Miracle-dz/UniFAR-FTUs huggingface dataset:
Anaphylactic reaction following forest fly (Hippobosca equina) bite: A human case

Abstract The authors report the case of a 46-year-old female patient, who experienced an anaphylactic reaction with a lucky outcome following an insect bite. Within a short time, a hard swelling of 15-cm diameter, covered by a serous crust, appeared at the border of her forehead and hairy scalp, with oedema on her forehead. Soon thereafter, erythema and itching developed locally and all over her body, with oedema of her hands, face and lips, later accompanied by shivering, nausea and vomiting. Based on identification with the help of a taxonomic key, the captured insect proved to be a forest fly (Hippobosca equina). As far as we know, this is the first published case of anaphylaxis induced by the bite of this species in Hungary. Forest flies are present all over the world; they have been known in Hungary for a long time; they suck blood several times a day mostly from horses, donkeys or cattle kept on pastures or in stables and cowsheds, and occasionally also from other animal species. As vectors, they tr.
Acetazolamide Use in Severe Chronic Obstructive Pulmonary Disease. Pros and Cons

&NA; Acetazolamide is a carbonic anhydrase (CA) inhibitor sometimes used as a respiratory stimulant for patients with chronic obstructive pulmonary disease (COPD) with the goal of improving oxygenation, reducing carbon dioxide retention, and aiding liberation from mechanical ventilation and/or attempting to correct a metabolic alkalosis. However, the net effect of CA inhibition is multifactorial and complex, because CA is inhibited in many tissues that may negatively affect the patient with lung disease. The full impact of acetazolamide and other CA inhibitors depends critically on dosing, age, and pulmonary, renal, hepatic, hematological, and respiratory muscle function and reserves. This review examines the literature and indications for acetazolamide use in patients with COPD dating back to its initial release 6 decades ago. There are very few studies specifically designed to address the population with severe COPD, as such patients were frequently excluded from trials. We therefore discuss the complexity of CA inhibition and its potential benefits and dangers and describe ways in which the pathophysiology of patients with severe COPD puts them at considerable risk for serious adverse consequences. We offer guidance on the careful and rational use of acetazolamide in patients with respiratory disorders.
Parental caregiving of children with cancer and family impact, economic burden: nursing perspectives

Pediatric cancer diagnoses affect the entire family: parents, well siblings, the ill child, and others. The objective of this study was to review nursing studies on parental caregiving of children with cancer, family impact, and costs. The study used inclusion/exclusion criteria and family systems theory, self/dependent-care, and symptom management (monitoring, alleviation) concepts. Regarding “levels of evidence,” 3 studies were Level II; 7 were Level IV; 7 were Level VI; 1 review was Level V and the second was Level I. Of 19 studies: 11 were qualitative; 4, quantitative; 2 were mixed methods. Content analysis themes were: Parental caregiving and family impact, economic burden. Conclusions were that (a) qualitative studies are predominant; findings supported quantitative findings; (b) quantitative nursing studies are less common: found one longitudinal, randomized controlled trial (RCT) focused on outcomes of an intervention for well siblings and parents, implemented by Clinical Nurse Specialists, CNSs; (c) few quantitative studies with large samples were found, especially ones with theoretical models of the family system and measures of illness impact on families; and (d) “mixed methods” longitudinal nursing research is illustrated. There is a need for “evidence-based” practice (EBP) nursing studies of interventions focused on parent education/support/assistance; respite care, and increasing family/well sibling knowledge/other information on the child’s illness.
Evidence‐based Utilization of Noninvasive Ventilation and Patient Outcomes

