Miracle-dz/UniFAR-FTUs huggingface dataset:
Procalcitonin (PCT), C reactive protein (CRP) and its correlation with severity in early sepsis

Sepsis is a common cause of death, and represents a potentially life threatening disorder. Biochemical markers useful to initiate early antimicrobial treatment are being studied. Procalcitonin (PCT) and C reactive protein (CRP) have been proposed as markers for this purpose. To establish the level of PCT and CRP in early sepsis and its correlation with the APACHE II scale, levels of PCT and CRP were taken from 39 patients with sepsis criteria. They were correlated with the severity scale of APACHE II. Cultures were taken prior to antimicrobial usage to corroborate the bacterial origin in patients who were admitted to the Internal Medicine Service of the North Central Hospital of Petroleos Mexicanos. Descriptive statistics were performed (mean and standard deviation for numerical values and percentages) for nominal values. Pearson correlation and relative risk tests were performed to determine correlations. 39 patients in total; 20 with positive cultures and 19 with negative; patients with positive cultures showed PCT levels above 0.5 ng/ml; negatives below this number. The mean for CRP was 128 mg/ml. Correlation of mortality/APACHE II r = 0.707 p = 0.01; PCT/APACHE II r = 0.523 p = 0.001. For cultures: CRP/culture r = 0.575 p = 0.0001, PCT/culture r =0.448 p = 0.004. Relative risk (RR): PCT > than 2 ng/dl and cultures RR= 4. The relative risk PCT >2 mg/dl and death RR= 3.3. Cultures and CRP>128 RR= 2.4; death and CRP > 128 mg/dl RR= 2. PCT and CRP values are useful markers to determine early gravity of an infectious illness; PCT is useful to demonstrate early form of bacterial processes.
An Occupational Performance Process Model: Fostering client and Therapist Alliances

Occupational therapists, known for their ability to coach others through difficult changes, now find themselves in changing environments that include clients' desire for participation in service delivery, and the need for evidence of the outcome of occupational therapy intervention. This paper proposes a process model that is based on core concepts of occupation and client-centred practice, that incorporates theoretical approaches, and can be applied to all clients. The process model coaches the occupational therapist through a client-centred problemsolving process. It represents a description or plan for occupational therapy assessment and intervention that leads to a collaborative approach to client-identified occupational performance issues. Examples of the application of the process to occupational therapy practice are included. This model helps to articulate core concepts and values, and provides guidance for occupational therapy practice within changing environments and expectations.
Circadian gene variants in cancer

Abstract Humans as diurnal beings are active during the day and rest at night. This daily oscillation of behavior and physiology is driven by an endogenous circadian clock not environmental cues. In modern societies, changes in lifestyle have led to a frequent disruption of the endogenous circadian homeostasis leading to increased risk of various diseases including cancer. The clock is operated by the feedback loops of circadian genes and controls daily physiology by coupling cell proliferation and metabolism, DNA damage repair, and apoptosis in peripheral tissues with physical activity, energy homeostasis, immune and neuroendocrine functions at the organismal level. Recent studies have revealed that defects in circadian genes due to targeted gene ablation in animal models or single nucleotide polymorphism, deletion, deregulation and/or epigenetic silencing in humans are closely associated with increased risk of cancer. In addition, disruption of circadian rhythm can disrupt the molecular clock in peripheral tissues in the absence of circadian gene mutations. Circadian disruption has recently been recognized as an independent cancer risk factor. Further study of the mechanism of clock-controlled tumor suppression will have a significant impact on human health by improving the efficiencies of cancer prevention and treatment.
Circadian clock and cancer therapy: an unexpected journey

Abstract Chronotherapy of cancer is one of the oldest examples of the clinical application of biological rhythms. Growing understanding of the importance of biological timing in physiology and pathophysiology of many diseases including cancer reforms our views on the role of biological clocks in cancer and cancer treatment. In the present issue the current progress in circadian clock-dependent mechanisms of cancer, polymorphism and mutations of clock gene in cancer, cancer-associated clock disruptions, and novel chronotherapeutic approaches are discussed.
Functional Magnetic Resonance of Human Breast Tumors

