Miracle-dz/UniFAR-FTUs huggingface dataset:
Association between Left Ventricular Global Longitudinal Strain and Functional Capacity Measured with Six-Minutes Walk Test in Patients after Acute Myocardial Infarction.

Background: The ischemia resulting from critical coronary narrowing or total occlusion first affects the subendocardialmyofibers. Thus, abnormalities in longitudinal function can be detected before reductions in LVEF and reflects infarct size. The 6MWT provides information that may be a better index of the patients ability to perform daily activities. This study was to assess the relationship between left ventricular (LV) global longitudinal strain (GLS) and functional capacity measured with 6 minute walk test (6MWT) after AMI.Subjects and Method: This is a cross sectional study of patients with STEMI and NSTEMI, at Moewardi Hospital, Surakarta. Eligible patients underwent echocardiography global longitudinal 2D-STE that performed within 48 hour of admission and 6MWT pre- discharge or at the first follow-up visits (day 4-9). Patients were divided into 2 groups according to the LV GLS value, patients with substantial infarction (LV GLS > -13.8%) and non-substantial infarction (LV GLS -13.8% (n=32) were more likely to be older (57.6 y.ovs 55 y.o), less in functional capacity (10.17 1.3 ml/kg/min vs 11.04 0.98 ml/kg/min; p= 0.018) and less in 6 MWT distance (347.97 65.49 m vs392.39 49.44 m; p=0.016). Using ROC curves, the 6 MWT distance cutoff value of 375 m identified patients with LV GLS >-13.8%, sensitivity of 72.2% and specificity 65.6%, respectively with AUC= 0.70 (CI 95%; 0.559-0.852; p= 0.017). However, LV GLS >-13.8% and age >60 y.o remained the independent predictor in a multivariate logistic regression analysis to identify 6 MWT distance -13.8%, (OR =7.967; CI 95%= 1.669-38.030; p=0.009) and age >60 y.o, (OR=10.898; CI95%= 2.201-53.971; p=0.003). Conclusions: In patients after AMI with substantial infarction (LV GLS >-13.8%) had less in functional capacity. The 6 MWT distance cutoff value of 375 m identified patients with LV GLS >-13.8% and could be used in rehabilitation program after AMI.Keywords: Acute Myocardial Infarction, LV Global longitudinal strain, functional capacity, 6 MWT.Correspondence:Trisulo Wasyanto. Department of Cardiology and Vascular Medicine, Faculty of Medicine, Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami No. 36 A, 57126, Surakarta, Central Java.Indonesian Journal of Medicine (2017), 2(3): 192-206https://doi.org/10.26911/theijmed.2017. 02.03. 07
Pathogenic Microorganisms Associated with Fresh Produce.

The presence of numerous genera of spoilage bacteria, yeasts and molds, and an occasional pathogen on fresh produce has been recognized for many years. Several outbreaks of human gastroenteritis have been linked to the consumption of contaminated fresh vegetables and, to a lesser extent, fruits. Salads containing raw vegetables have been identified as vehicles of traveler's diarrhea, an illness sometimes experienced by visitors to developing countries. Enterotoxigenic Escherichia coli is the most common cause of this illness. Enterohemorrhagic E. coli , specifically serotype O157:H7, has been implicated as the causative agent in an outbreak of gastroenteritis resulting from the consumption of cantaloupes. Outbreaks of salmonellosis in humans have been attributed to consumption of contaminated tomatoes, mustard cress, bean sprouts, cantaloupe, and watermelon. An onion-associated outbreak of Shigella flexneri gastroenteritis has recently been reported in the United States. Outbreaks of human listeriosis have been epidemiologically linked to the consumption of fresh cabbage and lettuce. Gastrointestinal illness caused by the consumption of raw vegetable seed sprouts contaminated by Bacillus cereus has been documented. The ability of Aeromonas hydrophila and Aeromonas sobria to produce several virulence factors has been documented and their fairly common occurrence in water raises concern over public health risks that may be associated with the consumption of salad vegetables, although their role as agents in foodborne illness has not been fully confirmed. Viruses are not likely to grow on contaminated vegetables and fruits but can survive long enough to cause life-threatening illness in humans. An increased per capita consumption of fresh and lightly processed produce in the United States and other countries, coupled with an increase in importation of produce to these countries from regions where standards for growing and handling produce may be compromised, has resulted in heightened interest in outbreaks of human gastroenteritis that may be attributed to contaminated fresh produce, particularly salad vegetables. Likewise methods of handling, processing, packaging, and distribution of fresh produce on a regional or local scale within countries are receiving attention in terms of identifying and controlling microbiological hazards. Hazard analysis critical control point (HACCP) programs are being developed in an effort to minimize the risk of illness associated with consumption of fresh produce. Examples of pathogenic microorganisms associated with fresh produce as well as procedures that can be used to reduce their incidence at the point of consumption are discussed.
Enlargement of Spontaneous Intracerebral Hemorrhage