Rationale: Strong evidence supports use of noninvasive ventilation (NIV) for patients with respiratory distress from chronic obstructive pulmonary disease and heart failure (strong evidence conditions [SECs]). Despite unclear benefits of NIV for other causes of acute respiratory failure, utilization for conditions with weaker evidence is increasing, despite evidence demonstrating higher mortality for patients who suffer NIV failure (progression from NIV to invasive mechanical ventilation [IMV])) compared with being treated initially with IMV. Objectives: To determine the association of hospital variation in evidence‐based utilization of NIV with patient outcomes. Methods: Using the California State Inpatient Database 2011, we identified adult patients who received NIV. Patients were considered to have an SEC for NIV if they had an acute exacerbation of chronic obstructive pulmonary disease or heart failure. We used multivariable hierarchical logistic regression to determine the association between hospital rates of NIV use for SECs and patient risk of NIV failure (need for IMV after NIV). Results: Among 22,706 hospitalizations with NIV as the initial ventilatory strategy, 6,820 (30.0%) had SECs. Patients with SECs had lower risk of NIV failure than patients with weak evidence conditions (8.1 vs. 18.2%, P < 0.0001). Regardless of underlying diagnosis, patients admitted to hospitals with greater use of NIV for SECs had lower risk of NIV failure (Quartile 4 vs. Quartile 1 adjusted odds ratio = 0.62; 95% CI = 0.49‐0.80). Even patients without an SEC benefited from admission to hospitals that used NIV more often for patients with SECs (Quartile 4 vs. Quartile 1 adjusted odds ratio for NIV failure = 0.68; 95% CI = 0.52‐0.88). Conclusions: Most patients who received NIV did not have conditions with strong supporting evidence for its use with wide institutional variation in patient selection for NIV. Surprisingly, we found that all patients, even those without an SEC, benefited from admission to hospitals with greater evidence‐based utilization of NIV, suggesting a “hospital effect” that is synergistic with patient selection.
Fluorodeoxyglucose-PET/CT for diagnosis of intravascular large B-cell lymphoma.

A 39-year-old woman was referred to our hospital with a 1-month history of recurrent fever. On physical examination, her spleen was palpable in the absence of peripheral lymphadenopathy and skin lesions. Laboratory studies yielded elevated values of serum lactate dehydrogenase at 1051 U/L, soluble interleukin 2 receptor at 24,500 pg/mL, and ferritin at 1019 μg/L. Blood cell counts showed a bicytopenia with a hemoglobin level of 7.0 g/dL and a platelet count of 3.7 × 109/L. Although the patient had no subjective symptoms such as dyspnea, her percutaneous oxygen saturation was low at 90%, suggesting hypoxemia. Findings on both chest radiography and computed tomography (CT) of the lungs were unremarkable. However, positron emission tomography (PET)/CT with 18F-fluorodeoxyglucose (FDG) revealed diffuse uptake in the bilateral lung, predominantly in the upper fields (Figure 1, A and B). In addition, FDG uptake was noted in the bilateral renal cortex (Figure 1, C) and vertebrae (Figure 1, A). Bone marrow aspiration yielded large atypical lymphoid cells with the appearance of hemophagocytosis. However, on bone marrow biopsy, lymphoma cells were not confirmed within the lumen of small blood vessels. Random skin biopsy specimens1 from normal-appearing skin on the patient's thigh revealed CD20+ large lymphoid cells filling the small vessels in the subcutaneous tissues (Figure 1, D and E). Intravascular large B-cell lymphoma (IVLBCL) was diagnosed.
Prenatal and Early Life Fructose, Fructose‐Containing Beverages, and Midchildhood Asthma

Rationale: Cross‐sectional studies have linked intake of high‐fructose corn syrup‐sweetened beverages with asthma in schoolchildren. Objectives: To examine associations of maternal prenatal and early childhood intake of sugar‐sweetened beverages and fructose with current asthma in midchildhood (median age, 7.7 yr). Methods: We assessed maternal pregnancy (first‐ and second‐trimester average) and child (median age, 3.3 yr) intake of sugar‐sweetened beverages and total fructose using food frequency questionnaires in 1,068 mother‐child pairs from Project Viva, a prospective prebirth cohort. In a multivariable analysis, we examined associations of quartiles of maternal and child sugar‐sweetened beverage, juice, and total fructose intake with child current asthma in midchildhood, assessed by questionnaire as ever having doctor‐diagnosed asthma plus taking asthma medications or reporting wheezing in the past 12 months. Results: Higher maternal pregnancy sugar‐sweetened beverage consumption (mean, 0.6 servings/d; range, 0‐5) was associated with younger maternal age, nonwhite race/ethnicity, lower education and income, and higher prepregnancy body mass index. Adjusting for prepregnancy body mass index and other covariates, comparing quartile 4 with quartile 1, higher maternal pregnancy intake of sugar‐sweetened beverages (odds ratio, 1.70; 95% confidence interval, 1.08‐2.67) and total fructose (odds ratio, 1.58; 95% confidence interval, 0.98‐2.53) were associated with greater odds of midchildhood current asthma (prevalence, 19%). Higher early childhood fructose intake (quartile 4 vs. quartile 1) was also associated with midchildhood current asthma in models adjusted for maternal sugar‐sweetened beverages (odds ratio, 1.79; 95% confidence interval, 1.07‐2.97) and after additional adjustment for midchildhood body mass index z‐score (odds ratio, 1.77; 95% confidence interval, 1.06‐2.95). Conclusions: Higher sugar‐sweetened beverage and fructose intake during pregnancy and in early childhood was associated with childhood asthma development independent of adiposity.
Compartment-specific overexpression of glutathione peroxidases during lung fibrosis