Abstract: This review is focused on two relatively new developments in magnetic resonance imaging (MRI) and their application to breast lesion characterization: diffusion and perfusion MRI. Diffusion MRI measures the mobility of the water protons and thus provides a window to tissue microstructure. Perfusion MRI measures the rate at which blood is delivered to tissue and thus provides information about microvasculature. Because both tissue structure and vasculature are likely to change in disease states, measurement of diffusion and perfusion may have direct physiologic relevance. This review covers topics related to the imaging sequences, image analysis, and clinical studies for diffusion and perfusion breast MRI. Preliminary studies show that the apparent diffusion coefficient (ADC) is a marker of cell density and can distinguish malignant from benign lesions. Perfusion MR also shows promise for breast tumor characterization: malignant tumors have consistently higher relative tissue blood volumes (rTBV) than normal and benign tumors. Additional research is required with large patient cohorts to establish these two techniques on a clinical footing.
Baptisms of fire or death knells for acute-slice physiology in the age of ‘omics’ and light?

Abstract With increasing use of various techniques to record optically and electrophysiologically from awake behaving animals and the growing developments of brain-machine interfaces, one might wonder if the use of acute-slice physiology is on its deathbed. Have we actually arrived at a stage where we can abandon the use of acute slices, with most of the information about brain functions coming from in vivo experiments? We do not believe that this is the case, given that our understanding of the nuts and bolts of the nervous system, such as ion channels and transporters in near-native state, neuronal compartmentalization, and single-neuron computation, is far from complete. We believe that in the foreseeable future, questions in these fields will still be best addressed by acute-slice physiology. We approach this review from the perspective of improving acute-slice physiology so it can continue to provide relevant and valuable contributions to neuroscience. We conclude that the death of acute-slice physiology is an obituary prematurely written, merely due to waxing and waning trends in science and the shortsightedness of investigators. Acute-slice physiology has at least one more life to live after the hype around new techniques has passed, but it needs to reinvent itself in light of current knowledge.
Situationally appropriate behavior: translating situations into appetitive behavior modes

Abstract If an organism’s responding to its present location or more abstract situation is similar to its responding to discrete motivationally salient stimuli, then principles of stimulus-response relationships and their acquisition may apply to the organization of behavior that appears to be sensitive and appropriate to the organism’s external context. Locations or situations become motivationally salient, insofar as they acquire the ability to compel the organism to obtain a specific type of reward through more or less constrained exploratory or foraging behavior. The ventral hippocampus is proposed to play a key role in linking a salient situation or location with an appropriate mode of behavior, whereas allocentric information predicted and updated by the dorsal hippocampus may be associated with, or translated into, a sequence of orienting and locomotor actions. The impact of ventral hippocampal representations of salient situations on behavior is mediated by the ventral subiculum, ventromedial prefrontal cortex, and ventral striatum. Projecting via the ventral subiculum to the ventromedial prefrontal cortex and ventral striatum, the ventral hippocampus maps motivationally salient environmental information, as well as emotional information reflective of the internal physiological milieu, onto an instrumental or emotional behavior mode that represents a specialized, more or less purposeful, state of behavioral arousal and global locomotor activation.
B-type natriuretic peptide as a predictor of declining cognitive function and dementia—a cohort study of an elderly general population with a 5-year follow-up

