Miracle-dz/UniFAR-FTUs huggingface dataset:
Effect of Acute Anoxia Produced by Breathing Nitrogen, on the Course of Schizophrenia

Previous work has led us to believe that a common factor in the hypoglycemic and metrazol treatments for schizophrenia is a diminished cerebral metabolism. The mechanism for the production of the decreased metabolism is different for each treatment. During hypoglycemia the cerebral metabolism diminishes because the brain is deprived of its chief substrate, glucose. 1 After the injection of metrazol, on the other hand, the inhibition of cerebral metabolism is evidently due to an acute anoxemia induced by the severity of the convulsions and the temporary arrest of respiration. 2 If the beneficial results following metrazol therapy are dependent upon decreased cerebral metabolism resulting from acute anoxia, then anoxia of a similar degree, produced by any means should be equally effective. It occurred to us that acute anoxemia might be produced under safer and more controllable conditions by having the patients breathe for short periods an atmosphere in which the nitrogen was increased at the expense of oxygen. By this method it is possibe not only to control the degree of anoxemia produced but also to terminate the bout immediately in the event of untoward reaction. The production of acute anoxemia was under the direction of one of US, F.A.D.A. , a trained anesthetist. The apparatus used included a tight fitting face mask with exhalation valve such as is used in anesthesia, a canister of soda lime and a 5-liter breathing bag connected in series. The apparatus was filled with pure oxygen, adjusted to the patient's face and after a few breaths, nitrogen was run into the mask gradually, displacing the oxygen. Unlike previous attempts of other workers the anoxia was intense. At the height of the bout the patient was respiring almost pure nitrogen. Carbon dioxide did not accumulate but was absorbed by soda lime, thus minimizing the patient's discomfort during the treatment.
Reflex sympathetic activation during static exercise is severely impaired in patients with myophosphorylase deficiency

During static exercise, metabolites accumulate in the muscle interstitium where they stimulate chemosensitive afferent nerves that reflexly increase efferent muscle sympathetic nerve activity (MSNA) and blood pressure. In experimental animals, lactic acid potently stimulates the muscle metaboreflex, but its role in humans is more controversial. To determine if lactic acid is a critical mediator of metaboreflex activation in humans, we performed microelectrode recordings of MSNA in eight patients with myophosphorylase deficiency (McArdle's disease) who cannot metabolize intramuscular glycogen and do not generate lactic acid in exercising muscles. Each patient was matched with three healthy control subjects to maximize statistical power. In controls, 2 min of static handgrip performed at 33 % or 45 % of maximal voluntary contraction (MVC) produced intensity‐dependent increases in MSNA (171 ± 22 % and 379 ± 95 %, respectively). In the patients, MSNA responses to static handgrip were markedly attenuated (33 ± 14 % at 33 % MVC; 32 ± 19 % at 45 % MVC; P < 0.05 vs. controls). Likewise, when static handgrip (30 % MVC) was performed to fatigue, MSNA increased by 366 ± 73 % in controls but only by 51 ± 14 % in patients (P < 0.05). Pressor responses to static handgrip were also attenuated in patients compared to controls, whereas heart rate responses were identical. In contrast to exercise, the MSNA responses to other reflex stimuli (the cold pressor test or Valsalva's manoeuvre) were similar in patients and controls. Together these data indicate that appropriate activation of glycogenolytic pathways is obligatory for normal metaboreflex‐mediated sympathoexcitation during static exercise in humans.
Impact of Body Mass Index on Activities of Daily Living in Patients with Idiopathic Interstitial Pneumonias

In patients with idiopathic interstitial pneumonias, undernutrition has a profound effect on prognosis. However, whether body mass index affects the ability to perform activities of daily living as measured by the Barthel index in patients with idiopathic interstitial pneumonias remains unknown. Therefore, we examined the impact of body mass index on the activities of daily living in inpatients with idiopathic interstitial pneumonia. We used a database constructed by the Japan Medical Data Center. Data were extracted from 2774 inpatients from participating hospitals with a diagnosis of idiopathic interstitial pneumonia. Multiple regression analysis adjusted for confounding factors was performed to determine whether body mass index classification would be independently related to change in Barthel index during hospitalization. Underweight, normal weight, overweight, and obesity numbered 473 (19%), 1037 (41), 795 (31%), and 235 (9%), respectively. Multivariable analysis showed that being underweight was independently associated with a change in Barthel index during hospitalization of −2.95 (95% confidence interval −4.82 to −1.07) points lower than being normal weight. Approximately 20% of the patients with idiopathic interstitial pneumonias were underweight. Those who were underweight had decreased independence in activities of daily living during hospitalization.
2020 International Society of Hypertension global hypertension practice guidelines - lifestyle modification.

