Miracle-dz/UniFAR-FTUs huggingface dataset:
Validity of Montreal Cognitive Assessment in non-english speaking patients with Parkinson's disease.

BACKGROUND The Montreal Cognitive Assessment is a brief and easy screening tool for accurately testing cognitive dysfunction in Parkinson's disease. We tested its validity for use in non-English (Malayalam) speaking patients with Parkinson's disease. MATERIALS AND METHODS We developed a Malayalam (a south-Indian language) version of Montreal Cognitive Assessment and applied to 70 patients with Parkinson's disease and 60 age- and education-matched healthy controls. Metric properties were assessed, and the scores were compared with the performance in validated Malayalam versions of Mini Mental Status Examination and Addenbrooke's Cognitive Examination. RESULTS The Montreal Cognitive Assessment-Malayalam showed good internal consistency and test-retest reliability and its scores correlated with Mini Mental Status Examination (patients: R = 0.70; P < 0.001; healthy controls: R = 0.26; P = 0.04) and Addenbrooke's Cognitive Examination (patients: R = 0.8; P < 0.001; healthy controls: R = 0.52; P < 0.001) scores. CONCLUSION This study establishes the reliability of cross-cultural adaptation of Montreal Cognitive Assessment for assessing cognition in Malayalam-speaking Parkinson's disease patients for early screening and potential future interventions for cognitive dysfunction.
Surgical considerations for 'intrinsic' brainstem gliomas: proposal of a modification in classification.

BACKGROUND Brainstem gliomas are highly heterogeneous tumors both in their clinical manifestation and in their pathology. Despite significant advances in the surgery for brainstem gliomas many aspects of this pathology are still unclear. OBJECTIVE To evaluate the clinical, radiological and surgical outcome of 40 focal 'intrinsic' brainstem gliomas and propose a surgical strategy-oriented classification. MATERIALS AND METHODS A total of 40 focal 'intrinsic' ("expanding variety") tumors have been operated over a period of 8.5-years (January 1998-June 2007). Our criteria included patients with (1) well-defined gadolinium enhancing tumor; (2) relatively long duration of symptoms (> six months) and (3) good neurological functional status and independent for all activities of daily living. The cutoff size of 2 cm was not rigidly adhered to. RESULTS The 'intrinsic' brainstem tumors were classified into three types: Expanding, diffuse infiltrative and pure ventral varieties. Only patients with expanding variety of brainstem gliomas were subjected to surgery, mean age 19.2 years (range 4-55 years) and male to female ration mean: 3:2). The tumor location included pons (n=19), midbrain (n=13) and medulla (n=8). Surgical approaches included midline suboccipital (n=28), retromastoid (n=7), subtemporal (n=3) and supracerebellar-infratentorial (n=2). Thirty-two cases with 'diffuse infiltrative' and 'pure ventral' variety were given radiotherapy only. Histology pathology revealed pilocytic variety (n=10), Grade II (n=17) and Grade III (n=13). There was one death in the surgical series (due to aspiration). Complications included meningitis (n=2), wound infection (n=1), chest infection (n=5) and transient mutism (n=1). Follow-up ranged from 3-68 months. Overall, 36 improved /remained same and three worsened in their clinical status at the time of discharge. CONCLUSION The surgical management of intrinsic brainstem tumors presents a surgical challenge; radical excision yielded a good outcome in the majority of cases. The authors propose a classification system for 'intrinsic' brainstem tumors for defining surgical strategy.
Laboratory assessment of iron status in pregnancy

