Miracle-dz/UniFAR-FTUs huggingface dataset:
Short-term therapeutic effects of combined therapy with metformin hydrochloride for aplastic anemia

Objective To screen and select new drugs for aplastic anemia (AA) and evaluate their clinical efficacy by clinical bioinformatics methods. Methods First, we established genome expression profiles of AA patients, and conducted similarity analyses with the pharmacogenomics database to screen and select drugs with possible efficacy. Intractable AA patients who received immunosuppressors and/or androgen for more than six months showing no clinical efficacy were enrolled in the study to evaluate therapeutic effects of the therapeutic regime. Clinical efficacy and adverse effects were evaluated after six months. Results The clinical bioinformatics results showed therapeutic effects of metformin hydrochloride on AA. Forty-three intractable AA patients (15 with severe AA) were treated with metformin hydrochloride combined with cyclosporin A (CsA) and stanozolol. Twenty-seven transfusion-dependent patients (100%) became transfusion independent after a 6-month therapy. The hemoglobin level completely returned to normal in 37 out of 40 anemia patients (92.5%). In the 40 patients with platelet count lower than 20×109/L, the platelet count of 28 patients (90.3%) increased to higher than 50×109/L. The white cell count increased to higher than 3.5×109/L in 30 out of 35 patients (88.6%) with white cell count lower than 2.5×109/L. Among 40 anemic patients, 1 was found to have abnormal renal function, but it recovered to the normal range after ending CsA treatment. Eighteen patients were found to have elevated transaminase levels which were lowered to normal range after using liver protectants and reducing the dosage of stanozolol. There were no instances of hypoglycemia in all patients throughout the treatment. Conclusion Combination of metformin hydrochloride, CsA and stanozolol is effective in refractory aplastic anemia with acceptable toxicity.
A Scoping Review of Transdermal Buprenorphine Use for Non-surgical Pain in the Pediatric Population

A preliminary evaluation to review the scope and quality of evidence surrounding transdermal buprenorphine use in the pediatric setting for non-surgical pain was conducted. Our review revealed limited data available on the use of transdermal buprenorphine in pediatric patients. Most studies surrounding this subject involve accidental ingestion of buprenorphine and its use in the treatment of neonatal abstinence syndrome. While indicated for use only in adult populations, small studies have shown encouraging results in reducing pain in children with few, if any, adverse effects. This is reassuring from a clinical perspective, as we hope to highlight the available evidence and invite researchers to expand future studies. Through this review, we have identified significant gaps in the literature surrounding the safety and use of buprenorphine in the pediatric population. To our knowledge, there are no major studies investigating this subject, and it is our hope that future studies will explore the use of transdermal buprenorphine as an alternative pain management technique in pediatrics. The intent of our scoping review is to highlight the lack of research in this area; therefore, future studies may be conducted to support its use in North America.
[Methodology of the National Health and Nutrition Survey for localities with less than 100 000 inhabitants (Ensanut 100k)].

OBJECTIVE To describe the methodological design of the National Health and Nutrition Survey in localities with less than 100 000 inhabitants (Ensanut 100k). MATERIALS AND METHODS The Ensanut 100k is a probabilistic survey that over-represents households with less economic capabilities. This paper describes the scope of the survey, sampling procedures, measurement and inference and logistics organization. RESULTS 10 461 home interviews and 26 161 individual interviews were obtained. The household response rate was 89 and 92% from individuals. CONCLUSIONS The probabilistic design of the Ensanut 100k allows to make valid statistical inferences about parameters of interest for public health in localities with less than 100 000 inhabitants, localities where 52% of the population lives according to the 2010 census. The comparability of the results with the Ensanut 2012 faci- litates the assessment of the government's support actions to populations with lower economic capacities in the period 2012-2018.
TRATAMENTO DE PERI-IMPLANTITE UTILIZANDO PROTOCOLO DE DESCONTAMINAÇÃO, CIRÚRGICO E LASERTERAPIA: RELATO DE CASO CLÍNICO

