Miracle-dz/UniFAR-FTUs huggingface dataset:
Fornix injury in a patient with diffuse axonal injury.

D I F F U S E A X O N A L injury (DAI) is characterized by widespread axonal d a m a g e d u e t o shearing forces by acceleration, deceleration, or rotation of the brain. Diffuse axonal injury is the most frequent cause of poor clinical outcomes in patients with traumatic brain injury. However, conventional brain magnetic resonance imaging is not sufficiently sensitive to diagnose DAI, as most DAI lesions are microscopic. Recent advancements in diffusion tensor tractography (DTT) have allowed the fornix to be visualized 3-dimensionally. Wang et al demonstrated that the fornix bodies of patients with DAI were injured using the data obtained from DTT. In the current study, we describe a patient with DAI who showed a fornix injury on DTT. A 40-year-old, right-handed man who was in a traffic crash underwent conservative management for DAI at the department of neurosurgery in a university hospital. The patient lost consciousness for 45 days after the injury. Brain magnetic resonance imaging, including diffusion tensor imaging, was performed 30 months after the injury and showed leukomalactic lesions at the isthmus of the corpus callosum and the cingulate gyrus (Figure). He showed severe memory impairments (total intelligence quotient on the Wechsler Adult Intelligence Scale, 114; total score on the Memory Assessment Scale, 56). The diffusion tensor images were acquired using a sensitivity-encoding head coil on a 1.5-T Philips Gyroscan Intera using single-shot echoplanar imaging. Sixty contiguous slices (matrix, 128 128; field of view, 221 mm; repetition time/ echo time = 10 726/76 milliseconds; b=1000 mm/s; thickness, 2.3 mm) were acquired for each of the 32 noncollinear diffusion-sensitizing gradients. Three-dimensional reconstructions of the fiber tracts were obtained using PRIDE, and the termination criteria were fractional anisotropy of less than 0.2 at an angle greater than 45°. Fiber tracts passing through both regions of interest (anterior and middle body of fornix) were designated as the final areas of interest. We recruited a 41year-old right-handed man without a neurological disease history as a control subject. The DTT results of the patient showed that the posterior body of the fornix was disrupted compared with that of the control subject.
Characteristics and surgical outcomes of patients with refractory magnetic resonance imaging-negative epilepsies.

OBJECTIVE To explore several characteristics of patients with pharmacoresistant epilepsy without distinct lesions on magnetic resonance images (MRI(-)), who account for a relevant proportion of presurgical patient cohorts. DESIGN Retrospective case series. SETTING University epilepsy center. PATIENTS A cohort of 1200 patients who had comprehensive presurgical assessment from January 1, 2000, through December 31, 2006. MAIN OUTCOME MEASURES Frequency of MRI(-) patients in the total presurgical cohort, seizure-free outcome rates in patients who had surgery and those who did not, outcome predictors, and spatial properties of epileptogenic areas in MRI(-) patients with epilepsy. All MRI(-) patients were retrospectively analyzed. Presurgical MRIs were reevaluated for subtle cortical dysplasias by postprocessing and visual reassessment. RESULTS One-hundred ninety MRI(-) patients were identified (16% of all presurgical candidates); 29 (15%) had surgery. Eleven (38%) became seizure free (including those with auras only; 45%). Surgical therapy was more frequently offered to MRI(+) patients (76%; P < .001), and their outcome was also superior (66% seizure-free; P = .001). The seizure-free rate of 16% in MRI(-) patients who did not have surgery was, however, inferior to that of the MRI(-) patients who did (P = .008). Nine MRI(-) patients who had surgery had distinct histopathological lesions, 8 of which turned out to be retrospectively detectable on presurgical MRI. Seven of the MRI(-) but histopathologically lesional patients became seizure free compared with only 4 of 20 patients without histopathological lesions (P = .003). Three-fifths of the histopathologically nonlesional patients had multifocal or extensive epileptogenic areas. CONCLUSIONS Patients with epilepsy who are MRI(-) can be successfully treated with surgery. Improved sensitivity of MRI will improve the outcomes of presurgically studied patients. Surgical failures in patients without histopathological lesions mostly result from extensive epileptogenic areas.
Wiedza uczniów na temat zagrożeń płynących z palenia papierosów - wyniki badań ankietowych

Referat wygloszony podczas XII Kongresu Pielegniarek Polskich w Krakowskiej Akademii im. Andrzeja Frycza Modrzewskiego, Krakow 12-14 czerwca 2014 r. Referat dostepny rowniez w publikacji "Pielegniarstwo na rzecz milenijnych celow" pod adresem http://hdl.handle. net/11315/693
Insulin resistance and risk of ischemic stroke among nondiabetic individuals from the northern Manhattan study.

