Miracle-dz/UniFAR-FTUs huggingface dataset:
Comportamiento clínico-epidemiológico del trasplante renal de donante vivo en el Instituto de Nefrología "Dr. Abelardo Buch López" en el período 1991-2008

Introduction: The renal transplantation is the therapeutical modality offering the better quality of life and survival for patients presenting with chronic renal disease and the better economic alternative to face this epidemics. Objective: To know the clinical-epidemiological behavior of renal transplantation in the case of live donor. Methods: A retrospective, cohort, descriptive and observational study was conducted in patients underwent transplants from live donors in the Institute of Nephrology from 1991 to 2008. Authors used the variables processed in a automated way with statistical technique of analysis of absolute and relative frequency distribution, as well as techniques of survival analysis by Kaplan-Meier method. For the graft and for the patient survival was estimated. One hundred two patients were studied. Results: The year with more carrying out of transplantation were 2000 and 2004. The predominant causes of chronic renal disease were the glomerulopathies (47.1 %) and the non-descripted ones (29.4 %) mainly between 20 and 49 years old. The early transplantation was performed in the 44.1 % of cases. There was predominance of transplantation between brothers (49 %) and from mothers to sons. The survival of graft and of patient at shortmediumand long-term is showed. Conclusions: The life donor transplantation is carried out mainly in young receptors arriving to renal failure due to glomerulonephritis or by unknown causes. Its survival is appropriate although there is a relatively high incidence of surgical complications and death of patient during the first year, perhaps related to the low number of transplantation by year.
The Effect on Total Mortality of Adding Inhaled Corticosteroids to Long-Acting Bronchodilators for COPD: A Real Practice Analysis in Italy

Abstract Purpose. Chronic therapy with long-acting bronchodilators (LB) is recommended to treat moderate-to-severe COPD. Although the benefits of adding inhaled corticosteroid (ICS) to LB are still unclear, patients who experience repeated exacerbations are suggested to add ICS to their LB treatment. The objective of this study is to analyze whether adding ICS to LB therapy reduces mortality. Methods. We identified a cohort of patients discharged from hospital with COPD diagnosis between 2006 and 2009. The first prescription for LB or ICS following discharge was defined as the index prescription. Only new users were included (no use of any study drug in the 6 months before treatment). A 4-day time window was used to classify patients into “LB alone” or “LB plus ICS” initiators. We used propensity score to balance the study groups. Sensitivity analyses were performed in patients with recent out-of-hospital exacerbations. Results. Among the 18615 adults enrolled, 12207 initiated “LB plus ICS” therapy and 6408 “LB alone. ” Crude mortality rates were 110 and 143 cases per 1000 person-years in the “LB plus ICS” and “LB alone” groups, respectively. The adjusted hazard ratio (HR) was 0.83 (95% CI: 0.72–0.97; p-value: 0.024). When analyzing patients with recent out-of-hospital exacerbations, the benefit of the combination therapy was more pronounced, HR = 0.63 (95% CI: 0.44–0.90; p-value: 0.012). Discussion. Our findings showed a beneficial effect on mortality of adding inhaled corticosteroids to long-acting bronchodilators. The advantage was much more pronounced in patients with frequent exacerbations.
Role of Fluid Dynamics and Inflammation in Intracranial Aneurysm Formation

The emergence of inflammation as a key mediator of aneurysmogenesis provides new opportunities to understand the processes underlying development of intracranial aneurysms (IA). Inflammation unifies the triptych influences of alterations in local flow, mechanical properties of the wall and biochemical mediators and opens new avenues for building robust predictive tools. This review discusses the impact of the inflammatory cascade during the formation of intracranial aneurysms, and its associated morphological, structural and mechanical changes especially in the setting of flow-induced endothelial dysfunction.
Adaptive Medium Access Control Protocol for Wireless Body Area Networks

