Miracle-dz/UniFAR-FTUs huggingface dataset:
Investigational drugs for bladder pain syndrome (BPS) / interstitial cystitis (IC)

ABSTRACT Introduction: Bladder pain syndrome (BPS)/interstitial cystitis (IC) is associated with sensory lower urinary tract symptoms. Unfortunately, many of the existing oral treatments are ineffective in most patients of BPS/IC, which is the motivation for developing new drugs and therapeutic approaches. This review covers the latest drugs that have been investigated in BPS/IC patients. Intravesical treatments offer the opportunity to directly target the painful bladder with less systemic side effects. Areas Covered: In this review, the authors analyze the existing literature supporting the treatment of BPS/IC with conventional drugs including heparin, hyaluronic acid, chondroitin sulfate, and dimethylsulfoxide (DMSO). Furthermore, investigational drugs such as tanezumab and adalimumab, capable of sequestering nerve growth factor (NGF), and Tumor necrosis factor-α (TNF- α) are discussed. Investigational treatments such as liposomes, botulinum toxin (BTX), liposomal BTX, PD-0299685 (a Ca2+ channel ɑ2δ ligand), continuous intravesical lidocaine, and AQX-1125 (a novel SHIP1 activating compound) are also covered. Expert opinion: New investigational drugs offer promising improvements in clinical outcomes for BPS/IC patients; however, BPS/IC is a chronic pain disorder that is very vulnerable to a strong placebo effect. In addition, BPS/IC is a heterogeneous disorder that can be classified into several phenotypes. Since different phenotypes of BPS/IC respond differently to systemic and intravesical treatments, the authors believe that new drugs developed for BPS/IC are more likely to meet their predetermined clinical endpoints if the inclusion/exclusion criterion is tailored to specific phenotype of BPS/IC patients.
Prognostic Significance of Vascular Endothelial Growth Factor-A Expression in Colorectal Cancer

AIM: To study the expression status and clinical relevance of vascular endothelial growth factor-A (VEGF-A) in colorectal cancer (CRC) tissues. METHODS: VEGF-A expression was investigated by immunohistochemistry in 89 cases with CRC. Some demographic and histopathologic variables were compared with VEGF-A expression to determine the prognostic significance in CRC. RESULTS: VEGF-A (−) was found in 24 cases; (+), (++) and (+++) stainings were detected in 24, 35 and 6 cases, respectively. VEGF-A (−) was found in 20 of 58 cases with left colon cancer, while only 4 of 31 cases with right colon cancer were VEGF-A (−)(P = 0.024). There was a trend for lower tumor grade and lesser serosal invasion in cases with VEGF-A (−) samples (P = 0.07 and P = 0.079, respectively). Although the correlation was not statistically significant, there was a trend for lower death rate in cases with VEGF-A (−) tumor (P = 0.087). The longest survival was found in cases with VEGF-A (−) tumor and the shortest survival was found in cases with VEGF-A (+++) tumor. Median survival for patients with VEGF-A (−), (+), (++) and (+++) tumors was 59, 47, 35 and 11 months, respectively (P = 0.02). The Cox proportional hazards model identified stage IV disease and VEGF-A (+++) tumor as having the most important influences upon overall survival (odds ratio: 5.1, 95% confidence interval: 2.0-13.0 and odds ratio: 3.6, 95% confidence interval: 1.0-12.7, respectively), followed by serosal invasion (odds ratio: 2.4, 95% confidence interval: 1.0-5.9). CONCLUSION: This study shows that VEGF-A is a poor prognostic factor in cases with CRC but the relatively small size of the study group precluded the correlation with all the known prognostic indicators.
Endophthalmitis after intravitreal injections

Endophthalmitis following intravitreal injection is an infrequent but serious clinical problem. Infectious endophthalmitis must be differentiated from noninfectious inflammation. Depending on the series, the risk of endophthalmitis is very low. The use of a standardized injection protocol can reduce the risk of infection.
Interleukin‐6 and interleukin‐8 in cervical fluid in a population of Swedish women in preterm labor: relationship to microbial invasion of the amniotic fluid, intra‐amniotic inflammation, and preterm delivery

