Miracle-dz/UniFAR-FTUs huggingface dataset:
Pathogenesis of glomerular sclerosis in the Fawn-Hooded rat

Direct in vivo determination of glomerular capillary hydraulic pressure in humans has thus far been impossible. Estimation of filtration pressure from sieving data has been of interest. However, a systematic evaluation of these calculated estimates with direct measured pressure has not been done. Here we report the outcome of comparisons between fitted and measured pressures made retrospectively from nine reported studies in the rat in which both fractional clearances of neutral dextrans were obtained and transcapillary hydraulic pressure (A P) was measured by micropuncture. In addition, data were analyzed from 25 fawn-hooded rats that had underwent different treatments and had undergone Ficoll sieving studies and micropuncture glomerular pressure measurements. Despite the use of more sophisticated models of glomerular permselectivity and the use of individual and group data, the results indicated that fitted pressures almost uniformly underestimated the actual measured values. Estimation of the change in A P between groups was often incorrect. Therefore, it is highly questionable whether estimation of A P, or directional changes in AP, from sieving data obtained in humans will be a reliable method. Numerous experimental studies in rats have shown that elevated glomerular capillary hydraulic pressure (PGc) or transcapillary hydraulic pressure (ll 'P) is associated with a progression of glomerular damage. The models are described in Section 1.3 of this thesis and include renal ablation and infarction (II, 13, 137, 138, 179,276,319), desoxycortieosterone-saIt hypertension (112), streptozolOcin-induced diabetes mellitus (464, 466), unilaterally nephrectomized spontaneously hypertensive rats (108), and the 2-kidney and uninephrectomized fawn-hooded rat (403-405). In all these models II P is elevated along with the single-nephron glomerular fiItration rate (SNGFR). Therapy in these animals which selectively reduces PGC and liP without reducing single-nephron hyperfiltration, such as with treatment with an angiotensin I converting enzyme inhibitor (ACEf), slows the progression of glomerular sclerosis. Acute and chronic elevations in A P are associated WiU, proteinuria (UpV) (43, 461, 462). In humans, P GC and liP are not known. A method for obtaining values of PGC or liP, or at least determining changes in these values, is required to fully evaluate the importance of U,e hemodynamic basis of renal damage and the results of therapeutic trials in humans. The estimation of filtration pressure from sieving curve data has been of interest for some time. Early attempts (18, 140, 141, 238, 240, 431) were based on the Pappenheimer-Renkin mathematical model (325, 326) and suffer from its limitations
Koebnerization of Hailey–Hailey disease into a cutaneous drug eruption of acute generalized exanthematous pustulosis associated with systemic symptoms

We describe a 65‐year‐old Caucasian female with well‐controlled Hailey–Hailey disease (HHD) who developed acute generalized exanthematous pustulosis (AGEP) with severe systemic symptoms. Despite sparing of the patient's intertriginous skin, histopathologic evidence of HHD was observed in all biopsies, suggestive of a unique koebernization phenomenon of HHD to areas of cutaneous drug eruption. While internal organ involvement is less commonly reported in AGEP, there are an increasing number of patients with signs and symptoms suggestive of an AGEP/drug reaction with eosinophilia and systemic symptoms (DRESS) spectrum of cutaneous drug disorders. Early diagnosis of patients with AGEP and systemic symptoms is critical so that these patients may receive prompt and aggressive systemic therapy to decrease the risk of end organ damage and improve overall morbidity and mortality.
Cutaneous mantle cell lymphoma: a clinicopathologic review of 10 cases

Cutaneous mantle cell lymphoma (MCL) is exceedingly rare, almost always occurring as a dissemination of systemic MCL. To date, only 32 cases have been described. We report a series of 10 cases of MCL in the skin, and provide a comprehensive clinicopathologic review with clinical follow‐up. Our cases occurred in older individuals (mean age = 70) and were more frequently in men (90%). Half of them presented in the head and neck region as a mass/nodule, and the remainder in the trunk and extremities as nodules. All patients have stage IV disease. In two of the 10 cases (20%) the cutaneous lesions preceded the diagnosis of disseminated disease. In two of the seven cases with available clinical follow‐up information (33%) the skin was immediately involved after the diagnosis of MCL, and in three of the seven the skin was the first site of recurrence (mean interval = 57 months). The mean time to recurrence of the disease was 45.4 months and the overall survival was 66.3 months. Histologically six out of 10 cases (60%) had either pleomorphic or blastoid morphology (four out of 10 and two out of 10, respectively). The mean number of mitoses per 10 high‐power fields was 18.44. While nine out of 10 cases expressed cyclin‐D1, one case was not positive for cyclin‐D1 but did label with SOX‐11. Limited cytogenetic data showed trisomy 14 in one case, in addition to the t(11;14) translocation.
EFFECT OF NISIN ON SHELF LIFE OF LASSI

