Miracle-dz/UniFAR-FTUs huggingface dataset:
Cognitive Impairment and Functional Performance of Patients Admitted to a Geriatric Assessment and Rehabilitation Centre

The purpose of this outcome study was to determine the effectiveness of interventions that were aimed at improving the functional performance of the cognitively impaired elderly persons admitted to a geriatric assessment and rehabilitation centre. Change in functional performance was measured using the Functional Independence Measure (FIM). Subjects in the study (n = 65) demonstrated significant levels of improvement between admission and discharge (f = 80.74, p < 0.0001) and the amount of improvement seen did not differ between those who were moderately or severely cognitively impaired. Admission FIM scores accounted for 81% of the variance seen in discharge scores and were therefore significant predictors of functional ability. Sixty-six percent of subjects in the study group were discharged home. The intensity of time in occupational and physical therapy was thought to be a variable contributing to the subject's change in functional status; however, the results of this study indicate that direct therap.
Biostatistics 203. Survival analysis.

Since survival time is a quantitative variable, why can’t we just use the usual techniques from Table I? Before we explain the main reason why we use survival analysis, let’ us consider a simple example on the survival times (in months) for 25 lung cancer patients who all died; the timings are : 1, 5, 6, 6, 9, 10, 10, 10, 12, 12, 12, 12, 12, 13, 15, 16, 20, 24, 24, 27, 32, 34, 36, 36, 44 months. Performing a simple descriptive, we have n = 25, mean (sd) = 17.52 (11.48) months and median = 12 months.
Detection and Qualification of Human Immunodeficiency Virus RNA in Patient Serum by Use of the Polymerase Chain Reaction

Human immunodeficiency virus (HIV) RNA was detected and quantified in the serum of HIV-seropositive individuals using the polymerase chain reaction (PCR) and a nonisotopic enzyme-linked affinity assay. Of 55 HIV-infected patients who were not receiving therapy, serum HIV RNA was detected in 9 of 19 who were asymptomatic, 11 of 16 with AIDS-related complex (ARC), and 18 of 20 with AIDS, with copy numbers ranging from 10(2) to greater than or equal to 5 x 10(4) 200 microliters of serum based on a relationship between absorbance and known copy number of gag gene RNA. Linear regression analysis demonstrated a correlation between infectious titer in 42 patient sera cocultured with donor peripheral blood mononuclear cells (PBMC) and PCR product absorbance (r = .70, P less than .01). Serum HIV RNA detected by PCR also correlated with serum p24 antigen positivity, CD4 counts less than 400/mm3, and the presence of HIV-related symptoms or disease. Quantification of infectious HIV RNA in cell-free serum by PCR may be useful as a marker for for disease progression or in monitoring antiviral therapy.
A high-MUFA diet alone does not affect ketone body metabolism, but reduces glycated hemoglobin when combined with exercise training in diabetic rats

Abstract Background Monounsaturated fat (MUFA) also has glucose-lowering action, but its effect on ketone bodies is unknown. Objectives To examine the effects of high-MUFA diet alone or in combination with exercise training, which can improve glucose and ketone body metabolism, in a rat model of diabetes. Methods Wistar rats were administered streptozotocin to induce diabetes and then randomly divided into five groups: sedentary rats fed a regular diet (1), a high-saturated-fat diet (2), a high-MUFA diet (3); and exercisetrained rats fed a regular diet (4), and a high-MUFA diet (5). Training was by a treadmill twice daily, 5 days/week. At 12 weeks, glucose, glycated hemoglobin (HbA1c), insulin, nonesterified fatty acids (NEFA), and β-hydroxybutyrate levels were measured in cardiac blood. Activity of the overall ketone synthesis pathway was determined in liver and 3-ketoacyl-CoA transferase activity determined in gastrocnemius muscle. Results A high-MUFA diet tended to lower plasma glucose without affecting other biochemical variables. Training did not change glucose metabolism, but significantly reduced serum NEFA. Only the high-MUFA diet plus training significantly decreased HbA1c levels. Hepatic ketone synthesis was decreased and 3-ketoacyl-CoA transferase activity was increased by training alone or in combination with a high-MUFA diet. Changes in NEFA, β-hydroxybutyrate, and the enzymatic activities in response to training plus a high-MUFA diet were comparable to those caused by training alone. Conclusion A high-MUFA diet alone does not alter ketone body metabolism. Combination of a MUFA-rich diet and exercise training is more effective than either MUFA or exercise alone for lowering HbA1c.
Impact of Vernal Keratoconjunctivitis on School Children in Egypt