Background. Intrauterine infection and inflammation in women with preterm labor are related to adverse perinatal outcome. Due to its subclinical nature, a correct diagnosis depends on retrieval of amniotic fluid. Amniocentesis is, however, not performed as a clinical routine because of its invasiveness. Hypothetically, cytokines in the cervical fluid may represent an alternative diagnostic approach. The aim was to examine cervical interleukin (IL)‐6 and IL‐8 in relation to microbial invasion of the amniotic fluid, intra‐amniotic inflammation, and preterm birth in women in preterm labor.
Pharmacotherapy of actinic keratosis

Actinic keratosis (AK) represents the initial intraepidermal manifestation of abnormal keratinocyte proliferation with the potential of progression to squamous cell carcinoma (SCC). When in limited numbers, clinically visible AKs are treated individually with ablative and/or surgical procedures (lesion-directed treatment), while multiple and sublinical AKs are treated with field-directed therapies that use ablative, nonablating and other topically applied treatment modalities. Owing to difficulties in predicting which AK will progress to SCC, the general rule is to treat all AKs. The goals of treatment are to eliminate the AKs, minimizing their risk of progression to invasive SCC, while pursuing good cosmetic outcomes. Prevention is the most important treatment modality for AKs. Avoidance of sun and artificial sources of ultraviolet light, applying sunscreen and self-examination are among the most effective preventive measures. Chemopreventive modalities such as retinoids, 2-(Difluoromethyl)-dl-ornithine (DFMO), perillyl alcohol, T4 endonuclease V, and dl-α-tocopherol are described. Lesion-directed treatment modalities include cryotherapy, surgery and electrodessication with or without curettage. Field-directed treatment modalities include nonablative and ablative laser resurfacing, dermabrasion, chemical peels, topical immunomodulators (imiquimod, 5-fluorouracil and diclofenac) and photodynamic therapy. And, finally, newer and investigational treatment modalities such as ingenol mebutate, resiquimod and betulinic acid are also being discussed.
Staging and risk factors of chronic kidney disease of outpatients in Shanghai

Abstract Purpose: We conducted a survey to determine the stages distribution of chronic kidney disease (CKD) using estimated glomerular filtration rate (eGFR) Study Equation and evaluate the risk factors for these patients. Methods: All participants completed a questionnaire documenting their social demographic status, personal and family medical history and lifestyle behaviors. Blood and urine samples were collected for laboratory testing. The Chi-square test/analysis of variance and multiple/logistic regression were applied for data analysis. There were 530 CKD patients enrolled in this survey. Results: The Chi-square analysis showed that there was significant difference among different CKD stages in age, gender, BMI (body mass index), medical insurance and education status. Five factors (age, gender, BMI, hypertension, and hyperuricemia) were associated with decreased kidney function (eGFR < 60 mL/min/1.73 m2). Five factors (age ≥ 65 years, hypertension, proteinuria, hematuria, and hyperuricemia) were associated with abnormal kidney function (eGFR < 90 mL/min/1.73 m2). Three factors (low education status, hypertension, and proteinuria) were associated with kidney failure (eGFR < 15 mL/min/1.73 m2). Conclusions: Older patients, female with higher BMI, proteinuria and hyperuricemia, complicating with hypertension and diabetes tend to be easier for CKD progression. However, patients with higher education have the lower risk of progressing to end-stage renal disease.
Experimental comparison of protective characteristics of enalapril and trimetazidine in diabetic nephropathy