Abstract Background. Several traditional cardiovascular risk factors assessed in the middle-aged are associated with the risk of dementia, but they are known to lose much of their prognostic value when measured in the elderly. The aim of the study was to compare B-type natriuretic peptide (BNP) with previously known risk markers for dementia in their association with cognitive decline and dementia during a follow-up. Methods. A total of 464 subjects free of dementia aged 75 years or more were examined and followed up for 5 years in a prospective population-based stratified cohort study. The association of clinical variables to base-line Mini Mental State Examination score (MMSE), the decline of MMSE, and onset of dementia during the follow-up were examined. Results. The only variable to significantly associate with the decline of MMSE was BNP (beta 0.140; P = 0.019). A total of 59 new cases of dementia were diagnosed after the follow-up. Significant predictors of the occurrence of dementia over the study period were BNP (adjusted odds ratio (OR) 1.53; 95% confidence interval (CI) 1.09–2.16; P = 0.013), length of education (OR 0.50; 95% CI 0.33–0.77; P = 0.001), and diagnosis of hypertension (OR 0.53; 95% CI 0.27–0.95; P = 0.036). BNP remained as a significant predictor of dementia and the decline of MMSE even after adjustment to the base-line MMSE. Conclusions. BNP is an independent harbinger of the cognitive decline and incidence of new onset of dementia in an elderly general population. This is a ground for testing the impact of antihypertensive treatment in the prevention of cognitive impairment in those with elevated BNP.
Treating prehypertension: medically sound and economically viable

Abstract The 7th Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure provided new guide-lines for the definition and management of hypertension. Notably, a new category—“prehypertension”—was created for intermediate systolic pressures exceeding 120 mmHg, the upper limit of normal, but less than 139 mmHg, the threshold for stage 1 hypertension. The therapeutic consequences of this new classification are not yet clear, but research indicates that prehypertension is an independent risk factor for cardiovascular, cognitive, and renal morbidities as well as diabetes, and statistical data indicate that prehypertension is present in over 30% of US, European, and Asian adults. However, while pharmacotherapy is recommended for hypertension, the use of drugs to control prehypertension is under question. Given the serious health consequences linked with prehypertension, such debates seem misplaced if patient well-being is our priority. While acknowledging the lack of specific randomized controlled trial data on this topic, we suggest that anti-hypertensive therapy be recommended for everyone with prehypertension and address resulting cost-benefit issues.
Tryptophan hydroxylase 2 in seasonal affective disorder: underestimated perspectives?

Abstract Seasonal affective disorder (SAD) is characterized by recurrent depression occurring generally in fall/winter. Numerous pieces of evidence indicate the association of SAD with decreased brain neurotransmitter serotonin (5-HT) system functioning. Tryptophan hydroxylase 2 (TPH2) is the key and rate-limiting enzyme in 5-HT synthesis in the brain. This paper concentrates on the relationship between TPH2 activity and mood disturbances, the association between human TPH2 gene expression and the risk of affective disorder, application of tryptophan to SAD treatment and the animal models of SAD. The main conclusions of this review are as follows: (i) the brain 5-HT deficiency contributes to the mechanism underlying SAD, (ii) TPH2 is involved in the regulation of some kinds of genetically defined affective disorders and (iii) the activation of 5-HT synthesis with exogenous l-tryptophan alone or in combination with light therapy could be effective in SAD treatment. The synergic effect of these combined treatments will have several advantages compared to light or tryptophan therapy alone. First, it is effective in the treatment of patients resistant to light therapy. Secondly, l-tryptophan treatment prolongs the antidepressant effect of light therapy.
Probing the relationship between Gram-negative and Gram-positive S1 proteins by sequence analysis

Escherichia coli ribosomal protein S1 is required for the translation initiation of messenger RNAs, in particular when their Shine–Dalgarno sequence is degenerated. Closely related forms of the protein, composed of the same number of domains (six), are found in all Gram-negative bacteria. More distant proteins, generally formed of fewer domains, have been identified, by sequence similarities, in Gram-positive bacteria and are also termed ‘S1 proteins’. However in the absence of functional information, it is generally difficult to ascertain their relationship with Gram-negative S1. In this article, we report the solution structure of the fourth and sixth domains of the E. coli protein S1 and show that it is possible to characterize their β-barrel by a consensus sequence that allows a precise identification of all domains in Gram-negative and Gram-positive S1 proteins. In addition, we show that it is possible to discriminate between five domain types corresponding to the domains 1, 2, 3, 4–5 and 6 of E. coli S1 on the basis of their sequence. This enabled us to identify the nature of the domains present in Gram-positive proteins and, subsequently, to probe the filiations between all forms of S1.
Functional outcome after intracerebral haemorrhage – a review of the potential role of antiapoptotic agents

