Urban population) and 2410 from R. D. Gardi Medical College (Rural population). Overall prevalence rate of intestinal parasite was 21.4%. Entamoeba histolytica (10.5%) was the commonest protozoa followed by Giardia lamblia (3.9%). Among the helminths, Ascaris lumbricoides (2.8%) was the commonest. Multiple infections were seen in 70 samples. There was difference in prevalence between urban (20.2%) and rural (23.1%) population. Females (27.4%) were more affected than males (18.2%) and age group 0 to 10 years old had the highest rate of infection. The results indicate that there is a need to implement control measures in form of regular deworming, health education and provision of safe water supply. Key words: Intestinal parasites, prevalence, rural, urban, Ujjain.
Efficacy of triple therapy with interferon alpha-2b, ribavirin and amantadine in the treatment of naïve patients with chronic hepatitis C

BACKGROUND: There is controversy about the efficacy of amantadine in the treatment of chronic hepatitis C. In this study, we evaluated the efficacy of triple therapy with interferon-alpha, ribavirin and amantadine in the treatment of na+ve patients with chronic hepatitis C. METHODS: Forty-eight patients with genotype 3 chronic hepatitis C received a three- drug regimen: interferon alpha-2b, 3 million units, three times a week, ribavirin 1000-1200 mg based on body weight, daily, in divided doses, and aman- tadine 100 mg twice daily, for six months. End of treatment response (ETR), sustained virologic response (SVR), bio- chemical response and histologic improvement were evaluated. RESULTS: Forty-eight patients, 41 male and 7 female, with a mean age of 37.42 ± 16.2 years, were enrolled in the study. During treatment, four patients were excluded from the study due to severe thrombocytopenia, major depression and incompliance. End of treatment response was seen in 38 (86.36%) patients. Among these patients, 34 (77.27%) had sustained virologic response 6 months after the end of treatment and 40 (91%) had improvement in serum level of liver enzyme. Among patients who had response to treatment, liver biopsy was performed for 33 at the end of treatment and 31 patients had histologic improvement. Five non-responsive patients underwent liver biopsy at the end of treatment, and 2 of them had histologic improvement. No major side effects due to amantadine occurred in our patients. CONCLUSIONS: Triple therapy with interferon-alpha-2b, ribavirin and amantadine is a safe and effective regimen in the treatment of chronic hepatitis C.
THE AMERICAN JOURNAL OF PSYCHIATRY

Articles 1278 An Inflammatory Biomarker as a Differential Predictor of Outcome of Depression Treatment With Escitalopram and Nortriptyline Rudolf Uher et. al 1287 Identification and Replication of a Combined Epigenetic and Genetic Biomarker Predicting Suicide and Suicidal Behaviors Jerry Guintivano et. al 1297 Clinical Outcomes and Genome-Wide Association for a Brain Methylation Site in an Antidepressant Pharmacogenetics Study in Mexican Americans Ma-Li Wong et. al
Osteoarthritic pain: a review of current, theoretical and emerging therapeutics

Background: Despite exciting progress and growth in the understanding of molecular and cellular mechanisms of chronic pain, osteoarthritis (OA) pain remains a challenging clinical entity to treat. There is an emerging diversity of algogenic mechanisms suggesting heterogeneity in pain aetiology in the OA patient population. Objective/methods: This review article summarises key issues in existing therapies for OA pain and highlights the emerging compounds in early and late development. It also highlights where tolerability may be a concern, especially in the older populations in which treatment interactions for co-morbid conditions may further narrow therapeutic index. Importantly, the authors also examine the diversity of biology that underpins OA pain and highlight the opportunities for the future. Results/conclusions: Many emerging therapies are presently in proof-of-concept clinical testing for treatment of OA. A growing understanding of the heterogeneity in the OA patient population, will challenge the ability to accurately understand observed efficacy or safety signals in these relatively small trials and how they may titrate to a broader patient population. We may need to wait several more years to understand whether the need for a differentiated therapy demanded by patients, payors and physicians alike, will be met.
Substrate–Enzyme Competition Attenuates Upregulated Anaplerotic Flux Through Malic Enzyme in Hypertrophied Rat Heart and Restores Triacylglyceride Content: Attenuating Upregulated Anaplerosis in Hypertrophy

