Miracle-dz/UniFAR-FTUs huggingface dataset:
Diagnosing diabetes mellitus in clinical practice: is fasting plasma glucose a good initial test?*

Aims. To investigate the sensitivity of using fasting plasma glucose as the first line test to diagnose diabetes mellitus by comparison of established 1985 WHO diagnostic criteria with use of a fasting plasma glucose of ≥7 mmol/L as recommended by the ADA and endorsed by WHO. Method. Retrospective analysis of 1864 oral glucose tolerance tests undertaken in patients with a clinical suspicion of diabetes. Results. Using an FPG of ≥7 mmol/L alone resulted in a 17.4% reduction in the prevalence of DM when compared with 1985 WHO criteria and a 8.7% reduction in the prevalence of any abnormality of glucose tolerance. Overall concordance between the two methods of assessment was 68.9%. Of those classified as abnormal by WHO, 257/990 (26.0%) (75/592 (12.2%) DM and 185/378 (46.5%) IGT), would be reclassified as normal if only FPG were measured. 667 (35.8% of those tested) could be diagnosed as diabetic if either an FPG≥7 mmol/L or a 2 h PP level ≥11.1 mmol/L were considered, of whom 178 (26.7%) would be missed if only FPG were considered. Of those diagnosed as diabetic on the basis of an FPG ≥7 mmol/L, 96 (19.6%) had a 2 hour glucose concentration <11.1 mmol/L. Using a reduced cut-off level to prompt further investigation with an OGTT improved sensitivity though at the expense of specificity and with the requirement for an increasing number of OGTTs. Conclusion. In people where there is a clinical suspicion of diabetes, using fasting plasma glucose alone for diagnosis will miss a significant number with abnormal glucose tolerance. Until long term outcome data are available, diabetes should not be excluded without a measure of either a post-prandial glucose level or OGTT. Copyright © 2001 John Wiley & Sons, Ltd.
The Steps Toward Developing the Physical Activity Guidelines for Americans

The Dietary Guidelines for Americans (DGA) have been in existence for nearly 30 years. The first set was released in 1980. Since their inception, the DGA have always mentioned a need for maintaining a healthy weight. In 1995, the Guidelines went one step further to advise Americans to ‘‘balance the food you eat with physical activity. ’’ The 2000 guidelines increased the physical activity recommendation, advising Americans to ‘‘be physically active each day. ’’ The most recent DGA, which were released in 2005, included a robust physical activity recommendation advising Americans to ‘‘engage in regular physical activity and reduce sedentary activities to promote health, psychological well-being, and a healthy body weight. ’’ Because of the large body of current research, there has been growing interest and pressure from many experts in the public health sector to see the government develop specific guidelines focused solely on physical activity and health. In October 2006, the process to develop the first-ever guidelines specific to physical activity was set into motion. Two years later, on October 7, 2008, the inaugural set of Physical Activity Guidelines for Americans was issued by the US Department of Health and Human Services (DHHS). The release of these guidelines is timely, with the current obesity epidemic and the latest statistics suggesting that nearly 70% of US adults do not participate in regular leisure-time physical activity.
Maternal employment in child‐care institutions and the risk of infant wheeze and atopic dermatitis in the offspring

It has been proposed that exposure to infections and microbes protects against atopic diseases, but epidemiological data has so far been conflicting. We hypothesized that maternal exposure to infections and microbes before or during pregnancy would be of particular importance. To test this hypothesis, we studied the incidence of wheezing and atopic dermatitis (AD) in infants of mothers employed in child‐care institutions – and thus presumably being highly exposed to infections and microbes – compared with infants of mothers not so employed. A total of 31471 mother‐child pairs enroled in the Danish National Birth Cohort were followed prospectively. Information on wheezing episodes, AD, maternal employment, and other variables were collected by interview at 12 and 30 wk of gestation, and 6 and 18 months of age, and by linkage to the Danish Medical Birth Register and the Child‐care Database. The relative risk was estimated in Cox proportional hazard models. Analyses were stratified by sibling status (first born or not), as older siblings are likely to be a significant source of infectious agents. The adjusted relative risks of wheeze, recurrent wheeze and AD was 1.14 (95% CI: 0.96–1.37), 1.37 (95% CI: 1.05–1.77), and 1.03 (95% CI: 0.81–1.31), respectively, for first‐born infants of mothers employed in child‐care institutions compared with infants of mothers not so employed. There was no effect of maternal employment in child‐care institutions among infants with older siblings. In conclusion, the results did not support the hypothesis that maternal microbial exposure before or during pregnancy as reflected by maternal employment in child‐care institutions protects the offspring against infant wheeze and AD.
A price to pay: The impact of user charges in ashanti-akim district, Ghana