Background and Purpose Standard radiographic criteria for hematoma enlargement have not been established. We undertook this investigation to assess the incidence and time course of hematoma growth using objective cutoff values. Methods We reviewed the clinical records of 204 patients with spontaneous intracerebral hemorrhage treated nonsurgically who underwent initial computed tomography (CT) within 48 hours and repeat CT within 120 hours of the onset of symptoms. The consensus of five observers reading the CT films was considered the “gold standard” for hematoma enlargement. The discriminant values of the difference (V2−V1) or the ratio (V2/V1) of the hematoma volume on the initial (V1) and second (V2) CT scans were determined by use of receiver operating characteristic curves. We chose the cutpoint that had the highest sensitivity and specificity for identifying hematoma expansion. Results The cutpoint for hematoma enlargement was determined as V2−V1=12.5 cm3 or V2/V1=1.4 (sensitivity=94.4%, specificity.
Topical Phenytoin in Painful Diabetic Neuropathy: Rationale to Select a Non-selective Sodium Channel Blocker

A short case of a patient suffering from painful diabetic neuropathy is presented to illustrate why it makes sense to prescribe a non-selective sodium channel blocker as a (co-)analgesic in a compounded topical formulation. To date, we have documented more than 100 patients treated with a compounded cream containing phenytoin. The case described here was one of the first in our data collection and was treated with 5% phenytoin cream, resulting in a 50% reduction of neuropathic pain. We selected phenytoin for compounding in a topical vehicle due to its profile as a broad acting archetypical sodium channel blocker and based on its remarkable properties as a repositioned multi-purpose drug. Its broad mechanism of action through blocking many subtypes of sodium channels in the skin not only inhibits overactivity of nociceptors but also may inhibit cross-talk between keratinocytes, immune-competent cell, and the nociceptor. After application, plasma levels of phenytoin were below the threshold of detection, and to date, no systemic adverse events related to its non-selective profile have been seen. Phenytoin is, therefore, uniquely suited for compounding in a topical formulation to treat peripheral neuropathic pain.
Regulation of apoptosis by the Epstein-Barr virus latent membrane protein LMP1

The Epstein-Barr virus (EBV) is a ubiquitous human herpesvirus that is implicated in the aetiology of African Burkitt’s lymphoma (BL) and several other cancers of lymphoid/epithelial origin. In vitro, expression of all of the eleven EBV latent proteins or just the oncogenic Latent Membrane Protein 1 (LMP1) can protect BL cells from apoptosis by several stimuli including growth factor deprivation and this is related to the ability to upregulate the expression of several anti-apoptotic 6c/-2-related genes. In this study, it is shown that EBV latent gene expression and in particular LMP1 can induce the upregulation of expression of the anti-apoptotic gene bfl-1 in addition to bcl-2 in BL cells and also that Bfl- 1 expression can not onlt protect BL cells from serum-deprivation-induced apoptosis but also exert a proliferative effect under these culture conditions Bfl-1 has been shown by others to suppress apoptosis and exhibits proliferative and potent cooperative transforming properties. Both increased mRNA stability and increased promoter activity were found to contribute to the effect of LMP1 on bfl-1 expression. The transcription factor NF-kB was shown to mediate the effect of LMP1 on bfl-1 promoter activity in both BL and T cells however, celltype- dependent differences in the regions of the promoter targeted by LMP1 were observed CD40, which engages similar signaling proteins (TRAFs) as LMP1, also stimulates bfl-1 mRNA expression, however, mechanistic similarities and differences were found between the two TNFR family members in this effect LMP1 could also be demonstrated to contribute to activation of the bfl-1 promoter in EBV-immortahsed B lymphoblastoid cell lines (LCLs), however, NF-kB activation may not be the only mechanism regulating bfl-1 promoter activity in different LCLs. A minor but significant finding in this study is that both transcriptional and translational mechanisms are involved in the LMPl-mediated upregulation of bcl-2 expression, with the latter exerting a stronger effect. The upregulation of bfl-1 expression by LMP1 represents the first example of regulation of expression of this anti-apoptotic gene by a viral protein and extends the list of anti-apoptotic proteins whose expression is controlled by LMP1. Protection against apoptosis constitutes an important part of the latent phase of the EBV life cycle, in that it provides a mechanism to ensure life-long viral persistence in the host by mimicking the natural process of selection of B cells into the memory compartment. The regulation of expression of bcl-2-related genes by LMP1 provides an important link between EBV and its cellular survival and growth transforming properties.
CURRENT APPROACHES IN OBSESSIVE COMPULSIVE DISORDER TREATMENT

