Miracle-dz/UniFAR-FTUs huggingface dataset:
Tratamento fisioterapêutico na síndrome da dor miofascial e fibromialgia

BACKGROUND AND OBJECTIVES: Myofascial pain syndrome and fibromyalgia are among chronic pain conditions affecting the musculoskeletal system. While fibromyalgia is a diffuse pain, miofascial pain syndrome is characterized by its localized involvement. This study aimed at reviewing the literature to identify and group information about myofascial pain syndrome and fibromyalgia. CONTENTS: Electronic Mediline, LILACS and Scielo databases were queried in the search for articles published in English and Portuguese, using the keywords myofascial pain syndrome / sindrome de dor miofascial, fibromyalgia / fibromialgia, physical therapy in myofascial pain syndrome / fisioterapia na sindrome de dor miofascial, and physical therapy in fibromyalgia / fisioterapia na fibromialgia, published from 1991 to 2012. Twenty-nine articles were selected. CONCLUSION: Physical therapy programs promote more gains to decrease the impact of myofascial pain syndrome and fibromyalgia symptoms on patients' lives, thus the importance of the multidisciplinary and educative work, where the physical therapist participates, accurately informing and guiding patients.
Pharmacology of cyclooxygenase-2 inhibitors and preemptive analgesia in acute pain management

Purpose of review NSAIDs have served as analgesic, antiinflammatory, and antipyretic medicines for over a century. A novel class of NSAIDs, cyclooxygenase-2 inhibitors, was introduced in 1999. All NSAIDs and aspirin inhibit active sites of cyclooxygenase-1 and cyclooxygenase-2. Recent studies have demonstrated an important role of cyclooxygenase-2 inhibitors in the management of acute pain processes. Recent findings There have been many reports related to an ‘imbalance theory’ suggesting that cyclooxygenase-2 inhibitors create an ‘imbalance’ between thromboxane and prostacyclin (reduction of prostacyclin), resulting in a prothrombic state; however, these drugs were designed to have improved gastrointestinal safety profiles by being more selective of the cyclooxygenase-2 pathway. Although balance and regulation of hemostasis is influenced in part by the balance of prostacyclin and thromboxane A2, many other substances are involved in thrombosis and include the coagulation cascade, fibrinogen and plasminogen pathways, numerous endogenous substances such as adenosine, nitric oxide, and serotonin. Summary On the basis of many human studies, one may conclude that perioperative cyclooxygenase-2 inhibitors, in standard doses, decrease opioid consumption. Future investigations that include different multimodal techniques, for example combining cyclooxygenase-2 inhibitors with regional blocks, may help elucidate and clarify the true benefits of perioperative cyclooxygenase-2 inhibitors in acute pain management strategies.
Modeling Clustered Data with Very Few Clusters

ABSTRACT Small-sample inference with clustered data has received increased attention recently in the methodological literature, with several simulation studies being presented on the small-sample behavior of many methods. However, nearly all previous studies focus on a single class of methods (e.g., only multilevel models, only corrections to sandwich estimators), and the differential performance of various methods that can be implemented to accommodate clustered data with very few clusters is largely unknown, potentially due to the rigid disciplinary preferences. Furthermore, a majority of these studies focus on scenarios with 15 or more clusters and feature unrealistically simple data-generation models with very few predictors. This article, motivated by an applied educational psychology cluster randomized trial, presents a simulation study that simultaneously addresses the extreme small sample and differential performance (estimation bias, Type I error rates, and relative power) of 12 methods to account for clustered data with a model that features a more realistic number of predictors. The motivating data are then modeled with each method, and results are compared. Results show that generalized estimating equations perform poorly; the choice of Bayesian prior distributions affects performance; and fixed effect models perform quite well. Limitations and implications for applications are also discussed.
An Opportunity to Improve School Wellness

n recent years, the public has become more aware of ~ the increasing incidence of childhood obesity. Unfortunately, the U.S. Centers for Disease Control recently revealed that, despite this public attention, the incidence of overweight children continues to rise (Ogden et al., 2006). Ironically, although many children are overfed, many are also malnourished. More than 60% of young people eat too much fat, yet less than 20% eat the number of servings of fruits and vegetables recommended in the Food Guide
Airway management in the outpatient setting: new devices and techniques

