Miracle-dz/UniFAR-FTUs huggingface dataset:
Combined Effects of Obesity and Chronic Obstructive Pulmonary Disease on Dyspnea and Exercise Tolerance

Rationale: Severity of lung hyperinflation is known to influence the extent of dyspnea and exercise intolerance among patients with chronic obstructive pulmonary disease (COPD) with similar degrees of airway obstruction. Lung volume components are consistently affected by body mass index (BMI) in health and in disease. Objectives: To explore the complex interactions between obesity, lung hyperinflation, dyspnea, and exercise performance in COPD. Methods: We compared dyspnea intensity ratings and ventilatory responses (breathing pattern, operating lung volumes, and gas exchange) during symptom-limited incremental cycle exercise in wellcharacterized groups of 18 obese (mean BMI 6 SD, 35 6 4 kg/m 2 ) and18normal-weight(meanBMI 6SD,22 62kg/m 2 )patientswith moderate to severe COPD. Measurements and Main Results: Groups were well matched for FEV1 (mean 49% predicted) and diffusing capacity (means .70% predicted),butrestinglunghyperinflation(end-expiratorylungvolume [EELV]) was significantly reduced in association with increasing BMI (P , 0.005). In the obese patients, peak symptom-limited oxygen uptake was increased (P , 0.01) and dyspnea ratings at a standardized ventilation were decreased (P , 0.01) compared with normalweight patients. Ratings of dyspnea intensity at a standardized ventilation during exercise correlated well with the concurrent dynamic EELV/total lung capacity (TLC) ratio (r 5 0.68; P , 0.00001) and with the resting EELV/TLC (r 5 0.67; P , 0.00001). Conclusions: The combined mechanical effects of obesity and COPD
Flat-detector computed tomography with intravenous contrast material application in experimental aneurysms: Comparison with multislice CT and conventional angiography

Background: Despite limited soft tissue resolution flat-detector computed tomography (FD-CT) provides substantial superior spatial resolution in comparison with multislice computed tomography (MS-CT). This may add value in the visualization of small vascular structures if intravenous contrast application leads to substantial opacification and visibility of intracranial vessels or aneurysms. Purpose: To evaluate the feasibility of visualization of vascular structures by FD-CT angiography (FD-CTA) after intravenous contrast injection compared with MS-CTA and intra-arterial digital subtracted angiography (IADSA) in an animal model. Material and Methods: Aneurysms were created in the right common carotid artery in six New Zealand White Rabbits using the elastase technique. Imaging was performed using FD-CTA, MS-CTA (injection of 1 ml/kg body weight) and IADSA. Anonymized volume rendering reconstruction (VRT), maximum intensity projection (MIP), and multiplanar reconstruction (MPR) images were reconstructed and evaluated by two experienced reviewers for aneurysm geometry and vascular structure anatomy using standard tools of a dedicated workstation. Results: Aneurysms could be successfully created in all animals. Measurements of aneurysm geometry (aneurysm height, width, neck width) and vascular structures (brachiocephalic trunk, carotid artery diameter and plane) were nearly identical in all three modalities. Intra- and inter-observer correlations of the different parameters showed high r values between 0.83 and 0.99. Conclusion: Our results show the feasibility of FD-CTA in comparison with MS-CTA and IADSA in an animal model. Despite limited soft tissue resolution, opacification of vascular structures with sufficient contrast to the surrounding structures was possible in all animals. Vascular structures appeared better delineated in FD-CTA than in MS-CTA, probably due to the superior spatial resolution.
Parenchymal and pleural findings in pulmonary embolism visualized by multi-channel detector computed tomography

