Miracle-dz/UniFAR-FTUs huggingface dataset:
Taste-masked tacrolimus-phospholipid nanodispersions: dissolution enhancement, taste masking and reduced gastric complications

Abstract Through the integration of orthogonal central composite design and desirability function, this work aimed to explore the potential of quality by design in understanding the formulation of phospholipid-stabilized tacrolimus nanodispersions by microfluidization. The influence of homogenization pressure, microfluidization time and phospholipid concentration (X1–X3) on nanodispersion performance was studied. Nanodispersions were characterized by differential scanning calorimetric (DSC), X-ray diffractometer (XRD) and Fourier transform infrared (FTIR) analysis. Moreover, masking the unpalatable taste of tacrolimus and reducing the gastric complications were also evaluated. FTIR analysis indicated its interaction with phospholipid. DSC and XRD analysis revealed the amorphous transformation of tacrolimus within nanodispersions. The dissolution was enhanced by 35 folds and 15 folds after 0.5 and 2 h, respectively. Maximum tacrolimus content, yield, polydispersity index, percentages dissolved after 0.5 and 2 h of 99.3%, 100%, 0.864, 39.7% and 95.3%, respectively, with particle size of 160 nm were obtained at X1, X2 and X3 values of 20 000 psi, 6 min and 30%, respectively. The Euclidean distance values demonstrated masking the unpalatable taste and taste perversion to stimuli of tacrolimus in its optimized nanodispersion. Moreover, the ulcerative indices following raw tacrolimus and its optimized nanodispersion oral administration were 6.73 and 2.45, respectively, to indicate that nanodispersion was significantly less irritating to the gastric mucosa.
Novel buccal adhesive system for anti-hypertensive agent Nimodipine

Novel buccal adhesive system (NBAS) containing Nimodipine (N) was prepared and evaluated by different parameters such as weight uniformity, thickness, hardness, surface pH, swelling index, mucoadhesive strength (MS), in vitro drug release and ex vivo drug permeation. Different formulations containing 5–20% Carbopol 934 (CP) and SCMC HV in sustained release part and sodium alginate:chitosan lactate in different ratios (1:1, 2:1, 1:2, and 3:1) in fast release part were prepared and tested. NBAS containing CP 5% and SCMC HV and sodium alginate: chitosan lactate 1:1 was selected as a suitable formula based on the (MS) and the release profile. Compared to the conventional buccal adhesive tablet, NBAS showed an effective controlled release pattern with faster release at the initial period. The mechanism of N release was found to be by non-fickian diffusion, followed first order release kinetics. It can be considered that NBAS is a superior, novel system that overcomes the drawback associated with the conventional buccal adhesive tablet.
A Polymorphism of the MMP-1, EGF, and IL-LB Gene Is Not Correlated with Gastric Carcinogenesis

MMP-1, EGF, and IL-1B gene polymorphism can be associated with gastric carcinogenesis. However, no study has yet confirmed the definitive role of these gene polymorphisms in gastric cancer risk. The 194 gastric cancer patients, 94 gastric adenoma patients, and 182 controls were used in this study. The SNP of the MMP-1 promoter, EGF, and IL-1B-31 were analyzed by PCR-RFLP and sequencing. The genotype frequency was compared between cases and controls, and a univariate and multivariate analysis were performed to determine the significant risk factors associated with gastric adenoma and adenocarcinoma. The frequency of 1G/2G genotypes in the MMP-1 promoter was similar to those in controls (p=0.734). The frequency of A/G genotypes in the EGF was similar to those in controls (p=0.239). The frequency of C/T genotypes in the IL-1B-31 was similar to those in controls (p=0.239). According to univariate analysis, male sex (p ＜0.0001), old age (≥60, p＜0.0001), atrophy (pepsinogen I/II ≤3, p＜0.0001), and G/G genotype of EGF (p=0.034) were significant risk factors associated with gastric adenoma and carcinoma. However, male sex (p=0.002), old age (p＜0.0001), and atrophy (p＜0.0001) were the only significant risk factors associated with gastric adenoma and carcinoma according to the multivariate analysis. In conclusion, the SNP of the MMP-1 promoter, EGF, and IL-1B-31 did not correlate with the risk of gastric adenoma and adenocarcinoma. Sex, age, and atrophy were the significant risk factors of gastric cancer.
Influência do complexo flúor-xilitol no controle da placa dentária e do sangramento gengival em pacientes herbiátricos com aparelho ortodôntico fixo

