Miracle-dz/UniFAR-FTUs huggingface dataset:
Oesophageal varices in cirrhotic patients: from variceal screening to primary prophylaxis of the first oesophageal variceal bleeding

Bleeding from oesophageal varices is still a lethal complication in cirrhotic patients with portal hypertension. Approximately 5–10% of patients with cirrhosis will develop oesophageal varices per year, and about 25–30% of cirrhotic patients with oesophageal varices and without previous variceal haemorrhage will bleed from ruptured varices. To date, data on preventing the formation/growth of oesophageal varices (preprimary prophylaxis) are conflicting, with insufficient evidence to use β‐blockers. There is evidence for the need for primary prophylaxis, and both β‐blockers and endoscopic variceal ligation have shown the same efficacy in preventing first bleeding, but which one to prefer is still controversial. The present article reviews the established and potential therapeutic strategies for preventing the development and rupture of oesophageal varices.
INCIDENCE OF ENDOPHTHALMITIS AFTER INTRAVITREAL INJECTION OF ANTIVASCULAR ENDOTHELIAL GROWTH FACTOR MEDICATIONS USING TOPICAL LIDOCAINE GEL ANESTHESIA

Purpose: The purpose of this study was to determine the incidence of infectious endophthalmitis after intravitreal injection of antivascular endothelial growth factor medications using 2% topical lidocaine gel anesthesia. Methods: Retrospective chart review of 4690 consecutive intravitreal injections of antivascular endothelial growth factor medications using 2% topical lidocaine gel anesthesia. All patients had at least 6 weeks of follow-up. Results: A total of 608 patients underwent intravitreal injection of antivascular endothelial growth factor medications during the study period. There were 428 injections of pegaptanib sodium, 1841 injections of bevacizumab, and 2421 injections of ranibizumab. There were no cases of infectious endophthalmitis. The per-injection infection rate was 0.0% (95% confidence interval, 0.0-0.06%). Conclusion: The incidence of infectious endophthalmitis after intravitreal injection of antivascular endothelial growth factor medications using 2% topical lidocaine gel anesthesia is low.
OXYGEN THERAPY FOR DIABETIC MACULAR ISCHEMIA: A Pilot Study

Purpose: To evaluate the structural and functional effects of systemic oxygen therapy in patients with diabetic macular ischemia. Methods: This interventional case series was performed on 20 eyes from 13 consecutive diabetic patients with macular ischemia. For each patient, baseline optical coherence tomography and electroretinography were obtained before and after administration of 100% oxygen by face mask at a flow rate of 10 L/minute for 1 hour. Central macular thickness and b-wave amplitude were measured before and after oxygen therapy. Results: The patients included 9 women and 4 men with mean (SD) age of 63.38 (7.34) years. Central macular thickness decreased from 358.55 ± 96. 27μm before to 326.55 ± 84. 11μm after the oxygen therapy (P < 0.001). A reduction of >10% was observed in 55% of the eyes. In dark-adapted combined response electroretinography, the amplitude of b-wave increased from 227.76 ± 105.66 μV before to 264.35 ± 128.48 μV after the oxygen therapy (P < 0.001), representing a 16% increase. More than a 10% increase in b-wave amplitude occurred in 60% of the eyes. Conclusion: Oxygen therapy seems to have beneficial effects on the structural and functional changes of the retina in patients with diabetic macular ischemia. It may decrease central macular thickness and improve electrophysiologic function of the retina.
Enhancing Nurse Assessment of Alcohol and Drug Dependency: A Preliminary Study

&NA; The purpose of this project was to prepare nurses to provide brief interventions for clients with alcohol or other drug (AOD) dependency in order to reduce hospitalization, morbidity, and mortality. The project was a collaborative process between a major medical center and a school of nursing. Nurses were surveyed for understanding of alcohol and other drug assessment, and a day long training was provided to teach techniques of brief interventions. The short‐term results included increased knowledge of nurses about AOD assessment. Long‐term results indicated that 95% of patients referred to the AOD team were confirmed to have AOD problems (Dunn & Ries, 1997). This project documents the need for nurses to have more knowledge about AOD problems and brief intervention techniques.
DEXAMETHASONE INTRAVITREAL IMPLANT FOR TREATMENT OF DIABETIC MACULAR EDEMA IN VITRECTOMIZED PATIENTS

