Miracle-dz/UniFAR-FTUs huggingface dataset:
Response to letter from Dr Freeman.

The authors of the manuscript ‘Comparison of flunixin meglumine and meloxicam for post operative management of horses with strangulating small intestinal lesions’ [1] would like to thank Dr Freeman for his correspondence regarding our manuscript. In both of the hospitals where this study was performed, lidocaine is administered as standard practice to cases with strangulating small intestinal lesions. Given the evidence that lidocaine may attenuate detrimental effects of flunixin meglumine on intestinal healing, the inclusion of this treatment in the study protocol was given full consideration. Having individually made the decision to routinely use lidocaine in horses with strangulating obstructions in both hospitals, we considered it to be unethical for us to withdraw this treatment simply for the purposes of conducting the study. It was not our intention to comment on the quality of evidence supporting the use of lidocaine; indeed, we acknowledge that this is weak but there is, nonetheless, limited evidence supporting its use. There are, of course, very many other factors that are equally, if not more, important in the prevention/management of post operative ileus and we are sure that you may be correct that lidocaine has minor, if any, benefit. However, until definitive evidence is made available, both of our hospitals independently decided to make the use of lidocaine standard. It was certainly not our intention to suggest that not using lidocaine is unethical but rather we were explaining our rationale for including the treatment in the management of our cases and our opinion that to withdraw its use as a standard treatment in the 2 hospitals just for the purposes of this study was inappropriate.
Comparative Study of Serum Albumin, γGT and LDH levels in HIV Coinfection with Hepatitis B Virus in Relationship with CD4 Count

This study was designed to determine the serum albumin, GGT and LDH level in relationship with the CD4 count and hepatitis B and C coinfection in HIV patient. Sixty HIV patients aged 16 to 75 years classified according to the CD4 cell count value and with reference to HBV/HCV co-infection status were studied. Viral Immunochemical status of the patients was determined by ELIZA and Immunoblotting. CD4 cell count was estimated by flow cytometry while the plasma LDH, GGT and Albumin was estimated biochemically by spectrophotometry. The results showed a significantly higher mean value in the plasma level of albumin in HIV-monoinfected patients with CD4 count of between 251-399cells/µl and those with values of ≥400 cells /µl than those with CD4count between 0-250 cells/µl. with p<0.05. The results showed a significantly higher mean value in the plasma level of albumin in HIV-HBV patients with CD4 count of between 251-399cells/µl and those with values of ≥400 cells /µl than those with CD4count between 0-250 cells/µl. with p<0.05. In conclusion there was a biochemical alteration in the plasma level of Albumin in the HIV monoinfected and HIV-HBV patients and this significant alteration was also found to be directly proportional to CD4 cell count hence the need for the estimation of these parameters in the management of HIV infection. None of the patients was coinfected with HCV. Keywords: : Serum Albumin, γGT, LDH HIV Coinfection, Hepatitis B Virus, CD4
FRATURA COMPLEXA DOS OSSOS DO ANTEBRAÇO POR PROJÉTIL DE ARMA DE FOGO DE ALTA ENERGIA: FIXAÇÃO EXTERNA VERSUS APARELHO GESSADO

Objetivo: Comparar os resultados do tratamento de fraturas complexas dos ossos do antebraco, causadas por projetil de arma de fogo (PAF) de alta energia, utilizando fixacao externa ou aparelho gessado. Metodos: Foram estudados 26 pacientes com ferimentos de alta energia, apresentando fratura de um ou de ambos os ossos do antebraco por PAF. Entre os pacientes, 25 eram do sexo masculino, com media de idade de 30,5 anos (variando de 15 a 50 anos). O membro superior direito foi acometido em 16 casos (61,5%). Nao houve registro de bilateralidade. Nenhum paciente chegou a instituicao com mais do que seis horas apos o trauma inicial. Um paciente apresentou lesao da arteria radial, requerendo reparo vascular simultaneamente a estabilizacao ossea. As fraturas foram classificadas de acordo com sistema alfanumerico do Grupo AO/OTA e, apos o desbridamento, de acordo com o estadiamento de Gustilo et al. Houve 15 fraturas 22-C1, oito 22-C2 e tres 22-C3. Das fraturas, 25 foram estadiadas como grau 3A e uma como grau 3C. As feridas foram deixadas abertas, sendo o osso coberto com partes moles. Fixacao externa foi empregada em 14 casos (grupo FE) e aparelho gessado antebraquiopalmar em 12 casos (grupo AG). Os resultados foram avaliados clinicamente, apos tempo medio de seguimento de 62 meses. (AU)
eComment. Creatinine in the diagnosis of acute kidney injury following cardiac surgery with cardiopulmonary bypass.

