Miracle-dz/UniFAR-FTUs huggingface dataset:
Significance of Cold Renal Perfusion on Renal Function and Clinical Outcomes When Renal Ischemia Time Exceeded 30 Min during Pararenal and Juxtarenal Abdominal Aortic Aneurysm Surgery

Objectives: To investigate the influence of cold renal perfusion on renal function and clinical outcomes in cases where the renal ischemia time exceeded 30 min during pararenal and juxtarenal abdominal aortic aneurysm (P/JAAA) surgery. Methods and Results: Fifty-four patients who underwent open repair for P/JAAAs were retrospectively analyzed. Thirty-nine patients received renal perfusion with cold Ringer’s solution (perfusion group) and 15 patients did not receive renal perfusion (non-perfusion group). There were no significant differences in preoperative serum creatinine level (Cr) (1.08 ± 0.42 vs. 1.35 ± 0.71 mg/dL, p = 0.09), percentage of patients with Cr > 2 mg/dL [2/38 (5%) vs. 2/15 (13%), p = 0.8], and renal ischemia time during proximal aortic clamping (49 ± 21 vs. 47 ± 11 min; p = 0.8) between the groups. Postoperative Cr was significantly lower in the perfusion group than in the non-perfusion group (1.48 ± 0.76 vs. 2.23 ± 1.21 mg/dL, p 2 mg/dL was also significantly lower in the perfusion group than in the non-perfusion group [5 (13%) vs. 7 (47%), p Conclusion: Renal artery perfusion with cold Ringer’s solution clearly reduced the deterioration of postoperative renal function compared to non-renal perfusion.
Clinical Profiles of Diffuse Interstitial Pulmonary Disease

By reading, you can know the knowledge and things more, not only about what you get from people to people. Book will be more trusted. As this clinical profiles of diffuse interstitial pulmonary disease, it will really give you the good idea to be successful. It is not only for you to be success in certain life you can be successful in everything. The success can be started by knowing the basic knowledge and do actions.
Comparison of Dexmedetomidine and Morphine as Adjuvants to Bupivacaine for Epidural Anesthesia in Leg Fracture Surgery: A Randomized Clinical Trial

Background Epidural block approach and drugs are common options for improving the sensory and motor block duration and postoperative pain management. Objectives The study aimed to compare the analgesic effects of dexmedetomidine and morphine as adjuvants to bupivacaine for epidural anesthesia in leg fracture surgery. Methods This prospective clinical trial was conducted on patients (n = 80, age range: 18 - 60 years) categorized as ASA class I or II. After a clinical examination, the patients were allocated to receive either lumbar epidural bupivacaine + morphine (BM) (12 mL bupivacaine 0.5% + morphine 2 mg) or bupivacaine + dexmedetomidine (BD) (12 mL bupivacaine 0.5% + dexmedetomidine 1 µg/kg). After drug administration, the sensory block level was assessed at 2-min intervals using the Cold Swab method until it reached the T12 level. At the T12 level of sensory block, the surgery began when motor block reached grade 3 of the modified Bromage scale. Results The BD group had a significantly shorter time to reach the sensory and motor block than the BM group (P < 0.001). The duration of sensory and motor block was significantly longer in the group BD than in the BM group (P < 0.001). Moreover, the BD group showed lower VAS scores (P < 0.0001) and longer time to first analgesia demand than the BM group. Conclusions Combined bupivacaine + dexmedetomidine prolongs the sensory and motor block duration and controls postoperative pain more effectively, indicating that it is an appropriate combination for epidural anesthesia.
Immunotherapy Based on Dendritic Cell-Targeted/-Derived Extracellular Vesicles—A Novel Strategy for Enhancement of the Anti-tumor Immune Response