BACKGROUND Whether insulin resistance predicts ischemic stroke (IS) is still a matter of debate. OBJECTIVE To determine the association between insulin resistance (IR) and risk of first ischemic stroke in a large, multiethnic, stroke-free cohort without diabetes. DESIGN Prospective, population-based cohort study. SETTING Longitudinal epidemiologic study. PARTICIPANTS A cohort of 1509 nondiabetic participants from the Northern Manhattan Study (mean [SD] age, 11 [10] years; 64.2% women; 58.9% Hispanics). MAIN OUTCOME MEASURES Insulin sensitivity, expressed by the homeostasis model assessment (HOMA) of insulin sensitivity (HOMA index = [fasting insulin × fasting glucose] / 22.5). Insulin resistance was defined by a HOMA-IR index in the top quartile (Q4). Cox proportional hazards models were used to determine the effect of HOMA-IR on the risk of incident IS, myocardial infarction (MI), vascular death, and combined outcomes (IS, MI, and vascular death). RESULTS The mean (SD) HOMA-IR was 2.3 (2.1), and Q4 was at least 2.8. During mean follow-up of 8.5 years, vascular events occurred in 180 participants; 46 had fatal or nonfatal IS, 45 had fatal or nonfatal MI, and 121 died of vascular causes. The HOMA-IR Q4 vs less than Q4 significantly predicted the risk of IS only (adjusted hazard ratio, 2.83; 95% confidence interval, 1.34-5.99) but not other vascular events. This effect was independent of sex, race/ethnicity, traditional vascular risk factors, and metabolic syndrome and its components. CONCLUSIONS Insulin resistance estimated using the HOMA is a marker of increased risk of incident stroke in nondiabetic individuals. These findings emphasize the need to better characterize individuals at increased risk for IS and the potential role of primary preventive therapies targeted at IR.
Stroke Prevention

Nine out of 10 strokes are due to modifiable factors. Yet, preventive strategies thus far have been relatively ineffective in curbing the global stroke burden. Although the pathophysiology and risk factors for stroke are well-characterized, our understanding of how to optimize healthcare systems and empower patients–to ensure prescription of evidence-based care for stroke prevention, access to care, adherence to medications, control of risk factors, and engagement in healthy lifestyles and self-management–is poor. In the first article of this issue, Hill and Towfighi provide an overview of the global burden of stroke due to modifiable risk factors, a summary of the literature regarding key behavioral, metabolic, and environmental stroke risk factors, and strategies for primordial, primary, and complex secondary stroke prevention. The succeeding contributions review specific behavioral and metabolic risk factors for stroke: blood pressure (Dakay and Silver); nutrition (Spence); diabetes, obesity, and metabolic syndrome (Tang, Liebeskind. Towfighi), and hyperlipidemia (Barkas and Milionis). Lightbody et al provide a systematic review and meta-analysis of cohort and case-control studies delineating the association between psychosocial risk factors and stroke. Subsequently, we approach stroke prevention strategies by pathophysiologic mechanism: intracranial and extracranial large artery atherosclerosis (Banerjee and Turan); small vessel disease (Smith); cardioembolism (Sacchetti, Furie, and Yaghi); cerebral arteriopathies, venous thrombosis, and migraine (Camargo and Singhal); genetic mechanisms (Majersik); and antiplatelets for noncardioembolic stroke (Krishnan et al). The penultimate article addresses special considerations in women (Al-Rasheed and Jaigobin). The final manuscript provides an overview of strategies for organized outpatient care for transient ischemic attack or minor stroke (Joundi and Saposnik). Our historical approach of targeting small high-risk populations for stroke prevention and focusing primarily on prescription of medications (with little attention to medication adherence or risk factor control) has been ineffective. To rein in the global burden of stroke, it is critical to understand how to promote health literacy, expand access to care, improve lifestyle behaviors, bolster self-management skills and adherence to stroke prevention medications, and ensure that providers follow evidence-based guidelines for stroke prevention. Amytis Towfighi, MD
University of Birmingham Concurrent and longitudinal predictors of reading for deaf and hearing children in primary school

