Miracle-dz/UniFAR-FTUs huggingface dataset:
Relationship between cardiovascular evaluation data on admission and secondary adverse cardiac event rate after acute coronary syndrome

The current study aimed to investigate the relationship of clinical data with mean platelet volume (MPV) and QT dispersion values on admission of acute coronary syndrome (ACS) patients to the adverse cardiac event rate in a follow-up period of 20 months after discharge. For this purpose demographic and clinical data with corrected QT dispersion on admission and MPV values of 97 consequtive patients with ACS were recorded, retrospectively. Their history of major adverse cardiac event (MACE) in a 20 months period after ACS was obtained from the hospital records, interviews with the attending physicians and telephone calls to patients. Demographic and clinical data with corrected QT dispersion on admission, and MPV values were compared between groups with and without MACE in terms of statistical significance. In our study, diabetesmellitus, left ventricular ejection fraction (EF) and wall motion score index (WMSI), corrected QT dispersion, total cholesterol, LDL, CK-MB and troponin levels were found significantly related to the secondary MACE rate (p values; 0.046, 0.0001, 0.0001, 0.032, 0.024, 0.002 and 0.0001, respectively). No significant relation was detected between groups with and without MACE in terms of conservative medical follow-up and revascularization history (p=0.774). In the comparison of mean MPV values, there was no statistically significant difference between MPV values of patients with MACE (10.4±1.8 fl) and without MACE (10.3±2 fl) (p=0.799). In addition, the subgroup analysis on acute ST-elevation myocardial infarction cases in our study group did not state a significant relationship between MPV values below/above 10.3 fl and MACE rates (p=0.774). Finally, this retrospective study showed that corrected QT dispersion, diabetes, contractile reserve of left ventricule, total and LDL- cholesterol and peak cardiac enzyme values assessed during ACS might predict MACE.
Myocardial Infarction in the Elderly: Does Advanced Age Impact on Survival?

our understanding of normal aging has improved, many declines in function previously attributed to the aging process have now been ascribed to disease processes. For example, cognitive function and cardiac output in the upright position have not been found to change in any meaningful way as a result of normal aging [2]. However, other organ systems have been found to undergo age-related changes that do not impair function in a clinically meaningful way in the absence of superimposed disease. For example, advancing age is well known to be related to a progressive impairment of the ability to metabolize a glucose load as well as to a
Clinical outcomes of prolonged infusion (extended infusion or continuous infusion) versus intermittent bolus of meropenem in severe infection: A meta-analysis

Background Meropenem exhibits time-dependent antimicrobial activity and prolonged infusion (PI) (extended infusion or continuous infusion, EI or CI) of meropenem can better achieve pharmacodynamics target when comparing with intermittent bolus (IB). However, the clinical outcomes between two groups remain inconclusive. Objective To evaluate current published literatures by meta-analysis to ascertain whether PI of meropenem can improve clinical outcomes. Methods Medline, Cochrane database and EMBASE were searched. Randomized control trails (RCT) and observational studies which compared the clinical outcomes of PI and IB groups were included and evaluated for quality. The data of studies were extracted and meta-analysis was performed using Revman 5.3 software. Results Six RCTs and 4 observation studies with relatively high quality were included in this analysis. Compared to IB group, PI group had a higher clinical success rate (odd ratio 2.10, 95% confidence interval 1.31–3.38) and a lower mortality (risk ratio 0.66, 95% confidence interval 0.50–0.88). The sensitivity analysis showed the results were stable. Conclusion PI of meropenem was associated with a higher clinical improvement rate and a lower mortality. It is recommended for patients with severe infection or infected by less sensitive microbial.
Regional Primary Care Team to Deliver Best-Practice Diabetes Care