Lassi was prepared by using five levels of nisin i.e. T0 (Control), T1 (100 IU/ml), T2 (200 IU/ml), T3 (300 IV/ml) and T4 (400 IV/ml). 8% cane sugar, 0.1% salt and 10% water level was used in all treatments. The Lassi prepared by addition of 400 IU/ml (T4) nisin was organoleptically superior over the other treatments for the parameters colour and appearance (8.15), body and texture (8.20), flavour (8.15), acidity (8.22) and overall acceptability (8.18), respectively. Treatments T0, T1, T2 and T3 were acceptable up to 5th, 9th, 11th and 12th days, respectively. While treatment T4 was acceptable up to 15th days. While studying microbial quality of preserved Lassi under refrigeration temperature (5°C). The treatment T0 (Control) showed the higher SPC, YMC and E.coli count during study ranged from 16.32–8.63 x 107), 9.00–30 X 107 and 6.00 2.00 x 107, respectively. Whereas the treatment T4 showed lowest microbial count over the other treatments i.e. ranged from SPC (14.97–7.85 x 107), YMC (5.00–30x107) and E.coli (4.00–1.00x 107), respectively.
Defining high bleeding risk in patients undergoing percutaneous coronary intervention: a consensus document from the Academic Research Consortium for High Bleeding Risk

Abstract Identification and management of patients at high bleeding risk undergoing percutaneous coronary intervention are of major importance, but a lack of standardization in defining this population limits trial design, data interpretation, and clinical decision-making. The Academic Research Consortium for High Bleeding Risk (ARC-HBR) is a collaboration among leading research organizations, regulatory authorities, and physician-scientists from the United States, Asia, and Europe focusing on percutaneous coronary intervention–related bleeding. Two meetings of the 31-member consortium were held in Washington, DC, in April 2018 and in Paris, France, in October 2018. These meetings were organized by the Cardiovascular European Research Center on behalf of the ARC-HBR group and included representatives of the US Food and Drug Administration and the Japanese Pharmaceuticals and Medical Devices Agency, as well as observers from the pharmaceutical and medical device industries. A consensus definition of patients at high bleeding risk was developed that was based on review of the available evidence. The definition is intended to provide consistency in defining this population for clinical trials and to complement clinical decision-making and regulatory review. The proposed ARC-HBR consensus document represents the first pragmatic approach to a consistent definition of high bleeding risk in clinical trials evaluating the safety and effectiveness of devices and drug regimens for patients undergoing percutaneous coronary intervention.
Carbohydrates, Physical Training, and Sport Performance

CARBOHYDRATE IS A KEY ENERGY SOURCE DURING EXERCISE. FACTORS SUCH AS FED/METABOLIC STATE, DIET, TYPE, INTENSITY/ DURATION OF EXERCISE, AND TRAINING STATUS INFLUENCE ITS USE DURING EXERCISE AND WHETHER EXTERNAL (E.G., DIET), INTERNAL (E.G., MUSCLE OR LIVER GLYCOGEN), OR BLOOD SOURCES ARE USED. ALONG WITH HYDRATION, CARBOHYDRATE AVAILABILITY IS A PRIMARY FACTOR LEADING TO MUSCULAR OR CENTRAL FATIGUE. PROPER TIMING OF CARBOHYDRATE INTAKE BEFORE, DURING, AND AFTER EXERCISE CAN SUSTAIN PERFORMANCE AND OPTIMIZE RECOVERY. CARBOHYDRATE TYPE CAN INFLUENCE OSMOTIC, DIGESTIBILITY, GLYCEMIC, AND INSULINEMIC EFFECTS. THIS ARTICLE BRIEFLY REVIEWS THESE KEY CONCEPTS AND PROVIDES PRACTICAL GUIDANCE FOR APPLICATION TO ATHLETES.
Examining the effectiveness of mindfulness meditation for chronic pain management in combat veterans with traumatic brain injury