AIM: to evaluate the effects of a dentifrice containing fluorine/xylitol in the reduction of the adhesion of the plaque to the dental structure, as well as in the gingival bleeding index in patients who had orthodontic braces. METHODS: 22 teenagers, in between 14 and 17 years old were evaluated. After the initial quantification of the indexes, they received instructions of brushing and started to use only the dentifrices from the research. There was a random division of the sample into two groups, A and B. In the first week, they all used a standard dentifrice and since the second week the teenagers from group A received a dentifrice with fluorine, while the ones from group B received a dentifrice containing the fluorine-xylitol complex, using for 28 days, when they were evaluated again (T1). There was an inversion of dentifrices for second phase. RESULTS: the results were compared intra-groups and in both groups there was a statistically significant reduction between phases initial and T1, initial and T2 and between T1 and T2. However, comparing the groups, there was no statistically significant difference between them, though the dentifrice containing fluorine/ xylitol provided a percentage of reduction of gingival bleeding index bigger than the one containing only sodium fluoride, specially between phases initial and T2, where reduction in group A was 90.13% and in group B was 78.84%. CONCLUSION: the utilization of dentifrice containing fluorine and xylitol, associated to instruction and motivation, seems to be a promising resource for maintenance of oral health in orthodontic patients.
Segunda Encuesta Nacional de Sobrepeso y Obesidad (ENSO 2) adultos (18-65 años o más)

Introduccion: la obesidad es una epidemia en expansion que determina una alta morbimortalidad para la poblacion general y altos costos para el sistema nacional de salud.Objetivos: evaluar la prevalencia de obesidad, sus comorbilidades y factores predispontenes mediante la Segunda Encuesta Nacional de Sobrepeso y Obesidad en Uruguay (ENSO 2) en individuos entre 18 y 65 anos o mas, realizada en el ano 2006.Material y metodo: estudio observacional de tipo transversal. Muestra representativa del pais urbano, 91% de la poblacion total. N = 900 (399 hombres y 501 mujeres (mujer/hombre = 1,25). Las entrevistas, el pesado y tallado, fueron realizados en la casa del encuestado. Se trabajo en diez de los 19 departamentos del pais.Resultados: en Uruguay, 54% de la poblacion adulta alcanza o excede (>) el indice de masa corporal de 25 kg/m2 (IMC = peso corporal en kg / talla en m2) y 20% el IMC > 30 kg/m2.Uno de cada dos adultos uruguayos padece sobrepeso u obesidad y uno de cinco es obeso.Se senalan grupos de riesgo y oportunidades en prevencion. Tambien se analiza la relacion de la obesidad con las enfermedades cardiometabolicas, que aumentan dramaticamente en linea con el IMC y la medida de la cintura, como la hipertension arterial, la cardiopatia isquemica, la diabetes 2 y el Stroke.Conclusiones: estas cifras epidemicas de obesidad y sus comorbilidades determinan un alto riesgo sanitario para la poblacion general y economico para nuestro sistema nacional de salud.
El acto médico como ética de la relación

This documentary paper approaches the issue of the possible types of ethics that can be used in the medical practice, conceived as both therapeutic and ethical actions carried out by health professionals. It is concluded that medical action can be carried out as the expression of two main ethical approaches, namely: The instrumental ethics in which the discourse used by the professional during medical actions has an instrumental value. The second one is called intersubjective ethics, which considers that the aforementioned discourse has a special role, since it may restore the patient's subjectivity and build a relational weave between the patient and the physician in which healing action can take place. It is concluded, in accordance with the second ethical approach, that medical vocation implies that physicians should develop a good, virtuous, and aesthetic life for themselves and for their patients.
Speeding up child immunization.