Os implantes osseointegrados sao realizados com altos indices de sucesso, porem, podem ocorrer complicacoes como a peri-implantite e aquelas associadas a causas mecânicas e biologicas. A literatura descreve diferentes tecnicas e protocolos para os tratamentos da peri-implantite, desde o tratamento conservador, com debridamento, uso de antisseptico, antibioticos locais e sistemicos, ate o tratamento cirurgico, com e sem terapia regenerativa e de suporte. Esse estudo tem como objetivo relatar caso clinico de peri-implantite tratada com um protocolo medicamentoso associado a acesso cirurgico para remocao do tecido de granulacao, aplicacao de laser de CO 2 e imediato enxerto osseo com osso autogeno, seguido de cobertura com membrana reabsorvivel polipropileno, posicionamento do retalho e sutura. Foi realizado controle clinico e radiografico apos seis meses do procedimento. O protocolo combinado de tratamento medicamentoso, cirurgico e laserterapia mostrou-se uma opcao de tratamento adequada para os casos de implantes que apresentam reabsorcao ossea como resultado da peri-implantite.
Natural Killer Cell Derived Exosomes As a Novel Therapeutic for Acute Myeloid Leukemia

Introduction: Natural killer (NK) cells play a critical role in the innate immune response through their capacity to lyse malignant cells without prior antigen-specific priming. NK cells have been evaluated for safety and efficacy in acute myeloid leukemia (AML), both in the transplant and non-transplant settings. Exosomes, small, 30-150 nm-sized extracellular vesicles originating from the endocytic compartment of parent cells, have recently emerged as a universal intercellular communication system. Exosomes are released by virtually all cells and carry proteins, lipids, and nucleic acids from the parent to recipient cells at short and long distances. The exosome molecular cargo reflects the content of the parent cell and is delivered to recipient cells in a membrane-protected vesicle. We hypothesize that exosomes produced by human activated NK cells carry the machinery necessary for the killing of leukemic cells. Methods: Venous blood (20-50 mL) was obtained from healthy donors (n=10). NK cells were isolated using Ab-based immunomagnetic selection from the recovered peripheral blood mononuclear cells. NK cells were cultured in the presence of interleukin-2 and interleukin-15, and NK-cell supernatants were used for exosome isolation by size exclusion chromatography. Protein levels, numbers and size (qNano), and exosome morphology (transmission electron microscopy) were determined. Exosome cargos were studied by Western blots and/or flow cytometry for NK cell activating and inhibitory receptors, immune inhibitory molecules and for perforin and granzyme B. Cytotoxicity of the NK cell-derived exosomes for K562 targets, AML cell lines (Kasumi, MLL-1) and primary leukemia blasts was measured using flow cytometry-based assays. Results: Activated human NK cells produced large quantities of exosomes. PKH-26-labeled NK cell-derived exosomes were avidly taken up by leukemic blasts. NK cell derived exosomes carried activating NK cell receptor NKG2D, natural cytotoxicity receptors, perforin, granzyme B, transforming growth factor beta (TGF-β), killer-cell immunoglobulin-like receptors and PD-1. NK cell derived exosomes mediated anti-leukemia activity against K562 targets, AML cell lines and primary leukemia blasts. Lysis of leukemic blasts by NK cell-derived exosomes was exosome concentration dependent. Conclusion: We report that NK cell derived exosomes have anti leukemia activity in vitro. These data provide a foundation for the future development of new therapeutic strategies using NK cell-derived exosomes for the elimination of leukemia. No relevant conflicts of interest to declare.
Comparison of the effects of variables in sperm preparation techniques on pregnancy rates in intrauterine insemination

Aim: To investigate the effects of two sperm preparation techniques, density gradient centrifugation (DGC) and swim-up, on the pregnancy rates per cycle and per group in two intrauterine (IUI) cycles. Material and Methods: The retrospective study reviewed 634 patients who presented to Firat University Medical School Hospital and underwent a total of 1,032 IUI cycles. Group I consisted of 306 (48.3%) patients who underwent a total of 524 IUI cycles between January 2012 and January 2016 and Group II included 328 (51.7%) patients who underwent a total of 508 IUI cycles between April 2015 and January 2019. The study investigated the effects of technical changes applied to sperm preparation techniques on pregnancy rates in both groups. Results:A significant difference was found between the clinical pregnancy rates of the two groups with regard to the numbers of patients and IUI cycles (p<0.001). The technique used in Group II increased the pregnancy rate by 3.195 times compared to the technique used in Group I. A logistic regression analysis revealed that the pregnancy rate in the first cycle was 3.530 times higher than that of the second cycle in both groups. Conclusion: The results indicated that the application of suitable alterations in sperm preparation techniques by taking into account the potential effect of all factors is likely to affect clinical pregnancy rates in IUI.
The high expression of lncRNA TUG1 correlates with progressive tumor condition and less satisfying survival profiles in prostate cancer patients