Rationale: Idiopathic pulmonary fibrosis (IPF) is associated with oxidative stress and depletion of the antioxidant glutathione (GSH) in epithelial lining fluid (ELF) and tissue. However, differential expression of GSH-metabolizing enzymes in bronchoalveolar lavage fluid (BALF) and tissue during lung fibrosis has not been comprehensively studied. Methods: In a label-free whole-proteome approach, we assessed levels of GSH-metabolizing enzymes in BALF and tissue during the onset and resolution of bleomycin-induced pulmonary fibrosis (day 3 through 56) in C57BL/6N mice. Western Blot analysis, assessment of Gpx activity, ELISA, and immunofluorescent stainings were used for validation and comparison with samples derived from interstitial lung disease patients. Results: GSH peroxidase 3 (Gpx3) was the only significantly increased GSH-metabolizing enzyme in BALF during bleomycin-induced lung fibrosis. This data was validated by Western Blot analysis and assessment of GPX activity in BALF.Immunofluorescent (IF) stainings revealed predominant expressionof Gpx3 by epithelial cells. Finally, BALF of ILD patients also contained high levels of GPX3. In tissue, however, Gpx7 was clearly upregulated and, as determined by IF co-stainings, localized to interstitial cells including myofibroblasts, while expression of Gpx1, the most abundant Gpx in tissue, appeared ubiquitous and remained largely unchanged. Conclusion: We show compartment-specific overexpression of selected Gpx during bleomycin-induced lung fibrosis. Hence, upregulation of Gpx enzymes might contribute to depletion of GSH in ELF and tissue, and thereby enhance the oxidant-antioxidant imbalance in pulmonary fibrosis.
Australian counsellors and psychotherapists: A profile of the profession

In the absence of comprehensive Australian data on the counselling and psychotherapy profession, this study aimed to examine the profile of professionals affiliated with the Psychotherapy and Counselling Federation of Australia (PACFA) to inform future policy and service planning. PACFA's first workforce survey was undertaken in 2004. This cross-sectional survey was mailed and e-mailed to all members of the 41 professional associations affiliated with PACFA. A total of 316 full responses were received. This paper presents findings related to demographics, training and specialisation, theoretical orientation, professional affiliations, work and practice settings, and work roles. The study provides a baseline for future workforce surveys and a resource for policy development for the profession.
Developing a home for midwives

For many years I was unconvinced of the value of birth centres and home-from-home units in hospitals. I was concerned about the term home-from-home because in fact there is no place like home, and felt (and still believe) that the woman's own home is best for women with healthy pregnancies who feel safe there.
Host factors and failure of interferon‐α treatment in hepatitis C virus

Failure of interferon‐α (IFN‐α) treatment in patients with chronic hepatitis C virus (HCV) infection is a challenging obstacle for clinical and experimental hepatology. Both viral and host factors have been implicated in reducing responsiveness to IFN‐α therapy. The role of viral factors has been studied extensively and has been summarized in several review articles; however, much less attention has been paid to host factors. In this paper, we review evidence of host factor involvement in IFN‐α treatment failure. We discuss possible underlying mechanisms responsible for these effects. Potential therapeutic strategies to enhance the effectiveness of IFN‐α therapy for HCV are also proposed. (HEPATOLOGY 2004;39:880ndash;890.)
Antidepressive‐like effect of a Kampo (traditional Japanese) medicine, kososan (Xiang Su San) in a stress‐induced depression‐like mouse model: Proteomic analysis of hypothalamus