Purpose of review There are an ever-increasing number of supraglottic airway devices available on the market, many being suitable for ambulatory surgery and the specific demands it creates. These include constraints of time, high turnover and the need for early and effective discharge. This article hopes to highlight the potential benefits of the current devices available. Recent findings Laryngeal masks are still undoubtedly the most popular supraglottic devices available but there are an increasing number of other airways on offer. Advantages of these include higher seal pressures, ease of insertion and the ability to drain gastric fluids. Summary Some of the unique advantages offered by certain devices lend themselves well to anaesthesia in ambulatory surgery. The laryngeal mask airway has a proven track record but newer airway devices are becoming more popular and may offer advantages. Further research is needed in this fast-moving field to assess these benefits, especially in specific cohorts of patients (such as the obese), who are appearing with increasing regularity on outpatient surgery lists.
Susceptibility of Candida albicans to common and novel antifungal drugs, and relationship between the mating type locus and resistance, in Lebanese hospital isolates

The incidence of antifungal resistance is on the increase worldwide and novel drugs are constantly being developed to counter this trend. One hundred and sixteen clinical isolates of Candida albicans were collected from Lebanese hospitals in order to first determine the degree of resistance of Lebanese isolates to four common azoles: fluconazole (FL), itraconazole (IT), ketoconazole (KE), and voriconazole (VO), in addition to amphotericin B (AP) and caspofungin (CS) through the Epsilometer test method and second, determine any relationship between the allelic compositions of the mating type loci (MTLa, MTL α, MTLa/α) with drug resistance. Results showed that resistance, among C. albicans isolates, was the highest with 12% for IT, followed by 7.7% for VO, 6% for KE, 5% for FL, 1.7% for AP and 0% for CS. Three isolates (2.6%) were resistant to all azoles tested, including one that was resistant to all drugs used except CS. Eleven isolates were homozygous at the MTL locus (9.5%), five of which (45%) were resistant to at least one antifungal drug whereas 14 of the 105 heterozygous strains (13%) exhibited similar resistance (P = 0.02), indicating a strong correlation between MTL locus homozygosity and resistance.
Cerebral revascularization: direct versus indirect bypass. Case presentation and review

Abstract Since 1985 when the EC-IC bypass study results were published and less procedures were performed for cerebral ischemia, the EC-IC bypass even high or low flow and the IC-IC bypass as flow replacement procedures gain acceptance for many neurosurgical pathologies, from extrinsic and intrinsic tumors requiring large vessels sacrifice to large giant and fusiform aneurysms. In recent years, after the results of Carotid Occlusion Surgery Study (COSS) and the Japanese EC-IC trial published their results the indications for extracranial-intracranial (EC-IC) by-pass expanded, including both extracranial carotid artery occlusive disease and intracranial atherosclerotic disease. The authors make a literature review of the indications for cerebral revascularization, with focus on the direct STA-MCA and indirect (EDAMS) revascularization techniques as a treatment for ischemic stroke. They present two cases of Moyamoya disease one treated with combined approaches and one with indirect approach and discuss the technical skills the surgeon should acquire in order to perform an anastomosis, focusing on the details of STA-MCA bypass, concluding that a combined approach gives better neurological results visible shortly after the surgery.
Quality of life in patients suffering from seborrheic dermatitis: influence of age, gender and education level