Background This study aimed to evaluate the correlation of long noncoding RNA taurine-upregulated 1 gene (lncRNA TUG1) with tumor characteristics and survival in prostate cancer patients, and the effect of lncRNA TUG1 on proliferation and apoptosis in prostate cancer cells. Methods Two-hundred and eight prostate cancer patients who underwent tumor resection were continuously reviewed in this study. Tumor tissue and paired adjacent tissue were obtained and polymerase chain reaction assay was performed to detect the expression of lncRNA TUG1 in tumor tissue. PANC-1 cells were obtained and transferred with blank mimic, lncRNA TUG1 mimic, blank inhibitor, and lncRNA TUG1 inhibitor plasmids, then cell proliferation was detected by CCK-8, and cell apoptosis was evaluated by AV/PI assay. Results LncRNA TUG1 expression was elevated in tumor tissue compared with paired adjacent tissue (P<0.001). Moreover, lncRNA TUG1 expression in tumor tissue positively correlated with pathological T stage (P=0.009) and lymph node metastasis (P=0.040). Patients with a high expression of lncRNA TUG1 had both worse disease-free survival (DFS) (P<0.001) and overall survival (OS) (P=0.003) compared with patients with a low expression of lncRNA TUG1. Multivariate Cox’s proportional hazards regression analysis revealed that high lncRNA TUG1 expression was an independent predicting factor for both worse DFS (P=0.001) and OS (P=0.003). Moreover, CCK-8 and AV/PI assays demonstrated that lncRNA TUG1 enhanced cell proliferation and repressed cell apoptosis in PANC-1 cells. Conclusions A high expression of LncRNA TUG1 in tumor tissue correlates with progressive tumor condition and poorer survival in prostate cancer patients, and promotes proliferation while inhibiting cell apoptosis in prostate cancer cells.
VLIV VOLNÝCH RADIKÁLŮ NA FERTILITU MUŽE A MOŽNOSTI LÉČBY EFFECTS OF FREE RADICALS ON MALE FERTILITY AND AVAILABLE TREATMENT

Bittner L. Infl uence of free radicals on male fertility and possibilities of treatment. In half of the cases of infertility in infertile pairs is due to the pathology of the man. Oxidative stress is one of the reasons of impaired fertility in a male. This article analyses the etiology and mechanism of oxidative stress and summarizes the current state of knowledge regarding the diagnostics options and treatment of oxidative stress of sperm.
Application of enhanced recovery pathway in abdominal wall reconstruction surgery in a tertiary care hospital in Andhra Pradesh

Aim & Objective: Enhanced recovery pathways are well-defined perioperative evidence based interventions in a protocol manner for standardising techniques involved in drug selection, dose, reduce cost and facilitate in early discharge by monitoring mortality rates. The hypothesis of the study is the application of enhanced recovery pathway after surgery in abdominal wall reconstruction could result in potential decrease in hospital stay. Methods: The study is performed in the period of February 2017 to June2019 and a total of 100 cases and 100 controls undergoing abdominal wall reconstruction were included. Enhanced recovery pathway after surgery is used to identify the results with respect to duration of the stay. Results: It was observed from the study results that, there was no change noted in the duration of stay and regular diet. The readmission rate is decreased and in analysis of subgroups we found, factors associated with duration of the stay were < 5 days with hernia. Conclusion: To conclude, administration of enhanced recovery pathways after surgery could not show a limitation in duration of stay. It was obviously noted that quality of baseline life scores, less operative times and small hernia defects were in co-ordination with duration of stay.
[Prevention of human immunodeficiency virus infection (HIV): condoms or abstinence (letter)]