Ways in which it has been possible to improve immunization coverage are outlined. Accelerated campaigns on a national level require careful planning at an early stage if potential benefits are to be fully realized. Existing health posts clinics and personnel can be used to provide immunization services. Success of outreach components whereby teams of health workers make regular visits to remote communities depends on reliable and affordable transport supplies of fuel and willingness on the part of the health workers. Immunization via mobile units can be relatively expensive if they provide only this intervention. The enumeration and registering of children eligible for immunization also called channelling may enhance the programs strategy. This strategy is labor-intensive and depends on good record-keeping and quick processing of data so that children found can be followed up. For an accelerated national campaign there has to be good cooperation between government ministries health services teachers religious leaders the private sector and the community. Newspapers radio and television are utilized along with other methods for communicating. National campaigns have made public health measures and the primary health care system more visible yet they are thougt to be unduly expensive if they do not contribute to the development of a permanent health service infrastructure.
COmplex coronary Bifurcation lesions: RAndomized comparison of a strategy using a dedicated self-expanding biolimus-eluting stent versus a culotte strategy using everolimus-eluting stents: primary results of the COBRA trial.

AIMS We aimed to compare healing responses with optical coherence tomography, and clinical and angiographic outcome after treatment of coronary bifurcation lesions with a dedicated stent versus a conventional culotte technique. METHODS AND RESULTS Forty patients with true and complex coronary bifurcation lesions were randomly assigned to treatment with the Axxess™ bifurcation stent in the proximal main vessel (MV) and additional BioMatrix™ stents in the branches (Biosensors Europe SA, Morges, Switzerland), versus a culotte technique using XIENCE™ stents (Abbott Vascular, Santa Clara, CA, USA). The primary endpoint of percentage of uncovered struts at nine months was similar with the dedicated strategy vs. culotte in the proximal MV (median 17.8 [IQR 3.3-24.7] vs. 6.8 [2.0-20.5]; p=0.19), bifurcation core (9.5 [5.7-19.5] vs. 4.0 [0.7-17.6]; p=0.17), distal MV (2.6 [2.3-18] vs. 2.2 [0.5-6.0]; p=0.09) and side branch (5.7 [1.5-11.5] vs. 1.9 [0-5.8]; p=0.14). As compared with culotte, a strategy using Axxess resulted in a significantly larger lumen in the proximal MV both acutely (minimum lumen diameter 3.03±0.51 vs. 2.71±0.44 mm, p=0.04) and at follow-up (mean lumen area 10.0±2.1 vs. 7.1±1.8 mm2, p<0.001), and in a lower angiographic late lumen loss (p=0.05). Both strategies resulted in good clinical outcomes at one year, and no stent thromboses. CONCLUSIONS As compared with a culotte strategy with XIENCE stents, complex bifurcation stenting using a dedicated strategy combining Axxess and BioMatrix stents results in similar stent strut coverage at nine-month follow-up, and a significantly larger lumen and lower angiographic late lumen loss in the proximal MV.
Changes of the Unique Odontogenic Properties of Rat Apical Bud Cells under the Developing Apical Complex Microenvironment

AimTo characterize the odontogenic capability of apical bud and phenotypical change of apical bud cells (ABCs) in different microenvironment.MethodologyIncisor apical bud tissues from neonatal SD rat were dissected and transplanted into the renal capsules to determine their odontogenic capability. Meanwhile ABCs were cultured and purified by repeated differential trypsinization. Then ABCs were cultured with conditioned medium from developing apical complex cells (DAC‐CM). Immunocytochemistry, reverse transcriptase polymerase chain reaction (RT‐PCR) and scanning electron microscope (SEM) were performed to compare the biological change of ABC treated with or without DAC‐CM.ResultsFirst we confirmed the ability of apical bud to form crown‐like structure ectopically. Equally important, by using the developing apical complex (DAC) conditioned medium, we found the microenvironment created by root could abrogate the “crown” features of ABCs and promote their proliferation and differentiation.ConclusionABCs possess odontogenic capability to form crown‐like tissues and this property can be affected by root‐produced microenvironment.
Occupation-focused interventions for well older people: An exploratory randomized controlled trial