Purpose: To evaluate the safety and efficacy of Ozurdex (dexamethasone intravitreal implant) 0.7 mg in the treatment of diabetic macular edema in vitrectomized eyes. Methods: This was a prospective, multicenter, open-label, 26-week study. Fifty-five patients with treatment-resistant diabetic macular edema and a history of previous pars plana vitrectomy in the study eye received a single intravitreal injection of 0.7-mg dexamethasone intravitreal implant. The primary efficacy outcome measure was the change in central retinal thickness from baseline to Week 26 measured by optical coherence tomography. Results: The mean age of patients was 62 years. The mean duration of diabetic macular edema was 43 months. The mean (95% confidence interval) change from baseline central retinal thickness (403 μm) was −156 μm (−190, −122 μm) at Week 8 (P < 0.001) and −39 μm (−65, −13 μm) at Week 26 (P = 0.004). The mean (95% CI) increase in best-corrected visual acuity from baseline (54.5 letters) was 6.0 letters (3.9, 8.1 letters) at Week 8 (P < 0.001) and 3.0 letters (0.1, 6.0 letters) at Week 26 (P = 0.046). At Week 8, 30.4% of patients had gained ≥10 letters in best-corrected visual acuity. Conjunctival hemorrhage, conjunctival hyperemia, eye pain, and increased intraocular pressure were the most common adverse events. Conclusion: Treatment with dexamethasone intravitreal implant led to statistically and clinically significant improvements in both vision and vascular leakage from diabetic macular edema in difficult-to-treat vitrectomized eyes and had an acceptable safety profile.
Avaliação da atividade in vitro do cefetamet e outros agentes antimicrobianos diante de bactérias isoladas de infecções do trato respiratório

Cefetamet pivoxil is a new s lactamase orally stable administered cephalosporin. Antimicrobial resistance among respiratory pathogens has become an important problem for both the physician and the microbiologist and the patterns of resistance vary greatly depending on geographic location, often requiring in vitro susceptibility testing of isolates. PURPOSE - The in vitro activity of cefetamet, the microbiologically active metabolite of the prodrug cefetamet pivoxil, was compared with other 11 drugs against 376 bacterial strains recently isolated from patients with respiratory tract infections. METHODS - The comparative activity in vitro of cefetamet and other 11 antimicrobial agents was measured against 376 bacterial strains isolated from patients with respiratory tract infections, during a six month period. Through the determination of minimum inhibitory concentration by the microdilution technique, patterns of antimicrobial resistance were reported. RESULTS - Cefetamet showed hihg in vitro activity against all the bacteria tested, possessing a spectrum of activity similar to that other recently developed oral cephalosporins. The good activity of cefetamet against s-lactamase producing isolates, like Moraxella catarrhalis, can be due to its s-lactamase stability. At a concentration of 1. 0µg/mL, cefetamet inhibited 97% of all the tested bacteria. CONCLUSION - The MIC90 of the cumulative susceptibility results of the 12 antimicrobics tested in the 376 strains studied, confirm the excellent activity of cefetamet against the common respiratory tract pathogens.
PREOPERATIVE INJECTION OF INTRAVITREAL BEVACIZUMAB IN DENSE DIABETIC VITREOUS HEMORRHAGE

Purpose: To evaluate the effect of preoperative intravitreal injection of bevacizumab on surgery and on the early postoperative course in diabetic patients undergoing vitrectomy for dense vitreous hemorrhage. Methods: Thirty-five patients with dense diabetic vitreous hemorrhage were randomly assigned to a group that received 1.25 mg of intravitreal bevacizumab 1 week before vitrectomy (18 patients) or the control group (17 patients). To compare the complexity of two groups, intraoperative complexity score and proliferative diabetic vitreoretinopathy stage were recorded. Intraoperative bleeding, break formation, number of endodiathermy applications, best-corrected visual acuity, anatomical outcome at Month 3 and at final follow-up, and postoperative complications were evaluated. Results: Mean complexity scores and proliferative diabetic vitreoretinopathy stages of both groups were similar. The mean score of bleeding was 1.05 in the injection group versus 1.76 in the control group (P = 0.35); endodiathermy applications and break formations were 0.44 versus 0.52 (P = 0.68) and 0.22 versus 0.29 (P = 0.60) in the injection and control groups, respectively. Anatomical outcome and visual acuity at Month 3 and at the final follow-up were similar. Conclusion: The results suggest that intravitreal injection of bevacizumab before vitrectomy for dense diabetic vitreous hemorrhage has no significant effect on facilitation of surgery or on the early postoperative course.
Acetaminophen hepatotoxicity and repair: the role of sterile inflammation and innate immunity

