Miracle-dz/UniFAR-FTUs huggingface dataset:
Protein choices targeting thermogenesis and metabolism.

BACKGROUND Dietary proteins stimulate thermogenesis and satiety more than does carbohydrate or fat; however, less is known about the differences between protein sources. OBJECTIVE The objective was to determine the differential effects of 3 proteins on energy metabolism, satiety, and glucose control. DESIGN Energy metabolism, satiety, and glucose control were measured in 23 lean, healthy subjects on separate occasions, before and 5.5 h after consumption of 4 isocaloric test meals in a randomized, double-blind, crossover design. Three meals consisting of 50% protein (whey, casein, or soy), 40% carbohydrate, and 10% fat and a fourth meal consisting of 95.5% carbohydrate were compared with a glucose meal that provided the same glucose load as the protein meals. RESULTS The thermic effect was greater after the whey (14.4 ± 0.5%) than after the casein (12.0 ± 0.6%; P = 0.002) and soy (11.6 ± 0.5%; P = 0.0001) meals and was greater after the whey, casein, and soy meals than after the high-carbohydrate meal (6.6 ± 0.5%; P < 0.0001). Cumulative fat oxidation tended to be greater after the whey meal (16.2 ± 1.1 g) than after the soy meal (13.7 ± 1.0 g; P = 0.097) and was greater after the whey and soy meals than after the high-carbohydrate meal (10.9 ± 0.9 g; P < 0.05). The glycemic response to glucose was attenuated 32% by the proteins (P < 0.001) at the expense of a greater insulin response after whey than after glucose (154%; P = 0.02), casein (143%; P = 0.07), and soy (151%; P = 0.03). Subjective appetite sensations indicated that casein and soy were more satiating than whey (P < 0.01), but whey was more "liked" compared with casein and soy (P = 0.025 and P = 0.09, respectively). CONCLUSION The results suggest that different protein sources could be used to modulate metabolism and subsequently energy balance.
Health care for refugees

abstract empathicinquiry to elicit information while minimizing distressto the patient. 18 A question might start ‘I understandsome people in your country were mistreated by the author-ities . was your family affected in this way at all? ’. Health issues may be complex, and a gradual, stagedapproach to management is useful. This may includedeferring the discussion and management of certainissues until the patient is ready to address them. It cantake time for adequate trust to develop. Allowing thepatient to be in control of what happens is one way ofpromoting this. In addition, notions of medical con-ﬁdentiality and informed consent may be new, or mayhave been eroded by past experiences. These principlesshould be explained and emphasized.If the patient and health worker do not share a com-mon language, trained interpreters are a valuableresource. Where available, they can facilitate accuratecommunication and can act as cultural advisors. 16 Friends and family members may interpret poorly andmake it difﬁcult to raise sensitive matters. In Australia,medical practitioners in private practice, and all healthworkers in the public system, are fortunate enoughto have access to on-site and telephone interpreterservices.Normalizing the symptoms that result from tortureand refugee trauma is important.
Cardiac Resynchronization Therapy: State-of-the-Art of Current Applications, Guidelines, Ongoing Trials, and Areas of Controversy

More than 2 decades of research has established the role of cardiac resynchronization therapy (CRT) in medically refractory, mild to severe systolic heart failure (HF) with abnormal QRS duration and morphology. CRT confers a mortality benefit, reduces HF hospitalizations, and improves functional outcome in this population, but not all patients consistently demonstrate a positive CRT response. The reported nonresponder rate ranges between 20% and 40%, depending on the response criteria used.1 Efforts to improve response to CRT have focused on methods to optimize the correction of electrical and mechanical dyssynchrony (the primary target of CRT) and on improving patient selection and optimizing postimplant care. The present article reviews the state-of-the-art of CRT and discusses developments on potential promises and areas of controversy. Although CRT became common clinical practice >10 years ago, the last 2–3 years have shown a series of large clinical trials that clearly outlined the categories of patients that benefit of CRT. First of all, 3 landmark studies—REsynchronization reVErses Remodeling in Systolic left vEntricular dysfunction (REVERSE),2 Multicenter Automatic Defibrillator Implantation Trial-Cardiac Resynchronization Therapy (MADIT-CRT)3 and Resynchronization for Ambulatory Heart Failure Trial (RAFT)4—have been performed to investigate the effectiveness of CRT in HF patients with a wide QRS complex and mild symptoms (New York Heart Association [NYHA] class I–II), in which patients have been randomized to CRT-ON and CRT-OFF. The main findings were that REVERSE showed significant reverse remodeling, MADIT-CRT showed less hospitalization, and RAFT also showed significant reduction in mortality in the CRT arm. The CRT benefit shown in these studies is consistent with those from older studies performed in patients with more severe HF symptoms. Figure 1 displays that the increase in left ventricular (LV) ejection fraction (EF) by CRT is independent of baseline EF. Figure 1. Change in left ventricular ejection fraction after …
Methodology for the development of normative data for Spanish-speaking pediatric populations.

