Miracle-dz/UniFAR-FTUs huggingface dataset:
Neonatal outcome in pregnant patients with antiphospholipid syndrome

Abstract Aims: The study aim was to evaluate pregnancy outcomes in patients with antiphospholipid syndrome (APS) and to determine which clinical parameters present risk factors for adverse pregnancy outcomes in these patients. Methods: The study included 55 patients with APS treated at the Clinic for Ob/Gyn, Clinical Center of Serbia, from 2006 to 2012. The control group consisted of 55 healthy pregnant women. Data regarding previous pregnancies and conception method were registered. Immunological and laboratory tests were performed. Pregnancy outcomes, including miscarriage, intrauterine fetal death, hypertensive disorders, diabetes mellitus, phlebothrombosis, fetal growth restriction, premature delivery, delivery method, perinatal asphyxia, respiratory distress syndrome, intraventricular hemorrhage, and necrotizing enterocolitis were followed. Results: The premature delivery rate in APS patients was 31.8%, and pregnancy loss was 18.2%. Significantly more patients with APS had thrombocytopenia, pregnancy losses, intrauterine growth restriction, and perinatal asphyxia compared with the control group. More miscarriages, preterm delivery, lower birth weight, preeclampsia, and IgM anticardiolipin antibody levels significantly correlated with adverse pregnancy outcomes. Although rare, respiratory distress syndrome can also worsen neonatal health status. According to ROC analysis, previous miscarriages correctly explained 66.3% of adverse pregnancy outcome cases. We generated four equations of adverse pregnancy outcome risk factors. Conclusions: The most important prognostic factor for pregnancy outcome in APS patients is the number of previous miscarriages. Using appropriate current therapeutic protocol can enable live birth of a healthy newborn in most cases.
In vitro and in vivo evaluation of self-microemulsifying drug delivery system of buparvaquone

Aim: The aim of this study was to prepare a lipid-based self-microemulsifying drug delivery system (SMEDDS) to increase the solubility and oral bioavailability of a poorly water-soluble compound, buparvaquone (BPQ). Methods: The solubility of BPQ was determined in various vehicles, and pseudo-ternary phase diagrams were constructed to determine the microemulsion region. A series of formulations with different compositions were selected in the microemulsion region for assessment of self-emulsification time and droplet size. The optimized SMEDDS formulation was used for in vitro dissolution and pharmacokinetic studies in rabbits. Results: The optimum formulation of SMEDDS consisted of Capryol 90 (9.82%), Cremophor EL (70.72%), Labrasol (17.68%), and BPQ (1.78%). Emulsification time and the mean droplet size were found to be 1 minute and 18.0 ± 0.25 nm, respectively, for the optimum formulation. The cumulative percentage of drug released in 90 minutes was 100% in both SGF and SIF. The calculated absolute oral bioavailability for BPQ was found to be 40.10%. Conclusions: The optimum SMEDDS formulation was increased the rate and extent of absorption of BPQ. The formulation is suitable for oral administration of BPQ. It would be useful to conduct efficacy studies of BPQ in diseased animal models and subsequently for toxicokinetics studies.
A “multi-hit” model of neonatal white matter injury: cumulative contributions of chronic placental inflammation, acute fetal inflammation and postnatal inflammatory events

Abstract Objective: We sought to determine whether cumulative evidence of perinatal inflammation was associated with increased risk in a “multi-hit” model of neonatal white matter injury (WMI). Methods: This retrospective cohort study included very preterm (gestational ages at delivery <32 weeks) live-born singleton neonates delivered at Hutzel Women’s Hospital, Detroit, MI, from 2006 to 2011. Four pathologists blinded to clinical diagnoses and outcomes performed histological examinations according to standardized protocols. Neurosonography was obtained per routine clinical care. The primary indicator of WMI was ventriculomegaly (VE). Neonatal inflammation-initiating illnesses included bacteremia, surgical necrotizing enterocolitis, other infections, and those requiring mechanical ventilation. Results: A total of 425 live-born singleton neonates delivered before the 32nd week of gestation were included. Newborns delivered of pregnancies affected by chronic chorioamnionitis who had histologic evidence of an acute fetal inflammatory response were at increased risk of VE, unlike those without funisitis, relative to referent newborns without either condition, adjusting for gestational age [odds ratio (OR) 4.7; 95% confidence interval (CI) 1.4–15.8 vs. OR 1.3; 95% CI 0.7–2.6]. Similarly, newborns with funisitis who developed neonatal inflammation-initiating illness were at increased risk of VE, unlike those who did not develop such illness, compared to the referent group without either condition [OR 3.6 (95% CI 1.5–8.3) vs. OR 1.7 (95% CI 0.5–5.5)]. The greater the number of these three types of inflammation documented, the higher the risk of VE (P<0.0001). Conclusion: Chronic placental inflammation, acute fetal inflammation, and neonatal inflammation-initiating illness seem to interact in contributing risk information and/or directly damaging the developing brain of newborns delivered very preterm.
In vitro evaluation of idebenone-loaded solid lipid nanoparticles for drug delivery to the brain