Background: A normal computed tomography (CT) scan of the pulmonary arteries in the presence of parenchymal and pleural abnormalities may indicate a false-negative diagnosis of pulmonary embolism (PE). Multi-channel detector CT (MDCT) with thinner collimation may improve the detection of small peripheral PEs causing such abnormalities. Purpose: To investigate parenchymal and pleural findings visualized by contrast-enhanced MDCT in patients with and without PE, and to identify possible predictors of PE. Material and Methods: 129 patients with clinical signs of PE were included. In all patients an iopromide-enhanced 64-MDCT (64×0.625 mm collimation, pitch 1.375, overlapping reconstruction with a slice thickness of 0.625 mm, increment of overlapping slice reconstruction 0.43) was performed within 24 h after the onset of the symptoms. Results: MDCT detected PE in 45 of the 129 patients (35%). PE and parenchymal/pleural findings were localized predominantly within the lower lobes. Wedge-shaped opacities were significantly associated with PE (OR =3.00; 95% confidence interval 1.13–7.91). Vascular signs were only visualized in patients with PE. Nodules, consolidations, atelectasis, or effusions were not predictive of PE. Conclusion: The present MDCT study verified that parenchymal and pleural findings can be found in patients with or without PE. Wedge-shaped opacities and vascular signs were significantly associated with PE and therefore can be potential predictors of PE.
Obesity Decreases Serum Selenium Levels in a Mammary Tumor Zucker Rat Model

Previously, we reported that obese Zucker rats had increased susceptibility to DMBA-induced mammary tumors compared to lean Zucker rats. In that experiment, 36% of the obese ovariectomized rats developed mammary tumors while lean ovariectomized rats developed no mammary tumors. The obese sham-operated rats developed mammary tumors (59%) compared to 30% of the lean sham-operated rats. On the other hand, several lines of evidence suggest that lower serum selenium (Se) may play an important role in increasing the risk of several types of cancers (e.g., colon, breast and prostate cancers). In the present study, we used this Zucker rat model to examine the effect of obesity on Se status, and the serum Se level was determined by graphite furnace atomic absorption spectrometry. We found that the serum Se levels did not differ by ovariectomy when comparing the combined sham-operated groups with the combined ovariectomized groups; similarly, there was little difference among the four sub-groups. However, obesity decreased the serum Se levels in the combined obese groups (480 ± 10.9 ng/ml) when compared with the combined lean groups (511 ± 10.3 ng/ml) (P<0.05). In summary, our data demonstrate for the first time that obesity decreases serum Se levels in an animal model and suggest that serum Se may play an important role mammary carcinogenesis.
Symptoms of Common Mental Disorders and Adverse Health Behaviours in Male Professional Soccer Players

Abstract To present time, scientific knowledge about symptoms of common mental disorders and adverse health behaviours among professional soccer players is lacking. Consequently, the aim of the study was to determine the prevalence of symptoms of common mental disorders (distress, anxiety/depression, sleep disturbance) and adverse health behaviours (adverse alcohol behaviour, smoking, adverse nutrition behaviour) among professional soccer players, and to explore their associations with potential stressors (severe injury, surgery, life events and career dissatisfaction). Cross-sectional analyses were conducted on baseline questionnaires from an ongoing prospective cohort study among male professional players. Using validated questionnaires to assess symptoms of common mental disorders and adverse health behaviours as well as stressors, an electronic questionnaire was set up and distributed by players’ unions in 11 countries from three continents. Prevalence of symptoms of common mental disorders and adverse health behaviours among professional soccer players ranged from 4% for smoking and 9% for adverse alcohol behaviour to 38% for anxiety/depression and 58% for adverse nutrition behaviour. Significant associations were found for a higher number of severe injuries with distress, anxiety/depression, sleeping disturbance and adverse alcohol behaviour, an increased number of life events with distress, sleeping disturbance, adverse alcohol behaviour and smoking, as well as an elevated level of career dissatisfaction with distress, anxiety/depression and adverse nutrition behaviour. Statistically significant correlations (p<0.01) were found for severe injuries and career dissatisfaction with most symptoms of common mental disorders. High prevalence of symptoms of common mental disorders and adverse health behaviours was found among professional players, confirming a previous pilot-study in a similar study population.
Community Attitudes Towards People with Down's Syndrome: A Sample From Iraq