Wireless Body Area Networks (WBANs) are widely used for applications such as modern health-care systems, where wireless sensors (nodes) monitor the parameter(s) of interest. Nodes are provided with limited battery power and battery power is dependent on radio activity. MAC protocols play a key role in controlling the radio activity. Therefore, we present Adaptive Medium Access Control (A-MAC) protocol for WBANs supported by linear programming models for the minimization of energy consumption and maximization of dataflow. Our proposed protocol is adaptive in terms of guard band assignment technique and sleep/wakeup mechanism. We focus on specific application to monitor human body with the help of nodes which continuously scan body for updated information. If the current value is within normal range, nodes do not try to access channel. However, if the current value rises or falls beyond the permissible range, nodes switch on their transceiver to access channel. Moreover, A-MAC uses TDMA approach to access channel and well-defined synchronization scheme to avoid collisions. Furthermore, we conduct a comprehensive analysis supported by MATLAB simulations to provide estimation of delay spread. Simulation results justify that the proposed protocol performs better in terms of network lifetime and throughput as compared to the counterpart protocols.
Effect of antidepressant medication use on emotional information processing in major depression.

OBJECTIVE Acute administration of antidepressant medication increases emotional information processing for positive information in both depressed and healthy persons. This effect is likely relevant to the therapeutic actions of these medications, but it has not been studied in patients with major depressive disorder taking antidepressants as typically prescribed in the community. METHOD The authors used eye tracking to examine the effects of antidepressant medication on selective attention for emotional stimuli in a sample of 47 patients with major depressive disorder (21 medicated and 26 unmedicated) and 47 matched comparison subjects without depression. Participants completed a passive-viewing eye-tracking task assessing selective attention for positive, dysphoric, threatening, and neutral stimuli in addition to providing medication information and self-report measures of depression and anxiety severity. RESULTS Depressed participants currently taking antidepressants and nondepressed comparison subjects demonstrated greater total gaze duration and more fixations for positive stimuli compared with unmedicated depressed participants. Depressed participants on medication also had fewer fixations for dysphoric stimuli compared with depressed participants not on medication. CONCLUSIONS Antidepressants, as prescribed in the community to patients with depression, appear to modify emotional information processing in the absence of differences in depression severity. These results are consistent with previous work and indicate a robust effect for antidepressants on positive information processing. They also provide further evidence for modification of information processing as a potential mechanism of action for antidepressant medication.
Enterovirus- und Parechovirus-Infektionen im Neugeborenenalter

Zusammenfassung Enteroviren (EV) und humane Parechoviren (HPeV) sind nahe Verwandte aus der Familie der Picornaviridae und verursachen meist asymptomatisch oder mild verlaufende Infektionen. In der Neugeborenenperiode können sie aber durchaus zu schweren Erkrankungen mit Sepsis-ähnlichem Bild, Meningitis, Myokarditis und Multiorganversagen führen. Eine spezifische Therapie oder Impfung ist bislang nicht möglich. Die schnelle Diagnostik mit molekulargenetischen Schnelltests ist wichtig, um unnötige antibiotische Therapien zu reduzieren und um frühzeitig Hygiene- und Isolationsmaßnahmen einzuleiten.
Calcific aortic valve disease: not simply a degenerative process: A review and agenda for research from the National Heart and Lung and Blood Institute Aortic Stenosis Working Group. Executive summary: Calcific aortic valve disease-2011 update.

Calcific aortic valve disease (CAVD) encompasses the range of disease from initial alterations in the cell biology of the leaflets to end-stage calcification resulting in left ventricular outflow obstruction. The first detectable macroscopic changes in the leaflets, seen as calcification, or focal leaflet thickening with normal valve function, is termed aortic valve sclerosis, but it is likely that the initiating events in the disease process occur much earlier. Disease progression is characterized by a process of thickening of the valve leaflets and the formation of calcium nodules – often including the formation of actual bone – and new blood vessels, which are concentrated near the aortic surface. End stage disease, e.g. calcific aortic stenosis, is characterized pathologically by large nodular calcific masses within the aortic cusps that protrude through the outflow surfaces into the sinuses of Valsalva, interfering with opening of the cusps. For decades, this disease was thought to be a passive process in which the valve degenerates with age in association with calcium accumulation. Moreover, although calcific aortic valve disease is more common with age, it is not an inevitable consequence of aging. Instead, CAVD appears to be an actively regulated disease process that cannot be characterized exclusively as “senile” or “degenerative. ” The NHLBI convened a group of scientists from different fields of study, including cardiac imaging, molecular biology, cardiovascular pathology, epidemiology, cell biology, endocrinology, bioengineering, and clinical outcomes, to review the scientific studies from the past decade in the field of CAVD. The purpose was to develop a consensus statement on the current state of translational research related to CAVD. Herein, we summarize recent scientific studies and define future directions for research to diagnose, treat and potentially prevent this complex disease process.
Novel Targets for Development of Drugs for Treating Schizophrenia: Focus on Glycine, D-Serine and Nitric Oxide