Context: Solid lipid nanoparticles (SLN) are regarded as interesting drug delivery systems and their preparation techniques have gained a great deal of attention. Objective: To evaluate the feasibility of preparing idebenone (IDE) loaded SLN from O/W microemulsions by the phase-inversion temperature (PIT) method. Since SLN have been proposed to improve drug delivery to the brain, IDE was chosen as model drug due to its activity in the treatment of neurodegenerative diseases. Materials and Methods: Cetyl palmitate was used as solid lipid to prepare SLN containing two surfactant/cosurfactant mixtures, isoceteth-20/glyceryl oleate (SLN A) and ceteth-20/glyceryl oleate (SLN B) by the PIT method. Results and discussion: All the formulations tested showed a mean particle diameter ranging from 30 to 95 nm and a single peak in size distribution. Stability tests showed that SLN B were more stable than SLN A. IDE release was dependent both on the type of primary surfactant used and the amount of loaded drug. IDE-loaded SLN were effective in inhibiting 2,2′-azobis-(2-amidinopropane)dihydrochloride (APPH)-induced lactic dehydrogenase (LDH) release and reactive oxygen species (ROS) production in primary cultures of astrocytes obtained from rat cerebral cortex. It is noteworthy that SLN B2 (containing ceteth-20 as primary surfactant and 0.7% w/w IDE) were able to prevent entirely both the LDH release and ROS production induced by APPH. Conclusion: The PIT method provided SLN with good technological properties. The tested SLN could be regarded as interesting carriers to overcome the blood brain barrier and increase the efficacy of the loaded drug.
Wild Edible Plant Consumption and Age-Related Cataracts in a Rural Lebanese Elderly Population: A Case control Study

The Mediterranean diet is characterized by considerable diversity and high consumption of wild leafy greens which are excellent sources of antioxidants, including lutein and zeaxanthin. The latter are the only carotenoids present in the human lens and observational and intervention studies suggest they may be protective against age-related cataracts. To better understand the role of dietary diversity in general (and lutein and zeaxanthin in particular) in preventing age-related cataracts and the determinants of wild leafy greens’ consumption, dietary and socioeconomic data were collected from one hundred cases and controls randomly selected from Hermel, a poor and fairly traditional Lebanese rural area. Results showed that dietary diversity and antioxidants (including but not limited to lutein and zeaxanthin) are inversely related to age-related cataracts and that wild leafy greens seem to substantially contribute to protection against age-related cataracts by optimizing nutrient and antioxidant intake especially in those of low socio-economic status.
Attenuation of Rodent Lung Ischemia Reperfusion Injury by Sphingosine 1 Phosphate

Objective. Lung ischemia–reperfusion (IR) injury, a sequela of transplantation characterized by alveolar damage, edema and inflammation in donor lungs, remains a significant cause of transplant failure despite improvements in lung preservation techniques. We investigated the effects of sphingosine 1-phosphate (S1P), a potent vascular barrier-protective agent, in a rat model of IR injury. Material and methods. S1P (26.5 mg/kg, i.v.) or vehicle was administered 15 min prior to ischemia via pulmonary artery ligation (1 h) and subsequent reperfusion (2 h). Lung vascular permeability and inflammation were assessed. Results. Animals pretreated with S1P exhibited reduced bronchoalveolar lavage (BAL) inflammatory cells (32% decrease; p<0.05), BAL neutrophils (63% decrease; p<0.04), and BAL albumin content (57% decrease; p<0.04) compared to controls. Lung myeloperoxidase activity, an index of parenchymal leukocyte infiltration, was also attenuated in S1P-treated animals (63% decrease; p<0.05). Finally, consistent .
Medico‐legal aspects of prescribing