Authors: Juan Bustamante-Munguira, Pablo Jorge-Monjas, Alfonso HernandezLorenzo and Eduardo Tamayo Department of Cardiovascular Surgery, Hospital Universitario de La Princesa, Madrid, Spain Department of Anesthesiology and Reanimation. Hopital Clinico Universitario de Valladolid, Valladolid, Spain doi: 10.1093/icvts/ivv252 © The Author 2015. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.
Aortenaneurysma und -dissektion: Pathophysiologie, Epidemiologie und Diagnostik

Kurzfassung: Aneurysma und Dissektion der thorakalen und abdominellen Aorta gehoren zu den haufigsten Erkrankungen der Hauptschlagader und sind mit einer hohen Morbiditat und Mortalitat assoziiert, welche durch Blutung bei Ruptur oder Minderperfusion von Organen bei Dissektion entstehen. Die Kenntnisse der Epidemiologie, der Pathophysiologie, sowie der Klinik ermoglichen bei akuten und chronischen aneurysmatischen oder dissezierenden Prozessen eine entsprechend adaquate Diagnostik zur Einleitung der optimalen Behandlung. Beim Aneurysma der abdominellen Aorta ist die vaskulare Duplexsonographie fur das Screening und die Verlaufskontrollen die geeignetste und kostengunstigste Bildgebung. Beim thorakalen Aneurysma sowie bei akuten Ereignissen mit Ruptur oder Dissektion ist die kontrastmittelverstarkte Computertomographie das diagnostische Verfahren der Wahl. Abstract: Aortic Aneurysm and Aortic Dissection: Pathphysiology, Epidemiology and Imaging. Aneurysms and dissections of the thoracic and abdominal aorta are the most common diseases of the aortic tree and are associated with a high morbidity and mortality caused by bleeding in case of rupture or malperfusion of vital organs in case of dissection. The knowledge of epidemiology, pathophysiology and clinical presentation allows the most appropriate diagnostic evaluation in both acute and chronic situations. Ultrasound is the ideal and most cost-effective imaging modality for screening and follow-up investigations of abdominal aortic aneurysms. Contrast-enhanced computed tomography is the most appropriate imaging for aneurysm of the thoracic aorta or for acute events with rupture or dissection. Z Gefasmed 2015; 12 (2): 4–8.
Valor preditivo da medida da cintura e da relação cintura-quadril no diagnóstico do diabetes melito e da dislipidemia

Introducao: O indice de obesidade esta aumentando no Brasil.A medida da cintura (MC) e uma boa medida para a avaliacao da obesidade localizada e e mais facil de ser adquirida do que a relacao cintura quadril (RCQ). Entretanto, os efeitos da obesidade regional foram melhores descritos entre a RCQ e fatores de risco cardiovasculares. Objetivo: testar se a medida da cintura isolada e melhor do que a RCQ para predizer diabetes e dislipidemia. Metodos: analisamos a razao de verossimilhanca positiva e negativa da MC e RCQ numa amostra de 202 homens e mulheres com idade variando de 20 a 74 anos e aparentemente saudaveis como fator preditivo para diabetes e dislipidemia. Resultados: (1) Para mulheres, a RCQ foi melhor fator preditivo para o diagnostico dediabetes (RV+ = 2,5 e RV- = 0,2) e dislipidemia (RV+2,5 e RV-=0,2) comparado a MC (diabetes, RV+ = 1,9 e RV- = 0,4; dislipidemia, RV+ = 1,6 e RV- = 0,6); (2) Para homens, a MC foi melhor fator preditivo para o diagnostico de diabetes (RV+ = 2,4 e RV- = 0,6) e dislipidemia (RV+ = 5 e RV- = 0,5) do que a RCQ (diabetes, RV+ = 1,0 e RV- = 0,9; dislipidemia, RV+ = 2,1 e RV- = 0,7). Conclusao: A MC e a RCQ se comportam diferentes entre homens e mulheres.
Neuropathologic basis of age-associated brain atrophy.