ABSTRACT Purpose: To evaluate the prevalence of vernal keratoconjunctivitis (VKC) and its impact on school children in Egypt. Methods: A total of 3,706 students from six randomly selected schools of Menoufia were included where 126 had symptoms according to the VKC related symptoms questionnaire. Selected children were referred to a hospital for further assessment. Results: The mean age of included children was 8.79±31.87 years, with a VKC prevalence of 3.3%, and male-to-female ratio of 2.3:1. The most frequently reported symptoms were ocular itching, followed by burning sensation, tearing, red eye, discharge, and photophobia. Signs vary between mild and severe cases; however, all cases had a negative impact on school attendance and performance. Conclusion: The prevalence of VKC differs according to the age group of included cases and the local temperature of the study area. School attendance, performance, lifestyle, and social activities were negatively affected by VKC.
Association of Interleukin-18 (-137G/C) Polymorphism with Rheumatoid Arthritis and Systemic Lupus Erythematosus: A Meta-Analysis

Background: Recent studies have suggested that interleukin (IL)-18 gene (−137G/C) polymorphism is associated with rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). However, other studies did not confirm this correlation. Objective: The objective of this study was to evaluate the relationships of IL-18 −137G/C and RA and SLE using a meta-analysis. Methods: Pubmed, Embase and Cochrane library databases were systemically searched. Data were extracted by two independent reviewers and pooled odds ratio (OR) with 95% confidence interval (CI) was calculated. Results: In RA, the overall ORs and 95% CIs of −137C were 1.03, 0.88–1.22 (p = 0.391); 1.22, 0.89–1.68 (p = 0.020) and 1.06, 0.93–1.21 (p = 0.110) in dominant, recessive, and additive models, respectively. Furthermore, in SLE, the overall ORs and 95% CIs of −137C were 1.10, 0.94–1.29 (p = 0.980); 1.21, 0.91–1.60 (p = 0.010) and 1.10, 0.97–1.24 (p = 0.454) in dominant, recessive, and additive models, respectively. IL-18 −137G/C could increase the risk of RA and SLE. No publication bias was found in this meta-analysis. After population stratification analysis, under recessive model, the pooled ORs and 95% CIs of −137C were 1.14, 0.82–1.60 (p = 0.008) and 1.01, 0.66–1.55 (p = 0.004) in European RA patients and Asian SLE patients, respectively. Conclusions: This meta-analysis showed that IL-18 −137G/C was a risk factor for RA and SLE, especially for RA in Europeans and SLE in Asians.
Investigational approaches to therapies for idiopathic pulmonary fibrosis

Importance of the field: In fibrosing diseases, scar tissue begins to replace normal tissue, causing tissue dysfunction. For instance, in lung fibrosis, foci of what resembles scar tissue form in the lungs, impeding the ability of patients to breathe. These conditions represent a significant source of morbidity and mortality. More than 150,000 people in the USA have some form of fibrotic lung disease, and the 5-year mortality rate for these diseases can be as high as 80%. Despite this large unmet medical need, there are no FDA-approved therapies. Although our understanding of the causes and the biology of fibrosing diseases remains relatively poor, we have made impressive advances in identifying the major cell populations and many biochemical mediators that can drive this process. As a result, novel therapeutics are being developed based upon these discoveries. Areas covered in this review: This review examines the experimental therapies currently under investigation as of late 2009 for a major class of lung fibrosis called idiopathic pulmonary fibrosis (IPF). What the reader will gain: The reader will gain an overview of current experimental therapies for IPF. Take home message: With the recent approval of Pirfenidone in Japan for use in IPF, and a rich pipeline of experimental therapies in various stages of clinical development, the future looks bright for new treatment options.
The science of aerosol delivery in cystic fibrosis