Psychiatric illness is a condition in which a person thinks for a variety of reasons, and behaves in a sad manner. Obsessive-compulsive disorder (OCD) is an anxiety disorder in which time people have recurring, unwanted thoughts, ideas or sensations (obsessions) that make them feel driven to do something repetitively (compulsions). The repetitive behaviors, such as hand washing, checking on things or cleaning, can significantly interfere with a person’s daily activities and social interactions. Such signs and symptoms are determined in the diagnosis of the disease. Many studies with clinical value have been performed for a long time so that the treatment of obsessive compulsive disorder can be successfully performed. If depression is severe, antidepressants are successful in reducing disease symptoms. The majority of physicians prefer psychotherapy and drug combinations to effectively treat obsessive-compulsive disorder, which affects millions of people around the world. It is also used in surgical procedures in the treatment of this disease. There are many independent studies completed independently in the literature. In this review, the diagnostic and treatment methods for the patients who have undergone these studies performed by academicians and specialists in a combined and arranged manner, especially those with obsessive compulsive disorder, are explained in detail.
Der diurnale Rhythmus der Haut: Mythos oder Realität?

Zusammenfassung Hintergrund Bisher weisen nur wenige Studien auf tageszeitabhängige Rhythmen des transepidermalen Wasserverlustes (TEWL), der Talgproduktion und des pH-Wertes hin. Detailliertere Beschreibungen des Hautbarriere-Rhythmus’ könnten für die Wahl des richtigen Zeitpunktes der dermalen Applikation von pharmazeutischen und kosmetischen Wirkstoffen von großer Bedeutung sein. Es ist denkbar, dass eine Optimierung der Wirkung oder Verträglichkeit dermatologischer Behandlungen erreicht werden kann. Somit ist es Ziel dieser Studie, den diurnalen Rhythmus der Hautbarriereparameter Hautrötung, transepidermaler Wasserverlust (TEWL), Stratum corneum-Hydratation, mechanische Eigenschaften, pH-Wert und Sebum zu erfassen. Methoden Insgesamt 24 hautgesunde Probandinnen (21 – 39 Jahre) wurden innerhalb von 12 Stunden in einem 4-Stunden-Rhythmus an den Wangen und an der Stirn anhand biophysikalischer Messverfahren untersucht. Ergebnisse Die Tageszeit wirkt sich auf die Barrierefunktion der Haut aus. Der mittlere Erythem-Wert ist nachmittags signifikant höher als morgens. Anhand der Datenanalyse ist zu erkennen, dass der TEWL-Mittelwert sich abends statistisch sehr signifikant gegenüber dem Mittelwert morgens unterscheidet. Schlussfolgerung Die Erkenntnisse über die tageszeitliche Veränderung der Barrierefunktion können Aufschluss über ideale Zeitfenster verschiedener Kosmetikbehandlungen geben. Somit bietet z. B. ein erhöhter TEWL am Abend aufgrund der Permeabilität eine bessere Absorption von Wirkstoffen mit höherem Molekulargewicht.
The relationship between positron emission tomography-computed tomography imaging and histopathological features of thyroid incidentalomas detected during follow-up for primary malignancy