A Kampo medicine, kososan (KS), has been used clinically for the treatment of certain depression‐like symptoms. Our previous studies using the stress‐induced depression‐like model mice, showed that oral KS treatment leads to an antidepressive‐like effect via the normalization of dysfunction of hypothalamic‐pituitary‐adrenal axis. In the present study, proteomic analysis was used to identify brain hypothalamus proteins that are affected by KS treatment.
Polimorfismo -219 G/T en el gen APOE en relación con los niveles de colesterol y la enfermedad aterosclerótica en Argentina

El alelo 4 del gen APOE se asocia con riesgo aumentado de Enfermedad Cardiovascular Aterosclerotica (ECA) y con mayores concentraciones de colesterol total (CT) y de LDL (c-LDL) en plasma; sin embargo, algunos estudios no reprodujeron esos resultados. Esta controversia senala que otros factores, geneticos y/o ambientales podrian actuar sobre estas asociaciones. Variaciones cuantitativas en los niveles de expresion del gen originadas por polimorfismos en el promotor, como el -219G/T, podrian tener un rol como factor de riesgo de la enfermedad. Previamente los autores del presente trabajo hemos reportado la asociacion entre el alelo 4 y la presencia de lesiones ateroscleroticas en varones. En este trabajo se investiga si hay asociacion entre el polimorfismo APOE -219G/T, la ECA y los niveles de lipidos en plasma. Se estudiaron 380 muestras de ADN de pacientes con estudios angiograficos realizados, provenientes de la zona sur de la provincia de Buenos Aires. El analisis con regresiones logisticas mostro diferencias no significativas en las distribuciones del alelo T y del alelo G entre casos y controles, aun despues de estratificar por sexo y por edad. Con regresiones lineales se observo que: hay diferencias no significativas entre los niveles de CT y c-LDL y la presencia/ausencia del alelo T, pero el alelo G se asocio con valores mas elevados de CT (p=0,001) y de c-LDL (p=0,020) en varones. Entre mujeres no hubo diferencias significativas. Estos resultados senalan que el alelo G del polimorfismo -219 del gen APOE se asocia con valores mayores de CT y LDL-c en varones, pero este polimorfismo no actuaria como un factor de riesgo de ECA en la poblacion argentina.
Altered Adrenal Sensitivity to Angiotensin II in Low-Renin Essential Hypertension

Low-renin essential hypertension (LREH) describes a widely recognized classification validated by clinical features, including salt-sensitive blood pressure and diuretic responsiveness. Classic physiological teaching has cited normal plasma aldosterone concentration despite suppressed renin as evidence for adrenal supersensitivity to angiotensin II (Ang II). We studied 94 patients with LREH, 242 normal-renin hypertensives, and 135 normal subjects as controls. Low-renin hypertensives did not differ significantly from the other groups in either basal or Ang II-stimulated aldosterone concentrations on a high-sodium diet. Stimulated with a low-sodium diet, LREH patients demonstrated the smallest rise in basal aldosterone secretion. Ang II responsiveness was also subnormal: the rise in aldosterone after Ang II infusion in LREH (613+/-39 pmol/L), although greater than in nonmodulators (180+/-17 pmol/L; P=0.001), was less than either the patients with intact modulation (940+/-53 pmol/L; P=0.001) or normotensives (804+/-50 pmol/L; P<0.05). Blacks with LREH demonstrated an even lower response than low-renin whites ((388+/-50 versus 610+/-47 pmol/L; P=0.0001). In contrast, the rise in systolic blood pressure with Ang II infusion on a low-salt diet was greatest among LREH patients (P=0. 001). Patients with LREH and nonmodulators were equally salt-sensitive. These results indicate that the adrenal response in LREH is normal on a high-salt diet but becomes progressively more abnormal as sodium control mechanisms are stressed. The factors that mediate enhanced adrenal response to Ang II with sodium restriction may be defective, suggesting the existence of alternative physiological mechanisms for sodium homeostasis in the low-renin state.
CEREBELLAR CORTEX, CYTOLOGY AND ORGANIZATION