Dendritic cell (DC)-based anti-tumor vaccines have great potential for the treatment of cancer. To date, a large number of clinical trials involving DC-based vaccines have been conducted with a view to treating tumors of different histological origins. However, DC-based vaccines had several drawbacks, including problems with targeted delivery of tumor antigens to DCs and prolong storage of cellular vaccines. Therefore, the development of other immunotherapeutic approaches capable of enhancing the immunogenicity of existing DC-based vaccines or directly triggering anti-tumor immune responses is of great interest. Extracellular vesicles (EVs) are released by almost all types of eukaryotic cells for paracrine signaling. EVs can interact with target cells and change their functional activity by delivering different signaling molecules including mRNA, non-coding RNA, proteins, and lipids. EVs have potential benefits as natural vectors for the delivery of RNA and other therapeutic molecules targeted to DCs, T-lymphocytes, and tumor cells; therefore, EVs are a promising entity for the development of novel cell-free anti-tumor vaccines that may be a favourable alternative to DC-based vaccines. In the present review, we discuss the anti-tumor potential of EVs derived from DCs, tumors, and other cells. Methods of EV isolation are systematized, and key molecules carried by EVs that are necessary for the activation of a DC-mediated anti-tumor immune response are analyzed with a focus on the RNA component of EVs. Characteristics of anti-tumor immune responses induced by EVs in vitro and in vivo are reviewed. Finally, perspectives and challenges with the use of EVs for the development of anti-tumor cell-free vaccines are considered.
‘It’s a whole cultural shift’: understanding learning in cultural commissioning from a qualitative process evaluation

ABSTRACT This qualitative process evaluation investigated learning from stakeholders (patient representatives, art managers/artists, clinicians and commissioners) involved in a co-produced cultural commissioning grant scheme. The scheme was devised as a mechanism to foster learning between, and within, stakeholder groups and to embed co-production in decision-making in clinical commissioning. The evaluation included respondents (n = 36) from four stakeholder groups in three sequential stages. Findings identified themes centred on outcomes, learning, co-production, and cultural and political change, specifically that stakeholder roles need to be clearly defined and understood and that co-production takes a significant time commitment. Co-production in innovative projects is both complex and challenging. However, despite this, involving stakeholders has benefits for service design and the clinical commissioning process.
LARGE THYROGLOSSAL DUCT CYST WITH ATYPICAL ENDOLARYNGEAL PRESENTATION - A RARE ENTITY.

Thyroglossal duct cysts are the commonest cystic neck swellings, usually seen in pediatric population. They are typically found in midline, and mostly infra-hyoid. Very rarely thyroglossal duct cysts are found with atypical endolaryngeal presentation. Literature search revealed 15 cases of endolaryngeal thyroglossal duct cysts reported in literature. In this article, we report the 16th case of thyroglossal duct cyst with endolaryngeal extension. This being a very rare case of a large cyst which presented with dysphonia in a 41-years-male who was referred to us for laryngoscopic examination by a speech language pathologist (SLP) His primary complaint was dysphonia and further inquiry revealed a painless, slow growing cystic neck swelling of submandibular triangle. It was diagnosed as a thyroglossal duct cyst with endolaryngeal extension following laryngoscopy and Computed tomography. Cyst was surgically removed with Sistrunks procedure with no recurrence and normal phonation without any therapeutic intervention by SLP post operatively. Literature search revealed that TGDCs with endolaryngeal extension are very rare.
dIetarY trends and cancer MorBIdItY rates In Poland In the Years 1960–2005

found between and C consumption and incidence rates. The used by the in could also be linked to reduction in the use of the salt, although due to the scarcity of the data estimates of the correlation coefficients were not possible. Growing colorectal cancer incidence was related to increasing consumption of edible fats and decline in dietary fibre content. Growing pancreatic cancer incidence rate up to the half of the 1990s was probably associated with the increasing consumption of alcohol, edible fats and sugar.
Changes in Biomarker Status in Metastatic Breast Cancer and Their Prognostic Value