Seborrheic dermatitis is a common inflammatory skin condition occurring mostly on the face, scalp and chest. Despite its high frequency, the impact of seborrheic dermatitis on patients’ quality of life (QoL) has not been studied well so far. The objectives of this study were to analyse how seborrheic dermatitis affects the patients’ QoL and which socio‐economic factors could modulate QoL in these patients. A total of 3000 patients with seborrheic dermatitis and/or dandruff were enrolled into the study. All participants were divided into subgroups according to gender, age and education level. A specially designed questionnaire with demographic and clinical details of patients as well as Dermatology Life Quality Index (DLQI) was completed during a patient visit in an outpatient clinic. Data were collected by local dermatologists who were instructed regarding the inclusion and exclusion criteria and the questionnaires were sent back to us upon completion. The mean DLQI score for all patients was 6.92 ± 5.34 points. Patients with dandruff had significantly better QoL than subjects with seborrheic dermatitis (5.34 ± 4.67 points vs. 7.73 ± 5.3 points, respectively; P < 0.001) or individuals with dandruff plus seborrheic dermatitis (7.54 ± 5.6 points, P < 0.001). In addition, women, younger patients and subjects with higher educational level were more affected than the rest of the patients. Seborrheic dermatitis had significant, negative influence on patients’ QoL. Observed discrepancies between subgroups could be explained by different roles played by different patient subgroups in the society. DLQI can be successfully used for the assessment of QoL in large populational studies.
Home independence and community care: Time for a wider vision?

This article begins by looking at past policy assumptions about the importance of home and independence to older people. It is shown that it has long been argued that older people should stay in their own homes as long as possible but that this was not backed up with domiciliary services because of concerns that this would enable families to push caring responsibilities onto the state. The second half of the article looks at present day assumptions on this issue as addressed by the 1990 National Health Service and Community Care Act and compares this to what older people themselves have to say. By drawing on research on 39 older households the importance of home as a place of privacy and self identity is illustrated as is the rich and varied lives of these respondents both inside and outside their homes. It is argued that local authorities as the lead agencies in community care should help to foster such independence and that this requires them to develop a broad vision of community care which covers issues such as transport, leisure and household maintenance.
Phylogenetic systematics of Syncephalis (Zoopagales, Zoopagomycotina), a genus of ubiquitous mycoparasites

ABSTRACT We examined phylogenetic relationships among species of the mycoparasite genus Syncephalis using sequences from three nuclear ribsosomal DNA genes (18S, 5.8S, and 28S nuc rDNA) and a gene encoding the largest subunit of RNA polymerase II (RPB1). Our data set included 88 Syncephalis isolates comprising 23 named species and several unnamed taxa. We also revived a culturing technique using beef liver and cellophane to grow several Syncephalis isolates without their host fungi to obtain pure parasite DNA. Most isolates, however, were grown in co-cultures with their host fungi, so we designed Syncephalis-specific primers to obtain sequence data. Individual and combined data sets were analyzed by maximum likelihood (ML) and Bayesian methods. We recovered 20 well-supported lineages and 38 operational taxonomic units (OTUs). Most major clades contained isolates from distant localities on multiple continents. There were taxonomic and nomenclature issues within several clades, probably due to high phenotypic plasticity or species dimorphism. We also conducted an analysis of Syncephalis nuc rDNA internal transcribed spacer (ITS) sequences for 31 phylogenetically diverse isolates, and we determined that most Syncephalis species have long ITS sequences relative to other fungi. Although commonly employed eukaryotic and fungal primers are compatible with diverse Syncephalis species, the ITS sequences of Syncepahlis are nonetheless rarely recovered in environmental molecular diversity surveys.
Physician entrepreneur: lessons learned in raising capital for biomedical innovation

Purpose of review The funding landscape for medical devices is becoming increasingly difficult and complex. The purpose of this article is to provide the physician entrepreneur with a review of the main sources of capital available to fund the development and commercialization of biomedical innovations, and to highlight some of the important nuances of these funding sources that the physician entrepreneur should consider. Recent findings The article examines the benefits and drawbacks of funding from venture capital firms, grants, friends and family, angel investors, incubators and industry partners from the perspective of the physician entrepreneur, and provides some key points to consider when selecting and working with an investor. The article's recommendations include: in selecting an investor, seek those whose investment thesis, areas of expertise and desired company stage (early vs. late) match the technology and the objectives of the company. In negotiating with an investor, an effective way to increase the company's valuation is to bring multiple bidders to the table. In working with an investor, respect junior staff members as much as senior partners and be wary of conflicts of interest with venture capital entrepreneurs-in-residence. Summary There are both advantages and disadvantages to each of the funding sources examined here, and the choice of a funding partner depends significantly on the stage of development (in both corporate and technology) of the physician entrepreneur's venture and the role that the physician entrepreneur desires to play in it.
Specificity and genetic diversity of xylose-fermenting Scheffersomyces yeasts associated with small blue stag beetles of the genus Platycerus in East Asia