Dobney Hypertension Centre, University of Western Australia – Royal Perth Hospital Campus, Perth, Western Australia, Australia, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy, Division of Cardiovascular Sciences, Faculty of Medicine, Biology and Health, University of Manchester, Manchester, UK, Third Department of Medicine, Hypertension Center STRIDE-7, School of Medicine, Sotiria Hospital, National and Kapodistrian University of Athens, Athens, Greece, Faculty of Medicine, University of New South Wales, The George Institute for Global Health, Sydney, New South Wales, Australia and CARIM – School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands
Pallidal deep brain stimulation in primary Meige syndrome: clinical outcomes and psychiatric features

Objectives To study the efficacy and safety of bilateral globus pallidus internus deep brain stimulation (GPi-DBS) in refractory Meige syndrome (MS) and evaluate the psychiatric disorders before and after surgery. Methods Twenty-two patients with MS treated with bilateral GPi-DBS were retrospectively analysed before surgery and after continuous neurostimulation. Before surgery, patients were assessed by the Burke-Fahn-Marsden Dystonia Rating Scale (BFMDRS), Self-Rating Depression Scale, Medical Outcomes Study 36-Item Short-Form General Health Survey (SF-36) and Pittsburgh Sleep Quality Index (PQSI), which corresponded to motor symptoms, depressive state, quality of life and sleep quality, respectively. The implantable pulse generator of each patient was activated at 1 month after surgery. At 1 month, 3 months, 6 months and 12 months after continuous neurostimulation, all patients were evaluated by the same scales above. Results The BFMDRS movement scores decreased from 15.0±5.3 before surgery to 3.5±4.5 at 12 months after neurostimulation, with a mean improvement of 78% (p<0.001). The BFMDRS disability scores improved from 7.4±4.9 before surgery to 4.0±4.6 at 12 months after neurostimulation, with a mean improvement of 56% (p<0.001). The postoperative SF-36 scores had the remarkable improvement compared with baseline scores. Impaired sleep quality was found in 82% of patients and depression in 64% before surgery, which didn’t neither obtained amelioration after continuous neurostimulation. Conclusions Bilateral pallidal neurostimulation is a beneficial therapeutic option for refractory MS, which could improve the motor symptoms except for depression and sleep quality.
Challenging the relationship of grip strength with cognitive status in older adults

Grip strength is a widely used motor assessment in ageing research and has repeatedly been shown to be associated with cognition. It has been proposed that grip strength could enhance cognitive screening in experimental or clinical research, but this study uses multiple data‐driven approaches to caution against this interpretation. Furthermore, we introduce an alternative motor assessment, comparable to grip dynamometry, but has a more robust relationship with cognition among older adults.
External Auditory Canal Cholesteatoma Causing Simultaneous Bezold Abscess and Sinus Thrombosis

Extra‐ and intracranial complications of cholesteatoma are rare in the new era of antibiotics. The rarity of the severe complications and the atypical symptoms cause difficulties to set up proper diagnosis and treatment. We report about a 76‐year old patient with external auditory canal cholesteatoma causing Bezold abscess and sigmoid sinus thrombosis. The patient underwent canal wall up mastoidectomy and mastoid obliteration with abdominal fat and Bezold abscess drainage. Systemic antibiotic and anticoagulant therapy were applied. The treatment resulted in fast improvement in the general condition of the patient, and the control magnetic resonance imaging (MRI) showed no recurrence of the disease. Laryngoscope, 131:E1282–E1285, 2021
Effect of Supplemental Enteral Fish Oil on the Development of Psychological Complications in Critically Ill Multiple Trauma Patients: 6 Months Follow up.

BACKGROUND Posttraumatic Stress disorder (PTSD) is common in ICU patients. One of the factors that may be associated with development of PTSD is deficit intake of omega-3 poly unsaturated fatty acids (PUFA). In this manuscript, we evaluated the effect of omega 3 PUFA's, gamma linolenic acid (GLA) and micronutrients on the long term onset of PTSD in multiple trauma patients. METHODS This study randomized mechanically ventilated patients suffering from multiple trauma (n = 150) into 2 groups: a study and control group that received enteral feeding with or without fish oil. Fifty one patients were interviewed 6 month after discharge from ICU. The psychometric parameters of PTSD were assessed by questionnaires. The fatty acid composition of erythrocyte membranes was performed by homogenization of the cells in hexane - isopropanol. RESULTS No differences were found in baseline characteristics between the groups. Erythrocyte membrane composition showed significant higher concentrations of omega 3 fatty acids in the study group. Anxiety and depression symptoms were correlated with an increase in EPA on day 4 and 8 for depression and EPA on day 4 and DHA on day 8 for anxiety. Total omega 3 content was positively correlated with anxiety and depression as well. An inverse correlation was found between DHA and EPA in the treatment group and with the total omega 3 and DHA in the control group for IPQ questionnaire. CONCLUSION Administration of n-3 PUFA enriched diet during the ICU stay didn't prevent development of PTSD in trauma patients six months after discharge from ICU. This article is protected by copyright. All rights reserved.
Patrones regionales en la estructura y composición florística de los manglares de la Costa Pacífica de Costa Rica