OBJECTIVE To describe the methodology utilized to calculate reliability and the generation of norms for 10 neuropsychological tests for children in Spanish-speaking countries. METHOD The study sample consisted of over 4,373 healthy children from nine countries in Latin America (Chile, Cuba, Ecuador, Guatemala, Honduras, Mexico, Paraguay, Peru, and Puerto Rico) and Spain. Inclusion criteria for all countries were to have between 6 to 17 years of age, an Intelligence Quotient of≥80 on the Test of Non-Verbal Intelligence (TONI-2), and score of <19 on the Children's Depression Inventory. Participants completed 10 neuropsychological tests. Reliability and norms were calculated for all tests. RESULTS Test-retest analysis showed excellent or good- reliability on all tests (r's>0.55; p's<0.001) except M-WCST perseverative errors whose coefficient magnitude was fair. All scores were normed using multiple linear regressions and standard deviations of residual values. Age, age2, sex, and mean level of parental education (MLPE) were included as predictors in the models by country. The non-significant variables (p > 0.05) were removed and the analysis were run again. CONCLUSIONS This is the largest Spanish-speaking children and adolescents normative study in the world. For the generation of normative data, the method based on linear regression models and the standard deviation of residual values was used. This method allows determination of the specific variables that predict test scores, helps identify and control for collinearity of predictive variables, and generates continuous and more reliable norms than those of traditional methods.
BODY CONDITION SCORE AS TOOL TO PREDICT THE REPRODUCTIVE POTENTIAL OF BEEF COWS

Resumen. El objetivo de esta revisión es describir el efecto de la condición corporal (CC) sobre el desempeño reproductivo y la función endocrina en vacas de carne. Los intervalos parto al primer estro y ovulación, intervalos desde el parto a la actividad luteal normal y a la concepción son más cortos en vacas con CC moderada cuando son comparados con vacas delgadas. El tamaño del folículo dominante al primer estro es más grande y la tasa de preñez es mayor para vacas con condición moderada en comparación con vacas delgadas. Además, han sido estudiados los efectos de la CC sobre la secreción de hormona luteinizante, estradiol, leptina, insulina y factor de crecimiento semejante a la insulina I (IGF-I). El programa para inducción de la ovulación puede aumentar la tasa de preñez en vacas de carne con CC pobre. Sin embargo, la eficacia del protocolo para inducir el estro y la ovulación es dependiente de la CC. En conclusión, la CC es un indicador útil del estado de energía y potencial reproductivo, por sus efectos sobre la dinámica folicular, actividad ovárica, función endocrina y tasa de preñez en vacas de carne.
The Obstetrician‐Gynecologist and the Management of Breast Cancer

n 1996, the American Cancer Society predicts that I 184,300 women will develop breast cancer and 44,300 women will die of this disease (1). Due to earlier diagnosis and the success of adjuvant therapy, there is a growing population of breast cancer survivors. Thus, knowledge about breast cancer is essential for the obstetrician-gynecologist to provide quality care for women. The American College of Obstetricians and Gynecologists (ACOG) has adopted goals of fully educating the obstetrician-gynecologist in the diagnosis and treatment of benign breast disease and in reducing mortality from breast cancer (2). Patterns of care surveys have revealed that obstetrician-gynecologists perform breast physical examinations and recommended regular screening mammography more than other primary care providers (3,4). The controversy surrounding screening mammography in women under 50 years of age has resurfaced with several new studies (5-7). An NIH consensus conference will be convened to evaluate this new information and to reevaluate the recommendations from the 1993 consensus conference on screening mammography. It is important for the obstetrician-gynecologist to keep abreast of this new data to advise women under 50 years of age and to interpret the outcome of this consensus meeting. Breast examination is an integral part of a complete physical examination. As the primary care provider for women, the obstetrician-gynecologist may be the first to detect a breast mass. It is imperative that residency training programs in obstetrics and gynecology teach a comprehensive approach to the evaluation of breast masses to prevent misdiagnosis and to limit the testing to essential
Estandarización de la técnica de western blot para el diagnóstico específico de la enfermedad de Chagas utilizando antígenos de excreción-secreción de los epimastigotes de Trypanosoma cruzi

