Miracle-dz/UniFAR-FTUs huggingface dataset:
Importance of CXCL12 and CXCR4 in radiotherapy of head and neck cancer, considering the association with HPV-infection

p16INK4A expression is an important, independent prognostic marker in HNSCC patients. We observed a strong correlation between tumour HPV status, particularly HPV-16, and p16INK4A expression. Accordingly, our data clearly revealed that p16INK4A expression may be a more powerful marker for predicting prognosis than HPV DNA detection from archived FFPE tumour tissues. The improved OS seen in HNSCC patients with positive p16INK4A expression are thought to be independent of the treatment approach. However, in this study we found that the combination of HPV/p16INK4A positivity and HGAOT as treatment-related toxicities may have an additional effect on improved treatment outcomes and OS of HNSCC patients. Morover, p16INK4A expression is more important for patients without HGAOT. For clinicians, the combined IHC report of p16INK4A expression from the pathology laboratory and the analysis of acute organ toxicity of patients during therapy or even seen after therapy at follow-up appointments could provide important prognostic information for the individual patient and also become the basis of treatment decisions in the future. In this study, we presented clinical and experimental data, underscoring the prognostic value of CXCL12 and CXCR4 in HNSCC patients treated with R(C)T. immunohistochemical analysis of HNSCC biopsies showed that the expression of CXCR4 alone in tumour tissue was a negative predictor for patients, while the expression of CXCL12 was associated with improved OS. We evaluated CXCR4 as a predictive indicator for HNSCC patients with poor prognosis with regard to reduced DMFS and also investigated its biological relevance in the migratory capacity of HNSCC tumour cell lines in a CXCL12 gradient. CXCL12 had a specific effect on migration of HNSCC cells that does not stem to enhanced proliferation. Additionally, we were able to show that CXCL12 also induces irradiated HNSCC cells to migrate, whereas this tendency was significantly reduced in a dose-dependent manner by irradiation. As shown by an experiment in the in vitro study, CXCR4 significantly induces the migration of CXCR4-positive tumour cells and promotes the progression of distant metastases in our in vivo analysis. Accordingly, these results indicate that the CXCL12/CXCR4-pathway is functionally relevant in head and neck cancer cell lines, which in turn supports the clinical data. we have also demonstrated that different indicators and biomarkers are of independent prognostic value in HNSCC. These results can also lead us to a new efficient treatment strategy, in which the intensity of CT or extent of the irradiated area can be altered while maintaining good tumour control with the ability to rationally personalise therapy to advance therapeutic outcomes.
Contrast-Associated Acute Kidney Injury (CA-AKI) in Children: Special Considerations

Contrast-associated acute kidney injury (CA-AKI) is a major concern when iodinated contrast material is administered, especially in patients at risk. Efforts have been undertaken to understand the detrimental effects of contrast media (CM). With the use of low-osmolar or iso-osmolar CM the incidence of CA-AKI has steadily decreased within the past decade; however, especially in the pediatric population information is scarce. Incidence rates have been reported to range between 0% to 18.75%, particularly depending on indication, selection of population (i.e. preexisting co-morbidities), and definition of AKI. Different biomarkers have been proposed, but confirmatory studies are either lacking or have contributed to their lack of diagnostic power. Proteomic approaches have been employed and may pave the way to such discovery. Prevention strategies have been tested and proposed, but the recently published AMACING and PRESERVE trials have shown that commonly used strategies (such as systematic hydration or administration of N-acetylcysteine) have no role in the prevention of CA-AKI. We propose that thoughtful assessment of one’s fluid state is the most appropriate approach and depending on the hydration status diuretics or fluid administration should be provided to achieve an euvolemic state ahead of contrast exposure.
LIPID PROFILE OF CHILDREN WITH TYPE I DIABETES COMPARED TO CONTROLS