The authors investigated the impact of user charges upon health service utilization in the Ashanti-Akim district of Ghana since the introduction of fees for service in 1985. The district has a population of 183100 of whom approximately 70% live in rural areas. The data analyzed in the study are from government institution monthly outpatient returns and registration books. The user charges have successfully recovered 15% of Ministry of Health expenditure and urban use has regained its pre-fees level. Some of the potential advantages of user charges however have not been realized because the health infrastructure as a whole has not changed enough. Moreover problems of equity and affordability should not be ignored. The rural population in the district seems to have suffered a disproportionate drop in utilization since the introduction of user charges and some people simply cannot afford services.
New visions in specific immunotherapy in children: an iPAC summary and future trends

Specific immunotherapy is indicated for confirmed immunoglobulin E‐mediated airway diseases using standardized allergen products with documented clinical efficacy and safety. For decades the subcutaneous route of administration (SCIT) has been the gold standard. Recently, the sublingual immunotherapy (SLIT) has also been investigated in children. SCIT, especially with grass and birch pollens but also house dust mites, is an effective treatment in children with allergic rhinitis and asthma when a significant part of their symptoms are caused by these allergens. A long‐term effect up to 12 yr after discontinuation of SCIT with timothy allergen has been shown. Efficacy and safety of SLIT in pollen allergic rhinoconjunctivitis have been demonstrated in adults. The evidence in children is a little less convincing, and more data is needed. The clinical relevance, long‐term results and the size of the effect, as well as the dose, the treatment regimen and duration has not been sufficiently elaborated. It is demonstrated that SCIT has the potential for preventing the development of asthma in children with allergic rhinoconjunctivitis. Also one randomized study indicates a preventive effect of SLIT in children on the development of asthma. At present, there are no studies who clearly demonstrates either a long‐term effect or a preventive effect on the development of asthma of SLIT in children. The areas with lack of evidence should be addressed in well performed prospective, randomized long‐term studies both with SCIT and SLIT. This review was initiated by iPAC (international Pediatric Allergy and Asthma Consortium) and aims to review current knowledge related to specific immunotherapy in childhood, and to identify needs for future research in this field.
Morphine metabolites: Clinical implications

ORPHINE, the major alkaloid of opium, gets its name from Morpheus, the Greek god of dreams. That the milky juice of the poppy, Papaver somniferum, has analgesic, sedative, and anxiolytic properties has been known for centuries. Butit was not until 1805, when Serttirner successfully synthesized morphine that it came to be used regularly as an analgesic. Since the 1960s it is known that morphine is metabolized mainly by glucuronidation. About 56% of the morphine molecules are metabolized to morphine-3-glucuronide (M3G), and about 10% to morphine-6-glucuronide (M6G). Other metabolites of morphine ~'2 are displayed in Figure 2. In the late 1960s, M6G was found to exert antinociceptive effects. 7 Since then, its clinical importance has become the subject of research, The following summary outlines our current opinion about the activity of M6G with a special focus on its clinical importance on the background of the current literature on this topic. In addition, the literature on the possible activity of the main metabolite of morphine, M3G, will be briefly reviewed.
Gender differences in the association of overweight and asthma morbidity among urban adolescents with asthma