Acetaminophen (APAP) hepatotoxicity because of overdose is the most frequent cause of acute liver failure in the western world. Metabolic activation of APAP and protein adduct formation, mitochondrial dysfunction, oxidant stress, peroxynitrite formation and nuclear DNA fragmentation are critical intracellular events in hepatocytes. However, the early cell necrosis causes the release of a number of mediators such as high‐mobility group box 1 protein, DNA fragments, heat shock proteins (HSPs) and others (collectively named damage‐associated molecular patterns), which can be recognized by toll‐like receptors on macrophages, and leads to their activation with cytokine and chemokine formation. Although pro‐inflammatory mediators recruit inflammatory cells (neutrophils, monocytes) into the liver, neither the infiltrating cells nor the activated resident macrophages cause any direct cytotoxicity. In contrast, pro‐ and anti‐inflammatory cytokines and chemokines can directly promote intracellular injury mechanisms by inducing nitric oxide synthase or inhibit cell death mechanisms by the expression of acute‐phase proteins (HSPs, heme oxygenase‐1) and promote hepatocyte proliferation. In addition, the newly recruited macrophages (M2) and potentially neutrophils are involved in the removal of necrotic cell debris in preparation for tissue repair and resolution of the inflammatory response. Thus, as discussed in detail in this review, the preponderance of experimental evidence suggests that the extensive sterile inflammatory response during APAP hepatotoxicity is predominantly beneficial by limiting the formation and the impact of pro‐inflammatory mediators and by promoting tissue repair.
Systemic therapy for metastatic colorectal cancer

A proliferation of new cytotoxic and biologic agents has led to improved survival in patients with metastatic colorectal cancer (mCRC). The ability of surgery to increase long‐term survival in patients with liver and/or lung metastases also has been firmly established. It has become increasingly difficult as the numbers and types of treatment options have expanded to identify optimal drug combinations, sequences, and duration and the best way to integrate systemic chemotherapy with potentially curative surgery for metastatic lesions. For this review, the authors examined how recent clinical trials have addressed some pertinent questions regarding the use of systemic chemotherapy and biologic agents in patients with mCRC. Cancer 2008. © 2008 American Cancer Society.
Fecal calprotectin is a useful screening parameter for hepatic encephalopathy and spontaneous bacterial peritonitis in cirrhosis

Objective: Bacterial translocation, causing intestinal inflammation, is one of the key mechanisms in the pathogenesis of hepatic encephalopathy (HE) and spontaneous bacterial peritonitis (SBP) The presence of fecal calprotectin quantitatively relates to intestinal neutrophil migration and is therefore considered as a marker of intestinal inflammation. We aimed to assess the role of fecal calprotectin concentrations (FCCs) in diagnosing the onset and severity of HE and SBP.
EVALUATION OF RETINAL NERVE FIBER LAYER THICKNESS IN PATIENTS WITH RETINITIS PIGMENTOSA USING SPECTRAL-DOMAIN OPTICAL COHERENCE TOMOGRAPHY