Objetivos. Evaluar la eficacia del Western Blot para el diagnostico especifico de la enfermedad de Chagas utilizando antigenos de excrecion-secrecion de epimastigotes de Trypanosoma cruzi. Materiales y metodos. Los antigenos fueron obtenidos luego de veinte horas de incubacion en medio Minimum Essential Medium-Eagle, los cuales fueron preparados a la concentracion proteica de 0,2 ug/uL para ser enfrentados a 10 mL de un pool de sueros de pacientes con la enfermedad de Chagas y un conjugado anti-IgG marcado con peroxidasa, se evidencio la presencia de los antigenos de 10, 12, 14,15, 19, 20, 23, 26, 30, 33, 36, 40, 42, 46, 58, 63, 69 91,100 y 112 KDa, de los cuales, los antigenos de 10, 12, 14, 15, 19, 20, 23 y 26 KDa, han sido considerados como especificos usando pools de sueros de pacientes con otras parasitosis y sueros de personas no parasitadas. La sensibilidad de la tecnica se evaluo empleando sueros individuales de 65 pacientes con la enfermedad de Chagas y la especificidad con sueros de 40 pacientes con otras parasitosis y cinco sueros de personas no parasitadas. Resultados. La tecnica tiene una sensibilidad de 95,4% en la deteccion de una a ocho bandas especificas, una especificidad de 100%, un valor predictivo positivo de 100% y un valor predictivo negativo de 93,7%. Conclusiones. La tecnica de Western Blot con antigenos de excrecion-secrecion de epimastigotes de T. cruzi es eficaz en el diagnostico de la enfermedad de Chagas en el Peru, pudiendo ser utilizada como prueba confirmatoria.
Atrial Septal Aneurysm and Patent Foramen Ovale as Risk Factors for Cryptogenic Stroke in Patients Less Than 55 Years of Age: A Study Using Transesophageal Echocardiography

Background and Purpose An association between atrial septal aneurysm and embolic events has been suggested. Atrial septal aneurysm has been shown to be associated with patent foramen ovale and, in some reports, with mitral valve prolapse. These two latter cardiac disorders have been identified as potential risk factors for ischemic stroke. The aim of this prospective study was to assess the role of atrial septal aneurysm as an independent risk factor for stroke, especially for cryptogenic stroke. Methods We studied the prevalence of atrial septal aneurysm, patent foramen ovale, and mitral valve prolapse in 100 consecutive patients <55 years of age with ischemic stroke who underwent extensive etiological investigations. We compared these results with those in a control group of 50 consecutive patients. The diagnosis of atrial septal aneurysm and patent foramen ovale relied on transesophageal echocardiography with a contrast study and that of mitral valve prolapse, on two-dimensional transthoracic echocardiography. Results Stepwise logistic regression analysis showed that atrial septal aneurysm (odds ratio, 4.3; 95% confidence interval, 1.3 to 14.6; P=0.1) and patent foramen ovale (odds ratio, 3.9; 95% confidence interval, 1.5 to 10; P=.003) but not mitral valve prolapse were significantly associated with the diagnosis of cryptogenic stroke. The stroke odds of a patient with both atrial septal aneurysm and patent foramen ovale were 33.3 times (95% confidence interval, 4.1 to 270) the stroke odds of a patient with neither of these cardiac disorders. For a patient with atrial septal aneurysm of >10-mm excursion, the stroke odds were approximately 8 times the stroke odds of a patient with atrial septal aneurysm of <10 mm. Conclusions This study shows that atrial septal aneurysm and patent foramen ovale are both significantly associated with cryptogenic stroke and that their association has a marked synergistic effect. Atrial septal aneurysms of >10-mm excursion are associated with a higher risk of stroke.
Utilidad de la prueba de la nitrato reductasa para la detección rápida de resistencia en Mycobacterium tuberculosis