OBJECTIVE Best-practice diabetes care can reduce the burden of diabetes and associated health care costs. But this requires access to a multidisciplinary team with the right skill mix. We applied a needs-driven evidence-based health workforce model to describe the primary care team required to support best-practice diabetes care, paying particular attention to diverse clinic populations. RESEARCH DESIGN AND METHODS Care protocols, by number and duration of consultations, were derived for twenty distinct competencies based on clinical practice guidelines and structured input from a multidisciplinary clinical panel. This was combined with a previously estimated population profile of persons across 26 patient attributes (i.e., type of diabetes, complications, and threats to self-care) to estimate clinician contact hours by competency required to deliver best-practice care in the study region. RESULTS A primary care team of 22.1 full-time-equivalent (FTE) positions was needed to deliver best-practice primary care to a catchment of 1,000 persons with diabetes with the attributes of the Australian population. Competencies requiring greatest contact time were psychosocial issues and dietary advice at 3.5 and 3.3 FTE, respectively (1 FTE/∼300 persons); home (district) nursing at 3.2 FTE; and diabetes education at 2.8 FTE. The annual cost of delivering care was estimated at just over 2,000 Australian dollars (∼2,090 USD) (2012) per person with diabetes. CONCLUSIONS A needs-driven approach to primary care service planning identified a wider range of competencies in the diabetes primary and community care team than typically described. Access to psychosocial competences as well as medical management is required if clinical targets are to be met, especially in disadvantaged groups.
Experience With Electric Prostheses for the Partial Hand Presentation: An Eight-Year Retrospective

This article provides a review of progressive partial hand prosthetic management as presented at the University of New Brunswick Myoelectric Controls Symposium in August 2008. This unique patient population allows an opportunity for further research and testing of upper limb principles, both historic and new. The prosthetic field is at the beginning of a paradigm shift of our current thinking as it relates to the treatment of individuals with partial hand limb differences.
Penicillin Treatment of General Paresis (Dementia Paralytica): Results of Treatment in 1,086 Patients the Majority of Whom Were Followed for More Than Five Years

Introduction This paper is a cooperative report of the clinical, spinal fluid, and serologic findings in a group of 1,086 patients with general paresis (dementia paralytica) treated with penicillin with or without fever therapy at eight different hospitals. A detailed account of the formation and function of this cooperative clinical study has been given previously as an introduction to the presentation of the group experience in treatment of asymptomatic central nervous system syphilis. 1 Shortly after the effectiveness of penicillin in the treatment of early syphilis was reported, various investigators began to study the efficacy of this new antibiotic in the treatment of central nervous system syphilis. These investigations were supported in part by grants from the Office of Scientific Research and Development, the National Institutes of Health, and the Division of Venereal Disease, U. S. Public Health Service. The findings of the individual investigators have provided much of the
Patterns of prescription and concern about opioid analgesics for chronic non-malignant pain in general practice

Aim The purpose of this study was to investigate the circumstances of opioid prescription among general practitioners (GPs) in the UK. Background Prescription of opioids for chronic pain, particularly non-malignant chronic pain, remains controversial. In the midst of this controversy, patterns of actual prescription and influences on these patterns are not well understood. Method A mail survey was posted to 1192 GPs and it was returned by 414 (35.0%). The survey addressed the frequency and reluctance in GP prescription of opioids for chronic pain. It also sampled their attitudes and concerns about opioids, including their views on appropriateness and effectiveness, adverse effects and potential social pressures presumed to impact on prescribing. Findings Overall, 57.9% of GPs reported they sometimes, frequently, or always, prescribe strong opioids for chronic pain, which was of significantly lower frequency than for prescribing of weak opioids, non-steroidal anti-inflammatory drugs (NSAIDs) or tricyclic antidepressant medications. Similarly, 69.1% reported a reluctance to prescribe strong opioids for chronic non-malignant pain, which was a significantly greater reluctance than for cancer pain, for example. GPs who were men, younger, had fewer years experience and worked full time (as opposed to part time), were more likely to prescribe opioids. Practice guideline use was unrelated to prescribing but those with specialty training were more likely to prescribe. Interestingly, a majority of GPs (83.0%) felt that opioids are effective for chronic non-malignant pain; however, they worry about long-term commitment (such as managing dosing and repeat prescriptions), addiction and other adverse events. Conclusions Based on multivariate analyses, both frequency of prescribing and reluctance were predicted by a combination of concerns about effects on patient behaviour, professional competency concerns and degree of belief in opioids as an effective option. These results may suggest a need for additional GP training in the management of analgesics for chronic non-malignant pain.
ANTI-ATHEROSCLEROTIC EFFECTS OF ALOE VERA IN HYPERCHOLESTEROLEMIC RABBITS