El presente estudio tiene como objetivo describir y cuantificar las caracteristicas estructurales y la composicion floristica de los manglares de la costa Pacifica de Costa Rica; asi como determinar la influencia de factores climaticos e hidrologicos sobre ellas. Este estudio sugiere que muchas de las especies de la vegetacion marginal estan obligatoriamente asociadas a los manglares, y deben ser incluidas como parte de la vegetacion propia de este ecosistema. La dependencia entre la distribucion de muchas de las especies marginales y la vegetacion nuclear sugiere un largo proceso evolutivo que se hace evidente e n la presencia de adaptaciones tales como viviparidad en Crinum e Hymenocallis , frutos flotantes en T. palustris , P. phellosperma y D. latifolius (bignoniaceae).
Human Keratinocyte Response to Superantigens

Staphylococcus aureus and Streptococcus pyogenes are common human pathogens, causing infections that include the skin. Both pathogens produce a family of secreted toxins called superantigens, which have been shown to be important in human diseases. The first cell types encountered by superantigens on skin are keratinocytes. Our studies demonstrated, that the human keratinocyte pathway, among other pathways, responds to superantigens with production of chemokines, setting off inflammation. This inflammatory response may be harmful, facilitating opening of the skin barrier. ABSTRACT Staphylococcus aureus and Streptococcus pyogenes are significant human pathogens, causing infections at multiple body sites, including across the skin. Both are organisms that cause human diseases and secrete superantigens, including toxic shock syndrome toxin-1 (TSST-1), staphylococcal enterotoxins (SEs), and streptococcal pyrogenic exotoxins (SPEs). On the skin, human keratinocytes represent the first cell type to encounter these superantigens. We employed transcriptome sequencing (RNA-seq) to evaluate the human primary keratinocyte response to both TSST-1 and staphylococcal enterotoxin B (SEB) in triplicate analyses. Both superantigens caused large numbers of genes to be up- and downregulated. The genes that exhibited 2-fold differential gene expression compared to vehicle-treated cells, whether up- or downregulated, totaled 5,773 for TSST-1 and 4,320 for SEB. Of these, 4,482 were significantly upregulated by exposure of keratinocytes to TSST-1, whereas 1,291 were downregulated. For SEB, expression levels of 3,785 genes were upregulated, whereas those of 535 were downregulated. There was the expected high overlap in both upregulation (3,412 genes) and downregulation (400 genes). Significantly upregulated genes included those associated with chemokine production, with the possibility of stimulation of inflammation. We also tested an immortalized human keratinocyte line, from a different donor, for chemokine response to four superantigens. TSST-1 and SEB caused production of interleukin-8 (IL-8), MIP-3α, and IL-33. SPEA and SPEC were evaluated for stimulation of expression of IL-8 as a representative chemokine; both stimulated production of IL-8. IMPORTANCE Staphylococcus aureus and Streptococcus pyogenes are common human pathogens, causing infections that include the skin. Both pathogens produce a family of secreted toxins called superantigens, which have been shown to be important in human diseases. The first cell types encountered by superantigens on skin are keratinocytes. Our studies demonstrated, that the human keratinocyte pathway, among other pathways, responds to superantigens with production of chemokines, setting off inflammation. This inflammatory response may be harmful, facilitating opening of the skin barrier.
Evolocumab for the treatment of homozygous familial hypercholesterolaemia

ABSTRACT Introduction: Homozygous familial hypercholesterolaemia (HoFH) is a genetic disorder of lipoprotein metabolism characterized by minimal or absent LDL-receptor (LDLR) function, markedly elevated low density lipoprotein cholesterol (LDLC) and premature atherosclerotic cardiovascular disease. Pharmacological control of LDLC in patients with HoFH is challenging. Areas covered: Evolocumab is a fully human monoclonal antibody directed against proprotein convertase subtilisin kexin type 9 (PCSK9). PCSK9 is a serine protease predominantly secreted by hepatocytes and interferes with physiological LDLR recycling. In HoFH monthly subcutaneous evolocumab 420mg lowers LDLC by 16-23% and by 41% from baseline compared to placebo in patients with at least one LDLR allele with residual function. Individual responses to evolocumab are highly variable. Increasing the dosing frequency to once every two weeks lowers LDLC by a further 6%. Evolocumab is not effective when both LDLR alleles carry mutations without residual function. Additionally, evolocumab lowers Lp (a) by approximately 10% in patients with HoFH. Expert opinion: Evolocumab is an effective additional option for treating HoFH patients with residual LDLR function and is likely to be used routinely in the majority of patients in addition to statins and ezetimibe because of its good tolerability and safety. Many patients receiving the triple combination of a statin + evolocumab + ezetimibe will still require additional therapies such as lipoprotein apheresis, lomitapide or mipomersen to reach their LDLC target.
Sepsis Definitions in Burns.

