Miracle-dz/UniFAR-FTUs huggingface dataset:
Immunologic response modulation during pregnancy

Medico pasante. Faculta de Medicina. Benemerita Universidad Autonoma de Puebla. Mexico. Medico pasante del Servicio Social. Facultad de Medicina. Universidad Popular Autonoma del Estado de Puebla. Mexico. Medico Especialista. Hospital Universitario de Puebla. Benemerita Universidad Autonoma de Puebla. Mexico. Catedratico-Investigador. Ciencias de la Salud. Universidad Popular Autonoma del Estado de Puebla. Mexico.
Estilo de vida, desarrollo científico-técnico y obesidad Lifestyle, scientific and technical development and obesity

The objective of this paper is to analyze the lifestyle and scientific-technical development roles on obesity and their impact on health and society. Unhealthy lifestyles that may be changed by individual behaviour such as sedentary lifestyle and bad nutritional habits contribute to body overweight and leads to obesity, which is a risk factor for the occurrence of chronic diseases like diabetes mellitus, ischemic cardiopathy and cancer. The scientific and technical development has allowed the improvement of living conditions, the humanization of working conditions and has facilitated home chores. This event, together with poor health policies, has encouraged sedentary lifestyle. Obesity has been recognized as an important nutritional and health problem worldwide and its progressive increase has been described as an emerging problem in the last few years.
Comparação da situação nutricional de crianças de baixa renda no segundo ano de vida, antes e após a implantação de programa de atenção primária à saúde

O Projeto Favela, da Escola Paulista de Medicina, Universidade Federal de Sao Paulo, realiza diversas atividades de educacao e promocao das acoes basicas de saude em comunidades carentes do Municipio de Sao Paulo, visando principalmente a prevencao e controle de carencias nutricionais. O objetivo do estudo foi comparar a situacao nutricional de criancas com idades entre 12 e 26 meses, antes e apos a implantacao de um conjunto de acoes preventivas. Formaram-se dois grupos, pre e pos implantacao, com 57 e 65 criancas respectivamente, que foram submetidas a avaliacao antropometrica e dosagem de hemoglobina. O grupo exposto a todas as acoes nao apresentou nenhum caso de desnutricao (0%) para os indicadores P/I e P/E, comparado a 12,3% e 1,8%, respectivamente, no grupo pre implantacao. Houve reducao da prevalencia de anemia, sobretudo a de maior gravidade, que passou de 33% para 7%, com aumento do valor medio da hemoglobina (de 10,1 g/dl para 11,0 g/dl) alem de maior porcentual de criancas com aleitamento materno total acima de 180 dias no grupo pos-implantacao.
Effect of Lactobacillus paracasei subsp. paracasei, L. casei 431 on immune response to influenza vaccination and upper respiratory tract infections in healthy adult volunteers: a randomized, double-blind, placebo-controlled, parallel-group study.

BACKGROUND Probiotics can modulate the immune system in healthy individuals and may help reduce symptoms related to respiratory infections. OBJECTIVE The objective of the study was to investigate the effect of the probiotic strain Lactobacillus paracasei subsp. paracasei, L. casei 431 (Chr. Hansen A/S) (hereafter, L. casei 431) on immune response to influenza vaccination and respiratory symptoms in healthy adults. DESIGN A randomized double-blind, placebo-controlled trial was conducted in 1104 healthy subjects aged 18-60 y at 2 centers in Germany and Denmark. Subjects were randomly assigned to receive an acidified milk drink containing ≥10(9) colony-forming units of L. casei 431 (n = 553) or placebo (n = 551) for 42 d. After 21 d, subjects received the seasonal influenza vaccination. The primary outcome was seroprotection rate (anti-influenza antibody titers by hemagglutination inhibition) 21 d after vaccination. Other outcomes were seroconversion rate and mean titers, influenza A-specific antibodies and incidence, and duration and severity of upper respiratory symptoms. Antibiotic use and use of health care resources were recorded. RESULTS There was no effect of L. casei 431 on immune responses to influenza vaccination. Generalized linear mixed modeling showed a shorter duration of upper respiratory symptoms in the probiotic group than in the placebo group (mean ± SD: 6.4 ± 6.1 vs. 7.3 ± 9.7 d, P = 0.0059) in the last 3 wk of the intervention period. No statistically significant differences were found for incidence or severity. CONCLUSIONS Daily consumption of L. casei 431 resulted in no observable effect on the components of the immune response to influenza vaccination but reduced the duration of upper respiratory symptoms. The trial was registered at www.isrctn. com as ISRCTN08280229.
FASTING SERUM FREE FATTY ACIDS AND TRIGLYCERIDES ARE INCREASED BEFORE 20 WEEKS OF GESTATION IN WOMEN WHO LATER DEVELOP PREECLAMPSIA