Aim of the Study: While the rate of thyroid incidentaloma detected on positron emission tomography (PET) was reported as 4%, the malignancy rate was 14%–50%. We evaluated the thyroid nodules which were detected by PET-computerized tomography (CT) in cancer patients and analyzed the pathological results of those thyroid nodules diagnosed by fine needle aspiration biopsy (FNAB) and their correlation with the maximum standardized uptake (SUVmax) value and PET imaging features. Materials and Methods: FNAB were performed for 40 thyroid incidentalomas. We analyzed the relationship between the histopathological findings and radiological features by Pearson's correlations and Chi-square-Fisher's exact tests to evaluate the factors associated with SUVmax. Results: The median SUVmax values were 5.4 for thyroid nodules. Totally, 14 malignancies were detected by FNAB (35%). The sensitivity and specificity of SUVmax value for diagnosis of malignancy were 87.5% and 52%, respectively. Positive and negative predictive values were 36.8% and 92.8%. The most common malignant and benign pathologies were classic variant papillary carcinoma and benign colloidal nodule. The median SUVmax was the higher in colon cancer thyroid metastasis and oncocytic neoplasia (SUVmax 14.5 and 13.6, respectively). Histopathological type was not related with nodule size but positively associated with categorical SUVmax(r = 0.318, P = 0.04) and negatively correlated with both the density of the thyroid nodule in PET-CT (r = −0.0042, P = 0.01) and density of nodule in ultrasound (USG) (r = −0.305, P = 0.05). Margin of the thyroid nodule in USG (P = 0.007) and internal component of the nodule in PET (P = 0.03) were found to be important factors to differentiate benign or malignant lesion. Conclusion: If the thyroid nodule is detected with flouro-2-deoxy-D-glucose uptake, to differentiate benign nodule from malignant, cytological examination is noteworthy to diagnose the more aggressive type of thyroid nodule and also thyroid metastasis from primary cancer.
The switch from patented medicine to the generic one: an option or a necessity?

This paper assesses the influence of a number of factors taken into account when a brand name drug is replaced by a generic one. It also evaluates responses of health professionals – physicians and pharmacist—and patients regarding the issue of switching. We compared and contrasted their responses in order to identify new points of cooperation for the intended benefit of the patient. Thus, the sample drew from all three groups, consisting of 50 doctors, 50 pharmacists, and 50 patients. We collected information regarding the age, residence, income level, and education level for the patients, and age and experience for the specialists. Based on responses to the survey, replacing the original medication with a generic one raises many issues, such as lack of information for the patient and specialist, lack of collaboration between physician and pharmacist, ineffective communication between specialist and patient, and the influence of the overall profit motive.
DPPH Free-radical Scavenging and Cytotoxic Activities of Leeamacrophylla

Structural damage inflicted to a wide variety of bioorganic compounds (DNA, protein, carbohydrates, and lipid) may occur as a consequence of oxidative damage which is naturally attributed to our daily lifestyle. A number of mechanisms are exploited to neutralize the reactive oxygen species. Medicinal plant can play a pivotal role of detoxifying the generated ROS. Leeamacrophylla (Leeaceae), a wild medicinal plant, has been taken into consideration of having antioxidant and cytotoxic properties. In this study, in vitro DPPH free radical scavenging activity, total phenolic content and total flavonoid content of methanol extract from the leaves of L. macrophylla were determined with using UV spectrophotometric method. Antioxidant activity of the crude extract was expressed as percentage of DPPH free radical inhibition and IC50 value (μg/ml). The IC50 value of L. macrophylla was found to be 152. 40μg/ml. Compared to standard ascorbic acid (4.36 μg/ml), L. macrophylla leaf extract has moderate antioxidant property. The total phenolic content was 65.75 mg/g of dry weight of extract, expressed as gallic acid equivalents. The total flavonoid concentration was 59.8 mg/g, expressed as quercetin equivalents. In the brine shrimp lethality test, LC50value of crude methanolic extract obtained from the best-fit line slope was 3. 06μg/ml which was significant comparing with control (vincristine sulphate). Above results suggested that the L. macrophylla can be regarded as a promising candidate for natural plant sources of antioxidants with high value.
positive distrust in simplicity--lessons from plant defences and from competition among plants and among animals