Introduccion. La deteccion temprana de la resistencia en Mycobacterium tuberculosis es de gran importancia para el manejo del paciente y el control de la infeccion. Objetivo. Evaluar el rendimiento de la prueba de la nitrato reductasa para la determinacion de la resistencia de M. tuberculosi s a los siguientes medicamentos antituberculosos de primera linea: rifampicina, isoniacida, estreptomicina y etambutol. Materiales y metodos. Se comparo la utilidad de la prueba de la nitrato reductasa con el metodo de las proporciones multiples para determinar la resistencia de aislamientos de M. tuberculosis . Resultados. Comparada con la del metodo de las proporciones multiples, la sensibilidad de la prueba de la nitrato reductasa para rifampicina, isoniacida, estreptomicina y etambutol fue de 92, 91, 63 y 80 %, respectivamente, en tanto que la especificidad fue de 100, 100, 100 y 98 %, respectivamente. Los valores pronosticos positivos fueron, en su orden, 100, 100, 100 y 80 % para rifampicina, isoniacida, estreptomicina y etambutol, y los valores pronosticos negativos fueron 97, 93, 73 y 98 %, respectivamente. El tiempo medio de obtencion de resultados fue menor cuando se uso la prueba de la nitrato reductasa (10 dias) comparado con el del metodo de proporciones multiples (28 dias). Se observo una excelente concordancia entre los dos metodos fenotipicos de 98, 96, 81 y 96 % para rifampicina, isoniacida, estreptomicina y etambutol, respectivamente. Conclusiones. Los resultados demostraron que la prueba de la nitrato reductasa es util para la deteccion precoz de farmacorresistencia y una herramienta valiosa para la deteccion rapida de la susceptibilidad de M. tuberculosis a los farmacos antituberculosos en paises con bajos recursos.
Mesurer l’insulinorésistance en pratique quotidienne et en recherche

La resistance a l’insuline est une diminution de l’action biologique de l’hormone portant plus particulierement sur le metabolisme glucidique. L’insulinoresistance est tres frequente et est impliquee dans de nombreux problemes de sante, principalement les maladies cardiovasculaires et le diabete de type 2. La methode de reference pour la mesurer est le clamp euglycemique hyperinsulinemique, mais cette technique n’est pas applicable en pratique quotidienne. Des methodes alternatives existent a partir des valeurs d’insuline et de glucose obtenues a jeun et/ou lors d’une hyperglycemie provoquee par voie orale. Les indices obtenus sont moins precis mais beaucoup plus faciles a obtenir, malheureusement leur validation est souvent limitee.
Evaluation of photoselective vaporization of the prostate

Photoselective vaporization of the prostate is gaining wide acceptance in the urologic community. Published studies have provided data on the efficacy and safety of the photoselective vaporization of the prostate laser procedure, which seems to have an expanding role in the management of special benign prostatic hyperplasia populations, including patients with large prostates, patients under anticoagulation treatment and high-risk patients with comorbidities. This paper presents the current status of the clinical outcomes of photoselective vaporization of the prostate in the treatment of lower urinary tract symptoms due to benign prostatic obstruction. Cost of the method, speed of tissue removal, need for larger high-quality studies with long-term follow-up and the introduction of the new 120-W high-performance system vaporization are also discussed this review.
Another Approach to the Assessment of Growth in Early Infancy

The object of this study was to ascertain the relationship between birthweights of thin‐for‐dates neonates and their weight gain during the first six weeks of life. 219 term, bottle‐fed infants with birthweights greater than 2.5kg were measured for weight and for triceps and subscapular skinfold thickness at birth and at six weeks of age.
Interaction between Cytomegalovirus and Herpes Simplex Virus Type 1 Associated with the Risk of Alzheimer's Disease Development.

BACKGROUND Several environmental factors, including infectious agents, have been suggested to cause Alzheimer's disease (AD). Cytomegalovirus (CMV) has been associated with AD in several recent studies. OBJECTIVE To investigate whether carriage of CMV, alone or in combination with Herpes simplex virus (HSV), increased the risk of developing AD. METHODS Plasma samples from 360 AD cases (75.3% women, mean age 61.2 years), taken an average of 9.6 years before AD diagnosis, and 360 age-, sex-, cohort-, and sampling date matched dementia-free controls were analyzed to detect anti-CMV (immunoglobulin [Ig] G and IgM), group-specific anti-HSV (IgG and IgM), and specific anti-HSV1 and HSV2 IgG antibodies by enzyme-linked immunosorbent assays. AD cases and dementia-free controls were compared using conditional logistic regression analyses. RESULTS The presence of anti-CMV IgG antibodies did not increase the risk of AD (odds ratio [OR], 0.857; p = 0.497). Among AD cases, an association between CMV and HSV1 carriage was detected (OR 7.145, p < 0.001); in a conditional logistic regression model, the interaction between CMV and HSV1 was associated with AD development (OR 5.662; p = 0.007). CONCLUSION The present findings do not support a direct relationship between CMV infection and the development of AD; however, an interaction between CMV and HSV1 was found to be associated significantly with AD development. These findings suggest that CMV infection facilitates the development of HSV1-associated AD, possibly via its effects on the immune system.
Evaluación de temefos y pyriproxifeno en Aedes aegypti (Diptera: Culicidae) de Guayaquil, Ecuador