Recent work identifies the recruitment of alternate routes for carbohydrate oxidation, other than pyruvate dehydrogenase (PDH), in hypertrophied heart. Increased carboxylation of pyruvate via cytosolic malic enzyme (ME), producing malate, enables “anaplerotic” influx of carbon into the citric acid cycle. In addition to inefficient NADH production from pyruvate fueling this anaplerosis, ME also consumes NADPH necessary for lipogenesis. Thus, we tested the balance between PDH and ME fluxes in hypertrophied hearts and examined whether low triacylglyceride (TAG) was linked to ME-catalyzed anaplerosis. Sham-operated (SHAM) and aortic banded rat hearts (HYP) were perfused with buffer containing either 13C-palmitate plus glucose or 13C glucose plus palmitate for 30 minutes. Hearts remained untreated or received dichloroacetate (DCA) to activate PDH and increase substrate competition with ME. HYP showed a 13% to 26% reduction in rate pressure product (RPP) and impaired dP/dt versus SHAM (P<0.05). DCA did not affect RPP but normalized dP/dt in HYP. HYP had elevated ME expression with a 90% elevation in anaplerosis over SHAM. Increasing competition from PDH reduced anaplerosis in HYP+DCA by 18%. Correspondingly, malate was 2.2-fold greater in HYP than SHAM but was lowered with PDH activation: HYP=1419±220 nmol/g dry weight; HYP+DCA=343±56 nmol/g dry weight. TAG content in HYP (9.7±0.7 &mgr;mol/g dry weight) was lower than SHAM (13.5±1.0 &mgr;mol/g dry weight). Interestingly, reduced anaplerosis in HYP+DCA corresponded with normalized TAG (14.9±0.6 &mgr;mol/g dry weight) and improved contractility. Thus, we have determined partial reversibility of increased anaplerosis in HYP. The findings suggest anaplerosis through NADPH-dependent, cytosolic ME limits TAG formation in hypertrophied hearts.
Theranostic Radiolabeled Anti-CD20 sdAb for Targeted Radionuclide Therapy of Non-Hodgkin Lymphoma

Anti-CD20 radioimmunotherapy is an effective approach for therapy of relapsed or refractory CD20pos lymphomas, but faces limitations due to poor tumor penetration and undesirable pharmacokinetics of full antibodies. Camelid single-domain Ab fragments (sdAb) might circumvent some of the limitations of radiolabeled full antibodies. In this study, a set of hCD20-targeting sdAbs was generated, and their capacity to bind hCD20 was evaluated in vitro and in vivo. A lead sdAb, sdAb 9079, was selected on the basis of its specific tumor targeting and significant lower kidney accumulation compared with other sdAbs. SdAb 9079 was then radiolabeled with 68Ga and 177Lu for PET imaging and targeted therapy. The therapeutic potential of 177Lu-DTPA-sdAb was compared with that of 177Lu-DTPA-rituximab and unlabeled rituximab in mice bearing hCD20pos tumors. Radiolabeled with 68Ga, sdAb 9079 showed specific tumor uptake, with very low accumulation in nontarget organs, except kidneys. The tumor uptake of 177Lu-DTPA-sdAb 9079 after 1.5 h was 3.4 ± 1.3% ID/g, with T/B and T/M ratios of 13.3 ± 4.6 and 32.9 ± 15.6. Peak tumor accumulation of 177Lu-DTPA-rituximab was about 9 times higher, but concomitantly with high accumulation in nontarget organs and very low T/B and T/M ratios (0.8 ± 0.1 and 7.1 ± 2.4). Treatment of mice with 177Lu-DTPA-sdAb 9079 significantly prolonged median survival compared with control groups and was as effective as treatment with rituximab or its 177Lu-labeled variant. Taken together, sdAb 9079 displays promising features as a theranostic drug to treat CD20pos lymphomas. Mol Cancer Ther; 16(12); 2828–39. ©2017 AACR.
A multicentre pharmacoepidemiological study of dermatological disorders in Wardha district