Down syndrome (DS) is one of the most common congenital d isorders associated with intellectual d isability and social stigma. Co mmunity attitudes and knowledge of this condition are important for inclusion of people with DS into the community and improving their quality of lives. Results from surveys from the world showed that people still hold negative attitudes towards inclusion of people with DS. Studies in the Arab world are sparse and there are no data exp loring these attitudes in Iraq in the absence of formal awareness programs; hence, this study was done to report and analyse the Iraqi co mmun ity attitudes towards people with Down syndrome. A survey questionnaire of the attitudes from a samp le fro m the co mmunity was done. Results showed that Iraqis still hold negative thoughts towards inclusion of people with DS, however they are less negative than their counterparts in Europe and United States. Female gender was the most common factor associated with positive attitudes. The results of this study underscore the importance for organized campaigns and programs to increase awareness towards DS and inclusion in the co mmunity. Further research is required to exp lore the factors underlying these attitudes.
Central Peripheral Temperature Gradient Correlated with the Simultaneous ScvO2 and Lactate Level in Severe Sepsis and Septic Shock Patients

Objective: To evaluate whether the central peripheral temperature gradient (CPTG) correlated with the simultaneous central venous oxyhemoglobin saturation (ScvO2) and serum lactate levels in severe sepsis and septic shock patients. Design: A retrospective observational study design was used with temporal artery thermometry (TAT) to measure CPTG. Results: A total of 61 patients with severe sepsis or septic shock in the intensive care unit (ICU) were analyzed and monitored for CPTG, mean arterial pressure (MAP), ScvO2, and lactate level. Four patients were excluded due to peripheral arterial occlusive disease. The correlation between the binary CPTG (high CPTG ≥5℃ and low CPTG＜5℃) and simultaneous ScvO2 and lactate level was evaluated. The effect of coexistent MAP (＜65 mmHg and ≥65 mmHg) on the lactate level and ScvO2 (＜70% or ≥70%) was also investigated. Compared with the low CPTG group, the high CPTG group had lower ScvO2 (60.1±13.6% vs 66.5±12.7%; p=0.001) and higher lactate levels (6.0±4.5 mmol/L vs 3.2±2.1 mmol/L; p＜0.001). The binary CPTG correlated to the ScvO2 (p＜0.001) after adjustment for the effect of MAP. The adjusted mean difference of ScvO2 between those patients with high CPTG and low CPTG was -4.4% (95% confidence interval [CI]: -7.0 to -1.8). The binary CPTG also correlated with the lactate level (p＜0.001) after adjustment for the effect of MAP. The adjusted mean difference of the lactate level between those patients with high CPTG and low CPTG was 2.5 mmol/L (95% CI, 1.6-3.4 mmol/L). In a multivariate analysis predicting the lactate level by the coexistent MAP, binary CPTG, and ScvO2, only the binary CPTG and MAP (＜65 mmHg or ≥65 mmHg) were independent predictors (both p＜0.001). Conclusions: CPTG correlated with the ScvO2 and serum lactate level in severe sepsis and septic shock patients.
SICKLE CELL DISEASE: WITH SPECIAL REGARD TO ITS NONANEMIC VARIETY

Three years ago it was pointed out by one of us1that the disease known as sickle cell anemia might better be named sickle cell disease, because anemia, though the best known and most frequent sign of this disease, is not the essential and not the most dangerous one. If this fact is not realized, diagnostic mistakes with disastrous consequences may occur. It is assumed that circulatory stasis in the small blood vessels of the internal organs is the primary and the most perilous consequence of the sickle cell trait (sicklemia), which is an inborn and constitutional abnormality of the red blood corpuscles encountered so far almost exclusively in Negroes. Patients afflicted with this disease do not, as a rule, die from anemia but may die from circulatory stasis in some vital organs. Since the sickling phenomenon—that is, the distortion of the red blood corpuscles of the affected persons—is
Family members of cancer patients: Needs, quality of life and symptoms of anxiety and depression