Publisher Rights Statement: This is a pre-copyedited, author-produced version of an article accepted for publication in Deaf Studies and Deaf Education following peer review. The version of record Harris, Margaret, Emmanouela Terlektsi, and Fiona Elizabeth Kyle. "Concurrent and longitudinal predictors of reading for deaf and hearing children in primary school. " The Journal of Deaf Studies and Deaf Education 22.2 (2017): 233-242. is available online at: https://academic.oup. com/jdsde/article/22/2/233/3044607/Concurrent-and-Longitudinal-Predictors-of-Reading? searchresult=1
Prevalence of metabolic syndrome in patients infected with HIV

Background: metabolic syndrome is a set of abnormalities related to one another that are associated with the development of diseases like diabetes, hypertension and dyslipidemia. In Colombia there are no published studies regarding the prevalence of metabolic syndrome in people with HIV infection. Methods: we carried out a cross-sectional observational study, the sample was composed by patients in consultation with HIV-AIDS in a hospital in third level, during the period March-April 2008; took into account patients over 18, who were not hospitalized during the past month. Results: the final sample was comprised of 137 patients, of whom 82.5% were men and 17.5% women, aged between 19 and 65 years (average age 39.7 ± 9.64 years), body mass index averaged 23.8 Kg/mt2 ± 3.13 and 78.4% were receiving antiretroviral therapy. The prevalence of metabolic syndrome according to the criteria of ATPIII was 15.4% (95% 9.8% 22.6%). According to the criteria of the IDF prevalence of metabolic syndrome was 21.3% (95% 14.43% 28.20%); There was no correlation between the use of antiretroviral therapy and the presPrevalencia de síndrome metabólico en pacientes infectados con VIH* Utilizando los criterios del ATP III y de la IDF Prevalence of metabolic syndrome in patients infected with HIV Using ATP III and IDF criteria FREDY ORLANDO GUEVARA, BIVIAN CAÑÓN, MARTHA CONSTANZA LIÉVANO, BERNARDO LOMBO, IVÁN RENDÓN • BOGOTÁ D.C. FRANCISCO BLANCO • MADRÍD, ESPAÑA * Trabajo ganador del premio al “Mejor Trabajo de Investigación Realizado por Residentes”. XX Congreso Colombiano de Medicina Interna. Medellín, 9 al 10 de octubre de 2008 Dr. Fredy Orlando Guevara P. Residente III año Medicina Interna, Universidad El Bosque-Fundación Santa Fe de Bogotá, Investigador Principal, Bogotá D.C.; Dra. Bivian Cañón: Internista, Coordinadora Unidad de VIH-Sida, Hospital Simón Bolívar, Bogotá D.C.; Martha Constanza Liévano F. : Epidemióloga, Universidad Javeriana, Fundación Santa Fe de Bogotá, Bogotá D.C.; Dr. Bernardo Lombo: Internista, Fundación Santa Fe de Bogotá, Bogotá D.C.; Dr. Iván Rendón: Residente III año, Medicina Interna, Universidad El Bosque-Fundación Santa Fe de Bogotá, Bogotá D.C.; Dr. Francisco Blanco: PhD, Internista, Coordinador de Sección de Ensayos Clínicos, Hospital Carlos III; Madrid (España). Correspondencia. Dr. Fredy Orlando Guevara P. Tel. 6030303, FSFB, Medicina Interna, Bogotá, D.C. Recibido: 31/VII/08 Aceptado: 9/X/08
Suicide Cases in a Province (Samsun) of Blacksea Region of Turkey Between1999-2 3 Years

Objective: Age, gender, race, cultural and ethnic structure are important factors in suicide epidemiology. Factors effecting suicide behaviour are important to establish effective prevention programs, so it is important to evaluate them in detail. The aim of this study was to determine the regional differences and to get detailed data for guiding the suicide prevention programs by reviewing all suicides in Samsun. Material and Methods: The judicial files of all suicides were evaluated that occurred in Samsun, between 1999-2003. Some information such as age, gender, marital status, occupation status, suicide place and time and, suicide methods used by the cases were obtained. In addition, the probable risk factors for suicide from the official statements of the parents in the judicial files were determined. Results: In five years period, 169 people committed suicide in Samsun. Most of them were at the age of 10-29 years and 58.6% of were males. They most commonly used a firearm (28.4%) as the suicide method, self poisoning (27.8%) and hanging (26.0%) were following it. While most of the males committed suicide by firearm, females preferred self poisoning. Leading risk factors were unemployment and economic problems followed by family problems, diagnosed psychiatric illnesses, alcohol abuse, emotional problems and undiagnosed psychiatric illnesses. Conclusion: Suicide is a multi-faceted problem that needs both social and individual approaches. This study shows that higher ratio of firearm suicides needs more attention, and detailed studies especially for determination risk groups for prevention programs are necessary.
Stroke and Alzheimer disease: fellow travelers or partners in crime?