Background: Sepsis is the leading cause of death in burns. Despite its importance, sepsis lacks a proper definition. An established definition will lead to early and accurate diagnosis, prompt treatment, and a reduced mortality rate. The aim of this work is to discuss current definitions and to look ahead at novel definitions with clinical implications. Method: A review of the current understanding of sepsis definitions in burns. Results: Adaptation of sepsis definitions in the general population and specific burn definitions have gotten better but still need improvements and, potentially, incorporation of molecular, laboratory, patient-specific, and clinical factors. This work includes the history, evolution, and predictive value of current definitions of sepsis in burns. A review of current and future markers of sepsis and potentially useful definitions are presented. Conclusions: Sepsis definitions have evolved over the last decades and will continue to do so. We believe the best definition in burn patients is the Sepsis-3 that was developed originally for critically ill patients. However, there are several studies investigating more specific definitions with better sensitivity and specificity.
Mild TBI/Concussion Clinical Tools for Providers Used Within the Department of Defense and Defense Health Agency.

Background Military personnel are at greater risk for sustaining mild traumatic brain injury (mTBI), or concussion, whether they are in a combat or garrison setting. Consequently, mTBI is a major health concern for health practitioners to understand, in order to provide timely assessment and treatment to service members (SM) who are suspected to have mTBI. Observations Providing early diagnosis and effective management of symptoms can optimize recovery and promote healthy outcomes. Understanding what resources and guidelines are available is important for those evaluating active duty SMs within the Military Health System. Conclusions This article showcases clinical tools for screening, evaluating, and diagnosing concussion used within the US Department of Defense, and provides resources for practitioners to find these clinical tools online.
Hemodynamic changes as early markers of diabetic retinopathy

Abnormalities of retinal blood flow and its ability to respond to metabolic and environmental changes have been described in patients with long-standing diabetic retinopathy. In order to assess the role of these abnormalities in the pathophysiology of diabetic retinopathy, it is important to investigate how early in the disease these derangements occur. Measurements of the effect of new treatment modalities on these hemodynamic abnormalities may help in the assessment of their therapeutic potential.
Telegenetics

Purpose of review The aim of the article is to provide an update on recent evidence for utilization and challenges of implementation of telegenetics in the clinical practice. Recent findings Implementation of telegenetics in health systems is still limited, below 10%, somewhat higher for cancer genetic counseling. Nevertheless, telegenetic services have been shown useful in the COVID pandemic. Key factors for efficient implementation include a patient-centered approach, engaging the major stakeholders, and incorporating telegenetics into existing health policies. Main barriers remain: limitations to billing and reimbursement, licensure, proper equipment and technical issues, engagement of referring providers and patients, coordination of services with local health providers, and lack of decision-making power. Further rigorous studies are needed to investigate the outcomes of telegenetics and to motivate health policies for change. Summary Despite continuous evidence of the benefits of telegenetics, its use in health systems remains limited. Further, larger, prospective, randomized, long-term studies are needed to address the outcomes. Enabling factors contributing to the implementation of telegenetics are patient-centeredness, the involvement of major stakeholders, and aligning telegenetics with the existing national health policies.
Correlation of metabolic syndrome with serum omentin‐1 and visfatin levels and disease severity in psoriasis and psoriatic arthritis

Psoriasis and psoriatic arthritis (PsA) have been linked to metabolic syndrome (MS). The impact of adipokines on psoriasis, PsA, and MS pathogenesis has recently received investigative attention. A total of 80 subjects with psoriasis, 40 subjects with PsA, and 60 healthy controls were enrolled. Serum omentin and visfatin levels were measured, and MS presence was determined. PASI and DAS28 were used to measure disease severity for psoriasis and PsA, respectively. The prevalence of MS was determined to be 49% in psoriasis, 48% in PsA, and 28% in control groups. Rates were similar in psoriasis and PsA groups and was significantly greater when compared to control (P = .028). Diastolic blood pressure and waist circumference were significantly greater in the psoriasis group. Although the presence of MS positively correlated with age and disease duration in the psoriasis group, no significant relationships with PASI and DAS28 were found. Among all groups combined, there was no significant relationship with omentin and visfatin levels. In the psoriasis group, omentin and visfatin levels were greater in those with MS compared to those without MS. The relationships between omentin and visfatin levels with MS in patients with psoriasis and PsA has not yet been fully elucidated. These results suggest that elevated omentin and visfatin levels seen in psoriasis may be linked to MS rather than psoriasis itself. Additional research is needed to investigate the utility of these measurements as indicators of MS in patients with psoriasis.