ABSTRACTFor many years the focus of neurochemical and pharmacological studies on schizophrenia was on dopamine, and that work yielded a great deal of information about the possible etiology of this debilitating disorder and contributed significantly to the development of antipsychotic drugs. However, it has become increasingly apparent that other neurotransmitters and neuromodulators must also play an important role, and in recent years there has been considerable interest in these other compounds and the systems related to them in the search for developing drugs that are more effective and have fewer side effects than the antipsychotics currently available. This review deals with three of those neurochemicals, namely glycine, D-serine and nitric oxide, and shows how an increased knowledge of them may be important in the future diagnosis and/or pharmacotherapy of schizophrenia.
Response by Lee and Ovbiagele to Letter Regarding Article, "Pioglitazone for Secondary Stroke Prevention: A Systematic Review and Meta-Analysis".

Response by Lee and Ovbiagele to Letter Regarding Article, “Pioglitazone for Secondary Stroke Prevention: A Systematic Review and Meta-Analysis” In Response: Liraglutide, semaglutide, and empagliflozin are antidiabetic drugs that have been proven in randomized controlled trials to have a beneficial effect at reducing the composite primary end point of major cardiovascular events (nonfatal myocardial infarction, nonfatal stroke, and cardiovascular death). The benefits of long-acting glucagon-like peptide 1 (GLP-1) receptor agonists, such as liraglutide and semaglutide, are perhaps related to the modified progression of atherosclerotic vascular disease, whereas benefits of sodium-glucose cotransporter 2 (SGLT-2) inhibitors, such as empagliflozin, may be more closely linked to hemodynamic changes. These differences in postulated mechanisms of action may explain, at least partly, why long-acting GLP-1 receptor agonists also showed decreases (significant and nonsignificant) in the rate of stroke and myocardial infarction, but SGLT-2 inhibitors did not show benefits in the reduction of stroke or myocardial infarction. Most diabetic patients need more than one antidiabetic drug for their blood glucose control to achieve the guideline-recommended goal of glycosylated hemoglobin ≤7%. Although there are no clear contraindications with regard to mechanism, and perhaps even potential benefits, to combining new categories of antidiabetic drugs (eg, GLP-1 receptor agonists, SGLT-2 antagonists, and dipeptidyl peptidase-4 inhibitors) for treatment of diabetes mellitus, cost concerns make some countries, such as Taiwan, not to allow national health insurance to reimburse for doing so. Our meta-analysis suggested that pioglitazone reduced recurrent stroke and major cardiovascular events in ischemic stroke and transient ischemic attack patients with glucose metabolism disorders. However, increased risks of heart failure and weight gain are major side effects of pioglitazone. On the contrary, empagliflozin substantially reduced hospitalization for heart failure (hazard ratio, 0.65; 95% confidence interval, 0.50–0.85), and empagliflozin, liraglutide, and semaglutide were associated with weight loss. To achieve the largest benefits of cardiovascular protection and avoid complications, such as heart failure or hypoglycemia, it may be time to reconsider strategies of antidiabetic therapy based on the evidence currently available. For diabetic patients without moderate or severe chronic kidney disease, it is reasonable to add on pioglitazone and a long-acting GLP-1 receptor agonist or empagliflozin after metformin. For diabetic patients with severe kidney disease, combination of pioglitazone and a long-acting GLP-1 receptor agonist may be a reasonable choice for the firstline therapy. Large randomized controlled trials are warranted to affirm or rebut the potential cardiovascular benefits of combining these antidiabetic drug classes.
Ocular adnexal lymphoma: diffusion-weighted mr imaging for differential diagnosis and therapeutic monitoring.