Abstract Hyperglycemia, hypertension, dyslipidemia, and inflammation have been proposed to account for the development of nephropathy in diabetic subjects. The beneficial effects of enalapril on diabetic nephropathy are known. However, the effects of trimetazidine (TMZ) are still unknown. We aimed at comparing the effects of the enalapril and TMZ treatment on fibronectin expression, inducible nitric oxide synthase expression, urine proteinuria, blood glucose and glomerular, and mesangial structures of kidney in rats that take streptozotocin (STZ). In this study, 32 male Sprague–Dawley albino mature rats of 8 weeks, weighing 200–220 g were used. Diabetes was induced by intraperitoneal injection of STZ (60 mg/kg) for 24 rats. We made four groups (Group 1: control, non-diabetic rats (n = 8), Group 2: diabetes, without treatment (n = 8), Group 3: diabetes treatment with enalapril (n = 8), Group 4: diabetes treatment with TMZ (n = 8). The positive effects of renal tissue and tubules in the mesangium immunohistochemical were shown in TMZ receiving rat groups. These positive effects were in parallel with the reduction in fibronectin and I-NOS expression and reduction in the proteinuria. TMZ and enalapril treatment of diabetic rats and renal parenchyma in this study are shown to have positive effects on the different levels.
Inhaled corticosteroids in chronic obstructive pulmonary disease: a review

Importance of the field: Chronic obstructive pulmonary disease (COPD) is a disease characterized by chronic airflow obstruction and a progressive lung function decline. Although widely used, the efficacy of inhaled corticosteroids (ICS) in the treatment of COPD remains a matter of debate. Areas covered in this review: This article reviews the evidence about the effects of inhaled corticosteroids in the treatment of COPD. What the reader will gain: Short-term treatment with ICS improves lung function and quality of life; in addition, several studies with longer follow-up have shown less decline over time in quality of life, and fewer exacerbations. By contrast, long-term studies have been unable to show substantial improvement in the decline of lung function in COPD. Based on these findings, it was concluded that the use of ICS did not influence the natural course of COPD. However, this conclusion has been challenged by two subsequent studies, TORCH and GLUCOLD, which both showed a reduction in lung-function decline over time with the use of ICS. These two studies indicate that ICS might indeed influence the natural course of the disease, at least in a subgroup of COPD patients. Take home message: Further studies are needed to identify which individuals have a favorable short- and long-term response to ICS treatment.
Death in dementia: A study of causes of death in dementia patients and their spouses

The certified cause of death in 455 married dementia patients admitted to a psychogeriatric unit between 1971 and 1986 was studied. The cause of death in 154 spouses of dementia patients who died within the study period was also recorded, and analysed for concordance between patients and spouses. The pattern of mortality was similar for male and female patients. Bronchoopneumonia was the most common certified cause of death (40%) in the patient group, and ‘non‐specific’ causes of death accounted for 63% of mortality. The pattern of mortality was significantly different to that in the general population, and non‐specific deaths were twice as common in the patient group. Comparison with previous studies shows that the pattern of mortality in dementia patients has remained relatively unchanged over the past 50 years despite alterations in medical practice. Common cause of death between patient and spouse was analysed and no evidence of significant concordance was found, but cause of death among spouses tended to follow the pattern of mortality in patients and was significantly different to that found in the general population. Possible explanations for the unchanging pattern of mortality in dementia are considered, and the case for an intrinsic mechanism of terminal weight loss and decline is discussed.
Diagnostic des infections à papillomavirus : état des lieux et perspectives