Purpose There is cumulative evidence that changes in biomarker status occur frequently during the metastatic progression of breast cancer and affect treatment response. The purpose of this study was to evaluate the frequency of biomarker changes in metastatic breast cancer (MBC) and its impact on prognosis. Methods A total of 152 patients diagnosed with MBC at the time of initial diagnosis or during post-surgical follow-up were included. Changes in biomarker status in MBCs, their frequency according to various metastatic sites, tumor characteristics, and their association with patient survival were analyzed. Results Estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2), and Ki-67 status changed in 9 (6.0%), 40 (26.3%), 12 (7.9%), and 29 (19.1%) patients, respectively. ER, PR, and HER2 mainly showed positive to negative conversion, whereas Ki-67 changed mostly from a low to high index. There were no differences in the frequencies of biomarker changes according to the metastatic sites. As for ER and HER2, cases with negative conversion showed low expression levels in the primary tumor. Survival analyses indicated that a positive to negative conversion of ER was an independent poor prognostic factor in patients with primary ER-positive breast cancer. Conclusion Changes in biomarker status are not rare, and usually occur in an unfavorable direction in breast cancer metastases. Negative conversion of ER status is a predictor of poor prognosis. Thus, it is beneficial to evaluate changes in biomarker status in MBC not only for the purpose of determining treatment options but also for prognostication of patients.
Invisible Color Variations of Facial Erythema: A Novel Early Marker for Diabetic Complications?

Aim (1) To quantify the invisible variations of facial erythema that occur as the blood flows in and out of the face of diabetic patients, during the blood pulse wave using an innovative image processing method, on videos recorded with a conventional digital camera and (2) to determine whether this “unveiled” facial red coloration and its periodic variations present specific characteristics in diabetic patients different from those in control subjects. Methods We video recorded the faces of 20 diabetic patients with peripheral neuropathy, retinopathy, and/or nephropathy and 10 nondiabetic control subjects, using a Canon EOS camera, for 240 s. Only one participant presented visible facial erythema. We applied novel image processing methods to make the facial redness and its variations visible and automatically detected and extracted the redness intensity of eight facial patches, from each frame. We compared average and standard deviations of redness in the two groups using t-tests. Results Facial redness varies, imperceptibly and periodically, between redder and paler, following the heart pulsation. This variation is consistently and significantly larger in diabetic patients compared to controls (p value < 0.001). Conclusions Our study and its results (i.e., larger variations of facial redness with the heartbeats in diabetic patients) are unprecedented. One limitation is the sample size. Confirmation in a larger study would ground the development of a noninvasive cost-effective automatic tool for early detection of diabetic complications, based on measuring invisible redness variations, by image processing of facial videos captured at home with the patient's smartphone.
Fatty acids profile of Serra da Estrela PDO cheeses and respective atherogenic and thrombogenic indices

Purpose This study aims to determine the physicochemical and fatty acids composition of Serra da Estrela cheese (SEC), as well as health-related lipid indices, like the atherogenic and thrombogenic indices, and to evaluate the influence of producer, geographical origin and production date. Design/methodology/approach All 24 SEC produced between November 2017 and March 2018 were collected at selected certified producers and analyzed by NIR spectrophotometer and by GC. Data were statistically evaluated by chemometric tools. Findings In all evaluated SEC, 23 fatty acids were quantified. Cheese origin influenced nutritional and health-related lipid indices). The cheeses were characterized by a relative high abundance of saturated fatty acids (67-76%), followed by a medium content of monounsaturated fatty acids (17-25%) and by low level of polyunsaturated fatty acids (5-7%). A putative positive association between cheese consumption and healthy lipid indices could be reached. Practical implications The contents of some medium and long chain fatty acids as well as of nutritional and health indices were influenced by cheese producer, geographical origin and production date pointing out the need for standardizing production procedures. Social implications The SEC plays a key role in the local economy, being an endogenous product with unique sensory characteristics and nutritional potential, for which the knowledge of the lipids profile and health indices is of utmost relevance. Originality/value SEC is an iconic Portuguese cheese with Protected Designation of Origin. Based on the results, like health-related lipid indices, evaluated for the first time, a positive association between cheese consumption and healthy lipid indices could be envisaged.
Characterization of Carotid Plaques with Ultrasound Non-Invasive Vascular Elastography (NIVE) : Feasibility and Correlation with High-Resolution Magnetic Resonance Imaging