Abstract : One in three Americans suffer from chronic pain, a condition more prevalent and costly than heart disease, diabetes, and cancer. Patients and providers report dissatisfaction with standard medical care, prompting the need for further research on effective chronic pain treatments. This pilot study examined the effectiveness of mindfulness meditation (iRest ) for managing chronic pain in U.S. Veterans deployed to Afghanistan or Iraq. iRest is used clinically at Veterans Affairs (VA) hospitals nationwide. However, few studies have investigated the health benefits of iRest, and no study has examined this intervention s effectiveness for chronic pain. Veterans at the War Related Illness and Injury Study Center at the Washington, DC VA Medical Center were randomly assigned to receive iRest (n=4) or routine medical treatment (n=5) for 8 weeks. Self-reported pain intensity and interference was assessed at baseline (B), endpoint (E) and 4-week follow-up (F); patient ratings of improvement at E and F; and cognitive functioning and biochemical measures at B and E. Veterans in the iRest group showed clinically meaningful reductions in pain intensity (23-42%) on the numeric rating scale and visual analog scale (VAS), and lowered pain interference (34-41%) on the Brief Pain Inventory and Defense and Veterans Pain Rating Scale. Effect sizes were large from B-E and B-F for pain interference (d=1.09 1.21) and medium to large for intensity (d=0.76 1.19). VAS pain intensity decreased from B-F (p=.041) and pain interference improved from B-E and B-F for both measures (p.05). Among controls, no improvements in pain were detected, and changes were less than minimally significant (20%). At E and F, iRest participants reported moderately better to a definite improvement in activity limitations, symptoms, and emotions related to their pain compared to hardly any change at all among controls.
Van polio tot meningokokken-C: Gedragingen en opvattingen van bevindelijk gereformeerden in Nederland

From poliomyelitis to meningitis: Behaviour and attitudes of Orthodox Protestants in the Netherlands The present paper studies vaccination against contagious diseases in the Netherlands. Administrative data show that vaccination rates are lower in municipalities where the orthodox protestant political party gains more votes. Survey data from 1981, 1998 and 2002 for pupils attending orthodox protestant high schools attest that their attitude towards vaccination became more positive. The 2002 survey establishes that mother’s rather than father’s level of education makes for higher chances of pupils to be vaccinated. A scale for Sykes & Matza’s neutralisation techniques shows the expected relationship with the intention of pupils to be vaccinated against meningitis in 2002, at the start of an outbreak of this disease.
The Large Allen Cognitive Level Screen as an Indicator for Medication Adherence among Adults Accessing Community Mental Health Services

Background: Medication remains the cornerstone treatment for mental illness. Cognition is one of the strongest predictors of non-adherence. The aim of this preliminary investigation was to examine the association between the Large Allen Cognitive Level Screen (LACLS) and medication adherence among a small sample of mental health service users to determine whether the LACLS has potential as a screening tool for capacity to manage medication regimens. Method: Demographic and clinical information was collected from a small sample of people who had recently accessed community mental health services. Participants then completed the LACLS and the Medication Adherence Rating Scale (MARS) at a single time point. The strength of association between the LACLS and MARS was examined using Spearman rank-order correlation. Results: A strong positive correlation between the LACLS and medication adherence (r = 0.71, p = 0.01) was evident. No participants reported the use of medication aids despite evidence of impaired cognitive functioning. Conclusion: This investigation has provided the first empirical evidence indicating that the LACLS may have utility as a screening instrument for capacity to manage medication adherence among this population. While promising, this finding should be interpreted with caveats given its preliminary nature.
13 Infectious and Sporadic Prion Diseases