Les infections a papillomavirus humains sont associees a un grand polymorphisme clinique, allant de lesions benignes a malignes avec une distribution cutanee ou muqueuse. Differents genotypes d’HPV a tropisme cutane ou muqueux sont impliques dans la genese de ces lesions. Ainsi, les techniques de detection et de typage des HPV doivent etre adaptees a la nature du tissu concerne et a la localisation de la lesion. Ces tests, de nature tres variee, reposent sur des techniques de biologie moleculaire. On peut repartir les principaux tests en techniques de depistage, reposant sur la detection d’un panel d’HPV HR et en techniques de genotypage, permettant la detection specifique des differents genotypes d’HPV ainsi que les infections multiples. La majorite des tests commerciaux a ete developpee dans le cadre du depistage des HPV a haut risque oncogene impliques dans la genese du cancer du col de l’uterus. Cependant, ces tests peuvent la plupart du temps etre utilises pour le diagnostic d’autres lesions papillomateuses. Le cas echeant, des techniques de PCR « maison » peuvent etre envisagees. La place des techniques de quantification de la charge virale par PCR en temps reel et de detection des ARN messagers reste encore a definir. Avec la mise en place de la vaccination HPV, de nouvelles recommandations sont attendues pour definir l’utilisation de chaque test et leur interpretation dans le cadre du depistage, du diagnostic et du suivi des infections persistantes.
Drugs for the treatment of menopausal symptoms

Importance of the field: Over the last decade, the management of the menopause has attracted extensive public and professional debate and has become one of the most controversial areas in clinical practice. Areas covered in this review: This review provides an overview of the field, primarily from a clinical practice perspective. However, as we have incorporated in this ‘big-picture’ snapshot of the field both conventional and complementary approaches to managing the menopause, it is not an exhaustive review of the literature. What the reader will gain: By reviewing menopausal management from the perspective of practicing clinicians, we hope readers will gain insight into decision making processes appropriate for dealing with symptomatic women. Take home message: Although most women do not require pharmacotherapy for menopausal symptoms, many are severely affected by estrogen deficiency at and beyond menopause and, for such women, hormone therapy is important if they are to retain an acceptable quality of life. This article considers the drug treatment of the symptomatic postmenopausal woman and the safety issues related to these medications.
Atopic dermatitis: an increasing problem

It is well known that atopic dermatitis is an extremely common disease in the industrialized world, and in recent decades an alarming increased frequency has been observed in several investigations. However, some of the main problems in studies on the changing pattern in the epidemiology of atopic dermatitis are related to the definition of the disease, which is notoriously hard to define in writing and the few reliable data on its frequency in the past. In this paper we report and discuss examples on solid and long-term population-based studies and a recently suggested framework for questionnaire in vestigations on atopic dermatitis.
Losartan: the dose does it

Modern drug therapy for chronic heart failure requires a multi-pathway approach. Consistent titration to recommended doses is frequently neglected, although this may imply lack of benefit from effective therapies. The randomized, double-blind Heart failure Endpoint evaluation with Angiotensin II Antagonist Losartan (HEAAL) study showed 150 mg of losartan to have favourable effects compared with the currently recommended dose of 50 mg per day. It was estimated that treatment with 150 mg instead of 50 mg per day losartan would prevent one primary event for every 31 patients treated for 4 years. This article highlights the findings of HEAAL and discusses them in light of current recommendations.
Psykiskt lidande och lindrande hos cancerpatienter i palliativ vård : en litteraturstudie

This article is based on a literature review. The aim of this study is to illustrate mental suffering and how to relieve mental suffering, in relation to cancer patients in palliative care. Mental suffering is affected by all dimensions in life; psychological-, social-, spiritualand physical. By reviewing the literature with this assumption, the result is presented in the same manner. The findings show that although every dimension has it’s own key elements, they are all interacting with each other. Mental suffering can be due to; confrontation with death, hopelessness, changed relations to family members and painful physical symptoms. Relieve of mental suffering can be reached by: professional treatment, coping strategies, family and friends participation in the care, physical contact, therapy and alleviation of the pain. The conclusion is that awareness of the different components of mental suffering and the relief of the same is crucial for a holistic treatment of cancer patients in palliative care.
Imunoglobulina A salivar (IgA-s) e exercício: relevância do controle em atletas e implicações metodológicas