INTRODUCTION: Diabetes mellitus in the most common endocrine-metabolic disease in children and is associated with cardiovascular risk factors. This study aimed to compare the lipid profile of diabetic children with controls. METHODS: In this case-control study, the lipid profiles and lipoprotein levels of 45 children aged 2-18 years with established diabetes were compared with those of 45 healthy controls. RESULTS: Mean apolipoprotein A and triglyceride levels in cases were higher than in controls, while mean apolipoprotein B and lipoprotein-a, as well as LDL, HDL and total cholesterol were higher in controls. CONCLUSIONS: Better apolipoprotein levels and lipid profiles in diabetic children compared to controls were likely due to tight nutritional control in diabetic patients under study.
Evaluation of role of Endovascular Intervention in Treatment of Patients with Critical Lower Limb Ischemia

Accept Date 2019-10-15 ABSTRACT Objective: The aim of this work is to evaluate the role of endovascular intervention in limb revascularisation , wound healing , pain relief and limb salvage for patients complaining from critical lower limb ischemia (CLI) in the vascular surgery department in Zagazig university hospitals. Methods: This is a Prospective cohort study. The study was carried on Zagazig university Hospitals . Sample size: Assuming that attendance rate of patients with CLI in vascular surgery department is 3/month so total total sample were 18/6months (period from September 2018 till February 2019) . Conclusion: Endovascular intervention is considered a safe and efficient technique in the treatment of critical limb ischemia, the technique has many advantages over open surgical procedure , being tolerable, easy, safe and effective with general anaesthesia avoidance and has low mortality and morbidity . Key words; Critical Limb Ischemia, Percutaneous trans-luminal angioplasty, Peripheral vascular disease
Type II DM Medication Non-Adherence in Adama Hospital Medical College, Central Ethiopia

Background: Type II Diabetes Mellitus is a significant and growing health problem worldwide. In Ethiopia, a limited number of studies have tried to investigate treatment non adherence and associated factors among type II Diabetes Mellitus patients. Therefore, this study was aimed to determine the magnitude of medication non-adherence and its associated factors among type II Diabetes Mellitus patients in Adama hospital medical college, central Ethiopia. Methods: A facility based cross-sectional study was conducted among 140 Type II Diabetes Mellitus patients in Adama Hospital Medical College, central Ethiopia. We used consecutive sampling method, in which every subject meeting the criteria of inclusion is selected until the required sample size is achieved. A standardized Patient Health Questionnaire (PHQ-9) and Morisky Medication Adherence Scale-8 (MMAS-8) were used to identify the major depressive disorder and medication non adherence, respectively. Data were entered into a computer using EpiData 3.1 then exported to SPSS software version 20 for analysis. Logistic regression analysis was used to identify factors associated with medication non-adherence. Results: The magnitude of type II Diabetes Mellitus drug non-adherence was 58.6% (95% CI: 54.7, 62.4). Individuals having major depressive disorders (AOR=2.3; 95% CI: 1.1, 5.8), experiencing one or more complications (AOR= 3.3; 95% CI: 1.9, 9.0), and average income greater than 1000 birr (AOR= 0.4; 95% CI: 0.1, 0.9) were found to be independent predictors of medication non-adherence. Conclusion: In this study, the magnitude of medication non-adherence was relatively high among type II Diabetes Mellitus patients. Therefore, health professionals should early screen for diabetes associated complications and comorbid major depressive disorder and treat them early in order to enhance Type II Diabetes Mellitus patients’ medication adherence. Keywords: Medication Non-Adherence; Type II Diabetes Mellitus; Adama; Ethiopia
Study on the effect of parents' migrating on the education of the rural left-behind children

With the increasing transfer of rural labor, the problems of the left-behind children attract extensive attention. This paper is based on a large sample random survey in Jiangxi Province and Anhui Province’s primary and high school in China, researching students and their guardians, head teachers, headmasters. The research applied a combination of quantitative and qualitative methods to study on the effect of parents’ migrant working on the education of the rural left-behind children in details. The study found that the effect changes with learning stages and subjects. The supervision of parents and teachers is helpful to the left-behind children at primary school stage, while it cannot show significant help to those at junior high school stage, which may even have the opposite effect. The number of siblings and living on campus do not have a negative effect on children’s study, which even have a positive effect in some respects. Children’s own prospect of their education have a significant positive effect on their learning performance, while parents’ prospect only have a positive effect on learning performance of the left-behind children at junior high school stage.
Acetylcysteine for Prevention of Contrast Nephropathy: Meta-Analysis