IMPORTANCE While brain volume changes are used as surrogate markers for Alzheimer disease neuropathology in clinical studies, the extent to which these changes are due to pathologic features of Alzheimer disease in the aging brain is not well established. This study aims to clarify the neuropathologic correlates of longitudinal brain atrophy. OBJECTIVE To examine the association between brain atrophy during life and neuropathology in an elderly population. DESIGN Autopsy study of a cohort of elderly individuals. SETTING Community-based population. PARTICIPANTS Seventy-one healthy elderly individuals were selected from participants of the Oregon Brain Aging Study for having an autopsy, more than 1 magnetic resonance imaging scan, and the last magnetic resonance imaging scan within 36 months of death. MAIN OUTCOMES AND MEASURES The associations between brain volume trajectories (ventricular, total brain, and hippocampal) and time interaction terms for neurofibrillary tangles, neuritic plaques, gross infarcts, microinfarcts, amyloid angiopathy, Lewy bodies, APOE ε4 presence, and clinical diagnosis (no cognitive impairment, mild cognitive impairment, or dementia as time-varying covariates) were examined in mixed-effects models, adjusting for duration of follow-up and age at death. RESULTS Ventricular volume trajectory was significantly associated with age, presence of infarcts, neurofibrillary tangle and neuritic plaque scores, APOE ε4 allele presence, and dementia diagnosis. Total brain volume trajectory was significantly associated with age and mild cognitive impairment diagnosis. Hippocampal volume trajectory was significantly associated with amyloid angiopathy. CONCLUSIONS AND RELEVANCE Ventricular volume trajectory is more sensitive than total brain and hippocampal volume trajectories as a marker of accruing Alzheimer disease and vascular pathology in elderly individuals. The association between brain volume trajectories and cognitive impairment (mild cognitive impairment and dementia) remained after controlling for the degree of neuropathology and other covariates. This suggests that there may be other factors not measured in this study that could be contributing to brain atrophy in those with cognitive impairment.
Migrant health in New Zealand: exploring issues concerning medicines access and use

Every year a cohort of new migrants enters New Zealand (NZ), bringing challenges that impact on medicines use and health outcomes. The prescribing of medicines is a common therapeutic intervention and access to medicines and optimal use cannot be assumed for these populations. Internationally the literature exploring issues relating to medicines access and use by migrants in high‐income countries is scarce. This study aims to explore attitudes, beliefs and perceptions of a cohort of migrants about medicines access and use in NZ.
Predicting hematoma expansion after primary intracerebral hemorrhage.

IMPORTANCE Many clinical trials focus on restricting hematoma expansion following acute intracerebral hemorrhage (ICH), but selecting those patients at highest risk of hematoma expansion is challenging. OBJECTIVE To develop a prediction score for hematoma expansion in patients with primary ICH. DESIGN, SETTING, AND PARTICIPANTS Prospective cohort study at 2 urban academic medical centers among patients having primary ICH with available baseline and follow-up computed tomography for volumetric analysis (817 patients in the development cohort and 195 patients in the independent validation cohort). MAIN OUTCOMES AND MEASURES Hematoma expansion was assessed using semiautomated software and was defined as more than 6 mL or 33% growth. Covariates were tested for association with hematoma expansion using univariate and multivariable logistic regression. A 9-point prediction score was derived based on the regression estimates and was subsequently tested in the independent validation cohort. RESULTS Hematoma expansion occurred in 156 patients (19.1%). In multivariable analysis, predictors of expansion were as follows: warfarin sodium use, the computed tomography angiography spot sign, and shorter time to computed tomography (≤ 6 vs >6 hours) (P < .001 for all), as well as baseline ICH volume (<30 [reference], 30-60 [P = .03], and >60 [P = .005] mL). The incidence of hematoma expansion steadily increased with higher scores. In the independent validation cohort (n = 195), our prediction score performed well and showed strong association with hematoma expansion (odds ratio, 4.59; P < .001 for a high vs low score). The C statistics for the score were 0.72 for the development cohort and 0.77 for the independent validation cohort. CONCLUSIONS AND RELEVANCE A 9-point prediction score for hematoma expansion was developed and independently validated. The results open a path for individualized treatment and trial design in ICH aimed at patients at highest risk of hematoma expansion with maximum potential for therapeutic benefit.
Endocrinology: A prospective randomized single-blind comparative trial of nafarelin acetate with buserelin in long-protocol gonadotrophin-releasing hormone analogue controlled in-vitro fertilization cycles