Stroke is a leading cause of death and morbidity worldwide, and a significant proportion of strokes are caused by carotid atherosclerotic plaque rupture. Prevention of stroke in patients with carotid plaque poses a significant challenge to physicians, as risks and benefits of surgical or medical treatments remain equivocal. Many imaging techniques have been developed to identify and study vulnerable (high-risk) atherosclerotic plaques, but none is sufficiently validated or accessible for population screening. Non-invasive vascular elastography (NIVE) is a novel ultrasonic technique that maps carotid plaque strain (elasticity) characteristics to detect its vulnerability; it has not been clinically validated yet. The goal of this project is to evaluate the ability of ultrasound NIVE strain analysis to characterize carotid plaque composition and vulnerability in vivo in patients with significant plaque burden, as determined by the reference standard, high resolution MRI. To undertake this study, a thorough understanding of stroke, atherosclerosis, vulnerable plaque, and current non-invasive carotid plaque imaging techniques is required. Thirty-one subjects underwent NIVE and high-resolution MRI of internal carotid arteries. Of 31 plaques, 9 were symptomatic, 17 contained lipid and 7 were vulnerable on MRI. Strains were significantly lower in plaques containing a lipid core compared to those without lipid, with high sensitivity and moderate specificity. A quadratic fit was found between strain and lipid content. Strains did not discriminate symptomatic patients or vulnerable plaques. In conclusion, ultrasound NIVE is feasible in patients with significant carotid stenosis and can detect the presence of a lipid core. Further studies of plaque progression with NIVE are required to identify vulnerable plaques.
Effect of home‐based resistance training performed with or without a high‐speed component in adults with severe obesity

The objectives of this study were to: (a) evaluate the effects of walking and home‐based resistance training on function, strength, power, anthropometry, and quality of life (QoL) in adults with severe obesity, and (b) assess whether performing resistance exercises with maximal concentric velocity provides additional benefits compared with traditional slow‐speed resistance training. Adults with a body mass index of ≥ 40 kg/m2 were randomized to slow‐speed strength training (ST; n = 19) or high‐speed power training (PT; n = 19). Both groups completed a walking intervention and home‐based resistance training (2× per week for 6 months). The PT group performed resistance exercises with maximal intended concentric velocity, whereas the ST group maintained a slow (2‐seconds) concentric velocity. At 6 months, weight loss was ~3 kg in both groups. Both groups significantly improved function (gz = 1.04‐1.93), strength (gz = 0.65‐1.77), power (gz = 0.66‐0.85), contraction velocity (gz = 0.65‐1.12), and QoL (gz = 0.62‐1.54). Between‐group differences in shoulder press velocity (−0.09 m·s−1, gs = −0.95 [−1.63, −0.28]) and 6‐minute walk test (−16.9 m, gs = −0.51 [−1.16, 0.13]) favored the PT group. In conclusion, home‐based resistance training and walking lead to significant improvements in functional and psychological measures in adults with severe obesity. In addition, considering the between‐group effect sizes and their uncertainty, performing resistance exercises with maximal concentric speed is a simple adjustment to conventional resistance training that yields negligible negative effects but potentially large benefits on walking capacity and upper‐limb contraction velocity.
Intrauterine Fluid Instillation and Transtubal Flow: A Randomized Controlled In vitro Trial Comparing Gel and Water

Background: Possible transtubal spillage of malignant cells is a major concern in fluid instillation sonography, as it is in hysteroscopy. This study aims to compare the transtubal flow of gel and saline and validate the clinical hypothesis that application of fluids with higher viscosity causes less spillage. Methods: Randomized controlledin vitro trial comparing gel and saline infusion on 15 tissue specimens after hysterectomy with bilateral salpingectomy. Instillations are performed with saline and gel dyed with a 1% ink solution. Qualitative assessment of tubal spill is investigated as primary outcome. Secondary outcomes are instillation-volume and -pressure, assessed by measuring endometrial cavity dilation atin vitro ultrasound examination and subjective numeric 10-point scoring of the instillation pressure by a dedicated examiner. Results: Tubal flow was more often observed during saline instillation (odds ratio 4.88,P= 0.008). Median subjectively assessed instillation pressures were nine arbitrary units for gel and three for saline (P< 0.001). Tubal flow occurred from 2 cc onward in the saline group versus five cc in the gel instillation group. Cavitary dilation did not differ between both groups. Conclusion: Gel instillation sonography isin vitro associated with less tubal flow and therefore could be a safer diagnostic test compared to saline infusion sonography or hysteroscopy.In vivo studies are necessary to confirm these results.
Health Related Quality of Life before, during and after pregnancy in Norwegian women with Rheumatoid Arthritis and Juvenile Idiopathic Arthritis