BACKGROUND AND OBJECTIVE: Aloe Vera is a medicinal plant that has diverse biological propertiessuch as antioxidant and anti-inflammatory activity. Atherosclerosis is one of the main causes of death in the world where in � the new studies have been introduced as an inflammatory diseaseHence the use of lipid-lowering drugs and inflammation may be useful inpreventing or controlling it. This study evaluated the anti-atherosclerotic effects of Aloe vera in hypercholesterolemic rabbits � METHODS: This experimental study was performed on 32 New Zealand male rabbits weighing 1800-2000 gr. Animal model of atherosclerosis was developed in 32 male rabbits using high-cholesterol diet (cholesterol 1%). Rabbits in four experimental groups (n=8) were treated for 30 days: normal diet group, high-cholesterol diet group, high-cholesterol diet group with Aloe vera gel (3.2%v/v per day in their drinking water), and Aloe vera with the normal diet group. At the beginning and end of study rabbits blood was used for total cholesterol, triglyceride, LDL, HDL, FBS measuring by enzymatic methods and CRP. The presence of fatty streaks in arteries of animals with histopathologicalmethods was investigated and compared � FINDINGS: High cholesterol diet group was significantly increased total cholesterol andCRP (p<0.05)� Results indicated that the use of Aloe vera in the third group withhigh-cholesterol diet significantly decreased total cholesterol (576.88±292.52 vs. 1059±79.11) and CRP in this group thanhigh-cholesterol group (p<0.05). Other lipoproteins after studying in groups 2 and 3 compared with normal dietand Aloe vera alone had a significant increase (p<0.05), but they have not significant difference with each other. The use of Aloe vera along with high- cholesterol diet significantly reduced the formation of fatty streaks in the high-cholesterol group (p<0.05). CONCLUSION: The results show that the consumption of Aloe vera by knowing the impact ofcholesterol and inflammation as major risk factors for atherosclerosis can bebeneficial effects in controlling this disease prevention.
Insulin glargine and receptor-mediated signalling: clinical implications in treating type 2 diabetes.

Most patients with type 2 diabetes mellitus will eventually require insulin therapy to achieve or maintain adequate glycaemic control. The introduction of insulin analogues, with pharmacokinetics that more closely mimic endogenous insulin secretion, has made physiologic insulin replacement easier to achieve for many patients. However, there are also concerns regarding alteration of binding affinities for the insulin receptor (IR) or insulin-like growth factor-1 receptor (IGF-1R) may increase the mitogenic potential of some analogues. Therefore, this article will review the relevant preclinical and clinical data to assess the mitogenic potential of insulin glargine, a basal insulin analogue, compared with regular human insulin (RHI). Searches of the PubMed database were performed using terms that included ‘IR,’ ‘insulin-like growth factor-1,’ ‘IGF-1R,’ ‘type 2 diabetes mellitus,’ and ‘insulin glargine. ’ Original articles and reviews of published literature were retrieved and reviewed. Although one study reported increased binding affinity of insulin glargine for the IGF-1R and increased mitogenic potential in cells with excess IGF-1Rs (Saos/B10 osteosarcoma cells), most in vitro binding-affinity and cell-culture studies have demonstrated behaviour of insulin glargine comparable to that of RHI for both IR and IGF-1R binding, insulin signalling, and metabolic and mitogenic potential. Currently published in vivo carcinogenic studies and human clinical trial data have shown that insulin glargine is not associated with increased risk for either cancer or the development or progression of diabetic retinopathy. Copyright © 2007 John Wiley & Sons, Ltd.
Physical Activity and Risk of All-Cause and Cardiovascular Disease Mortality in Diabetic Adults From Great Britain: Pooled Analysis of 10 Population-Based Cohorts