The commonest forms of stroke are silent, and Alzheimer disease begins decades before any symptoms appear. Moreover, epidemiological studies show that strokes and Alzheimer disease occur together and pose risks for each other (Figure), and clinical, pathological, and experimental studies suggest that they may also interact. Only 12% of all patients having a first stroke get a warning in the form of a transient ischemic attack prior to their event and patients with Alzheimer disease get no warning at all, until it is too late.
New Treatment Approaches to Arteriovenous Malformations

Abstract Arteriovenous malformations (AVMs) are high-flow vascular anomalies that have demonstrated a very high recurrence rate after endovascular treatment, surgical treatment, or a combination of both. Surgical treatments have shown good response when they are small and well localized but a poor response when diffuse. A better understanding of the nature of the lesion has led to a better response rate and a safer treatment for these patients. This has been accomplished through a detailed understanding of the angioarchitecture of the lesion, enabling a tailored approach in reaching and targeting the nidus of the AVM with different liquid embolic agents, more specifically ethanol. Flow reduction techniques help in exposing the nidus to sclerosant agents. A clinical classification, the Schobinger classification, will help determine the appropriate time to start or to pursue therapy.
Frequência de micronucleação e outras alterações nucleares em células da mucosa bucal de pacientes anêmicos

Introduction: The Micronucleus Cytogenetic Test is a biomarker that provides information to assess chromosomal damage which arises from genotoxic actions. The micronucleus frequency can be measured at situations of substances and environmental exposure with high genotoxic power. Many anemias have their genesis in nutritional deficiencies and have the consequence of an increment in DNA lesions, altogether with high oxidative stress. Folic acid and B12 vitamin determines more chromosomal instability, such cofactors deficiency or oxidative lesions in genetic material, with implications in DNA repair system. Objectives: Considering the correlation of the anemias and damage to genetic material, the present study aims to evaluate the micronucleation rate and other nuclei alterations in oral mucosal cells of anemic adults. Methods: This study was conducted with 60 patients, 30 of them were anemic and 30 were in the control group. The samples were collected and processed according to a pre-established protocol and thereafter slides were microscopically evaluated for proliferation, genotoxicity, cytotoxicity and cell death criteria. For statistical analysis, Shapiro-Wilk test, Student’s t-test, Levene test and Pearson correlation test were used to compare the variables. Results: The micronucleation rate and the others alterations were higher in anemic, while the control group showed a higher cellular proliferative capacity. Also, way of life influenced the cellular criteria assessed. Conclusions: The high frequency of micronuclei in anemia was attributed to oxidative stress, with malnutrition or other predisposing conditions such as genetic etiology of anemia or the presence of chronic disease.
Antecedentes y creación del Instituto de Sueroterapia, Vacunación y Barteriología de Alfonso XIII

This article studies the establishment of the Alfonso XIII Institute of Serotherapy, Inoculation and Bacteriology in 1899, using the general press and the professional-scientific, medical and pharmaceutical press as its prime source, It aims to highlight the principal factors which led to its gestation and later development, as well as the circumstances which led to its creation, by analyzing the antecedents and orgins of the aforementioned institution.
Diffusion tensor imaging in acute optic neuropathies: predictor of clinical outcomes.