Creutzfeldt-jakob disease (CJD) was first identified in 1921 by Jakob (Jakob 1921), who referred to a previous case described by Creutzfeldt in 1920 (Creutzfeldt 1920). These original cases were clinically heterogeneous, and review of pathologic material provided confirmation of the diagnosis of CJD in only two of the original five cases (Masters and Gajdusek 1982). Over subsequent decades, the nosology of CJD was confused and confusing. Wilson regarded CJD as a “dumping ground for several rare cases of presenile dementia” (Wilson 1940). Although an important monograph by Kirschbaum (1968) listed the clinical and pathologic features of all 150 cases identified before 1965, it included cases such as Creutzfeldt’s original case, which would not now fulfill clinical or pathologic criteria for the diagnosis of CJD. In 1954 (Jones and Nevin 1954) and 1960 (Nevin et al. 1960), Nevin and Jones described the typical clinical course, the “characteristic” electroencephalogram (EEG), and neuropathologic changes, including spongiform change, which in combination are now recognized as the paradigm features of sporadic CJD. In the late 1950s and early 1960s, with remarkable perseverance in difficult conditions, Gajdusek and colleagues investigated kuru, a fatal ataxic syndrome restricted to the Okapa area of the highlands of Papua New Guinea (Gajdusek and Zigas 1957). The similarity of the neuropathologic findings in scrapie and kuru was recognized in 1959 by Hadlow (Hadlow 1959) with the implication that kuru, like scrapie, might be transmissible in the laboratory. Successful laboratory transmission of kuru in 1966 (Gajdusek et al. 1966) was followed in 1968.
Delmar's Comprehensive Medical Assisting: Administrative and Clinical Competencies

The Critical Thinking Challenge simulates a three-month externship in a medical office. During your externship, you will be confronted with a series of situations in which you will need to use your critical thinking skills to choose the most appropriate action in response to each situation. Your decisions will be evaluated in three categories- how your decisions affect the practice, the patient, and your career. Your goal is to be hired by the office as a full-time medical assistant. Version 2.0 presents all scenarios using video, and features more variety and branching options, so you can have different experiences each time you go through the program.
Brain natriuretic peptide for the prediction of sudden cardiac death and ventricular arrhythmias: a meta‐analysis

The risk stratification of patients for sudden cardiac death (SCD) remains a challenge. Brain natriuretic peptide (BNP) predicts overall mortality in heart disease but it is unclear how well it predicts SCD. We therefore performed a meta‐analysis of studies evaluating the accuracy of BNP to predict SCD and ventricular arrhythmias (VA).
Assessing and grading congestion in acute heart failure: a scientific statement from the Acute Heart Failure Committee of the Heart Failure Association of the European Society of Cardiology and endorsed by the European Society of Intensive Care Medicine

Patients with acute heart failure (AHF) require urgent in‐hospital treatment for relief of symptoms. The main reason for hospitalization is congestion, rather than low cardiac output. Although congestion is associated with a poor prognosis, many patients are discharged with persistent signs and symptoms of congestion and/or a high left ventricular filling pressure. Available data suggest that a pre‐discharge clinical assessment of congestion is often not performed, and even when it is performed, it is not done systematically because no method to assess congestion prior to discharge has been validated. Grading congestion would be helpful for initiating and following response to therapy. We have reviewed a variety of strategies to assess congestion which should be considered in the care of patients admitted with HF. We propose a combination of available measurements of congestion. Key elements in the measurement of congestion include bedside assessment, laboratory analysis, and dynamic manoeuvres. These strategies expand by suggesting a routine assessment of congestion and a pre‐discharge scoring system. A point system is used to quantify the degree of congestion. This score offers a new instrument to direct both current and investigational therapies designed to optimize volume status during and after hospitalization. In conclusion, this document reviews the available methods of evaluating congestion, provides suggestions on how to properly perform these measurements, and proposes a method to quantify the amount of congestion present.
Tobacco control progress and potential.

The 1964 surgeon general’s report on the health harms of smoking “hit the country like a bombshell. ”1 More than 40% of US adults smoked, and smoking was accepted and considered normal behavior. Today, the US adult smoking rate is around 18%2 and about half of Americans are protected from secondhand smoke in workplaces.3
Therapeutic options for infections due to vancomycin-resistant enterococci