The present study aimed to discuss the main findings involving salivary immunoglobulin A (s-IgA) and exercise and evidence the importance of the control in athletes. Exercise is a great modulator of immune system characteristics such as the s-IgA that exerts important defense against upper respiratory tract infections (URTI). However, more evidence is needed to confirm a direct association between low levels of s-IgA and URTI. The level of s-IgA decreases after a high-intense exercise, increasing thus, the individual's susceptibility to infection, but athletes engaged in exhausting exercise are not clinically immune-deficient compared with sedentary subjects. The changes in s-IgA are transitory returning to normal status in approximately 48-h rest. The reason of these alterations remains unclear, but many causes have been investigated: hormones stressors rise; nutrition influences; action of reactive oxygen species, psychological stress. Despite the transitory effects of the exercise on the immune system, the variability in s-IgA differs in populations with different fitness levels. Differences in exercise protocols, saliva collection, manipulation or storage methods, the method used to assess s-IgA, subject's hydration status, dietary control, competition's seasonality, acclimatization, among other factors should be considered to compare different studies. In addition, these factors could partially explain the adverse results of studies involving moderate and intermittent exercise that have found increase, decrease and no changes in s-IgA levels. Investigations of recent immunologic issues such as the toll like-receptors and the advances in technology may contribute to increase the evidence on this issue.
Improving blood pressure control rates by optimizing combination antihypertensive therapy

Importance of the field: Hypertension is the most common preventable cause of cardiovascular morbidity and mortality. Despite the availability of a multitude of antihypertensive drugs, blood pressure (BP) control rates remain poor in the majority of patients with hypertension due to both patient- and clinician-related factors. The purpose of this review is to describe how healthcare professionals can best utilize combination therapy to optimize patient antihypertensive treatment and achieve BP goals. Areas covered in this review: Data are discussed describing the common need for multiple antihypertensive agents for achieving BP control, importance of the time required for BP control on patient outcomes, and key clinical trial experiences for guiding decisions in antihypertensive regimen selection, with particular attention to the efficacy and tolerability of triple-therapy combinations and the benefits and disadvantages of single-pill formulations for combination regimens. Literature searches of these various topics were conducted in July 2009 (using no time period limits), with the paper later updated with published literature available as of May 2010 (including abstracts from the 2010 annual meeting of the American Society of Hypertension). What the reader will gain: The reader will derive an appreciation for general need for the use of two, and often three or more, antihypertensive agents for achieving BP goals, supporting the importance of thorough patient assessment in determining the appropriateness of combination therapy early in the course of treatment. They will also be updated as to the clinical trial data available for triple-therapy combinations, including both published and recently presented data. Take home message: By optimizing efficacy, decreasing side effects, and increasing adherence, combination therapy using single-pill combinations can improve outcomes in patients with mild to moderate hypertension.
Probiotic strategies for the treatment and prevention of bacterial vaginosis

Importance of the field: Urogenital infections are on average the number-one reason for women to visit the doctor. Yet, treatment and preventive strategies have gone unchanged for close to 50 years. With prevalence rates for bacterial vaginosis at more than 29%, depending on the population, and similarly high incidences of vulvo-vaginal candidiasis and urinary tract infections, plus HIV, new therapies are urgently needed to improve the health of women around the world. Areas covered in the review: This review discusses the vaginal microbiota, our improved understanding of its composition, and its role in health and disease. It also discusses the progress made in the past 10 years or so, with the development and testing of probiotic lactobacilli to improve vaginal health and better manage urogenital infection recurrences. What the reader will gain: The reader will have an understanding of the clinical data obtained so far, and the potential mechanisms of action of probiotics. Despite the need for more clinical studies, the review illustrates a case for inclusion of probiotics as part of the approach to disease prevention, and as an adjunct to antimicrobial treatment. Challenges remain in optimizing clinical benefits, selecting new strains, preparing new products and having them tested in humans then approved with informative claims, and making products readily accessible to women in the developed and developing world. Take home message: The vaginal microbiota is a complex structure that can change quickly and dramatically, and significantly impact a woman's health. New health-maintenance and disease-treatment approaches are badly needed, and probiotics should be considered.