OBJECTIVE To examine associations between specific types of physical activity and all-cause and cardiovascular disease (CVD) mortality in a large nationally representative sample of adults with diabetes from Great Britain. RESEARCH DESIGN AND METHODS There were a total of 3,038 participants (675 deaths) with diabetes in the Health Survey for England and the Scottish Health Surveys conducted between 1997 and 2008. Participants aged ≥50 years at baseline were followed up for an average of 75.2 months for all-cause and CVD mortality. Data were collected on self-reported frequency, duration, and intensity of participation in sports and exercise, walking, and domestic physical activity, from which the number of MET-hours/week were derived. Sex-specific medians of time spent in each type of physical activity (for those physically active) were calculated, and Cox proportional hazards regression conducted to examine type-specific associations between the level of physical activity and all-cause and CVD mortality risk. RESULTS Inverse associations with all-cause and CVD mortality were observed for overall physical activity in a dose-response manner after adjusting for covariates. Compared with those who individuals were inactive, participants who reported some activity, but below the recommended amount, or who met the physical activity recommendations had a 26% (95% CI 39–11) and 35% (95% CI 47–21) lower all-cause mortality, respectively. Similar results were found for below/above median physical activity levels. Sports and exercise participation was inversely associated with all-cause (but not CVD) mortality, as were above average levels of walking. Domestic physical activity was not associated with mortality. CONCLUSIONS Moderate physical activity levels were associated with better prognosis in diabetic adults.
Response to Comment on Hong et al. Effects of Metformin Versus Glipizide on Cardiovascular Outcomes in Patients With Type 2 Diabetes and Coronary Artery Disease. Diabetes Care 2013;36:1304–1311

We thank Lund and Gong (1) for their letter and for taking an interest in our recent article (2). The following are responses to specific inquiries on the details of the trial. First, we respond to the statement that although our randomized clinical trial (RCT) is probably the first report of cardiovascular (CV) outcomes comparing the long-term effects of glipizide and metformin on the major CV events in type 2 diabetic patients who had a history of coronary artery disease, “several previous …
Gut Dysbiosis and Detection of “Live Gut Bacteria” in Blood of Japanese Patients With Type 2 Diabetes

OBJECTIVE Mounting evidence indicates that the gut microbiota are an important modifier of obesity and diabetes. However, so far there is no information on gut microbiota and “live gut bacteria” in the systemic circulation of Japanese patients with type 2 diabetes. RESEARCH DESIGN AND METHODS Using a sensitive reverse transcription–quantitative PCR (RT-qPCR) method, we determined the composition of fecal gut microbiota in 50 Japanese patients with type 2 diabetes and 50 control subjects, and its association with various clinical parameters, including inflammatory markers. We also analyzed the presence of gut bacteria in blood samples. RESULTS The counts of the Clostridium coccoides group, Atopobium cluster, and Prevotella (obligate anaerobes) were significantly lower (P < 0.05), while the counts of total Lactobacillus (facultative anaerobes) were significantly higher (P < 0.05) in fecal samples of diabetic patients than in those of control subjects. Especially, the counts of Lactobacillus reuteri and Lactobacillus plantarum subgroups were significantly higher (P < 0.05). Gut bacteria were detected in blood at a significantly higher rate in diabetic patients than in control subjects (28% vs. 4%, P < 0.01), and most of these bacteria were Gram-positive. CONCLUSIONS This is the first report of gut dysbiosis in Japanese patients with type 2 diabetes as assessed by RT-qPCR. The high rate of gut bacteria in the circulation suggests translocation of bacteria from the gut to the bloodstream.
Job Strain as a Risk Factor for Type 2 Diabetes: A Pooled Analysis of 124,808 Men and Women

OBJECTIVE The status of psychosocial stress at work as a risk factor for type 2 diabetes is unclear because existing evidence is based on small studies and is subject to confounding by lifestyle factors, such as obesity and physical inactivity. This collaborative study examined whether stress at work, defined as “job strain,” is associated with incident type 2 diabetes independent of lifestyle factors. RESEARCH DESIGN AND METHODS We extracted individual-level data for 124,808 diabetes-free adults from 13 European cohort studies participating in the IPD-Work Consortium. We measured job strain with baseline questionnaires. Incident type 2 diabetes at follow-up was ascertained using national health registers, clinical screening, and self-reports. We analyzed data for each study using Cox regression and pooled the study-specific estimates in fixed-effect meta-analyses. RESULTS There were 3,703 cases of incident diabetes during a mean follow-up of 10.3 years. After adjustment for age, sex, and socioeconomic status (SES), the hazard ratio (HR) for job strain compared with no job strain was 1.15 (95% CI 1.06–1.25) with no difference between men and women (1.19 [1.06–1.34] and 1.13 [1.00–1.28], respectively). In stratified analyses, job strain was associated with an increased risk of diabetes among those with healthy and unhealthy lifestyle habits. In a multivariable model adjusted for age, sex, SES, and lifestyle habits, the HR was 1.11 (1.00–1.23). CONCLUSIONS Findings from a large pan-European dataset suggest that job strain is a risk factor for type 2 diabetes in men and women independent of lifestyle factors.
Estudo prospectivo dos parâmetros periodontais e peri-implantares dos pilares que recebem prótese dento-implanto-suportada