Abstract Background. Family members of cancer patient's have multiple needs, many of which are not adequately met. Unmet needs may affect psychological distress and quality of life (QOL). The purpose of this study was to assess needs and unmet needs, QOL, symptoms of anxiety and depression, and the relationship between those variables in a large sample of family members of cancer patients in different phases of illness. Material and methods. Of 332 family members invited to participate, 330 accepted and 223 (67%) completed a cross-sectional, descriptive study. Data was collected with the Family Inventory of Needs (FIN), Quality of Life Scale (QOLS) and the Hospital Anxiety and Depression Scale (HADS). Results. Of 20 needs assessed the mean (SD) number of important needs and unmet needs was 16.4 ± 4.3 and 6.2 ± 5.6, respectively. Twelve important needs were unmet in 40–56% of the sample. The mean number of unmet needs was significantly higher among women than men, other relatives than spouses, younger family members, those currently working and those of patients with metastatic cancer. QOL was similar to what has been reported for healthy populations and cancer caregivers in advanced stages. The prevalence of symptoms of anxiety and depression was high (20–40%). Anxiety scores were higher among women than men and both anxiety and depression scores were highest during years 1–5 compared to the first year and more than five years post diagnosis. There was a positive relationship between number of important needs and QOL, and between needs met and QOL. Additionally, there was a significant relationship between anxiety and unmet needs. Finally, there was a significant relationship between QOL and symptoms of anxiety and depression. Conclusion. The results support the importance of screening needs and psychological distress among family members of cancer patients in all phases of illness.
Anti–viral effects of curcumin on influenza A virus–induced myocarditis via inhibiting Wnt/β–catenin signaling

Influenza A virus (IAV) is a widespread human pathogen which plays an important role in the devel opment and exacerbation of myocarditis and causes a significant impairment of the cardiac function and even mortality. Curcumin is an important component of traditional Chinese and Indian medicine with well-documented anti-inflammatory effects to prevent the cardiovascular disease. However, no study to date has addressed the effects and possible mechanism of curcumin on IAV-induced myocarditis in mice. In this study, a mouse model was firstly established for the study of IAV-induced myocarditis. H1N1infected mice were apparently ill with lethargy, poor coat condition, anorexia, irritability, back arching and even survival. After treatment with curcumin (100 mg/kg/day), the weight loss and survival rate were ameliorated throughout the study. On day 5 after infection, both the heart weight to body weight ratio and the left ventricular weight to body weight ratio were significantly decreased in mice treated with curcumin. The area of myocardial necrosis was significantly smaller in the hearts of mice treated with curcumin compared to IVA-infected mice. Gene expression of NS1, TNF- α, IL-6 and IL-1 β, I collagen, and MMP-2 mRNA in the heart tissue was markedly increased in IAV-infected mice, while curcumin sig nificantly attenuated the expression of these genes. RT-PCR analysis revealed that curcumin inhibited the mRNA expression of Wnt3, Tcf4 and β-catenin. Curcumin also suppressed mRNA levels of Wnt tar get genes, c-Myc and cyclin D1. Our results provided the first evidence for the effect of curcumin to treat IVA-induced myocardial damage in particular via inhibiting Wnt/ β-catenin signaling.
The Effect of Hypoxia on Endothelial Cell Function

A principal function of the vasculature is to transport and deliver O2. Thus, it is not surprising that a variety of mechanisms have evolved to optimize gas exchange in the lungs and O2 delivery to tissues. In both the systemic and pulmonary circulations changes in O2, induce a change in vessel caliber. Decreasing arterial pO2 causes vasodilation in coronary, skeletal muscle, cerebral and gastrointestinal circulations. In contrast, in the pulmonary circulation both airway hypoxia and pulmonary arterial hypoxemia cause vasoconstriction in a process known as hypoxic pulmonary vasoconstriction. Systemic hypoxic vasodilation provides a feedback mechanism of increasing blood flow to tissues with increased metabolic demands. In the pulmonary circulation hypoxic pulmonary vasoconstriction provides a mechanism for optimizing tissue oxygenation, matching perfusion to ventilation, therefore improving gas exchange.
Systemic sclerosis and dexamethasone cyclophosphamide pulse therapy.

Sir, There have been quite a few instances where the physician or may be even a dermatologist (mis) advices a patient having systemic sclerosis that there is no satisfactory treatment for this disease, as has also been done in the paper Therapeutic trials for systemic sclerosis: An update by Sardana and Garg. [1] Such patients often feel frustrated and disappointed, till another dermatologist colleague informs them of the pulse therapy and directs them to us.
Treatment of erectile dysfunction in the older diabetic patient