Abstract Background: Efforts to improve maternal nutrition during pregnancy prompted an observational study of the occurrence of maternal iron deficiency and its laboratory diagnosis in almost 500 pregnancies. Methods: In this longitudinal study, the biochemical and haematological iron indices of women (n=492) attending a prenatal clinic in a Dublin maternity hospital were assessed at first booking (mean 15.9 weeks), and after 24 weeks, and 36 weeks of gestation. Full blood counts were measured. Serum ferritin (SF), zinc protoporphyrin (ZPP), and transferrin receptor (sTfR) concentrations were assayed and transferrin receptor index (sTfR-Index) was calculated. The occurrence of low values and their diagnostic values were considered. Results: A high occurrence iron deficiency (ID) at first booking (SF<12 μg/L) had increased over six-fold by 24 weeks, and all biochemical iron indices reflected progressive iron depletion right up to term. The WHO recommended anaemia “cut-off” (Hb<110 g/L) was insensitive to biochemical iron deficiency at booking, missing over 90% of the low SF values (SF<12 μg/L) which were mostly associated with much higher Hb levels. Conclusions: This study stresses the importance of including a biochemical index of iron status in prenatal screening and supports SF as the best indicator of biochemical ID overall. sTfR was insensitive to iron deficiency in early pregnancy, whereas the sTfR-Index, as a ratio, has the potential to distinguish between ID and physiological anaemia, and may offer stability in the assessment of iron stores from early pregnancy to full term. A policy of early screening of both Hb and SF concentrations is recommended as the minimum requirement for surveillance of maternal iron status in pregnancy.
Endovascular treatment of ruptured distal anterior cerebral artery aneurysm.

BACKGROUND Distal anterior cerebral artery (DACA) aneurysms are less common, accounting for 3.1 to 9.2% of all intracranial aneurysms.The clinical characteristics and surgical techniques are quite different from those of other aneurysms of Willis circle. OBJECTIVE We aimed to investigate the clinical and radiographic characteristics of ruptured distal anterior cerebral artery (DACA) aneurysms and the efficacy of endovascular treatment for these lesions. PATIENTS AND METHODS From 1998 to 2008, 41 patients with 44 DACA aneurysms were treated by endovascular coiling, including parent vessel occlusion using coils or coils combined with n-butyle-2-cyanoacrylate (NBCA) in two, endosaccular coiling alone in 39, and stent-assisted coiling in three. RESULTS Technical success was achieved in 40 (97.6%) patients. Among the 41 aneurysms successfully treated with endosaccular coiling or stent-assisted coiling, complete occlusion was obtained in 37, neck remnant in two, and partial occlusion in two. Two patients with poor pretreatment conditions died of cerebral vasospasm. The morbidity was 4.87%. One case each of unruptured recurrence and rebleeding were seen in follow-up DSA of 34 patients and MRA in five cases. CONCLUSION Our preliminary results show that endovascular treatment for DACA aneurysms is safe and effective. However, the relative high recurrent rate highlights long-term follow-up for its security.
Vaspin plasma concentrations and mRNA expressions in patients with stable and unstable angina pectoris

Abstract Background: Vaspin was a recently identified adipokine, playing a protective role in many metabolic diseases. The present study aimed to investigate the association between vaspin plasma level and stable angina pectoris (SAP) and unstable angina pectoris (UAP). Methods: A total of 88 patients with angiographically-proved coronary artery disease (CAD) (SAP 47, UAP 41) and 103 control subjects without cardiovascular diseases were enrolled in this study. Circulating vaspin, mRNA expression of vaspin in peripheral blood mononuclear cells (PBMC), clinical parameters, lipid profile and high-sensitivity C-reactive protein (hsCRP) were assayed. The severity of CAD was also assessed according to the number of vessels diseased. Results: There are significant differences in circulating vaspin levels and mRNA levels of PBMC between SAP and UAP groups (SAP 0.91±0.95 ng/mL and UAP 0.43±0.38 ng/mL, p<0.01 in circulating vaspin level; SAP 1.19±0.85 and UAP 0.82±0.56, p<0.05 in mRNA level of PBMC). An inverse correlation between the number of diseased vessels and plasma vaspin concentration was observed (r=–0.350, p<0.01) in the CAD group. Construction of receiver operating characteristic curves confirmed that vaspin plasma concentrations significantly differentiated CAD patients (area under the curve=0.684, p<0.001), as well as UAP (area under the curve=0.640, p<0.05). Conclusion: Decreased vaspin plasma levels and mRNA levels in PBMC were observed in patients with UAP. Low vaspin concentrations correlate with CAD severity. The findings suggested that vaspin could serve as a novel biomarker of CAD as well as UAP.
Surgical treatment for large spontaneous basal ganglia hemorrhage: retrospective analysis of 253 cases