1. The address is concerned with the degree of complexity needed in a satisfying ecological theory. 2. Using the incidence of spines, it is argued that previous hypotheses intended to explain the development of anti-herbivore defences are inadequate, and a new «scarcity-accessibility» hypothesis is proposed instead. The variables that need to be considered are productivity, accessibility and proportion of the landscape covered, architecture, seasonal behaviour relative to neighbours, nutrient concentration relative to neighbours and kinds of herbivore present. The new hypothesis accounts for completely opposite kinds of plants being armed, for example, particularly slow-growing and particularly fast-growing plants, or the deciduous species in one system and the evergreen in another
Concordancia entre escalas para predicción de riesgo cardiovascular en una cohorte de pacientes. Fundación Cardio Infantil, 2015

Introduccion : La identificacion de personas sin enfermedad cardiovascular establecida con alto riesgo, es un objetivo en prevencion cardiovascular. Se han aplicado multiples escalas de riesgo cardiovascular, las mas ampliamente difundidas han sido ATP III (Framingham), SCORE y AHA/ACC 2013. Materiales y Metodos: Estudio observacional de concordancia de cohorte transversal en pacientes de 40 a 75 anos que asistieron durante el ano 2015 al programa de Chequeo Ejecutivo en la FCI, se evaluaron a 4783 pacientes, tamano de muestra aleatorizada de 861, a quienes se realizo el calculo de riesgo cardiovascular con las escalas de ATP III (Framingham), SCORE y AHA/ACC 2013. Resultados: De esta poblacion el 65.7 % eran hombres, edad promedio de 49.7 anos, encontrando alto riesgo AHA 2013 de 14,6%, Framingham 2.2% y SCORE 1.1%. Riesgo medio encontro SCORE de 26,9%, AHA 2013 de 17,1% y Framingham de 14.4%. Para riesgo bajo fue Framingham de 83,3%, SCORE de 73% y AHA 2013 68,3 %. Al realizar la concordancia para alto riesgo cardiovascular entre Framingham modificada y SCORE evidencio una concordancia moderada (Kappa : 0.47 ) y al calcular este indice entre Framingham modificada y AHA 2013 la concordancia fue debil ( Kappa : 0.3497). Conclusion :La estimacion de riesgo entre las escalas de ATP III (Framingham), SCORE y AHA 2013 no fue concordante. En esta poblacion, sus estimaciones no son intercambiables.
The epidemiology and characteristics of sepsis in Norwegian hospitals

Background: Severe sepsis is recognized as an inflammatory response causing organ dysfunction in patients with infection. Antimicrobial therapy is the mainstay of treatment. There is an ongoing demand for local surveillance of sepsis aetiology and monitoring of empirical treatment recommendations. The present study was established to describe the characteristics, quality of handling and outcome of patients with severe sepsis admitted to a Norwegian university hospital. Methods: A one year prospective, observational study of adult community acquired case-defined severe sepsis was undertaken. Demographics, focus of infection, microbiological findings, timing and adequacy of empirical antimicrobial agents were recorded. Clinical diagnostic practice was evaluated. Differences between categorical groups were analysed with Pearson’s chi-squared test. Predictors of in-hospital mortality were identified in a multivariate stepwise backward logistic regression model. Results: In total 220 patients were identified, yielding an estimated annual incidence of 0.5/1000 inhabitants. The focus of infection was established at admission in 69%. Respiratory tract infection was present in 52%, while genitourinary, soft tissue and abdominal infections each were found in 12-14%. Microbiological aetiology was identified in 61%; most prevalent were Streptococcus pneumoniae, Escherichia coli and Staphylococcus aureus. Independent predictors of in-hospital mortality were malignancy, cardiovascular disease, endocarditis, abdominal infections, undefined microbiological aetiology, delay in administration of empirical antimicrobial agents ≥ 6 hours and use of inadequate antimicrobial agents. In patients ≥ 75 years, antimicrobial therapy was less in compliance with current recommendations and more delayed. Conclusions: Community acquired severe sepsis is common. Initial clinical aetiology is often revised. Compliance with recommendations for empirical antimicrobial treatment is lowest in elderly patients. Our results emphasizes that quick identification of correct source of infection, proper sampling for microbiological analyses, and fast administration of adequate antimicrobial agents are crucial points in the management of severe sepsis.