Introduccion: el Ministerio de Salud Publica de la ciudad de Guayaquil, Ecuador, ha utilizado, hasta la fecha, temefos (abate) como principal medida quimica para el control larval de Aedes aegypti , principal vector del dengue en este pais. Objetivos: determinar la resistencia a temefos y sus mecanismos bioquimicos en dos cepas Aedes aegypti de Ecuador, asi como determinar la eficacia del regulador de crecimiento, pyriproxifeno, como posible alternativa para su control. Metodos: en larvas de Aedes aegypti provenientes de dos localidades (Pascuales y Guayacanes), de la ciudad de Guayaquil, Ecuador, se evaluo la resistencia al insecticida oganofosforado temefos y la eficacia del pyriproxifeno mediante metodologias recomendadas por la Organizacion Mundial de la Salud. Los mecanismos de resistencia metabolicos se determinaron a traves de ensayos bioquimicos y electroforesis en gel de poliacrilamida. Resultados: las larvas de la cepa Pascuales resultaron con moderado nivel de resistencia a temefos y Guayacanes resulto susceptible. A traves de ensayos bioquimicos y electroforesis se demostro que el mecanismo de resistencia de accion metabolica, basado en una incrementada actividad de la esterasa-A4, resulto ser responsable de la resistencia detectada a temefos. Las dosis de pyriproxifeno que causaron 50 % de inhibicion de la emergencia (IE 50 ) y 95 % (IE 95 ), resultaron muy similares entre las cepas de Ecuador y la cepa de referencia susceptible a insecticidas, Rockefeller. Conclusiones: se demostro que el mecanismo de esterasas, responsable de la resistencia a temefos, esta presente en Aedes aegypti de Guayaquil, Ecuador, de ahi la necesidad de monitorear este fenomeno en diferentes regiones del pais. El regulador de crecimiento pyriproxifeno resulto muy eficaz, y esto lo convierte en una alternativa a evaluar para el control de poblaciones de Aedes aegypti en Ecuador.
Randomized, Controlled Trial of Hydralazine Versos Nifedipine in Preeclamptic Women with Acute Hypertension

We studied 37 nulliparous women with late-onset gestational hypertension and significant proteinuria, with a diastolic blood pressure of 110 mmHg or higher. They were randomly assigned to receive intravenous hydralazine (5 ou 10 mg) plus an oral placebo; or oral nifedipine (10 or 20 mg) plus an intravenous placebo, with the goal of maintaining diastolic blood pressure at or below 100 mmHg. All drugs were administered in a double-blind fashion. Hydralazine decreased mean arterial pressure from 136± mmHg to 106±7 mmHg, while nifedipine decreased it from 135±8 mmHg to 109±10 mmHg. The incidence of adverse maternal and fetal effects were similar in the two treatment groups. This randomized trial contained a limited number of subjects and, therefore, did not have the statistical power to detect small differences between hydralazine and nifedipine. However, we have demonstrated that a trial of drug therapies for acute hypertension in pregnancy can be successfully blinded, and this approach would be valuable in .
« Le remodelage bronchique dans l'asthme : mécanismes et enjeux thérapeutiques »

Les remaniements de la paroi bronchique, connus sous le nom de « remodelage des voies aeriennes », touchent une partie des sujets asthmatiques. Ces alterations sont responsables d’un declin progressif et irreversible de la fonction respiratoire et de la constitution d’un trouble ventilatoire obstructif irreversible et resistant aux therapies conventionnelles, notamment aux corticoides. Le remodelage des voies aeriennes se caracterise, entre autres, par des lesions epitheliales et une hyperplasie/hypertrophie/metaplasie des fibroblastes et des cellules musculaires lisses bronchiques. L’etude des mecanismes cellulaires et moleculaires qui gouvernent ces alterations tissulaires est l’etape indispensable a l’identification de nouvelles strategies therapeutiques preventives et/ou curatives.