The most frequent subject of malpractice litigation in the United States concerns suicide or failure to exercise proper restraint of a patient. In applying the law of negligence to suicide, it has to be shown that the doctor had owed the deceased patient a duty of care, i.e. that the doctor‐patient relationship had existed. Furthermore, it has to be shown that the doctor's standard of practice did not conform to an appropriate known standard. The questions which need to be addressed are: was suicide predictable? ; was reasonable care provided with necessary precautions implemented? ; and was treatment reliably and dependably implemented?
High-Dose Dexamethasone Accentuates Nuclear Factor- κ B Activation in Endotoxin-Treated Mice

We examined the effects of dexamethasone treatment on nuclear factor (NF)- κ B activation and lung inflammation in transgenic reporter mice expressing photinus luciferase under the control of an NF- κ B–dependent promoter (HLL mice). In vitro studies with bone marrow and peritoneal macrophages derived from these mice showed that treatment with dexamethasone blocked luciferase induction after treatment with Escherichia coli lipopolysaccharide (LPS); however, treatment of mice with intraperitoneal injection of dexamethasone at doses of 0.3 μ g/g and 1 μ g/g failed to inhibit NF- κ B–dependent luciferase activity in the lungs. Furthermore, intraperitoneal treatment with 10 μ g/g of dexamethasone prior to LPS paradoxically resulted in augmented luciferase activity as compared with that of mice treated with LPS alone. NF- κ B–dependent luciferase expression in the lungs was detected by bioluminescence imaging and by measurement of luciferase activity in homogenized lung tissue. In these studies, there was an e.
Molecular analysis of genetic variation in angiotensin I-converting enzyme identifies no association with sporting ability: First report from Indian population

INTRODUCTION: A polymorphism in the angiotensin-converting enzyme (ACE) gene was the first performance enhancing polymorphisms (PEPs) to be identified and correlated with athletic abilities. This polymorphism (rs. 5186) is the absence (deletion; D allele), rather than the presence (insertion, I allele) of 287bp Alu repeat element in intron 16. However, the association of ACE I/D polymorphism in sports abilities have been contradicted and debated. No study has evaluated the ACE gene polymorphism in Indian athletes so far. Hence, the genotype distribution and allelic frequency of ACE gene in selected Indian athletic and non-athletic population was studied. MATERIALS AND METHODS: A total of 147 athletes and 131 controls were genotyped for the ACE gene polymorphism using PCR. RESULTS: No significant association was observed between the allelic frequencies of ACE gene in controls and athletes on a whole, as well as after sub-categorizing the athletes based on the type of sport they played (P > 0.1). However, a higher representation of I allele was observed in the athletes. CONCLUSION: ACE genotyping studies need to focus on truly elite athletes of a single sporting discipline, to be able to find an association. The ACE I/D polymorphism may not be considered a marker for human performance, but can be further studied in combination with other potent performance enhancing polymorphisms.
Cockayne syndrome–xeroderma pigmentosum complex with demyelination: A rare association

Xeroderma pigmentosum–Cockayne syndrome (XP–CS) includes facial freckling and early skin cancers typical of XP and some features typical of CS, such as mental retardation, spasticity, short stature, and hypogonadism. XP–CS does not include skeletal involvement, the facial phenotype of CS, or CNS demyelination and calcifications. We present a rare patient whose genome probably harbored a specific combination of mutations producing a rare double syndrome of XP–CS, with facial phenotype of CS, and CNS demyelination.
Sexual Assault Nurse Examiner (SANE) Programs