Asthma and obesity disproportionately affect US African‐American youth. Among youth with asthma, obesity has been associated with poor control. The impact of gender on this association is unclear. We examined these relationships in a sample of urban, African‐American adolescents with asthma. Questionnaires were used to identify high school students with asthma, and to examine the association of body mass index (BMI) to asthma morbidity, by gender. Of 5967 students completing questionnaires, 599 (10%) met criteria for asthma and 507 had data sufficient for inclusion in further analyses (46% male, mean age = 15.1 yr). Univariately, BMI > 85th percentile was significantly related only to reported emergency department visits (ED) and school days missed for any reason, Odds Ratio (95%Confidence Interval) = 1.7(1.1–2.7), p = 0.01 and 1.8(1.1–3.0), p = 0.01, respectively. A significant gender‐BMI interaction (p < 0.05) was observed in multivariate models for ED visits, hospitalizations and school days missed for asthma. In gender‐specific models, adjusted Risk Ratios for BMI > 85th and ED visits, hospitalizations, and school days missed because of asthma were 1.7(0.9–3.2), 6.6(3.1–14.6) and 3.6(1.8–7.2) in males. These associations were not observed in females. Gender modifies the association between BMI and asthma‐related morbidity among adolescents with asthma. Results have implications for clinical management as well as future research.
Maturation of cytokine‐producing capacity from birth to 1 yr of age

Little is known about the immunologic maturation in the early stages of life. The aim of this study was to investigate maturation of immune system from birth to 1 yr of age and to compare immune functions between mothers and their children. Also the effect of atopy to the immune responses of children was examined. Cord blood samples (n = 228) and peripheral blood samples of children (n = 200) and their mothers (n = 208) 1 yr after birth were collected. Whole blood samples were stimulated for 24 and 48 h with Staphylococcal enterotoxin B (SEB), lipopolysaccharide (LPS) and the combination of phorbol ester and ionomycin (P/I). Production of TNF‐α, IFN‐γ, IL‐5, IL‐8 and IL‐10 was determined using ELISA. Significant mother‐to‐child correlation was detected in cytokine‐producing capacity at the age of 1 yr. TNF‐α (P/I, SEB and LPS stimulation), IFN‐γ (P/I and SEB), IL‐5 (P/I and SEB) and IL‐10 (P/I, SEB and LPS) producing capacity increased from birth to 1 yr of age. In general, stimulated cytokine responses were higher in mothers’ than in children’s blood samples, except in the case of P/I and LPS‐stimulated IL‐8, which were highest at birth. Maternal inhalation atopy was associated with increased cord blood IL‐5 (24 and 48 h) and IL‐10 (48 h) production following P/I stimulation. Also children of food atopic mothers expressed elevated cord blood IL‐10 (48 h, P/I) responses and decreased IFN‐γ/IL‐5 ratio (24 h, P/I). In addition, the production of IFN‐γ (24 and 48 h, P/I) and the IFN‐γ/IL‐5 ratio (24 h and 48 h, P/I) at the age of 1 yr was lower among children with food atopic mothers. In conclusion, our results suggest that both adaptive and innate immune responses increase from birth to 1 yr of age, but are still weak in comparison to adult responses. Cytokine responses of children begin to correlate with those of their mothers during the first year of life. Although only few associations were observed between atopy and cytokine‐producing capacity, our results suggest that children of atopic mothers express Th2‐polarized cytokine pattern.
Antimalarial Drugs – What is in Use and What is in the Pipeline

Malaria continues to be a potentially fatal threat to almost half of the world's population. In light of this threat, the armory to fight this disease is rather limited. Resistance against the most common and affordable antimalarials is widespread. Only few new drugs are in clinical development, most of them belong to long used classes of antimalarial drugs. This review will concisely cover the drugs which are currently in use, and describe the drug candidates which are in clinical evaluation.
Hypoplasia of the Mandible as a Cause of Respiratory Difficulties in the Infant

Hypoplasia of the mandible in association with glossoptosis and often with palatoschisis is a not altogether unusual disease, often serious and probably not seldom overlooked. Of the 2 cases described here, the first one in particular is interesting. It shows the effect, in this case no doubt life‐saving, of a simple and logical therapy: the prone position and “orthostatic feeding”.
External Fixation of the Tibia in Private Practice: Indications, Techniques, and Complications

Summary The general principles of external fixation of the tibia from the viewpoint of its role in private practice are discussed. The volume and pattern of injuries, as well as the patient mix, changes from the trauma center setting to private practice and the role of external fixation changes as well. Key indications for external fixation in this setting include temporary and definitive stabilization of periarticular fractures with soft-tissue compromise and severe open shaft fractures of the tibia. The emphasis, in these complex cases, is on temporary external fixation for initial soft-tissue management with staged early conversion to internal fixation. Technique and patient management principles, complications, and their prevention are discussed.
Breastfeeding and the prevalence of allergic diseases in schoolchildren: Does reverse causation matter?