Objective: The null hypothesis of this study was that there was no difference in fasting serum concentrations of free fatty acids (FFA) and triglycerides (TG) before 20 weeks of gestation in women who later develop preeclampsia, compared to women with uneventful pregnancies.Methods: Healthy primigravida, n = 510, provided fasting blood samples at 16-18 weeks of gestation. Nineteen of these later developed preeclampsia. Nineteen matched controls were selected from the remaining 491 individuals. Blood samples were also obtained from 16 patients with manifest preeclampsia and from 16 control women with uncomplicated pregnancies. Concentrations of FFA and TG, and the lipolytic activity in maternal serum were measured.Results: In patients with manifest preeclampsia, serum levels of FFA and TG, and lipolytic activity were significantly increased compared to women with normal pregnancies. The group of 19 women who later developed preeclampsia had higher serum FFA and TG concentrations at 16-18 weeks of gestation.
Estudo clínico da mensuração da gibosidade e suas correlações com medidas radiológicas na escoliose idiopática.

FERREIRA, D. M. A. (1999). Clinical study of the measurement of hump deformity and their correlation with radiologics measurements in the idiopathic scoliosis. Ribeirao Preto, 1999. 76p. Dissertacao (Mestrado) – Escola de Engenharia de Sao Carlos, Faculdade de Medicina de Ribeirao Preto e Instituto de Quimica de Sao Carlos, Universidade de Sao Paulo. A clinical study were performed in 52 patients with idiopathic scoliosis to the comparison of the measurements of hump deformity performed with a level plane adjusted with a ruler in three positions (forward bending with the upper limb free, forward bending with the hands together and in a position sitting) and by three examiners. This work also studied the correlation among these measurements with the radiologic assessment in erect and supine position through of the measurements of Cobb angle and of the vertebral rotation for the Nash & Moe and the Raimondi method, and the comparison the curve magnitude and of the vertebral rotation, measured in the radiographs in erect and supine position was performed as well. The results showed a high accuracy of the measurements of hump deformity among the three examiners; and as for the three positions, the position 1 showed a better concordance to measure hump deformity, and when compared with the position 2 and 3 it showed no significant difference. The correlation of the measurements of hump deformity with the Cobb angle and vertebral rotation was good and excellent only for the thoracic curve, at the 1 and 2 positions. Correlation of Cobb angle with vertebral rotation for the Raimondi method was better than for the Nash & Moe method at the thoracic and thoracolumbar curves. Significant diferences in the Cobb angle measurements at the standing and supine position were observed, but the
Goal Attainment and Treatment Compliance in a Cognitive-Behavioral Telephone Intervention for Family Caregivers of Persons with Dementia

Introduction: The evaluation of effective interventions is still needed to prevent family caregivers of persons with dementia from becoming physically or mentally ill. However, in most existing intervention studies, primary outcomes are not well matched to the treatment goals. Method: A randomized controlled trial (N = 229) was conducted to compare a treatment group (CBT), a treated control group, and an untreated control group. In theses analyses we focused on the primary outcome measurement (GAS) as a perceived treatment success as well as treatment compliance and participants’ evaluation. Results: Results showed that 30.1% achieved complete goal attainment, 39.8% partial goal attainment, and 24.1% declared no change (overachievement 2.4%; deterioration 3.6%). Discussion: The intervention can be considered to have been successful.
Effect of a tomato-rich diet on markers of cardiovascular disease risk in moderately overweight, disease-free, middle-aged adults: a randomized controlled trial.

BACKGROUND Cardiovascular disease (CVD) is a major cause of mortality in the United Kingdom. Epidemiologic studies suggest that consumption of tomato-based foods may lower CVD risk. Such potential benefits have been ascribed in part to high concentrations of lycopene in the tomatoes. However, these findings have not yet been validated by comprehensive intervention trials. OBJECTIVE The aim of this study was to conduct a single-blind, randomized controlled intervention trial with healthy middle-aged volunteers to assess whether the consumption of tomato-based foods affects recognized biomarkers of CVD risk. DESIGN After a 4-wk run-in period with a low-tomato diet, 225 volunteers (94 men and 131 women) aged 40-65 y were randomly assigned into 1 of 3 dietary intervention groups and asked to consume a control diet (low in tomato-based foods), a high-tomato-based diet, or a control diet supplemented with lycopene capsules (10 mg/d) for 12 wk. Blood samples were collected at baseline, at 6 wk, and after the intervention and were analyzed for carotenoid and lipid profiles and inflammatory markers. Blood pressure, weight, and arterial stiffness were also measured. Dietary intake was also determined during the intervention. RESULTS None of the systemic markers (inflammatory markers, markers of insulin resistance and sensitivity) changed significantly after the dietary intervention. Moreover, lipid concentrations and arterial stiffness were also unaffected by the interventions. CONCLUSION These data indicate that a relatively high daily consumption of tomato-based products (equivalent to 32-50 mg lycopene/d) or lycopene supplements (10 mg/d) is ineffective at reducing conventional CVD risk markers in moderately overweight, healthy, middle-aged individuals. This trial was registered at isrctn.org as ISRCTN34203810.
Efficacy and tolerability of budesonide/formoterol added to tiotropium in patients with chronic obstructive pulmonary disease.