PURPOSE To describe the magnetic resonance (MR) imaging and diffusion-weighted (DW) imaging features of ocular adnexal lymphomas (OALs), to determine the diagnostic accuracy of apparent diffusion coefficient (ADC) for discriminating OALs from other orbital mass lesions, and to assess whether variations in ADC constitute a reliable biomarker of OAL response to therapy. MATERIALS AND METHODS Institutional ethical committee approval and informed consent were obtained. In this prospective study, 114 white subjects (65 females and 49 males) were enrolled. Thirty-eight patients with histopathologically proved OAL underwent serial MR and DW imaging examination of the orbits. ADCs of OALs were compared with those of normal orbital structures, obtained in 18 healthy volunteers, and other orbital mass lesions, prospectively acquired in 58 patients (20 primary non-OAL neoplasms, 15 vascular benign lesions, 12 inflammatory lesions, 11 metastases). Interval change in ADC of OALs before and after treatment was analyzed in 29 patients. Analysis of covariance and a paired t test were used for statistical analysis. RESULTS Baseline ADCs in OALs were lower than those in normal structures and other orbital diseases (P < .001). An ADC threshold of 775 x 10(-6) mm(2)/sec resulted in 96% sensitivity, 93% specificity, 88% positive predictive value, 98.2% negative predictive value, and 94.4% accuracy in OAL diagnosis. Following appropriate treatment, 10 (34%) of 29 patients showed OAL volumetric reduction, accompanied (n = 7) or preceded (n = 3) by an increase in ADC (P = .005). Conversely, a further reduction of ADC was observed in the seven patients who experienced disease progression (P < .05). CONCLUSION ADC permits accurate diagnosis of OALs. Interval change in ADC after therapy represents a helpful tool for predicting therapeutic response.
The application of transthoracic dynamic three-dimensional echocardiography by computer-controlled parallel slicing in patients with fixed subaortic obstruction

Abstract A 64-element phased-array echocardiographic transducer mounted on a sliding carriage was used transthoracically in 11 patients with subaortic obstruction caused by various different morphological substrates. The transducer is moved in a plane from the outflow tract to the apex of the heart in steps of 0.5 to 1.3 mm and records a tomographic slice of the heart at each step. Parallel images are recorded at a frame rate of 25–30 images per second and triggered to heart rate and respiration. A complete cardiac cycle is recorded at each level. The images are digitized and stored in the image-processing computer, which reconstructs the anatomic structures of the heart in a three-dimensional format by means of different gray-scales. Good quality echocardiographic pictures were obtained in 10 of the 11 patients and three-dimensional reconstructions were possible in those 10 patients. The technique is able to display the heart in real-time in any desired plane, and in up to five planes simultaneously, without the need to change the position of the transducer on the chest. Thus the best views with which to display the substrate of subaortic stenosis could be selected. The left ventricular outflow tract could also be displayed in a view similiar to the one obtained by the surgeon during operative procedures for resection of the subaortic stenosis through an incision in the aortic root. Image acquisition took three to five minutes, and three-dimensional reconstruction of various cardiac structures took 20–90 minutes. Display of the subaortic area in three-dimensional format may enhance our understanding of cardiac anatomy and identify the different morphological lesions in the left ventricular outflow tract which cause subaortic obstruction.
O4-4.6 Role of medical factors in the aetiology of upper aerodigestive tract cancers in Europe: the ARCAGE study

Background Cancer of the upper aerodigestive tract (UADT) (oral cavity, pharynx, larynx and oesophagus) is, globally, the fourth most common cancer and cause of cancer mortality. In addition to established risk factors such as tobacco and alcohol consumption, other risk factors were suggested, including human papillomavirus infection. Objective To investigate the role of medical history (skin warts / verrucae; Candida albicans / thrush; herpetic lesions / cold sores; heartburn; regurgitation) and medication (for heartburn; for regurgitation; aspirin) use in UADT cancer risk. Methods A case-control study conducted in 10 European countries. Results There were 1779 cases of UADT cancer (all SCC) and 1993 controls. Having had warts / verrucae and history of Candida / thrush infection protective for UADT cancers (OR 0.80, 95% CI (0.68 to 0.94) and 0.73 (0.60 to 0.89), respectively) but there was no association with herpetic lesions. Neither symptoms of gastro-oesophageal reflux (heartburn or regurgitation) nor medication for associated symptoms were associated with risk of UADT cancer. When considered by sub-site, regurgitation was associated with a non-significant increased risk for cancer of the oesophagus (1.47; 0.98 to 2.21). Regular aspirin use (at least once a week for a year) was not associated with risk of UADT cancer. When considered by sub-site, it had protective effect for cancer of oesophagus (0.51; 0.28 to 0.96) and non-significant protective effect for cancers of hypopharynx (0.53; 0.28 to 1.02) and larynx (0.74; 0.54 to 1.01). Conclusion There is conflicting evidence regarding association between medical history and medication use and UADT cancer risk.
Integration of Infarct Size, Tissue Perfusion, and Metabolism by Hybrid Cardiac Positron Emission Tomography/Computed Tomography: Evaluation in a Porcine Model of Myocardial Infarction