: The use of gonadotrophin-releasing hormone (GnRH) agonists to control ovulation induction cycles for in-vitro fertilization (IVF) has been shown to increase the pregnancy rate and live birth rate compared with non-analogue cycles. Different formulations of GnRH agonist are available with different routes and frequencies of administration. In this prospective study, the efficacy and safety of intranasal nafarelin and buserelin as adjunctive therapy during IVF were assessed. A total of 240 female patients were recruited to the study and in the first phase patients were randomized to receive either intranasal nafarelin 200 micrograms twice daily or buserelin 200 micrograms five times daily. In the second phase, patients received either nafarelin 400 micrograms twice daily or buserelin 200 micrograms five times daily. Nafarelin 400 micrograms and buserelin 200 micrograms both produced clinical pregnancy rates of 31% per recruit and 39% per embryo transfer. The rates for nafarelin 200 micrograms were 23 and 37% respectively. There was no statistically significant difference in pregnancy rates, by either drug or dosage. The time taken for pituitary down-regulation to be achieved was significantly longer on nafarelin 200 micrograms than on either nafarelin 400 micrograms or buserelin. The total number of days stimulation with human menopausal gonadotrophin required to reach criteria for human chorionic gonadotrophin (HCG) administration was significantly longer on buserelin than on either dose of nafarelin. Median serum oestradiol concentrations on the day of HCG administration were significantly higher on either dose of nafarelin than on buserelin.
Incidencia de neoplasias internas después del trasplante hepático

BACKGROUND: De novo malignancy developing after transplantation constitutes a well-known complication or organ transplantation, mainly described among renal recipients. AIM: To determine the incidence of de novo internal malignancies (excluding therefore skin cancers and recurrent hepatocellular carcinoma) in a cohort of 183 patients undergoing liver transplantation (OLT) between 6/1/1991 and 12/1/1996 with a minimum follow-up of 12 months and under cyclosporine-azathioprine-prednisone. PATIENTS AND METHODS: The study comprised 183 patients (mean age: 53 [8] years, with 70% males) whose charts were reviewed retrospectively. Rejection, steroids treatment, methyl-prednisolone bolus and OKT3 use were compared in the cases and in the matched control group. RESULTS: Seven malignancies were detected: 3 lung carcinomas, 1 larynx, 1 prostate, 1 colon and 1 ovarian. The mean age was 53 (8) years. The diagnosis of cancer was made at an average time of 24 (17) months (range, 10-54) post-OLT. Three patients died with a mean survival of 31 (16) months. OLT indication was mainly for viral liver disease (5/7). Although not statistically significant, immunosuppression data were higher among patients with cancer than in the matched group. Two additional patients developed post-transplantation lymphoproliferative diseases at 2 and 9 months, respectively. CONCLUSION: We observed a wide variety of malignancies after OLT, but no associated factor was found, even though there was a trend to higher doses of immunosuppression in patients with cancers. The institution of preventive measures and surveillance programs may allow for early institution of therapy, improving therefore the survival.
Early versus late pulmonary valve replacement in patients with transannular patch-repaired tetralogy of Fallot.

OBJECTIVES Although the effects of pulmonary regurgitation after tetralogy of Fallot repair are detrimental, timing of pulmonary valve replacement (PVR) is unclear. Our goal was to evaluate the midterm efficacy and safety of early PVR. METHODS Patients with tetralogy of Fallot who underwent repair from 1962 to 2015 were included from the local database. Statistical analyses compared patients who underwent early PVR (age ≤16 years), late PVR and no PVR. The timing of the intervention was compared for efficacy-all-cause mortality and the combined end-point of all-cause mortality, ventricular tachycardia and defibrillator implantation-and for safety-the combined end-point of 1-year postoperative mortality after PVR, endocarditis and reintervention. Echocardiographic and electrocardiographic data at the last follow-up examination were compared across the 3 groups. RESULTS Two hundred seventy-three patients (age 21 ± 5 years; 52% female) were included. The mean follow-up was 24 (95% confidence interval 22.7-26.2) years; the observed median was 21 years (interquartile range 11-31). No significant difference in survival was found between the early PVR (n = 106; 39%), the late PVR (n = 47; 17%) and the no PVR groups (n = 120; 44%) (P = 0.990). No significant difference in the combined efficacy end-point was noted between patients who underwent early PVR compared with patients who underwent late PVR (P = 0.247). Worse event-free survival for the 3-point safety end-point was observed after early PVR (P < 0.001). Right ventricular morphology (P < 0.001) and function (P < 0.001) were better preserved in the patient group that underwent PVR before the age of 16 years. CONCLUSIONS As expected, PVR-related morbidity was higher in patients who underwent early PVR but the midterm outcome was similar. Nevertheless, better preservation of right ventricular morphology and function in the early PVR group might result in better long-term survival.
GENETIC ANALYSIS OF MATE DISCRIMINATION IN DROSOPHILA SIMULANS