The first published study of acetylcysteine for prevention of contrast nephropathy showed that the drug conferred renal protection (Journal Watch Aug 1 2000). But not all subsequent acetylcysteine studies have reached this conclusion. In this meta-analysis, researchers examined 7 randomized trials, in which acetylcysteine and placebo were compared in …
Role of Dietary Macronutrients and Fatty Acids in Obesity and Metabolic Risk in Older Adults

The aim of the study was to examine the role of dietary consumption of different types of fatty acids on metabolic risk factors and regional fat deposition in older men and women. We hypothesized that saturated fatty acid (SFA) intake, monounsaturated fatty acid (MUFA) and low intake of polyunsaturated fatty acids (PUFA) would be associated with markers of insulin resistance, hyperlipidemia, and hypertriglyceridemia. Sedentary, overweight and obese (body mass index: 29–48 kg/m2) adults (N=20) aged 45–78 years underwent two-hour oral glucose tolerance test, blood draw, DXA scan, and completed seven-day diet records. Subjects had low fitness levels (VO2 max=23.5 ± 2.4 mL/kg/min) and high total body fat (43.5 ± 1.7%). The average macronutrient composition of the diet was high in fat as a percent of total kcal (35.5%). The ratio of MUFA to PUFA was associated with serum cholesterol (r=0.48, P=0.03) and tended to be associated with higher fasting glucose (r=0.42, P=0.06) and glucose at 120 min (r=0.43, P=0.06). PUFA intake as a percentage of fat intake was associated with lower serum cholesterol (r=−0.44, P=0.05). Therefore, dietary MUFA intake unbalanced by PUFA may confer increased risk for diabetes among obese, sedentary individuals. Future investigation of food sources, or context of dietary lipids, could lead to individualized dietary recommendations to promote healthy eating habits and potentially alter metabolic risk.
Effect of Using Melatonin Implants on Reproductive Performances in Turcana Ewes

It is estimated by some authors that the administration of subcutaneous melatonin implants during a period of 30 days, in lactating or dry ewes, would improve the reproductive performance in some sheep breeds. This study was conducted in Giarmata Mare, Timis County, on 78 lactating ewes and 75 dry ewes, which were individually inserted with implants containing 18 mg melatonin on 31 August 2009. Control group consisted of 100 lactating and dry ewes in equal proportions. The results shown that the main reproduction indices as prolificacy, birth rate and the lamb number productivity index are significantly (p < 0.05) higher in ewes from the experimental group, compared with ewes from the control group, and that treated ewes shortened the period of mating and lambing to half-time comparing to the control group. There is a suggestion that the use of melatonin implants Melovin ® type near the normal breeding season increases the reproductive performance of ewes from Turcana breed.
Estimation of Beta-CTXin gingival crevicular fluid and serum of periodontally healthy individuals and chronic periodontitis patients before and after non-surgical periodontal therapy- An in-vivo study

Objective and Design: Beta Cross-linked C-terminal telopeptide of type I collagen (fragment β- CTX) is newer addition to the list of bone resorption markers in serum. The purpose of our study was to estimate and compare the levels β-CTX in gingival crevicular fluid (GCF) and serum of periodontally healthy individuals and chronic periodontitis (CP) patients before and after nonsurgical periodontal therapy (NSPT). Materials and Methods: Twenty Five subjects with equal distribution of males and females were divided into two groups i.e Group I: 10 Periodontally healthy individuals, Group II: 15 CP patients aged between 30-50 years. GCF and serum samples were collected at baseline in Group I whereas in Group II GCF and serum samples were collected at baseline and 2 months after NSPT. The levels of GCF and serum β-CTX were quantified using enzyme-linked immunosorbent assay (ELISA). The clinical parameters evaluated were plaque index (PI), gingival index (GI), probing pocket depth (PPD) and clinical attachment level (CAL) and the correlations of β-CTX in GCF and serum with clinical parameters were evaluated. Results: The mean concentration of β-CTX increased from Group I to Group II. The mean concentration of β-CTX in GCF and serum was reduced after 2 months of NSPT. Furthermore, reduction in β-CTX levels was positively correlated to gain in CAL in GCF. Conclusion: Periodontal treatment resulted in the reduction of β-CTX levels suggesting that β- CTX can be considered as a potential marker of bone resorption in CP.
Prevalence and Predictors of Non-Alcoholic Fatty Liver Disease in Obese and Overweight Children in the Northwest of Iran