Abstract Objective: The aim of this exploratory randomised controlled trial (RCT) was to evaluate three different occupation-focused interventions for well older people by estimating effect sizes for leisure engagement and ability in activities of daily living (ADL) and thereby identifying the most effective interventions. Methods: One hundred and seventy seven persons, 77–82 years old, living alone and without home help, were randomized to a control group (CG), an individual intervention (IG), an activity group (AG), and a one-meeting discussion group (DG). All interventions focused on occupational engagement and how persons can cope with age-related activity restrictions in order to enhance occupational engagement. Data were collected by blinded research assistants at baseline, three, and 12 months. Ordinal outcome data were converted, using Rasch measurement methods, to linear measures of leisure engagement and ADL ability. Standardized between-group effect sizes, Cohen’s d, were calculated. Results: While all groups showed a decline in leisure engagement and ADL over time, the IG and the DG were somewhat effective in minimizing the decline at both three and 12 months. However, the effect sizes were small. Conclusions: The findings indicate that occupation-focused interventions intended to minimize a decline in leisure engagement and ADL were sufficiently promising to warrant their further research.
An amyotrophic lateral sclerosis-like syndrome revealing an amyloid polyneuropathy associated with a novel transthyretin mutation

Abstract Objective: Familial amyloid polyneuropathy (FAP) is typically a predominantly sensory and autonomic neuropathy with progressive and late motor involvement leading to death within 10 years. Recently, prognosis was transformed with liver transplantation. Methods: We report an atypical sporadic pure motor and bulbar neuropathy initially mistaken for amyotrophic lateral sclerosis (ALS) in a 50-year-old Malian man. Results: The diagnostic procedure of this clinical purely motor and bulbar neuropathy disclosed amyloid deposits on nerve biopsy which led to the identification of a new Val93Met mutation of transthyretin. This case was also remarkable by its slow progression. Conclusions: This report confirms the motor phenotype of TTR-FAP. That should be considered in the differential diagnosis of motor neuron diseases in order to start accurate therapy.
24-Hour Blood Pressure and Stroke

A large body of epidemiological evidence demonstrates that the rate of cerebrovascular events is directly related to clinic blood pressure values. Although highly statistically significant, however, the relationship is not very close, which implies that within a general trend several patients with a lower blood pressure suffer from a stroke whereas other patients with a higher blood pressure do not. Whether and to what extent the ability to predict the future occurrence of stroke can be increased is discussed in this paper, which considers three main possibilities: (1) genetic factors that make some populations and individuals more prone to the occurrence of a cerebrovascular event for a given systolic or diastolic blood pressure, (2) risk factors other than hypertension (e.g. smoking) interacting in a positive fashion to increase the stroke risk profile, and (3) evaluation of blood pressure by ambulatory monitoring rather than by "clinic" measurements. This last possibility is supported by studies that show that the end organ damage associated with hypertension is more closely related to 24-hour average than to clinic blood pressure and that the relationship becomes closer if 24-hour blood pressure variability is also taken into accout. It is more specifically supported by evidence that 24-hour blood pressure values correlate more than clinic blood pressure with cerebrovascular damage, provided that the damage is quantified on an almost continuous scale by nuclear magnetic resonance rather than being expressed as an all-or-none clinical event. Improving prediction of future occurrence of stroke also improves efficacy of therapeutic intervention, thus having a great practical relevance. To date it would appear that the greatest protection against cerebrovascular events is obtained by removal of risk factors other than hypertension and by effective control of 24-hour blood pressure. Although the matter is still controversial, this should include a reduction in nighttime blood pressure at least in patients with no major organ damage. (Hypertens Res 1994; 17: 161-163)
Epidemiological survey of methicillin resistant Staphylococcus aureus in the community and hospital, Gannavaram, Andhra Pradesh, South India

Center for Boitechnology Acharya Nagarjuna University, Guntur, Andhra Pradesh, India Department of Biochemistry, Acharya Nagarjuna University, Guntur, Andhra Pradesh, India Department of Zoology, VSR & NVR College, Tenali, Andhra Pradesh, India Department of Microbiology, Dr. Pinnamaneni Siddhartha Institute of Medical Sciences and Research Foundation, Chinoutpalli, Andhra Pradesh, India Department of Molecular Microbiology & Infectious Diseases, Herbert Wertheim College of Medicine, Florida International University, Miami, Florida, USA
Stability and reproducibility of simultaneously detected plasma and serum cytokine levels in asymptomatic subjects