Aerosolized drugs are universally used for treatment of cystic fibrosis airway disease. Inhalation can increase topical efficacy and reduce systemic exposure and toxicity of many drugs. A wide variety of inhaled drugs already exist with many more in the therapeutic pipeline. Understanding the principles of aerosol delivery and how aerosol devices function is important in designing the best therapeutic regimens for CF patients. The variables that determine where an aerosol deposits are numerous and complex. Important aerosol‐related variables include particle‐size distribution, hygroscopic properties, viscosity and surface tension of the drug. Patient‐related variables include inspired flow rate, tidal volume, respiratory rate, breath‐holding, upper airway anatomy, lower airways obstruction, and the cognitive and physical ability to use the device. These factors vary widely between patients of different age groups and disease severities, and cause the high variability in drug delivery seen with aerosol drugs. Classic aerosol delivery devices like metered dose inhalers and dry‐powder inhalers are small, portable, and have short treatment times. However, they are limited by small drug payloads and user technique problems. Jet nebulizers are commonly used for CF drugs, are easy to operate, require no special breathing pattern, and can deliver very large quantities of drug. However, they require a power or air source, cleaning and sanitizing, and are relatively time consuming. Recently, novel aerosol delivery systems and formulations have been developed to improve delivery efficiency and reduce variability and delivery time. These new systems can ease the treatment burden and improve adherence and outcomes in cystic fibrosis. Pediatr Pulmonol. 2008; 43:S5–S17. © 2008 Wiley‐Liss, Inc.
Management and treatment of feline tarsal injuries

Feline tarsal injuries are common, particularly in male cats, and can result from dog bites, road traffic accidents or falls from heights. Complete physical and orthopaedic examinations are required to reliably identify all injuries in these cases, but life-threatening injuries must take precedence over orthopaedic trauma. This article discusses the management and treatment of injuries to the feline tarsus.
Vertebral Fractures and Mortality in Older Women

Results:Atbaseline,1915women(20.0%)werediagnosed as having vertebral fractures. Compared with women who did not have a vertebral fracture, women with 1 or more fractureshada1.23-foldgreaterage-adjustedmortality rate (95% confidence interval, 1.10-1.37). Mortality rose with greater numbers of vertebral fractures, from 19 per 1000 woman-years in women with no fractures to 44 per 1000 woman-years in thosewith5ormore fractures (P for trend, ,.001). Inparticular,vertebral fractureswererelated to the riskofsubsequentcancer(hazardratio,1.4;95%confidence interval, 1.1-1.7) and pulmonary death (hazard ratio, 2.1; 95% confidence interval, 1.4-3.0). In the subset of women who underwent thoracic curvature measurements, severe kyphosis was also related to pulmonary deaths (hazard ratio, 2.6; 95% confidence interval, 1.3-5.1).
Long-Term Outcome and Treatment Modifications in a Prospective Cohort of Human Immunodeficiency Virus Type 1-Infected Patients on Triple-Drug Antiretroviral Regimens

We designed a cohort in order to assess the long-term effects of triple-drug antiretroviral combinations in 608 patients infected with human immunodeficiency virus type 1 (HIV-1). We recruited patients who had been previously treated with nucleoside analogues as well as treatment-naive patients who were starting triple-drug antiretroviral combinations consisting of nucleoside analogues, either alone or in combination with a protease inhibitor. After a median follow-up time of 22 months, the incidence rates of acquired immune deficiency syndrome-defining events and death were, respectively, 6.9 (95% confidence interval [CI], 5.3-8.8) and 2.9 (95% CI, 1.9-4.2) per 100 person-years. Advanced clinical stage of disease (P=.004), a low CD4(+) cell count (P=.002), and a low quality-of-life score (P=.001) at baseline were independent predictors of clinical progression. The initial triple-drug combination was modified a total of 647 times in 321 patients. The only independent predictor of treatment modification was previous exposure to a nucleoside analogue in patients who did not receive a new nucleoside analogue at inclusion (P=.001). Plasma HIV RNA values below 500 copies/mL were obtained in 88% of the treatment-naive patients and in 57% of the previously treated patients (P or = 1 new nucleoside analogue at enrollment, previously treated patients who did not receive a new nucleoside analogue at enrollment were twice as likely to have plasma HIV RNA values >500 copies/mL at the last visit (adjusted odds ratio [OR], 1.8; 95% confidence interval [CI], 1.2-2.8), and the antiretroviral-naive patients were significantly less likely to have plasma HIV RNA values >500 copies/mL at the last visit (adjusted OR, 0.2; 95% CI, 0.1-0.4).
Poland syndrome and renal cell cancer