Kusunoki T, Morimoto T, Nishikomori R, Yasumi T, Heike T, Mukaida K, Fujii T, Nakahata T. Breastfeeding and the prevalence of allergic diseases in schoolchildren: Does reverse causation matter? Pediatr Allergy Immunol 2010: 21: 60–66. © 2010 John Wiley & Sons A/S
Satisfaction and Quality of Life in Children with Type 1 Diabetes and Their Parents Following Transition to Insulin Pump Therapy

The purpose of this study was to describe satisfaction with the transition to insulin pump therapy and subsequent quality of life among 22 children with type 1 diabetes and their parents. Following the transition to pump therapy, children and parents completed a newly developed measure of insulin pump therapy satisfaction (Insulin Pump Therapy Satisfaction Questionnaire [IPTSQ]), and children completed a standardized measure of diabetes-related quality of life. IPTSQ results suggest that children and parents were overwhelmingly satisfied with insulin pump use. Parents and children reported greatest satisfaction with flexibility related to eating and sleeping afforded by pump therapy. Parent-child satisfaction were highly correlated (r = .53), and children's pump satisfaction was significantly positively correlated with diabetes-related quality of life (r = .51). These pilot data are among the first to document specific areas of satisfaction and indicate an association between insulin pump therapy satisfaction and quality of life. Understanding specific aspects of insulin pump therapy that are related to quality of life is important for improving health outcomes among youngsters with type 1 diabetes using insulin pumps.
Allergic sensitization is associated with rhinovirus‐, but not other virus‐, induced wheezing in children

Jartti T, Kuusipalo H, Vuorinen T, Söderlund‐Venermo M, Allander T, Waris M, Hartiala J, Ruuskanen O. Allergic sensitization is associated with rhinovirus‐, but not other virus‐, induced wheezing in children. Pediatr Allergy Immunol 2010: 21: 1008–1014. © 2010 John Wiley & Sons A/S
Minimum energy oriented global stabilizing control of the PVTOL aircraft

A global stabilizing control law is proposed for a non-minimum phase under-actuated planar vertical take-off and landing (PVTOL) aircraft. The proposed approach is based on receding horizon control and takes into account the positiveness of the thrust and its saturation to any arbitrary level. Moreover, the angular acceleration can also be bounded. Contrary to non-linear optimal control, the proposed approach, based on quadratic programming, improves significantly the computational cost of the algorithm and the convergence to a solution can be insured. The chosen cost function has a direct link with the energy needed to reach a desired point which is one of the main worries in the design of embedded control systems such as micro unmanned aerial vehicles (UAV).
Pathogenesis of the Fibromyalgia Syndrome