This letter to the editor takes issue with several assertions concerning the efficacy of condoms in a previously published article by F. Guillen and I. Aguinaga. The article identified sexual abstinence as the means of completely eliminating risk of HIV infection and argued that condoms have a relatively low efficacy. Guillen and Aguinaga used the preventable fraction as an indicator of efficacy and interpreted its complement as corresponding to condom failure. The authors of this letter believe this interpretation to be erroneous because some of the studies on which the conclusions were based failed to consider whether condoms were always used or to consider outside sexual contacts not protected by condom use. They also argue that extrapolation of results of an experimental in vitro model ignores receptor factors such as sex age and sexually transmitted diseases as well as the phase of infection. Maintaining that there is insufficient scientific evidence for the efficacy of condoms in prevention of sexually transmitted diseases shows a lack of scientific objectivity. Failure to mention other riskier practices such as sharing of needles runs the risk of distorting the magnitude of the problem. Efforts should not be spared to promote teach and facilitate condom use for prevention of sexually transmitted diseases including AIDS. A more careful review of the literature would have demonstrated that messages on the importance of condoms are rigorous and do not exclude abstinence or underestimate the risks of sexual relations.
Avaliação de medidas de resistência e secreção de insulina em pacientes HCV positivos

Objective: The aim of the present study is to assess insulin resistance and insulin secretion in HCV-positive patients without diabetes diagnosis and without cirrhosis and to compare to healthy volunteers. Secondary objectives are to analyze factors that could be associated with insulin resistance, like viral genotype, and degree of hepatic fibrosis and steatosis. Research design and methods: In a cross-sectional study by sample of convenience, 39 HCV positive and 13 HCV negative subjects were assessed for glucose, insulin and C-peptide in fasting state and after oral 75g glucose tolerance. Fasting samples were than evaluated for HOMA-IR, HOMA-C-peptide and HOMA-%B. Excluding criteria were clinical cirrhosis, neoplasia, HIV co-infection, previous treatment for HCV, fasting plasma glucose levels equal or above 126mg/dL, BMI above 35 and drugs that could change insulin secretion or insulin resistance. Results: HOMA-IR was higher in HCV positive than in HCV negative group, respectively: median and interquartile ranges 2.4 (1.5-5.0) vs. 1.4 (0.7-2.3): p=0.007; HOMA-C-peptide and HOMA-%β did not differ between groups. However, fasting serum insulin was higher in HCV positive than in HCV negative patients, respectively: median serum and interquartile ranges 2 (6.8-17.8) vs. 6.5 (3.4-10.9), p = 0.009. Mean fasting C-peptide did not differ between groups. The increase of glucose, insulin and C-peptide at fasting state and after the glucose tolerance test were all similar. Results of HOMA-IR, HOMA-β% and HOMA-C-peptide were not difference between genotypes 1 and 3. Genotypes 1 and 3 were also similar in relation to the degree of histological steatosis and hepatitis activity. Genotype 3 presented higher degree of fibrosis compared to genotype 1 (5/16 vs. 4/10), p=0.019. C-reactive protein showed positive correlation with the levels of triglycerides (0.574, p = 0.001) among all HCV positive patients.
Esclerosis lateral amiotrófica: una actualización

Amyotrophic Lateral Sclerosis (ALS) is the most common degenerative motor neuron disease in adults. It is characterized by the progressive loss of motor neurons resulting in a complex clinical manifestation and finally, death. This review presents the most recent findings about this disease. Less than 10 % of patients are familial ALS, associated to several loci of different functions. From them, more than 20 % have mutations in the gene encoding Cu/Zn superoxide dismutase (SOD1) enzyme. Neuronal inclusions and defects in protein folding are present in both forms of ALS. Aberrant accumulation of neurofilament, defects in axonal transport, neuronal oxidative imbalance and glutamate excitoxicity are some of the possible mechanisms involved in the disease pathogenesis. Riluzol, a glutamate inhibitor, is the only approved drug for ALS treatment, producing an increase of 3 months in survival. More than 30 clinic trials have been carried out to obtain new treatments for ALS, including antioxidants, glutamate inhibitors, immunomodulators and growth factors, all with failed results. Genetic therapy, interference RNA and stem cell therapy are currently in study. Probably, the right strategy to follow must be the simultaneous intervention in different molecular events to alter the disease progression.
P1239His-bundle pacing in CHF-patients with narrow QRS and chronic AF using dual-chamber ICD