Background: Vancomycin-resistant enterococci (VRE) are an important cause of nosocomial infection occurring in critical care or immunocompromised patients. Objectives: To provide updated information about therapeutic options for VRE infection. Methods: MEDLINE, EMBASE, and the Cochrane Library were searched to identify in vitro susceptibility data of VRE isolates, randomized and non-randomized controlled trials, case series, and cohort studies of VRE therapy published before 31 July 2008. Results/conclusion: The updated in vitro susceptibility data for VRE show high resistance to ampicillin and aminoglycosides. Quinupristin-dalfopristin is limited by its lack of activity against vancomycin-resistant Enterococcus faealis and its musculoskeletal side effects. Emerging linezolid resistance has been reported to cause hospital spread and may be related to prolonged linezolid use. Quinupristin-dalfopristin resistance is usually linked to agricultural use of streptogramin. Nitrofurantoin and fosfomycin are alternatives in uncomplicated VRE urinary tract infection. Daptomycin and tigecycline have shown excellent potential for treating VRE infection.
Prognosis of heart failure patients with reduced and preserved ejection fraction and coexistent chronic obstructive pulmonary disease

The long‐term prognosis of patients with heart failure with preserved left ventricular ejection fraction (HFPEF) and coexistent chronic obstructive pulmonary disease (COPD) has not been previously investigated. The primary aim of this study was to determine whether the long‐term prognosis of HFPEF patients with COPD differs from that of heart failure patients with reduced left ventricular ejection fraction (HFREF) and COPD. The secondary aim was to identify independent predictors of event‐free survival in patients with HF and COPD.
Risk of end-stage renal disease following live kidney donation.

IMPORTANCE Risk of end-stage renal disease (ESRD) in kidney donors has been compared with risk faced by the general population, but the general population represents an unscreened, high-risk comparator. A comparison to similarly screened healthy nondonors would more properly estimate the sequelae of kidney donation. OBJECTIVES To compare the risk of ESRD in kidney donors with that of a healthy cohort of nondonors who are at equally low risk of renal disease and free of contraindications to live donation and to stratify these comparisons by patient demographics. DESIGN, SETTINGS, AND PARTICIPANTS A cohort of 96,217 kidney donors in the United States between April 1994 and November 2011 and a cohort of 20,024 participants of the Third National Health and Nutrition Examination Survey (NHANES III) were linked to Centers for Medicare & Medicaid Services data to ascertain development of ESRD, which was defined as the initiation of maintenance dialysis, placement on the waiting list, or receipt of a living or deceased donor kidney transplant, whichever was identified first. Maximum follow-up was 15.0 years; median follow-up was 7.6 years (interquartile range [IQR], 3.9-11.5 years) for kidney donors and 15.0 years (IQR, 13.7-15.0 years) for matched healthy nondonors. MAIN OUTCOMES AND MEASURES Cumulative incidence and lifetime risk of ESRD. RESULTS Among live donors, with median follow-up of 7.6 years (maximum, 15.0), ESRD developed in 99 individuals in a mean (SD) of 8.6 (3.6) years after donation. Among matched healthy nondonors, with median follow-up of 15.0 years (maximum, 15.0), ESRD developed in 36 nondonors in 10.7 (3.2) years, drawn from 17 ESRD events in the unmatched healthy nondonor pool of 9364. Estimated risk of ESRD at 15 years after donation was 30.8 per 10,000 (95% CI, 24.3-38.5) in kidney donors and 3.9 per 10,000 (95% CI, 0.8-8.9) in their matched healthy nondonor counterparts (P < .001). This difference was observed in both black and white individuals, with an estimated risk of 74.7 per 10,000 black donors (95% CI, 47.8-105.8) vs 23.9 per 10,000 black nondonors (95% CI, 1.6-62.4; P < .001) and an estimated risk of 22.7 per 10,000 white donors (95% CI, 15.6-30.1) vs 0.0 white nondonors (P < .001). Estimated lifetime risk of ESRD was 90 per 10,000 donors, 326 per 10,000 unscreened nondonors (general population), and 14 per 10,000 healthy nondonors. CONCLUSIONS AND RELEVANCE Compared with matched healthy nondonors, kidney donors had an increased risk of ESRD over a median of 7.6 years; however, the magnitude of the absolute risk increase was small. These findings may help inform discussions with persons considering live kidney donation.
Proteomic analysis of myocardial tissue from the border zone during early stage post‐infarct remodelling in rats

Long‐term outcome of patients after myocardial infarction (MI) largely depends on the extent of post‐infarct remodelling. To explore the molecular mechanism of remodelling, comparative proteomic analysis was undertaken to identify differential myocardial proteome profiles expressed in the border zone of the post‐MI heart.