Abstract Objectives. Spontaneous intracerebral hemorrhage (ICH) is a challenge to both neurologists and neurosurgeons. We aim to summarize the surgical treatment of ICH based on retrospective analysis of our patients. Methods. Two hundred and fifty-three patients with spontaneous ICH from August 2008 to August 2011 were retrospectively analyzed. Clinical data, including preoperative ICH score, pre- and postoperative GCS score, hematoma volume, postoperative brain infarction, 30-day mortality, and GOS 3 months postictus, were collected. One hundred and fifty patients had their intracranial pressure (ICP) monitored, and data were recorded and analyzed. All patients underwent craniotomy and clot removal under general anesthesia. Outcome analysis was stratified using hematoma volume, ICH score, preoperative GCS score, and decompressive craniectomy (DC). Results. The mean hematoma volume was 70.8 mL, and 68 patients (26.9%) underwent DC. The mean postoperative ICP was 28.8 ± 6.7 mmHg for patients without DC, and only 17.5 ± 8.6 mmHg for patients with DC. Twenty-five patients (9.9%) died within 30 days of operation, and 88 patients (34.8%, GOS ≥ 4) had good outcome 3 months after surgery. ICH volume > 50 mL, preoperative GCS score ≤ 8, and ICH score ≥ 3 are risk factors for unfavorable outcomes. Conclusions. DC can be used for patients with low preoperative GCS score, and it effectively reduces ICP and 30-day mortality. Hematoma volume, preoperative GCS score, and ICH score are of predictive value for surgical outcome of large basal ganglia hemorrhage.
THE CLINICAL AND ENDOCRINOLOGICAL EFFECT OF OESTRADIOL IMPLANTS AT THE TIME OF HYSTERECTOMY AND BILATERAL SALPINGO‐OOPHORECTOMY

The plasma oestrogen level was maintained within the premenopausal physiological range for 16 months following the insertion of an implant of 100 mg. of oestradiol B.P.C. during the operation of hysterectomy and bilateral salpingo‐oophorectomy. The karyopyknotic index (KI) was elevated for the same duration, and levels of luteinizing hormone (LH) and follicle stimulating hormone (FSH) were depressed. None of the 42 patients who had an oestrogen implant developed hot flushes whereas 11 out of 14 without an implant did so and were severely distressed thereby.
Review of Sjögren’s Syndrome for Primary Physicians

Sjogren`s syndrome is a chronic systemic autoimmune disease characterized by lymphocytic infiltration of the exocrine glands resulting in a dry mouth and eyes. The disease can present either alone or in association with other autoimmune diseases such as rheumatoid arthritis, systemic lupus erythematosus, systemic sclerosis, and inflammatory myopathy. In addition to symptoms caused by exocrinopathy, about half of patients present with extraglandular (systemic) manifestations including arthritis, Raynaud`s phenomenon, lymphadenopathy, vasculitis, peripheral neuropathy, and interstitial nephritis. Patients often suffer from severe fatigue, myalgia, and dryness, which lead to a poor quality of life. Physicians should be aware of the increased risk of lymphoma development in patients with Sjogren`s syndrome. Currently, there are no drugs available that are able to improve the natural course of disease, making symptom relief the primary goal of therapy. Currently, pilocarpine is the only drug clinically proven for the treatment of dry eyes and mouth in patients with Sjogren`s syndrome. (Korean J Med 2015;89:291-294)
Radial artery grafts for symptomatic cavernous carotid aneurysms in elderly patients.

BACKGROUND Radial artery grafts (RAG) have been used in the treatment of complex vascular lesions, but not for symptomatic cavernous carotid aneurysms in elderly patients. AIM To investigate the safety, usefulness, and perioperative complications of RAGs for symptomatic cavernous carotid aneurysms in elderly patients. MATERIAL AND METHODS Of the 74 consecutive patients, in whom RAGs were used, we retrospectively investigated the postoperative outcomes and complications in eight elderly patients aged over 70 years with symptomatic internal carotid artery aneurysms in cavernous sinus. RESULTS Postoperative complications included one case of cerebral infarction, one case of symptomatic seizures, and one case of delayed cranial nerve palsy. OUTCOME Seven patients had an mRS score of 0, and one patient had a score of 2. Postoperatively there was improvement in cranial nerve palsy in seven patients and the patients who had symptoms for one year and eight months had residual deficits. Although it cannot be stated that the frequency of perioperative complications was low, the final outcomes were favorable. CONCLUSION Even in carotid disease that is difficult to treat among the elderly, RAG would appear to be a useful and safe treatment.
Rising trends of HCV infection over a period of 4 years among blood donors in central India: A retrospective study