A degree of erectile dysfunction affects more than 30% of men over the age of 50 years and is thought to be approximately three times more prevalent in diabetic compared with nondiabetic individuals. The etiology and pathophysiology of erectile dysfunction in this subpopulation is multifactorial and a good understanding of the contributing issues is required in order to provide holistic and effective management to the patients. Phosphodiesterase 5 inhibitors are currently the first-line treatment modality, but these are ineffective in approximately a third of patients and more so in diabetics. Other treatments available include androgen replacement, vacuum-erection devices, intracavernosal injections of drugs such as vasoactive intestinal peptide, phentolamine and prostaglandin E1 (also available as intraurethral and topical preparations), as well as surgical prostheses. Future therapeutic options that are promising include drugs that combine nitric oxide donation and phosphodiesterase 5 inhibitory activi.
Strongyloides stercoralis e strongiloidiasi in Umbria: analisi di una casistica decennale

(Strongyloides stercoralis and strongyloidiasis in Umbria: ten years of investigations). The Authors relate prevalences concerning strongyloidiasis in Perugia,Torgiano and Deruta, Provence of Perugia, Region of Umbria, Central Italy, between 1995 and 2004. The specific investigation for Strongyloides stercoralis was initially obtained using Baermann’s Method, and after with a modified tecnique of this method and/or with colture on agar of larvae. During 10 years S. stercoralis had been found in 69 elder subjects in relation to 734 examined people (9.4%). The research of this nematode was usually justified by a periferical hipereosinophilia; infact, among positive people, an increased eosinophilia was documented in 88.4% of subjects. The Authors describe biological features of this worm as for diagnostical aims as for epidemiological findings, in order to understand the persistence in these moist and temperate areas around rivers and lakes of central Umbria.Thus, the Authors report operating procedures to research and/or to exclude this helminthiaisis in Italian and immigrate population, on the base of anamnestical suggestions of potential infection.
Aneurisma subvalvar de ventrículo esquerdo com regurgitação mitral grave e compressão extrínseca do tronco de artéria coronária esquerda

A 21-year-old woman with a history of progressive exertion dyspnea, fatigue and mild chest pain lasting 1 year and worsening 1 month before progressing quickly for minimum effort dyspnea, orthopnea and paroxysmal nocturnal dyspnea. She denied past of rheumatic fever and repeated pharyngitis. Transesophageal echocardiogram (ETE) evidenced an important subvalvar aneurysm in the left ventricle with severe mitral regurgitation, without suggestive images of thrombus in its interior. A coronary showed dynamic narrowing of up to 75% of the left main coronary artery (LMCA), the left anterior descending artery (LAD) in communication with aneurysm structure with thrombus in its initial portion and circumflex artery (Cx) with narrowing of 75-90% that was attributed to an extrinsic compression caused by the above mentioned subvalvar aneurysm. A surgical procedure was indicated but was refused, both by the patient and by her family; such refusal evolved into death 30 days after.
A Delphi consensus study among patients and clinicians in the Netherlands on the procedure of informing young breast cancer patients about Fertility Preservation

Abstract Background. The aim of this study was to obtain feedback from, and reach consensus among different experts who are or have been involved in information provision about FP, regarding the (procedure of) information provision about Fertility Preservation (FP) and use of a web-based decision aid (DA) about FP to create optimal conditions for the implementation of the DA-website, as we prepare to implement a DA about FP in the Netherlands. Material and methods. A two round Delphi study in which experts (patients and clinicians) rated their (dis)agreement with a list of statements (Rounds 1, 2), and additional online forum to discuss dissensus (Round 3). We assessed opinions about FP, web-based DAs, and about the procedure of informing patients. Answer categories ranged from 1 (totally disagree) to 5 (totally agree). Consensus was considered significant when at least 80% of the experts scored either the lowest or the highest two categories. Results. Experts reached rapid consensus on all five statements about the use of a DA (5/5; 100%), and all eight statements about which patients should be offered information about FP (8/8; 100%). However opinions about FP (4/11 statements; 36%), and procedural aspects such as who should inform the patient (6/10 statements; 60%) and when (3/10 statements; 30%) remained for discussion in round 3. In the online discussion some level of agreement was reached for these statements after all. Conclusion. It was deemed important that FP options exist. Every eligible patient should receive at least some (general) information about FP, soon after diagnosis. Detailed information should be provided by a fertility expert at a later moment. Exact timing and amount of information should be adjusted to patient's needs and situational context. A DA-website can offer a fair contribution to this.