The heart rate regularization is crucial for proper treatment of patients with atrial fibrillation and congestive heart failure. The standard resynchronization can be applied, but in patients with narrow QRS this procedure is of no use. The aim of our study is to assess the efficacy of direct His-bundle pacing in patients with congestive heart failure and chronic atrial fibrillation using dual chamber ICD implanted for prevention of sudden cardiac death. The study population included 78 patients with CHF and chronic AF: group A - 56 pts treated with direct His-bundle pacing using atrial port of dual chamber ICD and group B - 22 patients implanted with single chamber ICD as recommended by the guidelines. The patients in group B constituting clinical controls were derived from the Heart Failure Outpatients Clinic with established clinical status and pharmacotherapy. The demographic data, clinical characteristics and echocardiography measurements at baseline and during follow-up were presented in the table: Table 1 Group A Group B P value Age (years) 69.7±6.9 66.7±11.3 n.s. Sex (% of male sex) 84.0 86.4 n.s. Ventricular pacing (%) – 46.3±31.2 – His-bundle pacing (%) 81.7±9.2 – – pre post pre post pre vs. post LVEDD (mm) 66.9±4.9 59.9±4.7 64.8±8.0 64.7±8.1 <0.01 n.s. EF (%) 29.6±3.8 43.6±5.9 28.1±6.1 28.8±7.3 <0.01 n.s. NYHA class 2.7±0.6 1.4±0.6 2.5±0.6 2.0±0.2 <0.05 n.s. B-blocker dose (metoprolol equivalent dose) 104.6±41.6 214.3±82.6 78.3±56.6 103.1±49.2 <0.001 <0.05 During 12-months of follow-up the mean values of NYHA functional class, EF and LV dimensions did not change in group B but significantly improved in group A. The physiological His-bundle based pacing enabled optimal beta-blocker dosing. The studied groups had no tachyarrhythmia at baseline so the presumable atrial fibrillation-related harm depends on the rhythm irregularity. His-bundle-based pacing in CHF-chronic AF patients contributes to significant echocardiographic and clinical improvement. Standard single-chamber ICD implantation in CHF-chronic AF patients yields only SCD prevention without influence on remodeling process. The CHF-patients with narrow QRS and chronic AF benefit from substantially higher beta-blockade which can be instituted in His-bundle pacing group.
Effects of Eye Movement with PNF Neck Movement on Trunk Stability and Standing Position Balance Ability of Chronic Stroke Patients

Abstract Objective We investigated the effects of eye movement with PNF neck movement on trunk stability and standing position balance ability of chronic stroke patients. Methods A total of 30 patients were randomly divided into EMPN group and CON group. EMPN group was performed 60 min three times a week for 8 weeks in eye movement and PNF neck movement. CON group performed conservative treatment for 60min. The trunk stability was measured by the Trunk impairment scale (TIS) and the standing balance ability test was performed by Center of Pressure (COP), Limited of Stability (LOS), Berg Balance Scale (BBS) and Functional Reach Test (FRT). Results There was a significant difference (P<0.05) between before and after training in both groups, and EMPN group showed significant improvement in both groups. Conclusions In this study, we confirmed oculogyration and neck movement by PNF have positive effects on the trunk stability and the standing position balance ability of chronic stroke patients.
Which interventions incorporating physical and cognitive elements are most effective to improve gait in cognitively impaired older adults? A systematic review

Abstract Background: The primary objective of this systematic review was to determine effective interventions to improve gait (speed, stride length, double limb support) in older adults with cognitive impairments. Methods: Eligibility criteria included randomized controlled trials in English, older adults aged 45 years and over with mild to severe cognitive impairments, outcomes of gait, and interventions including exercise/physical activity, cognitive elements, or both. Databases searched were PubMed, CINAHL, Scopus, ProQuest, and Cochrane. PEDro was utilized to assess risk of bias. Results: Ten randomized controlled trials were included. Statistically significant changes were found in different aspects of gait with dual task, exercise programs, multimodal exercises, and functional training. Conclusion: It was found that performing multiple modes of interventions to treat older adults with cognitive impairments demonstrated best results. Gait performance of older adults with cognitive impairments is shown to improve with a myriad of interventions that challenge the physical and cognitive performance of this population. The strengths of the review are performing a comprehensive search. All included articles were randomized controlled trials and a moderate agreement. The limitations of the review are small exclusion criteria, small sample sizes, and detail reporting issues.