Poland's syndrome is a rare congenital anomaly characterized by chest wall and upper limb abnormalities. Some lymphreticular and solid malignancies have been reported with this syndrome. Renal cell carcinoma associated with Poland's syndrome has not been described previously. We herein describe the first case of a Poland's syndrome associated with renal cell carcinoma diagnosed incidentally after a road accident. All the cases with Poland's syndrome should be aware of onchologic attention by the radiologists and clinicians.
Valores de referencia espirométrica en 5 grandes ciudades de Latinoamérica para sujetos de 40 o más años de edad

Objetivo La espirometria es una prueba de gran utilidad clinica, que requiere un estricto control de calidad, una estrategia de interpretacion y valores de referencia adecuados. El proposito del presente trabajo es comunicar los valores de referencia para la espirometria en 5 ciudades de Latinoamerica. Pacientes y metodos El estudio PLATINO se llevo a cabo en Caracas, Mexico, Santiago, Sao Paulo y Montevideo e incluyo a un total de 5.315 sujetos con espirometria realizada. De ellos, se estudio a 906 (17%) que tenian entre 40 y 90 anos de edad para crear valores de referencia, porque nunca habian fumado, estaban asintomaticos y no tenian enfermedad pulmonar diagnosticada ni obesidad. Se efectuaron modelos de regresion multiple con los valores espirometricos –volumen espiratorio forzado en el primer segundo (FEV 1 ) y en 6 s (FEV 6 ), flujo espiratorio maximo, capacidad vital forzada (FVC), FEV 1 /FEV 6 , FEV 1 /FVC y flujo mesoespiratorio forzado–, la talla, el sexo y la edad. Resultados Los sujetos estudiados presentaron en promedio valores similares a los de la poblacion norteamericana blanca y americana de origen mexicano del estudio NHANES III, pero superiores a los de la poblacion negra en un 20%. Conclusiones Los valores de referencia propuestos representan una ventaja sobre los disponibles en la actualidad en Latinoamerica, ya que se eligio a los participantes por metodos de muestreo poblacional y el metodo empleado es estandarizado y actualizado.
Typing and Antibiogram of Vibrio cholerae Isolates from a Tertiary Care Hospital in Pune: A 3 Year Study

A retrospective analysis was done over a period of 3 years (January 2010- December 2012) in a tertiary care hospital, Pune, to note the changes in the prevalence and distribution of biotypes, serotypes, antibiotic susceptibility pattern and phage types of Vibrio cholerae isolates from clinical samples so as to be vigilant and curtail major outbreak in future. Vibrio cholerae isolates were obtained from 4.4% of the 1126 fecal specimens processed from cases of acute watery diarrhea. Majority of the isolates were identified as V. cholerae O1 biotype El Tor serotype Ogawa (98%); Phage 27 was the predominant type (77.5%). Majority of the cases were encountered during the months June-August (68%). Antibiogram over a period of 3 years showed that isolates were consistently resistant to Ampicillin (90%) and Furazolidone (88%). Low level of resistance was seen with Norfloxacin (8%), Gentamicin (8%) and Tetracycline (6%). All isolates were susceptible to Chloramphenicol.
Early investigational TNF receptor antagonists for the treatment of ulcerative colitis

Introduction: Ulcerative colitis (UC) is a life-long, immunologically mediated condition that results from an inappropriate activation of the mucosal immune system by intestinal luminal antigens in genetically susceptible individuals. TNF-α is a pro-inflammatory cytokine central to UC pathogenesis. Areas covered: This review examines the evidence for the use of the anti-TNF (αTNF) medications infliximab, adalimumab, certolizumab and golimumab in the management of UC. It highlights the newer biosimilar agents that are becoming available and the early stage investigation of an orally administered αTNF agent. Expert opinion: αTNF therapy is effective but only in a proportion of UC patients. As there is now strong evidence that UC is not just a single disease but a series of phenotypes with distinct genetic, serological and environmental aspects, understanding the heterogeneity of the innate immunological response in UC could allow for better targeted patient management. Identifying differences in the efficacy of the various αTNF agents is difficult as there are no head-to-head studies, but only infliximab has proven clinical efficacy in the management of acute severe colitis. Biosimilars to the αTNF agents are now available and with the added competition, medications costs should fall allowing for greater patient access.
Active agents of health promotion? The school's role in supporting the HPV vaccination programme