Background: There is a known interaction between pregnancy and rheumatic disease. Women with rheumatoid arthritis (RA) and juvenile idiopathic arthritis (JIA) are concerned about the potential impact of a pregnancy. Therefore, it is important to get more knowledge on how pregnancy affects these womens health related quality of life (HRQL). Purpose: To study changes in HRQL in Norwegian women with RA and JIA before, during and after pregnancy.Methods: A total 35 patients with RA and 27 patients with JIA were assessed up to six times (before pregnancy, once in each trimester, and at six weeks and six months postpartum) using the short form 36 (SF-36). In addition, these women were compared to a group of nonpregnant reference women in the same age group, 66 women with RA and 33 women with JIA.Results: In the study group RA women had better HRQL than the JIA patients at baseline in the aspects of mental health, vitality and role physical. Independent of disease group the womens, experience of vitality was lower in 1st, 2nd and 3rd trimester compared to baseline. Six months postpartum, the RA women in the study group scored better in the aspects of social function, physical function, role physical and role emotional than the non-pregnant reference women with RA.Conclusion: HRQL was lower during pregnancy for both RA and JIA women. However, despite a wide range, the women seemed to reach the same level as pre-pregnancy at the time of six months postpartum.
Andersen-Tawil syndrome – a case report

stReszCzenie Zespół Andersen-Tawil (Andersen-Tawil syndrome – ATS, long QT syndrome type 7, LQTS Type 7) jest rzadko występującą kanałopatią potasową, spowodowaną głównie mutacją genu KCNJ2. Część przypadków spowodowana jest mutacją genu KCNJ5. Mutacja dziedziczona autosomalnie dominująco jest wykrywana u około 60% pacjentów z rozpoznanym zespołem. Około 30% mutacji może być spowodowanych de novo. Obraz kliniczny obejmuje triadę objawów: okresowe, napadowe osłabienie siły mięśniowej występujące po dłuższym spoczynku lub w trakcie spoczynku po intensywnym wysiłku fizycznym, wydłużenie odstępu QT wraz z zaburzeniami rytmu serca i cechy dysmorficzne (m.in. niski wzrost, hypoteloryzm, hipoplazja żuchwy, krótkie palce rąk i stóp). Duża zmienność fenotypowa oraz często subtelne objawy kliniczne powodują trudności diagnostyczne. Jednak wczesne rozpoznanie jest kluczowe ze względu na możliwości zapobiegania i leczenia objawów neurologicznych oraz zaburzeń rytmu serca, które mogą być przyczyną nagłego zgonu. Celem pracy jest przedstawienie przypadku 15 letniego pacjenta z zespołem Andersen-Tawil. Słowa kluczowe: Zespół Andersen-Tawil, arytmia serca, cechy dymorficzne, KCNJ2, napadowy paraliż mięśniowy abstRaCt Andersen-Tawil syndrome is a rare potassium ion channelopathy. Mutations in KCNJ2 are the primary cause. The second causative gene is KCNJ5. Mutations inherited as an autosomal dominant characteristic, are usually found in 60% of patients with the diagnosed syndrome. De novo mutations occur in 30% of cases. The clinical presentation of the syndrome includes: periodic, paroxysmal muscular weakness occurring after prolonged rest or during rest after prolonged physical exertion, prolonged QT interval, cardiac arrhythmias and dysmorphic features (short stature, hypertelorism, hypoplastic mandible, short fingers and toes). Phenotypic heterogeneity and subtle physical symptoms cause diagnostic difficulties. However, early diagnosis is crucial because of the possibility of prevention and treatment of neurological symptoms and cardiac arrhythmias, which can be the cause of sudden death. The aim of this paper is to present the case report of a 15-year-old patient with Andersen-Tawil syndrome.