Blood levels of cyto- and chemokines might reflect immune deregulations which might be related to lymphomagenesis. Potential utility of stored blood samples of a prospective cohort was evaluated by the effect of different blood sample types and freeze-thaw cycles on analyte levels. Bead-based immunoassays were performed on two fresh samples (serum, citrate and heparin plasma) of 10 asymptomatic adults collected 14 days apart and on aliquots of the first samples which were put through one to three freeze-thaw cycles to measure 11 cytokines, four chemokines and two adhesion molecules. Median coefficients of variation (CVs) of the measured analytes were 20%, 24% and 32% in serum, citrate and heparin plasma, respectively. Strong correlations (rank correlation coefficient 0.74–0.98) were observed between sample types, although small differences in analyte levels were observed for most analytes. Freeze-thaw cycles did not markedly change analyte levels. Our study supports the use of this assay among asymptomatic subjects in epidemiological studies.
Endotracheal tube cuff pressures in adult patients undergoing general anaesthesia in two Johannesburg academic hospitals

Background: Endotracheal tube (ETT) cuff pressure commonly exceeds the recommended range of 20–30 cm H₂O during anaesthesia. A set volume of air will not deliver the same cuff pressure in each patient and the pressure exerted by the ETT cuff can lead to complications, with either over- or under-inflated cuffs. These can include a sore throat and cough, aspiration, volume loss during positive pressure ventilation, nerve palsies, tracheomalacia and tracheal stenosis. No objective means of ETT cuff pressure monitoring is available in the operating theatres of Charlotte Maxeke Johannesburg Academic Hospital (CMJAH) and Chris Hani Baragwanath Academic Hospital (CHBAH). The ETT cuff pressure of patients undergoing general anaesthesia is therefore unknown. Method: ETT cuff pressure of 96 adult patients undergoing general anaesthesia without nitrous oxide at CMJAH and CHBAH was measured by one researcher. A RUSCH Endotest™ manometer was used to measure ETT cuff pressure in size 7.0 – 8.5 mm ETTs. The cuff inflation technique that was used by the anaesthetist was also documented. Results: The mean ETT cuff pressure recorded was 47.5 cm H₂O (range 10–120 cm H₂O). ETT cuff pressures exceeded 30 cm H₂O in 64.58% of patients. Only 18.75% of patients had ETT cuff pressures within the recommended range of 20–30 cm H₂O. There was no statistically significant difference between the ETT cuff pressures measured at the two hospitals. Minimal occlusive volume was the most frequent technique used to inflate the ETT cuff (37.5%); this was followed by inflating the ETT cuff with a predetermined volume of air in 31.25% of cases and palpation of the pilot balloon (27.08%). There was no statistically significant difference between the ETT cuff pressure measured and the inflation technique used by the anaesthetist. Conclusion: ETT cuff pressures of the majority of patients undergoing general anaesthesia at two academic hospitals were higher than the recommended range. ETT cuff pressure should routinely be measured using a manometer.
Assessment of risk factors for in-hospital mortality after intensive care unit discharge

Context: Post-intensive care unit (ICU) mortality predictors are unknown. Objective: To assess post-ICU in-hospital mortality predictors. Materials and methods: Analysis of 296 patients discharged alive from a medical-surgical ICU during an 18-month period. Results: Post-ICU in-hospital mortality was 22.6%. Nonsurvivors had significantly higher Charlson comorbidity score and more often had a tracheostomy. C-reactive protein (CRP) “alert measurement”, ≥ 6 mg/dL, independently discriminated survivors from nonsurvivors. Discussion: A CRP “alert measurement” or the need for tracheostomy may be used to identify patients with high risk of dying after ICU discharge. Conclusions: Charlson comorbidity score, CRP and tracheostomy predicted post-ICU in-hospital mortality.
Endogenous granulocyte colony-stimulating factor: a biomarker in acute ischemic stroke

Granulocyte colony-stimulating factor (G-CSF) may protect ischemic brain injury either in animal or human. No studies have reported that endogenous G-CSF (enG-CSF) level is related to the severity of ischemic stroke. This study was designed to assess the severity of ischemic patients correlated with the alteration of enG-CSF on the 1st day after an ischemic event. Patient’s plasma enG-CSF and scoring of National Institute of Health Stroke Scale were measured on the 1st day after ischemic stroke. The acute ischemic stroke could significantly induce enG-GCF secretion as compared with healthy control group (16.77 vs. 22.86 μg/L, p = 0.001). Elevated enG-CSF concentration was positively correlated with the severity of stroke patients on day 1 after the event (p = 0.006; Spearman correlation coefficient = 0.268). The enG-CSF is a good biomarker for prediction of severity of acute ischemic stroke.