Purpose To measure the peripapillary retinal nerve fiber layer (RNFL) thickness using spectral-domain optical coherence tomography in patients with retinitis pigmentosa. Methods Fifty eyes of 30 patients with retinitis pigmentosa underwent a complete ocular examination, including best-corrected visual acuity using a Snellen chart, slit-lamp biomicroscopic examination, and Goldmann applanation intraocular pressure measurement. Dilated fundus examination was performed using both direct and indirect ophthalmoscopy. In addition, all patients underwent peripapillary RNFL thickness measurements using an OPKO spectral-domain optical coherence tomography (OPKO Instrumentations, Miami, FL). Results The mean (±SD) age of the study cohort was 45.8 (±16.3) years. Of the 50 eyes, 18 (36%) showed a thinning of the peripapillary RNFL in 1 or more quadrants and 21 (42%) showed a thickening of the peripapillary RNFL in 1 or more quadrants. Four eyes (8%) showed both thinning and thickening of the peripapillary RNFL thickness. The overall circumferential RNFL thickness of the 14 eyes that showed only thinning in at least 1 quadrant was 78.78 &mgr;m. For the 17 eyes that showed only thickening in at least 1 quadrant, the RNFL thickness was 119.69 &mgr;m. The values of the eyes with thinning and the eyes with thickening were significantly different from normal (t = 6.31 and P < 0.01 for thickening; t = 3.62 and P < 0.01 for thinning). Conclusion Using spectral-domain optical coherence tomography testing, we demonstrated in the current study that the peripapillary RNFL thickness in patients with RP can be decreased, increased, or maintained within normal limits. Assessment of the RNFL thickness seems prudent in these patients, particularly for identifying notable degrees of RNFL thinning in those being considered for future therapeutic trials.
MACULAR FEATURES FROM SPECTRAL-DOMAIN OPTICAL COHERENCE TOMOGRAPHY AS AN ADJUNCT TO INDIRECT OPHTHALMOSCOPY IN RETINOPATHY OF PREMATURITY

Purpose: To compare vitreoretinal pathology imaged with portable handheld spectral-domain optical coherence tomography (SD-OCT) to conventional indirect ophthalmoscopic examination in neonates undergoing screening for retinopathy of prematurity. Methods: Spectral-domain optical coherence tomography images were collected from 76 eyes of 38 neonates during 118 routine retinopathy of prematurity examinations. Imaging sessions in the Neonatal Intensive Care Unit were performed immediately after the subjects underwent a standard ophthalmic examination with indirect ophthalmoscopic by a pediatric ophthalmologist. Masked certified SD-OCT graders evaluated scans for preretinal and retinal findings including material in the vitreous, epiretinal membrane, intraretinal cystoid structures and deposits, optic nerve and vascular features, and severity and location of retinopathy of prematurity. The frequency of detection of these features by clinical examination and evaluation of SD-OCT images was compared to determine potential clinical advantages for each modality. Results: Portable SD-OCT imaging characterized macular features of retinal cystoid structures in 39% of examinations and epiretinal membrane in 32% of examinations. Neither feature was visualized by indirect ophthalmoscopy in any cases. The clinician using indirect ophthalmoscopy detected stage of retinopathy of prematurity and the presence or absence of Plus or pre-Plus disease. These were not visualized with SD-OCT. Conclusion: Spectral-domain optical coherence tomography provides new information about the premature infant retina that is of unknown importance relative to visual development and acuity. As used in this study, SD-OCT does not replace indirect ophthalmoscopy for evaluation of retinopathy of prematurity.
ERCC1 expression as a prognostic marker in N2(+) nonsmall‐cell lung cancer patients treated with platinum‐based neoadjuvant concurrent chemoradiotherapy

Excision repair cross‐complementation Group 1 (ERCC1) overexpression is associated with resistance to cisplatin‐based chemotherapy in patients with nonsmall‐cell lung cancer (NSCLC). A preliminary study also suggested that ERCC1 expression is associated with radioresistance in lung cancer cells. The aim of this study was to evaluate the clinical implications of ERCC1 expression in stage IIIA N2‐positive NSCLC patients treated with platinum‐based neoadjuvant concurrent chemoradiotherapy (CCRT) followed by surgery.
A randomized study assessing the efficacy of communication skill training on patients' psychologic distress and coping

Although studies have shown the usefulness of improving health professionals' communication skills by training, to the authors' knowledge none have demonstrated the efficacy of communication skill training (CST) for health professionals in terms of improving patient outcomes. This study aimed to assess the efficacy of CST for nurses in improving psychologic distress and coping among patients after being informed of a cancer diagnosis.
SEGREGATION OF OPHTHALMOSCOPIC CHARACTERISTICS ACCORDING TO CHOROIDAL THICKNESS IN PATIENTS WITH EARLY AGE-RELATED MACULAR DEGENERATION