OBJECTIVE To evaluate directional diffusivities within the optic nerve in a first event of acute optic neuritis to determine whether decreased axial diffusivity (AD) would predict 6-month visual outcome and optic nerve integrity measures. DESIGN Cohort study. SETTING Academic multiple sclerosis center. Patients Referred sample of 25 individuals who presented within 31 days after acute visual symptoms consistent with optic neuritis. Visits were scheduled at baseline, 2 weeks, and 1, 3, 6, and 12 months. MAIN OUTCOME MEASURES Visual acuity, contrast sensitivity, visual evoked potentials (VEPs), and thickness of the retinal nerve fiber layer (RNFL). RESULTS An incomplete 6-month visual recovery was associated with a lower baseline AD (1.50 μm(2)/ms [95% confidence interval {CI}, 1.36-1.64 μm(2)/ms for incomplete recovery vs 1.75 μm(2)/ms [95% CI, 1.67-1.83 μm(2)/ms] for complete recovery). Odds of complete recovery decreased by 53% (95% CI, 27%-70%) for every 0.1-unit decrease in baseline AD. A lower baseline AD correlated with worse 6-month visual outcomes in visual acuity (r = 0.40, P = .03), contrast sensitivity (r = 0.41, P = .02), VEP amplitude (r = 0.55, P < .01), VEP latency (r = -0.38, P = .04), and RNFL thickness (r = 0.53, P = .02). Radial diffusivity increased between months 1 and 3 to become higher in those with incomplete recovery at 12 months than in those with complete recovery (1.45 μm(2)/ms [95% CI, 1.31-1.59 μm(2)/ms] vs 1.19 μm(2)/ms [95% CI, 1.10-1.28 μm(2)/ms]). CONCLUSIONS Decreased AD in acute optic neuritis was associated with a worse 6-month visual outcome and correlated with VEP and RNFL measures of axon and myelin injury. Axial diffusivity may serve as a marker of axon injury in acute white matter injury.
Warm Well Families: Doncaster Final Report

Cold homes harm health. There is a growing knowledge and evidence base related to the direct negative impacts on morbidity and mortality of living in cold housing. We know for example that in children, cold homes are associated with poor infant weight gain, slower development, worse asthma, and more hospital admissions. Adolescents are five times more likely to suffer multiple mental health problems. Adults – particularly those who are vulnerable – suffer more heart disease, stroke and respiratory disease, their general health is worse and existing conditions are exacerbated by living in cold properties. Older people suffer worse mental health and higher mortality rates. Living in cold housing can also indirectly harm health. It afects children’s educational attainment, emotional wellbeing and resilience; limits the dietary opportunities and choices people make; and the impact of cold on dexterity leads to a higher risk of accidents and injuries. The Warm Homes, Warm Families research project adds to our knowledge about the complex interaction between cold homes and health by exploring factors influencing the ability of households with children with asthma to keep warm at home in winter and access help. The experience, knowledge, beliefs and values of adults living in households with children with asthma affect the choices they make. This work will help to design improved information and support to enable families to protect themselves better from the harm to health caused by cold, damp housing. This work is particularly important at a time when energy costs are spiralling upward and when many families are faced with very stark economic choices.
Long-term Efficacy of Vedolizumab for Ulcerative Colitis

Background and Aims The GEMINI long-term safety [LTS] study is a continuing phase 3 trial investigating the safety and efficacy of vedolizumab, an α4β7 integrin antagonist for ulcerative colitis [UC] and Crohn's disease. We provide an interim analysis of efficacy in patients with UC. Methods Patients from the C13004 and GEMINI 1 studies and a cohort of vedolizumab-naïve patients received open-label vedolizumab every 4 weeks. Interim data were collected from May 22, 2009 to June 27, 2013. Clinical response and remission, evaluated using partial Mayo scores, and health-related quality of life [HRQL] were assessed for up to 152 weeks of cumulative treatment in the efficacy population. Results As of June 27, 2013, 63% of the efficacy population [n = 532/845] were continuing treatment. Among patients who responded to vedolizumab induction and had data available, 88% [n = 120/136] were in remission after 104 weeks of exposure (96% [n = 70/73] after 152 weeks). Among patients who withdrew from every-8-week vedolizumab maintenance in GEMINI 1 [n = 32] before week 52, increased dosing to every 4 weeks in GEMINI LTS resulted in response and remission rates of 41% and 28%, respectively, after 52 weeks, an increase from 19% and 6%, respectively, from before the dose increase. Similar benefits were demonstrated regardless of prior tumour necrosis factor-antagonist exposure. Durable benefits on HRQL were also observed. Conclusions Patients with UC experienced clinical and HRQL improvements with continued vedolizumab treatment. Increased dosing frequency to every 4 weeks was beneficial in patients who had loss of response to 8-weekly dosing.