ABSTRACT Among insect-fungus relationships, xylose-fermenting Scheffersomyces yeasts are well known for their potential in utilizing wood hemicelluloses and their association with various wood-feeding insects. However, their specificity to host insects or strain-level diversity within host species has not been clearly elucidated. In the insect family Lucanidae, larvae usually feed on decaying wood, and adult females consistently possess a fungus-storage organ, called the mycangium, near the abdominal tip. Here the authors investigated host-symbiont relationships between Scheffersomyces yeast symbionts and small blue stag beetles of the genus Platycerus (Coleoptera: Lucanidae) in East Asia by using intergenic spacer (IGS) region as a genetic marker. All yeast strains isolated from the female mycangium of three Platycerus species, P. hongwonpyoi from Korea and P. acuticollis and P. delicatulus from Japan, were allied to Scheffersomyces segobiensis based on the sequences of the nrDNA 26S and internal transcribed spacer (ITS), in which no sequence difference was observed among those strains. However, IGS regions showed clear genetic differentiation within the yeast symbionts of P. hongwonpyoi, as well as between those of Korean and Japanese Platycerus species. In the IGS sequences, nucleotide substitutions were mainly distributed in the whole stretch of IGS1 and the anterior half of IGS2, whereas nucleotide gaps were localized at IGS1 and the middle of IGS2. Despite the conserved association between the Platycerus beetles and the specific strains of S. segobiensis in East Asia, geophylogenetic divergence patterns of the yeast symbionts were not concordant with those of the insect hosts.
Conditioned pain modulation (the diffuse noxious inhibitory control-like effect): its relevance for acute and chronic pain states

Purpose of review There is a growing body of knowledge on pain modulation in various disease states. This article reviews the state of the art regarding the clinical relevance of pain inhibition as revealed by ‘pain inhibits pain’ test paradigms, trying to organize the clinically relevant data, and emphasizing the pathophysiology of pain. In line with recent experts' recommendations, the term conditioned pain modulation (CPM) will be used, replacing the previous terms ‘diffuse noxious inhibitory control (DNIC)’ or ‘DNIC-like’ effects. Recent findings Most of the work in this context was done on the idiopathic pain syndromes, such as irritable bowel syndrome, temporomandibular disorders, fibromyalgia, and tension type headache. The pattern of reduced CPM efficiency seems common to these syndromes and an assertion is made that low CPM efficiency, reflecting low pain inhibitory capacity, is a pathogenetic factor in the development of the idiopathic pain syndromes. Low CPM efficiency was shown to be predictive of acute and chronic postoperative pain, and, in some reports, to be associated with neuropathic pain levels. Summary Low CPM efficiency is associated with higher pain morbidity and vice versa. Further work is awaited on clarifying plasticity of CPM and its relevance to selection and efficacy of pain therapy.
Principles and Practice of Mechanical Ventilation

Principles and Practice of Mechanical Ventilation , edited by Martin J. Tobin, MD, is an outstanding text, unique and surprisingly up to date. Even with 76 contributing authors, the text maintains cohesion and reads well. It should be examined by pulmonologists, intensivists, anesthesiologists, and respiratory care practitioners, although anyone interested in the subject of mechanical ventilation should find it informative and helpful. I especially liked the sections dealing with the historical basis of mechanical ventilation, the work of breathing, and ethical problems associated with mechanical ventilation. The book is very comprehensive. Virtually all aspects are covered, along with provocative thoughts on possible future modes, such as closed-loop mechanical ventilation. The "inner workings" of ventilators are discussed. The performances of those currently available are compared for various modes of ventilatory support. Tables and figures are thoughtful and descriptive. The text is indexed well. In conclusion, Principles and Practice of Mechanical Ventilation is
Dermatophytes as a cause of epizoonoses in dairy cattle and humans in Iran: epidemiological and clinical aspects