In recent years, new programs have emerged in hospital emergency departments to care for sexual assault victims. These programs, collectively known as Sexual Assault Nurse Examiner (SANE) programs, improve the treatment of sexual assault victims through explicit attention to the medical, emotional, and legal needs of sexual assault survivors. Although SANE programs have proliferated over the past several years and now number nearly 100 nationwide, details about how these alternative services were developed have been missing in the literature. In this article, two recently established SANE programs are studied in depth to reveal how rape crisis centers in different communities created these services. Factor associated with the successful implementation of these SANE programs included (a) strong organizational history, (b) use of sexual assault councils and task forces, (c) affiliation with larger organizations, (d) positive relationships with hospitals, (e) engaging in training and collaboration with community systems, and (f) strategies for resolving differences. Implications for the health care of sexual assault victims are discussed.
Composition specification of teicoplanin based on its estimated relative bioavailability

Abstract Context: Teicoplanin is a fermentative antibiotic consisting of several active components that contribute similarly to the antibacterial activity, but exhibit different pharmacokinetic properties. Differences in systemic exposure between batches of teicoplanin are possible within pharmacopeial specifications as the proportion of subcomponents may vary from batch to batch. Objective: The aim of this paper is to study the possible modification of the present pharmacopeial specification for teicoplanin composition to ensure an a priori pharmacokinetic equivalence between all pharmacopoeial-compliant batches. Methods: The expectable whole Area Under the Curve (AUC) of plasma levels of teicoplanin was predicted for different experimental batches and also for the theoretical extreme batches within pharmacopeial specifications. Calculations were done based on the AUC of each teicoplanin active subcomponent. Subsequently, the equivalence between a generic teicoplanin and a reference drug product was investigated by means of the ratio of AUCs. Results: Batches under study, complying with current pharmacopoeial specifications, showed a maximum predicted difference in AUC slightly larger than 40%. The observed variability in teicoplanin compositions surpasses the conventional ±5% specification used for drugs obtained by chemical synthesis, but no 5% differences have been observed for any of the AUC means of the reference product when compared with the whole pooled data. Discussion and conclusion: Alternative specifications of actives composition can be defined to ensure that all batches complying with the pharmacopoeia are inside ±10% interval between them.
Infection Control in the Sonography Department

Knowledge of how to prevent healthcare-associated infections within the sonography department is an important step in providing quality care. Employing scientifically based preventative measures will ensure that the tools we use do not become vectors for the spread of pathogens that cause infections. These avoidable infections have not only an added financial cost to patients and the already burdened healthcare system but also physical and emotional costs to the patients we treat. Specific infection control guidelines for the sonography department are lacking, and the guidelines that are available are often based on proven infection control practiced in similar situations. Within this article are the applicable infection guidelines sonographers can use to provide safe quality care.
3D Printing technologies for drug delivery: a review

Abstract With the FDA approval of the first 3D printed tablet, Spritam®, there is now precedence set for the utilization of 3D printing for the preparation of drug delivery systems. The capabilities for dispensing low volumes with accuracy, precise spatial control and layer-by-layer assembly allow for the preparation of complex compositions and geometries. The high degree of flexibility and control with 3D printing enables the preparation of dosage forms with multiple active pharmaceutical ingredients with complex and tailored release profiles. A unique opportunity for this technology for the preparation of personalized doses to address individual patient needs. This review will highlight the 3D printing technologies being utilized for the fabrication of drug delivery systems, as well as the formulation and processing parameters for consideration. This article will also summarize the range of dosage forms that have been prepared using these technologies, specifically over the last 10 years.
Mini Series : Brachial Plexus Brachial plexus injury in adults : Diagnosis and surgical treatment strategies

Adult post traumatic Brachial plexus injury is unfortunately a rather common injury in young adults. In India the most common scenario is of a young man injured in a motorcycle accident. Exact incidence figures are not available but of the injuries presenting to us about 90% invole the above combination This article reviews peer-reviewed publications including clinical papers, review articles and Meta analysis of the subject. In addition, the authors’ experience of several hundred cases over the last 15 years has been added and has influenced the ultimate text. Results have been discussed and analysed to get an idea of factors influencing final recovery. It appears that time from injury and number of roots involved are most crucial.
Gender influence on selection and outcome of deep brain stimulation for Parkinson's disease