Perceptions regarding the pathogenesis of the fibromyalgia syndrome [FMS] have had an interesting history. In retrospect, they appear to have gone through five distinct phases with overlaps in time. The first phase was shamefully marked by ignorance and posturing. It can be viewed as a time when the FMS was considered to be a psychiatric or functional disorder, referred to unkindlyas“all in thehead. ”Patientswith thisdisorder were often denigrated and accused of role-playing for the benefit of secondary gain. For a time, this attitude seemed to be accepted, even in sophisticated medical circles. One explanation for that may have been that the FMS was widely considered to be so marginal in importance to health care policy that it could be safely joked about or simply ignored. When approached with a protocol to examine cerebrospinal fluid in FMS, an Institutional Review Board official reported the committee’s decision with the statement, “It would be ethically inappropriate to perform a procedure with some risk of injury when studying people who have nothing wrong with them. ” Then, a cascade of medical specialty organizations acknowledged FMS as a clinical entity, as have many countries, and eventually, the World Health Organization. The United States National Institutes of Health offered grants to study the FMS. The subject became a part of medical school curriculum and questions about FMS regularly appear in National Medical Board examinations. In the new age of “respect forallpatients”andpainas the“fifthvital sign,” FMS is less often the focus of snide remarks, and the intended audience is generally less appreciative of the inappropriate behavior. Then, there was the muscular dysfunction phase in which exercise and muscle physiology studies abounded. There was some evidence to implicate skeletal muscle in the FMS, but apparent confusion with the myofascial pain syndrome in some arenas may have misguided patient selection. This phase seemed to have lost its momentum when electron microscopy studies disclosed an essentially normal architecture for FMS skeletal muscle. Then, there was the renaissance in which the scientific community begrudgingly conceded that the pain of FMS was best described as “chronic widespread allodynia. ” Central nervous system dysfunction was documented by experiments with wind-up and brain imaging
The long‐term outcomes of pediatric kidney transplantation: A single‐centre experience in China

Abstract: To explore the long‐term outcomes of paediatric kidney transplantation and the effects of renal allograft on growth, education, employment, marriage and procreation. Twenty‐seven children with ESRD received the renal allograft from 1985 to 2001. The patient and kidney survival rate, renal function, growth and employment, etc., were reviewed retrospectively. The average follow‐up period was 10.3 ± 4.4 yr. The one‐, three‐, five‐ and 10‐yr graft survival rates were 96.3%, 88.9%, 81.5% and 66.7%, respectively, and the corresponding patient survival rates were 100%, 92.6%, 85.2% and 68.8%. The body weight gain was 4–10 kg in one‐yr post‐operative and the height increased 0–2 cm for girls and 2–5 cm for boys. A total of 44.4% of the recipients accomplished their education above junior high school. The employment rate was 46.2% in males, and 57.2% in females. Twelve patients were married. Non‐adherence occurred in 30% of the recipients. Forty percent of the surviving recipients developed complications. Seven patients died. More attention should be paid to non‐adherence of medications and more supports from the society are required to improve the life quality of paediatric recipients, especially in employment and education.
Discovery of 2‐Phenyl‐N‐(5‐(trifluoromethyl)‐1,3,4‐thiadiazol‐2‐yl)acetamide Derivatives as Apoptosis Inducers via the Caspase Pathway with Potential Anticancer Activity

In the current research of medicinal chemistry, apoptosis induction is one of the novel strategies for the development and discovery of novel anticancer therapeutics. In the present study, a new series of 1,3,4‐thiadiazole derivatives (4a–4p) were synthesized and their in vitro anticancer activities were evaluated against three cancer cell lines: PC3 (prostate cancer), MCF7 (breast cancer), and SKNMC (neuroblastoma). These cell lines were utilized in MTT assays and the obtained results were compared to doxorubicin. Apoptosis induction was also investigated through exploration of the activation of caspases 3, 8, and 9. According to the obtained results, compounds 4b (3‐Cl) and 4c (4‐Cl) demonstrated the best caspase activation. In fact, compounds 4b and 4c enhanced the activity of caspases 3 and 9 in the MCF7 cell line.
New‐onset post‐transplantation food allergy in children – Is it attributable only to the immunosuppressive protocol?

Abstract: New‐onset post‐transplantation food allergy has been described mainly after liver transplantation, and its pathogenesis was attributed to the immunomodulatory effects of tacrolimus therapy. The aim of the present study was to evaluate the association of food allergy with solid organ transplantation in our center. The medical records of children who underwent kidney transplantation and children who underwent liver or liver and kidney transplantation from 1986 to 2005 were reviewed. A total of 189 children (124 after kidney transplantation, 65 after liver or liver and kidney transplantation) received tacrolimus as part of the immunosuppressive regimen. New‐onset post‐transplantation food allergy was documented in four of them: two with liver transplants and two with combined kidney and liver transplants. The absence of new‐onset food allergy in the children with isolated kidney transplants is compatible with other reports in the literature. This study supports the concept that the functioning liver itself, and not only tacrolimus immunosuppression, is a main contributor to food allergy in this patient population.