Zoophilic dermatophytosis is a major public and veterinary health problem globally widespread among cattle. To identify the causative agent and geographical distribution of dermatophytes involved in cattle ringworm and to establish if they would be related to human diseases in Iran, a study was carried out on 6789 heads of cows and 130 herdsmen during 2006–2007. Samples were taken from 380 cattle and 43 herdsmen with suspected dermatophytosis. The causative agents were identified macroscopically and microscopically by KOH examination and culture isolation. Only 352 cases of dermatophytosis were identified in cattle and Trichophyton verrucosum was the exclusive fungus isolated from animals. Moreover, 27 cases of human dermatophytosis were identified and T. verrucosum was the prevalent causative agent for dermatophytosis in the body, scalp, foot, nail and groin of the patients. The obtained results showed that T. verrucosum was the predominant cause of dermatophytosis in livestock and dairy farmers. There is a scarcity of information on isolation and identification of the epizoonotic agents of dermatophytoses in cattle in Iran. This study showed the occurrence of dermatophytosis in humans and cattle and confirms that the dermatozoonoses are responsible for predominant forms of the disease in people who were in contact with cattle.
Bismuth triple therapy: still a very important drug regimen for curing Helicobacter pylori infection.

: Bismuth triple therapy (bismuth compound, metronidazole and tetracycline) is the oldest effective regimen to cure Helicobacter pylori infection. When tetracycline is replaced by amoxycillin the cure rate decreases. In 1990, it was the first-line regimen. However, the great number of pills in the rather complicated regimen, together with a relative high rate of side-effects, have stimulated the search for other regimens. In developed countries, it has now mainly been surpassed by the simpler, but much more expensive proton-pump inhibitor-based triple therapies. In many developing countries however, bismuth-based therapy is the only effective therapy patients can afford. Worldwide, this drug combination is therefore probably one of the most widely used regimens. The efficacy of bismuth triple therapy can be improved by adding acid suppressants (quadruple therapy), increasing treatment duration or increasing the total daily dose of metronidazole. The choice of the bismuth compound and the total daily dose of tetracycline seem less important. Treatment can be shorter (7 days) in areas with a low rate of metronidazole resistance or when acid inhibition is added. Bismuth is usually given four times daily; tetracycline is usually given 500 mg q.i. d. in a 7- or 10-day treatment, but this can probably be reduced to 250 mg q.i. d. in a 14-day regimen. A higher total daily dose of metronidazole increases the cure rate but also gives more side-effects. A daily dose of 1000-1200 mg metronidazole in three or four divided doses for one week suffices in areas with a low rate of metronidazole resistance. In areas with a higher rate of resistance one can either increase the treatment duration to 10-14 days or increase the daily dose of metronidazole to 1500-1600 mg and leave the treatment duration at 7 days.
Monod–Wyman–Changeux allosteric mechanisms of action and the pharmacology of etomidate

Purpose of review Formal Monod–Wyman–Changeux allosteric mechanisms have proven valuable in framing research on the mechanism of etomidate action on its major molecular targets, &ggr;-aminobutyric acid type A (GABAA) receptors. However, the mathematical formalism of these mechanisms makes them difficult to comprehend. Recent findings We illustrate how allosteric models represent shifting equilibria between various functional receptor states (closed versus open) and how co-agonism can be readily understood as simply addition of gating energy associated with occupation of distinct agonist sites. We use these models to illustrate how the functional effects of a point mutation, &agr;1M236W, in GABAA receptors can be translated into an allosteric model phenotype. Summary Allosteric co-agonism provides a robust framework for design and interpretation of structure–function experiments aimed at understanding where and how etomidate affects its GABAA receptor target molecules.