Abstract Intracerebral haemorrhage (ICH) is the second most common form of stroke and is associated with greater mortality and morbidity compared with ischaemic stroke. The current ICH management strategies, which mainly target primary injury mechanisms, have not been shown to improve patient’s functional outcome. Consequently, multimodality treatment approaches that will focus on both primary and secondary pathophysiology have been suggested. During the last decade, a proliferation of experimental studies has demonstrated the role of apoptosis in secondary neuronal loss at the periphery of the clot after ICH. Subsequently, the value of certain antiapoptotic agents in reducing neuronal death and improving functional outcome following ICH was evaluated in animal models. Preliminary evidence from those studies strongly supports the potential role of antiapoptotic agents in reducing neuronal death and improving functional outcome after intracerebral haemorrhage. Expectedly, the ongoing and subsequent clinical trials will substantiate these findings and provide clear information on the most potent and safe antiapoptotic agents, their appropriate dosage, and temporal window of action, thereby making them suitable for the multimodality treatment approach.
Masked hypertension is “unmasked” by low-intensity exercise blood pressure

Abstract Purpose: Masked hypertension (MH) independently predicts mortality but cannot be diagnosed from clinic blood pressure (BP) taken under resting conditions. We sought to determine if MH could be identified from BP taken during a single bout of low-intensity exercise. Methods. BP was recorded at rest and during brief low-level cycling exercise (60–70% of age-predicted maximal heart rate) in 75 untreated subjects with a hypertensive response to exercise (aged 54 ± 9 years). All subjects underwent 24-h ambulatory BP monitoring (ABPM) and MH was defined as clinic BP < 140/90 mmHg and ABPM BP ≥ 130/80 mmHg. Results. There were 42 (56%) patients with MH, and at rest systolic (SBP) was higher in subjects with MH compared with those without MH (127 ± 9 vs 120 ± 9 mmHg; p < 0.05). During exercise, MH subjects had significantly higher SBP (188 ± 22 vs 168 ± 15 mmHg; p < 0.05), with a greater change from baseline (61 ± 21 vs 48 ± 15 mmHg; p < 0.05). Low-level exercise SBP was independently associated with MH, and if ≥175 mmHg, identified MH with 74% sensitivity and 67% specificity (p < 0.001). Conclusion. MH can be identified in untreated individuals from low-intensity exercise SBP. Further research on the diagnostic value of BP during early phases of exercise stress testing is needed.
Influencia de la prematuridad sobre el sistema nervioso en la niñez y en la adultez

OBJETIVO: Revisar la influencia de la prematuridad sobre el sistema nervioso durante los primeros anos de vida y posteriormente durante la adultez. DESARROLLO: Los recien nacidos pretermino constituyen una poblacion vulnerable. Tienen un elevado riesgo de sufrir problemas de salud, discapacidades neurologicas y trastornos de la conducta, pobre desempeno cognitivo. Tambien cursan con un riesgo elevado de presentar paralisis cerebral y trastornos sensoriales. Por otra parte, es conocido que algunos eventos que ocurren tempranamente en la vida influyen en el desarrollo de enfermedades en la vida adulta. A largo plazo, los ninos que nacieron prematuramente tienen mayor riesgo de desarrollar enfermedades cardiovasculares, hipertension arterial y diabetes mellitus en la edad adulta y posiblemente, tambien presenten un riesgo mayor de padecer cancer. El conocimiento de estos aspectos por parte de los profesionales permitiria una mejor compresion de las morbilidades que presentan durante la vida los ninos nacidos prematuramente. CONCLUSIONES: Los programas de atencion, evaluacion y seguimiento de ninos pretermino deben tener en cuenta el efecto de dicho evento en las diferentes etapas de la vida
Intra-articular infiltration therapy for patients with glenohumeral osteoarthritis: A systematic review of the literature