Background: Over recent decades, with the increase in the prevalence of childhood overweight/obesity, the prevalence of pediatric non-alcoholic fatty liver disease (NAFLD) has increased. Objectives: The aim of this study was to investigate the prevalence of NAFLD and its predisposing factors in overweight and obese children of Urmia, Northwest of Iran. Methods: In this cross-sectional study, a total of 843 children aged 2 to 19 years were recruited out of 10800 children referred to the Digestive Disease Clinic of Shahid Motahari Hospital during 2016 2017. Anthropometric and laboratory measurements and abdominal ultrasound were performed for the children. Demographic data and their medical history were collected by a questionnaire. Unconditional logistic regression was used to predict the predisposing factors of NAFLD. Results: Fatty liver was diagnosed by ultrasound in 9.5% of overweight and 21.4% of obese children. The prevalence of NAFLD in obese children was 9.26% for the 2 5.9-year age group, 22.3% for the 6 11.9-year age group and 35.5% for the 12 19-year age group. Compared to the normal liver group, the adjusted odds ratios (ORs) [95% confidence interval (CI)] for predictive factors of NAFLD were as follows: ALT: 1.05 (1.03 1.09), ALK: 1.02 (1.01 1.03), AST: 1.04 (1.02 1.08), triglycerides: 1.1 (1. 08 1.21), TSH: 1.18 (1.1 1.40), FBS: 1.04 (1.01 1.08) and HOMA-IR: 1.19 (1.03 1.38). Compared to the age group of 2 5.9 years, the odds ratio of NAFLD was increased by 4 and 8 times in the age group 6 11.9 and 12 19 years, respectively. Conclusions: There was a strong relationship between pediatric NAFLD and ALT, AST and HOMA-IR in the overweight and obese children. Our findings emphasized the importance of prevention of obesity and early intervention to prevent abnormalities among obese children.
New method of preoperative selection of patients with gastro-oesophageal reflux disease

Introduction: The identification of sliding hiatal hernia (SHH) less than 3 cm in size using barium swallow fluoroscopy (BSF) and oesophagogastroduodenoscopy (OGD) was recently noted as a non-reliable method, allowing for approximately 2 cm of inherent error in its size estimate. Aim of the research: We aimed to develop a reliable method, which could be used for preoperative visualisation and accurate anatomic depiction of any hiatal hernia and anatomical abnormalities in patients with incomplete gastro-oesophageal reflux disease (GORD) symptom remission after appropriate medical therapy. Material and methods: Within the period 2015–2017, 29 GORD patients (15 women, mean age 51 years) with incomplete symptom resolution on acid inhibition and equivocal findings as for SHH after endoscopy and/or BSF, were evaluated before laparoscopic anti-reflux surgery (LARS) using a computed tomography scan with a Sengstaken-Blakemore tube (CTSBT) provocation probe to confirm hernia existence. We calculated the sensitivity of each of these diagnostic tests. Results: SHH was diagnosed in 21 patients by OGD and/or BSF, but during the surgery this diagnosis was confirmed in 18 patients. The sensitivity was found to be significantly higher in CTSBT modality, comparing with each of the other diagnostic tests and even higher than in OGD and BSF together. Conclusions: CTSBT has been verified as the most efficient method to confirm or rule out SHH diagnosis or other anatomical abnormalities, which could be used to provide a surgeon with detailed information while making a decision about the advisability of LARS.
A study of the complications among the patients undergoing retroperitoneal and transperitoneal laparoscopic nephrectomy for pyonephrosis