RATIONALE Budesonide/formoterol and tiotropium are commonly used maintenance treatments for patients with chronic obstructive pulmonary disease. Combining these medications may provide additional benefits. OBJECTIVES To assess the efficacy and tolerability of budesonide/formoterol added to tiotropium in patients eligible for inhaled corticosteroid/long-acting beta(2)-agonist combination therapy. METHODS In this 12-week, randomized, double-blind, parallel-group, multicenter study, after a 2-week run-in, 660 subjects (75% male; mean age, 62 yr; FEV(1), 1.1 L; 38% predicted normal), 40 years of age or older, received tiotropium (18 microg once daily) plus either budesonide/formoterol (320/9 microg) (n = 329) or placebo (n = 331) twice daily. MEASUREMENTS AND MAIN RESULTS Clinic predose (primary outcome) and postdose FEV(1), predose and postdose forced vital capacity and inspiratory capacity, and health status were measured. Other outcomes included daily measurements taken at home (pre- and postdose morning FEV(1) and peak expiratory flow, morning symptoms and activities, and morning reliever use), severe exacerbations, and tolerability. Over the treatment period, budesonide/formoterol plus tiotropium significantly increased predose FEV(1) by 6% (65 ml) and postdose by 11% (123 and 131 ml at 5 and 60 min postdose, respectively) versus tiotropium alone (both P < 0.001). Other outcomes all significantly improved with budesonide/formoterol plus tiotropium versus tiotropium alone. The number of severe exacerbations decreased by 62% (rate ratio, 0.38; 95% confidence interval, 0.25-0.57; P < 0.001). Both treatments were well tolerated. CONCLUSIONS In patients with chronic obstructive pulmonary disease, budesonide/formoterol added to tiotropium versus tiotropium alone provides rapid and sustained improvements in lung function, health status, morning symptoms and activities, and reduces severe exacerbations. Clinical trial registered with www.clinicaltrials. gov (NCT00496470).
Adaptive Dynamics of Infectious Diseases: In Pursuit of Virulence Management. Eds. U. Dieckmann, J. A. J. Metz, M. W. Sabelis and K. Sigmund. Cambridge: Cambridge University Press, 2002. Pp. 532, £50.00. ISBN 0-521-78165-5.

Some of Professor Everitt’s previous books are among my most thumbed, so I was glad of the opportunity to review this one. In general, I have not been disappointed. The target user is the medical researcher who is not a statistician. Since I am the latter as well as the former, I will concentrate on themore advanced topics, but, on the whole, this book should prove a lucid and practical guide. The first chapter is a short run-through of the generalized linear model. Other gentle introductions to this topic are already available, but this one, as well as standing up in its own right, serves as a necessary grounding for the later chapters on longitudinal data, survival analysis, and generalized additive models. Of these three, the last may be the least familiar : it is a way of fitting curves which uses ‘the data themselves to suggest the appropriate functional form’. All these topics are described with admirable conciseness, and important practical issues are discussed without oversimplification. I was glad, for example, of the comparison of marginal and conditional models, differences which even professionals may find rather subtle. The author lists neural networks and data mining as two ‘very obvious’ omissions (p. ix), but I agree with him that these are not great losses. Of perhaps more regrettable omissions, I could only think of geostatistical methods. Regarding topics which were included, I remain sceptical of the utility of classification and regression trees. However, now that I understand themethod far better, I hope a suitable problemwill crossmypath so I can put it to the test. There are also chapters on missing data, Bayesian methods, exact inference, and mixture models. I found the structure of the book logical, apart from the long appendix on graphical methods, which I thought deserved a chapter by itself. It also contains an uncharacteristically obscure graph – a 3D scatter plot – which, like a similar one in the main text, induces an increasingly Zen-like state as one wills the floating circles to bond themselves to the axes. In the review copy, some of the later bubbleplots were almost invisibly faint. Nevertheless, I found some sections useful, for example the one on coplots, and, like the rest of the book, the appendix is to be commended on printing full datasets, even though some of these may already be familiar to some readers. The index is not fully comprehensive. In general, however, this book should provide an accessible and useful introduction to the topics presented for infectious disease epidemiologists.
Utility of Absolute and Relative Changes in Cardiac Troponin Concentrations in the Early Diagnosis of Acute Myocardial Infarction