Objective: The aim of the study was to find out the sero-prevalence of Hepatitis C infection among blood donors. Materials and Methods: All collected blood bags were screened for anti-hepatitis C virus antibodies (HCV Ab; MicroELISA 3rd generation, J. Mitra) during the study period of 4 years and data were analyzed. Results: A total of 28621 blood donors were screened for transfusion transmissible infections (TTIs) in which 80 donors were positive for Hepatitis C infection, constituted 11% of total sero-reactive donors. In 2009, only 10 cases were sero-reactive while in 2012, 36 cases were sero-reactive for Hepatitis C infection. Conclusions: Hepatitis C infection among blood donors are in rising trends in this study area. Voluntary donors are safer than replacement donors as they have very low sero-prevalence. As these blood donors represent the highly selective community of a general population in most of the countries. So the actual sero-prevalence of hepatitis C infection may be more in the general population. Promoting HCV screening, voluntary blood donation, diagnosis and treatment among blood donors are very important measures to control the transmission of HCV infection, decrease sero-reactive cases and ensure safe blood collection.
Reply to Rychlik et al.

We would like to thank Rychlik et al. [1] for their interest regarding our comparative study about postoperative ipsilateral shoulder pain treatment and prevention [2]. The idea of injecting the periphrenic fat pad prior to resection and handling of the hilium seems to be very interesting to us, and probably will lead to a better control of postthoracotomy ipsilateral shoulder pain as has been well documented with the use preemptive analgesia through peridural catheter in thoracic (and others) surgeries [3, 4]. In contrast, even though we agree with Rychlik et al. [1] that levobupivacaine is a theoretically better agent for phrenic nerve block (longer half-time live and more powerful effect) than lidocaine, we would like to reflect our concerns about its clinical use because of its potential cardiotoxicity in case of systemic absorption that is something that could occur with its use in a wellvascularized area as the periphrenic fat pad. Regarding this matter, we believe that ropivacaine would be a better option than lidocaine or levobupivacaine because it’s a long-lasting, powerful anaesthetic with less cardiac toxicity [5], and it has proved safety in a clinical setting for phrenic nerve block [6]; unfortunately, we have no experience with this anaesthetic. Finally, we concur that further research is necessary to refine the technique of phrenic nerve infiltration for ipsilateral shoulder pain, but we strongly believe that actually there is enough evidence to recommend the widespread of the technique all over the thoracic surgery units.
Extra-Intestinal Manifestation of Helicobacter pylori Infection: Allergic Diseases Including Asthma, Atopy and Idiopathic Urticaria

Correspondence to Cheol Min Shin, M.D. Department of Internal Medicine, Seoul National University Bundang Hospital, 82 Gumi-ro, Bundang-gu, Seongnam 463-707, Korea Tel: +82-31-787-7009, Fax: +82-31-787-4052, E-mail: scm6md@gmail.com Copyrightc 2013 The Korean Association of Internal Medicine This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited. 알레르기 질환: 천식, 아토피, 특발성 두드러기
B vitamin therapy for homocysteine: renal function and vitamin B12 determine cardiovascular outcomes

Abstract Therapy to lower homocysteine with B vitamins does reduce the risk of stroke, if not myocardial infarction. The apparent lack of efficacy of vitamin therapy in most of the large clinical trials was probably determined by the failure to take account of the metabolic deficiency of vitamin B12, which is very common and often missed, and by the failure to take account of impaired renal function. Metabolic B12 deficiency is present in 20% of people over 65 years of age, and in 30% of vascular patients above 70 years, so higher doses of B12 are needed in elderly patients. However, high-dose cyanocobalamin leads to accumulation of cyanide in patients with renal failure. B vitamin therapy is beneficial in patients with good renal function, but harmful in patients with significantly impaired renal function (a glomerular filtration rate <50). It seems likely that in patients with renal impairment, methylcobalamin should be used instead cyanocobalamin.
The Goals and Pitfalls of Gastric Submucosal Dissection: A Special Focus on Dissection of Lesions with Severe Fibrosis