Background: Nowadays laparoscopy have gained wider acceptance in urology that leads to more reports on the potential complications. This study was conducted to evaluate the complications among the patients undergoing retroperitoneal and transperitoneal laparoscopic nephrectomy.Methods: Analysis was done retrospectively through review of a maintained database of 219 consecutive laparoscopic simple nephrectomies done for pyonephrosis from July 2001 to February 2013 at the department of urology Civil Hospital and B J Medical College Ahmedabad.Results: Total 219 simple nephrectomies performed between July 2001 to February 2013 for pyonephrosis. In 165 (75.3%) of patient’s procedure was through trans peritoneal route while retroperitoneal access was used in 54(24.6%) patients. In our study there were major complications in 12 patients with laparoscopic transperitoneal group and in 4 patients in laparoscopic retro peritoneal group. The minor complication rate in present study was 13.3% (22/165) in laparoscopic transperitoneal group and 11.1% (6/54) in laparoscopic retroperitoneal group.Conclusions: There were major complications in patients with laparoscopic transperitoneal group and in few patients in laparoscopic retro peritoneal group. In most other series it was seen that retroperitoneoscopic surgery may be associated with more complications, the findings are unfounded. Minor complications can be managed easily if there is low threshold for conversion to open surgery.
Neuroendocrine consequences of childhood traumatic brain injury

Objectives: 1) To determine the prevalence, aetiology and clinical significance of pituitary dysfunction after moderate or severe childhood traumatic brain injury (TBI); and 2) to examine its impact on quality of life (QoL) and body composition. Subjects: Retrospective observational study of 33 survivors of accidental TBI (27 males) and two of inflicted TBI (both males). Accidental TBI group: mean (SD) age at study was 13.4y (3.7y) and interval since injury, 4.1y (1.6y). King's Outcome Scale for Childhood Head Injury (KOSCHI) rating: 15 good recovery, 16 moderate disability, 2 severe disability. Inflicted TBI group: ages at study were 5.0 and 3.7 years at 4.9 and 3.3 years post-injury with good recovery and moderate disability respectively. Methods: Early morning urine samples were obtained for osmolality. Basal hormone evaluation (0800-1OOOh) was followed by the gonadotropin-relasing hormone (GnRH) and insulin tolerance (ITT, n=26) or glucagon tests (if previous seizures, n=9). Subjects were not primed. Body composition was evaluated using bioelectrical impedance analysis. Standardised quality of life (QoL) questionnaires were completed. Head injury details were extracted from patient records. Results: There were no abnormal findings in the two survivors of inflicted TBI. Among the accidental TBI group, no subject had clinical evidence of impaired growth: mean height standard deviation score (SDS) was +0.5 (range -1.6 to +3.0 SD). Median peak growth hormone (GH) response to stimulation was 7.9 pg/L. Six peri-pubertal males had suboptimal GH responses (<5 pg/L). Their height SDS at study ranged from -1.5 to +1.4; one had slow growth on follow-up. GH response was borderline low in one post-pubertal male (3.2 pg/L). Median peak Cortisol responses were 538 nmol/L (ITT) and 562 nmol/L (glucagon). 9/25 (ITT) and 2/8 (glucagon) subjects had sub-optimal responses. In two cases (one ITT, one glucagon test), basal Cortisol levels were high (624 and 722 nmol/L). For the rest, in 6/9, further testing or no action was advised; in 3/9, steroid cover was recommended for moderate or severe illness or injury. None required routine glucocorticoid replacement. No subject had diabetes insipidus. Thyroid function, IGF-I, oestradiol/testosterone, and baseline and GnRH-stimulated LH and FSH were appropriate for age, sex and pubertal stage. One male was prolactin deficient (<50 mU/L). Abnormal endocrine findings were unrelated to severity of TBI, nature of primary or secondary brain injury, or KOSCHI rating. No significant difference in QoL was observed between those with normal or abnormal pituitary function <16y. QoL was poorer in the post-pubertal male with GH deficiency than in other subjects >16y. Conclusions: Whilst mild pituitary 'dysfunction' was common (39%), no unequivocal clinically significant endocrinopathies were found, although the GH and hypothalamopituitary-adrenal axes may be vulnerable.