The dv/dt characteristics of a bidirectional thyristor are improved by irradiating selected portions of the device with high energy crystal lattice-damaging particles. In an exemplary embodiment, the commutating dv/dt of a triac is enhanced by the masked, selective irradiation of the boundaries between conducting portions and between the gate and the conducting portions.
Trauma to the Skull: A Historical Perspective from the Southern Levant (4300BCE–1917CE)

Background: Although the southern Levant is commonly perceived as having been a violent region throughout history, few studies have explored the pattern and intensity of skull trauma through time in the general population. The aim of this study is to follow changes in traumatic injury patterns in the southern Levant, over an extensive period of 6,000 years. Methods: 783 archaeological skulls from the Tel Aviv University osteological collection were examined for evidence of trauma. The specimens were divided into three periods: Chalcolithic-Bronze-Iron Age (4300–520 BCE), Hellenistic-Roman-Byzantine Period (332 BCE-640 CE), and Early and Late Arab Period (640–1917 CE). The characteristics of injury on each skull were recorded. Results: A high frequency (25%) of traumatic lesions to the skull was evident among historic populations of the southern Levant, a rate that did not fluctuate significantly over 6,000 years. The most common pattern of trauma was minor circular depressed injuries. Most of the injuries were located on the parietal or frontal bones. Traumatic lesions were more frequent in males than in females, and in mature individuals than in adolescents and children, during all periods. Conclusions: The rate of trauma in the southern Levantine populations was shown to be considerably higher than in other archaeological populations worldwide. The fact that no significant differences in trauma rates were found over time implies that socio-economical shifts (from agrarian to urban populations) had little impact on the local populations’ aggressive behavior. In contrast, changes in type of injury, from blunt force trauma to sharp force trauma and eventually projectile trauma, reflects changes in weaponry over time. The accumulated characteristics of cranial trauma pattern (type, location, side, size, sex, age) suggest that most of the individuals studied were not engaged directly in warfare. Rather, most injuries seem to be due to blows given during interpersonal violent encounters. Copyright © 2012 John Wiley & Sons, Ltd.
Toxicity of polyunsaturated aldehydes of diatoms to Indo-Pacific bioindicator organism Echinometra mathaei

Abstract Although it is well known suitability of early developmental stages of sea urchin as recommended model for pollutant toxicity testing, little is known about the sensitivity of Indo-Pacific species Echinometra mathaei to polyunsaturated aldehydes. In this study, the effect of three short chain aldehydes, 2,4-decadienal (DD), 2,4-octadienal (OD) and 2,4-heptadienal (HD), normally found in many diatoms, such as Skeletonema costatum, Skeletonema marinoi and Thalassiosira rotula, was evaluated on larval development of E. mathaei embryos. Aldehydes affected larval development in a dose-dependent manner, in particular HD>OD>DD; the results of this study highlighted the higher sensitivity of this species toward aldehydes compared with data registered for other sea urchin species. In comparison with studies reported in the literature, contrasting results were observed during our tests; therefore, an increasing toxic effect was registered with decreasing the chain length of aldehydes. This work could provide new insights in the development of new toxicological assays toward most sensitive species.
Future of Personalized Prescription in Psychiatry

Personalized prescription and pharmacogenomics are related concepts, but are not the same. The 'Introduction' describes the concept of pharmacogenomics, which can be included within person- alized prescription, and the role of the Human Genome Project and the Food and Drug Administra- tion in promoting advances in these concepts. In the author's comprehensive view of personalized prescription, clinicians need to consider genetic, environmental and personal variables when pre- scribing any medication. Known important genetic variables in specific drug responses can be ex- plored by pharmacogenetic tests. Environmental variables - such as co-medication, herb supple- ments, foods, beverages and smoking - may be much more important than genetic factors for some drugs. Personal factors such as age, gender or medical illnesses (renal or hepatic insufficiency) may be crucial personal variables in the response to some other drugs. The pharmacological knowledge needed to understand personalized prescription includes pharmacokinetics and pharmaco- dy namic actions, efficacy and safety, idiosyncratic and dose-related adverse drug reactions, pre- scriber's role and therapeutic window, and linear versus non-linear pharmacokinetics. The applica- tions of these pharmacological concepts in psychiatry are briefly reviewed. Risperidone personalized prescription is provided as an example by describing personalized risperidone selection and per- sonalized risperidone dosing. The future of pharmacogenomic tests and personalized prescription in psychiatry is briefly summarized.