Since the introduction of implants in Dentistry, controversies have arisen about the possibility of connecting implants to teeth in fixed prostheses. Osseointegrated implants do no present any periodontal ligature and are more firmly anchored to the bone. The difference presented by this type of anchorage has led to some concern about the limited flexibility of the osseointegrated implant to share the functional loads with the connected teeth. This study intended to follow-up prospectively the periodontal parameters bleeding index, probing depth between the pillar tooth of an implant supported prosthesis with one control tooth of the same patient and also the implants that support theses prostheses. That is why subtraction radiography of the region in which the prosthesis was placed was used, with radiographs taken at prosthesis placement, after six months and one year of use to verify if the periimplant osseous support had or had not undergone changes. Twelve patients with normal health conditions were selected who presented a posterior area edentulous jaw where a prosthetic rehabilitation by a fixed prosthesis joining tooth to implant was indicated. Patients were treated with an implant of one stage of 10mm standard Straumann (ITI) with a 2.8 mm polished neck, in which the remaining intraosseous portion of the implant has a treated surface of 4.1 mm diameter. The implant was placed in the space where according to the protocol, the more distal retainer of the future fixed partial prosthesis would be located. Digital radiographs were assessed with a subtraction radiography software Matrox Inspector version eight, to corroborate the change of contrast in the radiographs when superimposed, with values observed in the implant compared with the success criteria , widely mentioned in surveyed studies. All implants placed in patients became osseointegrated. There was no record of bone change around them and in the dental pillars of the prostheses at the one year follow-up. Prostheses continue to be in excellent conditions after the one year follow-up based upon clinical and radiographic analyses. Furthermore, in accordance with the Wilcoxon test of matched pairs and signed rank, it was concluded that there was no statistical difference between each group of each patient during the time period analyzed (baseline and one year) as well as when the pillars were compared to their respective controls.
New Insulin Glargine 300 Units·mL−1 Provides a More Even Activity Profile and Prolonged Glycemic Control at Steady State Compared With Insulin Glargine 100 Units·mL−1

OBJECTIVE To characterize the pharmacokinetics (PK) and pharmacodynamics (PD) of a new insulin glargine comprising 300 units·mL−1 (Gla-300), compared with insulin glargine 100 units·mL−1 (Gla-100) at steady state in people with type 1 diabetes. RESEARCH DESIGN AND METHODS A randomized, double-blind, crossover study (N = 30) was conducted, applying the euglycemic clamp technique over a period of 36 h. In this multiple-dose to steady-state study, participants received once-daily subcutaneous administrations of either 0.4 (cohort 1) or 0.6 units·kg−1 (cohort 2) Gla-300 for 8 days in one treatment period and 0.4 units·kg−1 Gla-100 for 8 days in the other. Here we focus on the results of a direct comparison between 0.4 units·kg−1 of each treatment. PK and PD assessments performed on the last treatment day included serum insulin measurements using a radioimmunoassay and the automated euglycemic glucose clamp technique over 36 h. RESULTS At steady state, insulin concentration (INS) and glucose infusion rate (GIR) profiles of Gla-300 were more constant and more evenly distributed over 24 h compared with those of Gla-100 and lasted longer, as supported by the later time (∼3 h) to 50% of the area under the serum INS and GIR time curves from time zero to 36 h post dosing. Tight blood glucose control (≤105 mg·dL−1) was maintained for approximately 5 h longer (median of 30 h) with Gla-300 compared with Gla-100. CONCLUSIONS Gla-300 provides more even steady-state PK and PD profiles and a longer duration of action than Gla-100, extending blood glucose control well beyond 24 h.