Background—Hybrid positron emission tomography/computed tomography (PET-CT) allows for combination of PET perfusion/metabolism imaging with infarct detection by CT delayed contrast enhancement. We used this technique to obtain biomorphological insights into the interrelation between tissue damage, inflammation, and microvascular obstruction early after myocardial infarction. Methods and Results—A porcine model of left anterior descending coronary artery occlusion/reperfusion was studied. Seven animals underwent PET-CT within 3 days of infarction, and a control group of 3 animals was scanned at >4 weeks. Perfusion and glucose uptake were assessed by [13N]-ammonia/[18F]-deoxyglucose (FDG), and 64-slice CT delayed contrast enhancement was measured. In the acute infarct model, CT revealed a no-reflow phenomenon suggesting microvascular obstruction in 80% of all infarct segments. PET showed increased FDG uptake in 68% of the CT-defined infarct segments. Ex vivo staining and histology showed active inflammation in the acute infarct area as an explanation for increased glucose uptake. In chronic infarction, CT showed no microvascular obstruction and agreed well with matched perfusion/metabolism defects on PET. Conclusions—Perfusion/metabolism PET and delayed enhancement CT can be combined within a single hybrid PET-CT session. Increased regional FDG uptake in the acute infarct area is frequently observed. In contrast to the chronic infarct setting, this indicates tissue inflammation that is commonly associated with microvascular obstruction as identified by no reflow on CT. The consequences of these pathophysiological findings for subsequent ventricular remodeling should be explored in further studies.
I. Receptors on visceral afferents

Visceral afferents are the information superhighway from the gut to the central nervous system. These sensory nerves express a wide range of membrane receptors that can modulate their sensitivity. In this themes article, we concentrate on those receptors that enhance the excitability of visceral afferent neurons. Some receptors are part of a modality-specific transduction pathway involved in sensory signaling. Others, which are activated by substances derived from multiple cellular sources during ischemia, injury, or inflammation, act in a synergistic fashion to cause acute or chronic sensitization of the afferent nerves to mechanical and chemical stimuli. Such hypersensitivity is the hallmark of conditions such as irritable bowel syndrome. Accordingly, these receptors represent a rational target for drug treatments aimed at attenuating both the inappropriate visceral sensation and the aberrant reflex activity that are the foundation for alterations in bowel function.
Seguimiento farmacoterapéutico en pacientes ingresados en el Servicio de Medicina Interna del Hospital Infanta Margarita

Summary Introduction: In pharmacotherapeutic follow-up a pharma- cist is responsible for drug-related patient needs (DRPN) by detec- ting, preventing and solving medication-related problems aiming at specific results to improve patient quality of life. Drug-related problems are pharmacotherapy failures leading to failed therapeu- tic goals or undesirable events. Material and methods: In this study, Dader's methodology for pharmacotherapeutic follow-up was used in patients admitted to the Internal Medicine Department of "Hospital Infanta Margari- ta", Cabra-Cordoba, Spain. Results: In all, 85 DRPNs (2.7 DRPNs per patient) were iden- tified, and 36 pharmaceutical procedures were performed, with physicians accepting 92% of said procedures. Forty-nine percent of drug-related problems were related to need, 40% to effective- ness, and 11% to safety. Conclusions: The presence of a pharmacist at the Internal Medicine Department allows the detection of DRPNs that are mostly related to need and effectiveness. Pharmaceutical proce- dures are widely accepted by medical teams.