Background: Skin diseases are common among the general population and account for a high percentage of all diseases. For considering the increase in the prevalence of specific skin diseases, prevalence data are needed. Appropriate treatment of common diseases and provision of essential drugs are two essential components of the primary health care. The aim in dermatological therapy is to use the safest and least number of drugs in order to obtain the best possible effect in the shortest period at reasonable cost. For that important step is taken to monitor, evaluate and therapeutically analyze the prescribing pattern of dermatological drugs. Methods: 12210 cases were screened for dermatological disorders in the Primary Health Care Centers and Rural Hospital of Wardha district during the time frame 1st January 2006 to 30th September 2010, out of which 1000 patients experienced different variety of dermatological disorders were analyzed. In prescription analysis 800 prescriptions with 1946 drugs were analyzed. Results: The prevalence of dermatological disorders in our study was found 8.19%. Out of 1000 patients, there were 567 females (56.7%) and 433 male (43.3%). 1000 cases were divided into five age groups viz. 1-20 yrs, 21-40 yrs, 41-60 yrs, 61-80 yrs and more than 80 yrs. Percentage distribution for the various age ranges were 21%, 48%, 20%, 8% and 3% respectively. In spectrum of dermatological disorders, Acne vulgaris (14.8%) was the most common disorder followed by Tinea infection (13.6%) , Eczema (13.2%), scabies (12.4%) and pyoderma (11.6%), Acute urticaria (6.6%), Melasma (5.8%), Psoriasis (3.8%), Polymorphous light eruption (3.6%), Phytophotodermatitis (2.6%), Leprosy (2%) and other disorders (10%). The total number of drugs prescribed in 800 prescriptions was 1946 i.e. on average 2.43 drugs were prescribed per patient. Out of 1946 drugs, 1054 were topical and 892 were oral preparations. Antifungal was most common topically prescribed drug. Conclusions: The prevalence of dermatological disorders is 8.19 %. Younger age group (21-40 yrs) and Females is most affected by dermatological disorders. The commonest dermatological disorder is Acne and in prescription analysis, antifungals are most commonly prescribed.
Effects of isokinetic velocity spectrum exercise on torque production

The purpose of this study was to assess the effect of variation in the order of four different isokinetic velocity exercise protocols on muscle torque production. Twenty‐two subjects were randomly assigned to four exercise trials, each containing an isokinetic exercise session involving the dominant knee extensor and flexor. Each trial consisted of performing two sets of 10 repetitions at velocities of 30°, 90°, 150°, and 210° per second in varying order. Peak torque (Nm), average peak torque (Nm), and average torque (Nm) were used to make comparisons between the four protocols. Univariate analysis showed no significant effect (p >0.05) of varying the order of isokinetic velocity of muscle contraction in the four protocols described for any of the three torque measurements. It was concluded that varying the pattern of isokinetic velocity at which a specific torque is developed does not interfere with general or specific torque at a particular velocity of contraction.
Excessive bronchoconstriction induced by histamine and effects of volume history in patients with bronchial asthma

: The aim of this study was to examine the inter-relationships between the different effects of deep breaths and histamine provocation on airway function in patients with bronchial asthma. Group 1 consisted of 38 consecutive out-patients with newly diagnosed mild asthma, group 2 consisted of 20 patients with bronchial asthma of varying severity who were studied during clinical remission. We measured bronchial responsiveness (BR) to histamine inhalation as the dose of histamine which provoked a 20% fall in FEV1 (PD20). The fall in forced vital capacity (FVC) after inhaling the highest dose of histamine during each BR test was calculated and expressed as percentage of the value measured at baseline (delta FVC in percentage). We studied the effects of deep breaths on airway caliber in group 2 patients by comparing isovolumic flow rates on partial (P) and maximal (M) forced expiratory flow volumes curves expressed as the M/P ratio. The changes in residual volume (RV) after deep breaths (delta RV) were expressed as a percentage of the largest VC measured on the composite M and P curves. The patients in group 1 had significantly higher PD20 and lower delta FVC than patients in group 2. There was, however, no significant correlation between PD20 and delta FVC measurements in individual patients (r 0.05). The M/P ratio was significantly related to delta FVC (r = -0.6, P < 0.006). There was also a significant positive relation between the magnitude of increase in residual volume following deep breaths (delta RV) and the degree of fall in FVC following histamine inhalation (delta FVC) (r = 0.65, P = 0.001). This significant relationship between the degree of airway closure after a deep breath and airway closure after histamine challenge is a new finding. In patients with bronchial asthma, the effects of a deep breath on airway function may be indicative of the tendency for airway closure during BR testing.
Individual and social determinants of multiple chronic disease behavioural risk factors in Canadian children and adolescents