Courtship is an elaborate behavior that conveys information about the identity of animal species and suitability of individual males as mates. In Drosophila, there is extensive evidence that females are capable of evaluating and comparing male courtships, and accepting or rejecting males as mates. These relatively simple responses minimize random sexual encounters involving subpar conspecific males and heterospecific males, and over generations can potentially select novel physical and behavioral traits. Despite its evolutionary and behavioral significance, little is still known about the genes involved in mating choice and how choices for novel males and females arise during evolution. Drosophila simulans and Drosophila sechellia are two recently diverged species of Drosophila in which females have a preference for conspecific males. Here we analyzed a total of 1748 F2 hybrid females between these two species and found a small number of dominant genes controlling the preference for D. simulans males. We also mapped two redundant X‐linked loci of mating choice, Macho‐XA and Macho‐XB, and show that neither one is required for female attractiveness. Together, our results reveal part of the genetic architecture that allows D. simulans females to recognize, mate, and successfully generate progenies with D. simulans males.
A multiancestral genome-wide exome array study of Alzheimer disease, frontotemporal dementia, and progressive supranuclear palsy.

IMPORTANCE Previous studies have indicated a heritable component of the etiology of neurodegenerative diseases such as Alzheimer disease (AD), frontotemporal dementia (FTD), and progressive supranuclear palsy (PSP). However, few have examined the contribution of low-frequency coding variants on a genome-wide level. OBJECTIVE To identify low-frequency coding variants that affect susceptibility to AD, FTD, and PSP. DESIGN, SETTING, AND PARTICIPANTS We used the Illumina HumanExome BeadChip array to genotype a large number of variants (most of which are low-frequency coding variants) in a cohort of patients with neurodegenerative disease (224 with AD, 168 with FTD, and 48 with PSP) and in 224 control individuals without dementia enrolled between 2005-2012 from multiple centers participating in the Genetic Investigation in Frontotemporal Dementia and Alzheimer's Disease (GIFT) Study. An additional multiancestral replication cohort of 240 patients with AD and 240 controls without dementia was used to validate suggestive findings. Variant-level association testing and gene-based testing were performed. MAIN OUTCOMES AND MEASURES Statistical association of genetic variants with clinical diagnosis of AD, FTD, and PSP. RESULTS Genetic variants typed by the exome array explained 44%, 53%, and 57% of the total phenotypic variance of AD, FTD, and PSP, respectively. An association with the known AD gene ABCA7 was replicated in several ancestries (discovery P=.0049, European P=.041, African American P=.043, and Asian P=.027), suggesting that exonic variants within this gene modify AD susceptibility. In addition, 2 suggestive candidate genes, DYSF (P=5.53×10(-5)) and PAXIP1 (P=2.26×10(-4)), were highlighted in patients with AD and differentially expressed in AD brain. Corroborating evidence from other exome array studies and gene expression data points toward potential involvement of these genes in the pathogenesis of AD. CONCLUSIONS AND RELEVANCE Low-frequency coding variants with intermediate effect size may account for a significant fraction of the genetic susceptibility to AD and FTD. Furthermore, we found evidence that coding variants in the known susceptibility gene ABCA7, as well as candidate genes DYSF and PAXIP1, confer risk for AD.
Childhood Renal Neoplasms in Lagos Nigera- A 28 Year Review

Out of 131 nephretomies received at the Morbid Anatomy Department of the Lagos University Teaching Hospital, there were 63 cases of childhood renal cancer representing 48% of total renal neoplasm seen over a period of 1970-1997. The ages range from 21/2 months - 11 years; over 75% of the cases were found under 5 years with only 3.2% occurring above 10 years. The male female ratio is 1:1. Of the cancers, there were 42 cases of classical nephroblastoma and 10 cases of the blastema type of nephroblastoma. We had 7 cases of purely sarcomatous nephroblastoma one of which is a rhabdomyosarcoma and the remaining 6 were undifferentiated sarcoma. There was one case of anaplastic carcinoma. Also seen was a case of mesoblastic nephroma in a 21/2 months male infant. In this study, neither benign neoplasm nor congenital tumour (angiomyolipoma) was encountered, in all cases, there was no age nor sex disparity. Most of the patients presented with abdominal mass with a unilaterally enlarged kidney, abdominal pain, haematuria and weight loss. All of them had nephrectomy as initial treatment followed by radiotherapy and chemotherapy. Nigerian Quarterly Journal of Hospital Medicine Vol. 9, No. 1 (1999) pp. 4-7