Background: Gender differences exist in Parkinson's disease (PD), both in clinical manifestations and response to medical treatment. We investigated whether gender differences occur in the clinical characteristics of patients selected for bilateral subthalamic nucleus deep brain stimulation (STN DBS) or in the outcome when resource limits influence treatment choices made by patients. Materials and Methods: Fifty-one consecutive patients were evaluated 1 month before, and 12 months after bilateral STN DBS. All patients were rated using Unified Parkinson's Disease Rating Scale, Parkinson's Disease Quality of Life (PDQL) Scale, Addenbrooke's Cognitive Examination and Beck Depression Inventory. Results: Pre-operative characteristics did not differ between the genders except for lower doses of drugs (P = 0.03), worse emotional scores in PDQL (P = 0.01) and worse depression (P = 0.03) in women. There was no gender difference in the surgical outcome, except a lesser reduction of dopaminergic drugs in women. Depression and quality of life (QOL) improved equally well in women and men. Conclusion: Bilateral STN DBS is equally efficacious in both genders as a treatment for motor complications of PD and for improving QOL. Women are likely to be undertreated because of more severe dyskinesia and may experience less emotional well-being, and could therefore potentially benefit from earlier surgical treatment.
National Epilepsy Surgery Support Activity

While there are over one million people with drug-resistant epilepsy in India, today, there are only a handful of centers equipped to undertake presurgical evaluation and epilepsy surgery. The only solution to overcome this large surgical treatment gap is to establish comprehensive epilepsy care centers across the country that are capable of evaluating and selecting the patients for epilepsy surgery with the locally available technology and in a cost-effective manner. The National Epilepsy Surgery Support Activity (NESSA) aims to provide proper guidance and support in establishing epilepsy surgery programs across India and in neighboring resource-poor countries, and in sustaining them.
The Effect of Acute Vibration Training on Delayed Onset Muscle Soreness in Young Non-Athlete Women

in the VT group, while no vibration was applied for the non-VT group. Then, both groups ran downhill on a -5° treadmill at a speed of 5-7.5 km/hour (increasing speed). Twenty-four-hours before and after the vibration training, serum creatine kinase levels, pressure pain threshold and the rate of edema were measured. Results: Compared with the non VT group, the VT group showed a significant decrease in pressure pain threshold at 15 cm of patellar point (P = 0.042) and calf muscle (P = 0.041), there were no significant differences between groups in the pressure pain threshold at 5 cm (P = 0.509) and 10 cm (P = 0.152) points. There was no significant change in the edema rate at the Gastrocnemius muscle (P = 0.420) and midpoint of quadriceps muscle (P = 0.380) in VT and non-VT groups. Despite the increase in creatine kinase enzymes in the two groups, there was no statistically significant difference between the groups (P = 0.173). Conclusions: The results showed that using the vibration training can affect delayed onset muscle soreness (DOMS) reduction between non-VT and VT groups. Further studies with larger samples are needed to determine the vibration training positive and negative effects.
Actividad antinflamatoria de extractos y fracciones obtenidas de cálices de Physalis peruviana L.

Introduction. Cape gooseberry calyces (Physalis peruviana) have been used in folk medicine for their medicinal properties including anticancer, antimycobacterial, antipyretic, diuretic, immunomodulatory and antiinflammatory properties. Objective. The antiinflammatory effect was evaluated for extracts and fractions obtained from Physalis peruviana calyces in a mice model of acute inflammation. The fractions responsible for antiinflammatory activity were extracted for possible identification. Materials and Methods. The Physalis peruviana calyces were extracted by percolation with organic solvents. The primary hydroalcoholic fraction was purified by column chromatography. The antiinflammatory effect of extracts and fractions was evaluated using the 12-Otetradecanoylphorbol-13-acetate-induced mouse model of ear edema. Results. Thirty-eight secondary fractions were obtained by column chromatography of primary hydroalcoholic fraction. Six fractions, evaluated in 12-O-tetradecanoylphorbol-13-acetateinduced inflammation assay, showed significant antiinflammatory activity (p<0.05). The major fraction, Pp-D28-LF, showed a significant dose-dependent response at doses over 250 μg/ear. Conclusion. The antiinflammatory activity attributed to Physalis peruviana calyces was confirmed and validated its use in folk medicine. Fractions responsible for the antiinflammatory action were identified and seem promising for phytomedicinal development. Further studies are needed to isolate and identify the active constituents of these fractions as well as to ascertain the mechanisms involved in the antiinflammatory effect.