Background: Conservative treatments are especially in patients with glenohumeral osteoarthritis (GH-OA) important, since shoulder arthroplasty has its limitations. In this systematic review, we will evaluate the current evidence regarding the efficacy of intra-articular (IA) infiltration treatment options in patients with GH-OA. Materials and Methods: The following databases are searched: Pubmed/Medline, Cochrane Clinical Trial Register, Embase and the WHO clinical trial register. All IA injection products used for the treatment of shoulder OA in humans are included. Results: A total of 8 studies could be included in this review. Hyaluronic acid (HA) showed effect sizes of 2.07, 2.02 and 2.11 at 6, 12 and 26 weeks follow-up, respectively. Placebo (1.60, 1.82 and 1.68) also showed stable effect sizes at the same time points. The efficacy of corticosteroids (CS) decreased rapidly at follow-up (1.08, 0.43 and 0.19). Although statistical significant, the maximum difference in effect sizes between HA and placebo was only 0.43 with absolute values between 2.0 and 6.4 on a 100-point visual analogue score for pain. Conclusion: IA treatment with HA has a good efficacy at follow-up compared to baseline. However, the difference in efficacy between HA and placebo never reaches the minimal clinically important difference at any of the follow-up points. We are not able to give clear recommendations for the use of IA CS injections in patients with GH-OA. In future research, we recommend focusing on sufficiently powered randomized trials to compare the efficacies of HA, CS, placebo and other IA treatment options in patients with GH-OA.
Chronic inflammatory demyelinating polyneuropathy: Clinical subtypes and their correlation with electrophysiology

Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is currently classified into “typical CIDP” and other variants, such as “multifocal acquired demyelinating sensory and motor neuropathy (MADSAM)”. Typical CIDP is a classic form, clinically characterized by symmetric proximal and distal muscle weakness and motor‐dominant manifestation. In typical CIDP, demyelination predominantly affects the distal nerve terminals and nerve roots, presumably because of the lack of the blood–nerve barrier in these regions, and this could be responsible for the “non‐nerve length‐dependent” distribution of muscle weakness. Furthermore, the safety factor of impulse transmission is physiologically lowered by axonal branching in the intramuscular motor nerves, and therefore, conduction block develops more readily in motor axons than in sensory axons, leading to motor‐dominant polyneuropathy in typical CIDP. These findings suggest the importance of humoral immunity in typical CIDP. In contrast, MADSAM is characterized by multifocal demyelination in the intermediate nerve trunks with preservation of the nerve terminals/roots, and such distribution of lesions should result in multiple mononeuropathy or asymmetric polyneuropathy. In MADSAM neuropathy, cellular immunity might be predominantly involved in the breakdown of the blood–nerve barrier at the site of the conduction block. Clinical features are likely to be determined by the distribution of demyelinative lesions, and probably reflect the different immunopathogenesis of each CIDP subtype. This review focuses on clinical‐electrophysiological correlation in the subtypes of CIDP. (Clin. Exp. Neuroimmunol. doi: 10.1111/j.1759‐1961.2011.00020.x, May 2011)
Prevalence of herbal medicine use by UK patients/consumers: a systematic review of surveys

Objective To estimate the prevalence of herbal medicine (HM) use in the UK. Methods The databases AMED, CINAHL, COCHRANE, EMBASE and MEDLINE were searched for peer-reviewed surveys published between January 2000 and September 2011. The authors’ own departmental files were also manually searched for relevant references. Results Ten surveys were included with a total of 20 601 participants. All surveys had major methodological limitations. Across all surveys, the average prevalence rate for a range of time periods was 37.1% (range 4.8–92.4). One-year prevalence was provided by just one survey and amounted to 36%. The vast majority of patients did not discuss their use of HM with a conventional healthcare professional. The average incidence rate of adverse effects that was associated with HM use was 15.8%. Conclusion Many UK patients and/or consumers use HM, often without consulting their conventional healthcare professionals. In order to maximise patient-safety, a full medical history should include questions about HM usage.