Purpose: To investigate the association of fundus features with choroidal thickness in eyes with early age-related macular degeneration. Methods: Consecutive patients with age-related macular degeneration were evaluated. Major exclusionary criteria included late age-related macular degeneration (central geographic atrophy or choroidal neovascularization), macular laser therapy, myopia greater than −6 diopters, past vitreoretinal surgery, or central serous chorioretinopathy. Charts and multimodal imaging were reviewed for refraction, cataract, hypertension, diabetes, open-angle glaucoma, &bgr;-zone peripapillary atrophy, fundus tessellation, pigmentary changes, drusen, subretinal drusenoid deposits (also known as reticular pseudodrusen). Data measured from enhanced-depth imaging spectral-domain optical coherence tomography included subfoveal choroidal thickness, central foveal thickness, outer nuclear layer thickness, inner segment to retinal pigment epithelium aggregate thickness, presence of subretinal drusenoid deposit, and outer retinal hyperreflective layers (including the band corresponding to overlap between retinal pigment epithelium apical processes and outer segments). Correlations were calculated among the measured variables, fundus features, open-angle glaucoma, and visual acuity. Results: In 90 eyes of 70 early age-related macular degeneration patients with mean visual acuity 20/31 (logarithm of the minimum angle of resolution 0.193), subfoveal choroidal thickness showed a significant inverse correlation with age (P = 0.004) and increasing myopic spherical equivalent refractive error (P = 0.023). Subfoveal choroidal thickness was thinner in eyes with fundus tessellation (P < 0.001), subretinal drusenoid deposit (P = 0.023), an absence of conventional drusen (P < 0.001), the presence of &bgr;-zone peripapillary atrophy (P < 0.001), and in eyes with a diagnosis of open-angle glaucoma (P = 0.003) or an absent band on optical coherence tomography corresponding to overlap between outer segment and retinal pigment epithelium apical processes (P = 0.022). Conclusion: Major ocular manifestations in early age-related macular degeneration and open-angle glaucoma are associated with the choroid—the main blood supply in the eye. Theories concerning the pathogenesis of these two diseases should incorporate interactions involving the choroid.
Assessing the performance and microbial community of hybrid moving bed and conventional membrane bioreactors treating municipal wastewater

ABSTRACT A conventional (SB-CMBR) and a hybrid moving-bed (SB-HMBR) sequencing batch membrane bioreactor treating municipal wastewater were compared during their start-up in terms of organic matter and nutrient removal, membrane fouling characteristics and microbial community. Both systems exhibited similar COD, ammonium, total nitrogen (TN) and phosphorus removal efficiency, amounting up to 96%, 99%, 70% and 85%, respectively. Results from cycle tests revealed that the contribution of attached biomass to the overall ammonium removal in the hybrid reactor was marginal. Moreover, higher despite the similar phosphorus removal efficiency attained in both reactors, nitrate-dosing activity batch assays specifically revealed that the anoxic phosphate uptake rate (PUR) in the SB-HMBR was 1.71 times higher than in the SB-CMBR. Moreover, a higher frequency of Candidatus Accumulibacter-related polyphosphate-accumulating organisms was observed in the biofilm carriers of the hybrid reactor. These findings may explain why the overall PUR was almost 50% higher in the SB-HMBR. By operating the reactors in sequencing batch mode, adhesion of particles on the membrane surface was reduced while fouling was mitigated as compared to continuous MBR systems. Better filterability conditions with lower fouling rate were found in the SB-HMBR, important features of the hybrid reactor for reducing membrane cleaning-related energy demand.
Years of potential life lost and productivity costs because of cancer mortality and for specific cancer sites where human papillomavirus may be a risk factor for carcinogenesis—United States, 2003

Although years of potential life lost (YPLL) and mortality‐related productivity costs comprise a substantial portion of the burden of cancers where human papillomavirus (HPV) may be a risk factor for carcinogenesis (called HPV‐associated cancers in this report), estimates of these costs are limited. The authors estimated the mortality‐related burden (in terms of YPLL and productivity costs) of HPV‐associated cancers (without regard to the percentage of each of these cancers that could be attributed to HPV) and all malignant cancers in the United States in 2003.