Background: Behavioural risk factors including physical inactivity, sedentary behaviour, cigarette smoking, alcohol drinking, and being overweight are major modifiable causes of chronic diseases such as cancer, cardiovascular diseases and diabetes. These lifestyle risk factors also co-occur in individuals and lead to increased risks of chronic diseases morbidity and mortality. Although single behavioural risk factors have been extensively studied, little is known about the distribution, clustering patterns and potential determinants of multiple behavioural risk factors for chronic diseases, particularly in children and adolescents. Objectives: This thesis aims 1) to describe the prevalence and clustering patterns of multiple chronic disease behavioural risk factors in Canadian children and adolescents; 2) to explore potential individual, social and school correlates of multiple chronic disease behavioural risk factors in Canadian children and adolescents; and 3) to assess, based on the conceptual framework of this study, the longitudinal influence of selected individual (sense of self, sense of achievement), social (social relations, others’ behaviours) and school (collective commitment to success, comprehension of rules) distal variables (variables situated at an intermediate distance from behaviours), as well as selected individual (demographics and personality traits), social (parental socioeconomic characteristics) and school (type of school, supportive environment, disciplinary climate) ultimate variables (variables situated at an utmost distance from behaviours) on the rate of occurrence of multiple chronic disease behavioural risk factors in Canadian children and adolescents. Methods: Cross-sectional data (n = 4724) from Cycle 4 (2000-2001) of the National Longitudinal Survey of Children and Youth (NLSCY) were used to describe the prevalence and clustering patterns of multiple behavioural risk factors in Canadian youth aged 10-17 years. Clustering was assessed using an observed to expected ratio method. Ordinal logistic regression was used to explore correlates of multiple behavioural risk factors in a crosssectional sample (n = 1747) of Canadian youth aged 10-15 years from Cycle 4 (2000-2001)
Psychiatric help for survivors of torture

When asked for advice about a survivor of torture (or of some other form of organised state violence), there are at least two people to consider. In addition to the needs of the patient, those of the person asking for advice – the health professional – must be taken into account. There are some forms of violence which can damage others, even in the controlled circumstance of a consulting room. There is a context, often a community or a family, in which the person exists. This paper will first address some of these broader issues before going on to consider some of the narrower, more technical, matters of best available treatment.
Cytogenetic Characterization of Brown Howler Monkeys, Alouatta guariba clamitans (Atelidae, Platyrrhini): Meiotic Confirmation of an X1X1X2X2X3X3/X1X2X3Y1Y2 Sex Chromosome System

For brown howler monkeys (Alouatta guariba clamitans), diploid chromosome numbers varying from 2n = 45 to 2n = 52, with XX/XY, X<sub>1</sub>X<sub>1</sub>X<sub>2</sub>X<sub>2</sub>/X<sub>1</sub>X<sub>2</sub>Y, and X<sub>1</sub>X<sub>1</sub>X<sub>2</sub>X<sub>2</sub>X<sub>3</sub>X<sub>3</sub>/X<sub>1</sub>X<sub>2</sub>X<sub>3</sub>Y<sub>1</sub>Y<sub>2</sub> sex chromosome systems have been described by mitotic studies but still await confirmation by meiotic analyses. We analyzed 3 male individuals sampled in the wild (in the municipality of Santa Maria, RS, Brazil) as well as 1 male and 1 female individual in captivity at the São Braz breeding center. Peripheral blood samples and testicular biopsies were taken. We found different diploid numbers for both sexes in somatic cells, 2n = 45,X<sub>1</sub>X<sub>2</sub>X<sub>3</sub>Y<sub>1</sub>Y<sub>2</sub> in males and 2n = 46,X<sub>1</sub>X<sub>1</sub>X<sub>2</sub>X<sub>2</sub>X<sub>3</sub>X<sub>3</sub> in females, with 4 metacentric (9-12), 7 submetacentric (1-6, 8), and 9 acrocentric autosomal chromosome pairs (13-20, 22). X<sub>1</sub> and X<sub>2</sub> were submetacentric chromosomes, while X<sub>3</sub>, Y<sub>1</sub>, and Y<sub>2</sub> were acrocentric ones. Spermatocyte microspreads were examined for synaptonemal complexes. Pachytene spermatocyte analysis was done to verify the chromosome number and morphologies observed in mitotic karyotypes. Immunodetection was performed using anti-SMC3 and anti-CREST antibodies. The presence of a sex chromosome pentavalent X<sub>1</sub>X<sub>2</sub>X<sub>3</sub>Y<sub>1</sub>Y<sub>2</sub> in the males was confirmed by C-banding in metaphase I and by immunodetection in prophase I by the clear identification of 5 centromeres. The G-banded karyotype corresponded to that previously described for A. g. clamitans in the south of Brazil (Curitiba, Parana State, and Blumenau, Santa Catarina State) and for the Misiones Province, Argentina.