By providing a place in which children can be accessed, the school has long been a site for population-level health initiatives. Recent policy shifts towards health-promoting schools have however re-cast the school from passive host to active collaborator in public health. This paper examines secondary school teachers' views of their roles as partners in Scotland's human papilloma virus vaccination programme. Focus groups were held in seven schools across Scotland. Confusion was evident in relation to this role, with competing understandings of young women's sexuality, concerns about parental perceptions and uncertainty about professional responsibilities. Many teachers sought to distance themselves from the vaccination programme. Evidence was found of a ‘sedimentation of discourses’, as mass models of state-sanctioned health intervention persist alongside contemporary discourses of individual choice.
Anti-TNF-α therapies for the treatment of Crohn’s disease: the past, present and future

ABSTRACT Introduction: Anti-TNF-α therapy is a novel approach that has transformed the way moderate-to-severe Crohn’s disease (CD) is treated and has significantly improved clinical outcomes of patients with enhanced remission induction and maintenance efficacies. As a result, anti-TNF-α agents have become the primary cost driver in the treatment of CD, as the frequency of hospitalizations and surgical interventions have been drastically reduced. Areas Covered: In the review, the authors cover current anti-TNF-α treatments for CD including efficacy, mechanisms of action, pharmacokinetics and safety. In addition, the authors discuss future anti-TNF-α agents currently in the development pipeline including biosimilars, golimumab, oral AVX-470, TNF-α-kinoid vaccine, and non-biologic HMPL-004. Expert opinion: While new therapeutics are in the pipeline like anti-integrin and anti-interleukin therapeutics, anti-TNF-α therapy remains at the forefront of CD treatment due to its long-term efficacy and safety profiles. The next horizon for new anti-TNF-α agents is biosimilars, which offer comparable safety and effectiveness to the originator molecules. Biosimilars promise to expand accessibility to anti-TNF-α therapy while significantly reducing the cost burden to patients and healthcare systems.
Emerging immunotherapy for the treatment of esophageal cancer

ABSTRACT Introduction: Esophageal cancer is the third most common cancer of the gastrointestinal tract. Despite new therapies, the prognosis for patients with these cancers remains poor with 5-year survival rates lower than 15%. Recently, immunotherapy has increasingly gained attention as a novel treatment strategy for advanced esophageal cancer. Areas covered: Recent success of immunotherapy in treating other solid tumors has shed light on the utility of these approaches for esophageal cancers. Here, the authors focus on antibody-based, adoptive-cell-therapy-based, and vaccine-based immunotherapies, and briefly address their rationale, clinical data, and implications. Expert opinion: Immunotherapy is now established to be a key treatment modality that can improve the outcomes of many cancer patients and appears to be ushering in a new era in cancer treatment. Checkpoint inhibitor drugs have shown preliminary favorable results in esophageal cancer treatment. Adoptive cell therapy and vaccine studies have also shown some promise in various clinical studies. Future endeavors will need to focus on identifying patients who are likely to benefit from immunotherapy, monitoring and managing immune responses and designing optimal combination strategies where immunotherapy agents are combined with other traditional treatment modalities.
Pharmacotherapy in stroke rehabilitation

Background: Pharmacotherapy is commonly given to patients recovering from a stroke to prevent further complications (e.g. recurrent stroke, seizures) or enhance recovery. However, some drugs may have a negative impact on neuroplasticity. Objectives: This review examines currently used drugs that are believed to promote recovery from motor and cognitive disturbances associated with stroke. Methods: Literature regarding the properties, efficacy, safety, and dosing of drugs used to promote recovery after stroke was reviewed. Results: The data on pharmacotherapy are insufficient to support a claim of significantly improved rehabilitation outcomes. Moreover, a growing body of evidence indicates that some agents can impair functional reorganization and slow the recovery process. However, a few chemicals are reported to be beneficial for stroke rehabilitation. The most promising are noradrenergic and dopaminergic agents, as well as several growth factors; these should be the future focus of extensive randomized clinical trials. Conclusions: Currently there is no drug with proven efficacy in enhancing poststroke recovery.