The Korean Journal of Helicobacter and Upper Gastrointestinal Research is an Open-Access Journal. All articles are distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. REVIEW ISSN 1738-3331, http://dx.doi. org/10.7704/kjhugr.2014. 14.3. 163 The Korean Journal of Helicobacter and Upper Gastrointestinal Research, 2014;14(3):163-173
Individualized vs. global assessments of quality of life after head injury and their susceptibility to response shift

Primary objective: The aim was to compare individualized and global assessments of quality of life (QoL) after traumatic brain injury (TBI) and to investigate perceived changes in QoL. Methods and procedures: The Schedule for the Evaluation of Individual Quality of Life (SEIQoL-DW) and Hadorn's overall 1–10 QoL Scale were administered to 28 participants 1–10 years post-injury together with the GOS-E, HADS and SF-36. Perceived change in quality of life after TBI was investigated by comparing current and retrospective judgements. Main outcome and results: Correlations between the QoL measures confirm validity of the SEIQoL-DW; however, correlations were generally stronger for the simpler 1–10 Scale. Paradoxically, there was little overall change in the mean QoL when current and retrospective judgements were compared; with some participants reporting worse quality of life before injury. A positive change in perceived QoL was associated with better overall functioning. Conclusions: Where an overall rating of QoL is required it seems that Hadorn's 1–10 Scale is a simpler and more direct measure than the SEIQoL-DW. The greater detail provided by the SEIQoL-DW may mean it is of benefit when looking at individual differences. The results suggest that both the SEIQoL-DW and Hadorn's scale are susceptible to response shift (where a person changes the basis on which they evaluate QoL); and this has implications for the interpretation of QoL assessments.
The effects of Corylus Avellana on serum lipid profile and oxidative stress in hyperlipidemic-diabetic rats -

Abstract Background and Aim: There is limited evidence suggesting that nuts improve plasma antioxidant potential. The aim of this study is to investigate the effects of hazelnut consumption on serum lipids, atherogenic indexes and oxidant-antioxidant status in hyperlipidemic-diabetic rats. Methods: Wistar-albino rats of both sexes, weighing 200-250 g were used in this study. The group of animals used in this study, which consisted of 32 rats, were divided into 4 groups: control, control + hazelnut, hyperlipidemic-diabetic, hyperlipidemic-diabetic + hazelnut. Each group was fed with control or hyperlipidemic diets with the same amount of hazelnut (0.63%) added for 12 weeks. Diabetes has been induced by streptozotocin (STZ) injection in diabetic groups. Blood glucose, serum lipids, glutathione (GSH), lipid peroxidation (LPO) and atherogenic indexes (AI and AIP) have been evaluated after the experiment was over. Results: In hyperlipidemic-diabetic group atherogenic indexes, LPO and serum lipid levels were found to have increased significantly, whereas HDL-cholesterol (HDL-C) and GSH levels were found to have decreased significantly in comparison with the control group (p < 0.01). Hyperglycemia was also seen to have increased in this group. Impaired antioxidant-oxidant balance was noted to have improved, GSH increased while triglyceride (TG) decreased significantly (p < 0.01). Hazelnut consumption also increased blood GSH levels and atherogenic index levels in the control group. Conclusions: Consumption of hazelnut at this dose (0.63%) may improve oxidant-antioxidant balance in healthy and hyperlipidemic-diabetic status without increasing blood lipids. Keywords: Hazelnut, hyperlipidemia, diabetes, lipids, glutathione, lipid peroxidation.
Mild traumatic brain injury meta-analyses can obscure individual differences

Primary objective: Several published meta-analyses indicate that mild traumatic brain injury (MTBI) is associated with a favourable course of recovery over a period of days-to-weeks, with no indication of permanent impairment on neuropsychological testing by 3 months post-injury in group studies. These meta-analyses provide important but not definitive information relating to outcome from MTBI in individual patients. The purpose of this paper was to illustrate that a sub-group of patients with residual cognitive deficits could exist, yet be obscured using group inferential statistics. Main outcome and results: A sample of 30 concussed amateur athletes and a hypothetical sample of 30 adults who had sustained MTBIs were used to illustrate these statistical issues. In both groups, a minority of subjects with residual cognitive deficits were not identified using group statistics. Conclusions: It is important to appreciate that MTBI meta-analyses represent an aggregation of effect sizes derived from multiple groups across multiple studies. Therefore, this methodology could, theoretically, obscure small sub-group or individual effects. Implications for interpreting meta-analyses are discussed.