Background— Current guidelines for the diagnosis of acute myocardial infarction (AMI), among other criteria, also require a rise and/or fall in cardiac troponin (cTn) levels. It is unknown whether absolute or relative changes in cTn have higher diagnostic accuracy and should therefore be preferred. Methods and Results— In a prospective, observational, multicenter study, we analyzed the diagnostic accuracy of absolute (&Dgr;) and relative (&Dgr;%) changes in cTn in 836 patients presenting to the emergency department with symptoms suggestive of AMI. Blood samples for the determination of high-sensitive cTn T and cTn I ultra were collected at presentation and after 1 and 2 hours in a blinded fashion. The final diagnosis was adjudicated by 2 independent cardiologists. The area under the receiver operating characteristic curve for diagnosing AMI was significantly higher for 2-hour absolute (&Dgr;) versus 2-hour relative (&Dgr;%) cTn changes (area under the receiver operating characteristic curve [95% confidence interval], high-sensitivity cTn T: 0.95 [0.92 to 0.98] versus 0.76 [0.70 to 0.83], P<0.001; cTn I ultra: 0.95 [0.91 to 0.99] versus 0.72 [0.66 to 0.79], P<0.001). The receiver operating characteristic curve–derived cutoff value for 2-hour absolute (&Dgr;) change was 0.007 &mgr;g/L for high-sensitivity cTn T and 0.020 &mgr;g/L for cTn I ultra (both cutoff levels are half of the 99th percentile of the respective cTn assay). Absolute changes were superior to relative changes in patients with both low and elevated baseline cTn levels. Conclusions— Absolute changes of cTn levels have a significantly higher diagnostic accuracy for AMI than relative changes, and seem therefore to be the preferred criteria to distinguish AMI from other causes of cTn elevations. Clinical Trial Registration— URL: http://www.clinicaltrials. gov. Unique identifier: NCT00470587.
Role of Bone Marrow–Derived Progenitor Cells in Cuff-Induced Vascular Injury in Mice

Objectives—Arterial injury results in vascular remodeling associated with proliferation and migration of smooth muscle cells (SMCs) and the development of intimal hyperplasia, which is a critical component of restenosis after angioplasty of human coronary arteries and an important feature of atherosclerotic lesions. However, the origin of SMCs and other cells in the development of vascular remodeling is not yet fully understood. Methods and Results—We utilized a cuff-induced vascular injury model after transplantation of the bone marrow (BM) from green fluorescent protein (GFP)-transgenic mice. We found that macrophages were major cells recruited to the adventitia of the vascular injury lesion along with SMCs and endothelial cells (ECs). While investigating whether those cells are derived from the donor, we found that most of the macrophages were GFP-positive, and some of the SMCs and ECs were also GFP-positive. Administration of the anti–c-fms antibody resulted in a marked decrease in macrophages and a relative increase of SMCs, while administration of antibodies against the platelet-derived growth factor receptor-&bgr; caused a prominent decrease in SMCs and a relative increase in macrophages. Conclusions—The current study indicates that BM-derived cells play an important role in vascular injury, and that differentiation of macrophages and SMCs might be dependent on each other.
Pharmaceutical Care for Dialysis Patients

The incidence of end stage renal disease (ESRD) is increasing worldwide. Dialysis centers are overwhelmed by the increased number of patients. When a patient becomes aware that his/her kidneys are nonfunctional, he/she is likely to be confused and depressed. The counseling of the patient in the matter of drugs, disease, and lifestyle forms an important necessity, which can help the patient′s confidence and motivate the patient for self-care of his/her condition. The counseling of the patient and dispelling the myths regarding ESRD and dialysis is vital for all patients on a continuous basis. This can be achieved by practicing the pharmaceutical care in ESRD patients on dialysis. In this article, the knowhow and the significance of self-management of ESRD patients on dialysis is discussed.
Post-transplant anaemia

Anaemia, as a complication of end stage kidney disease (ESKD), is well studied (Eschbach and Adamson 1985). Reports indicate that anaemia in this patient population is associated with numerous morbidities, but predominantly cardiovascular complications such as left ventricular hypertrophy and heart failure (Wizemann, Schafer et al. 1993; Harnett, Foley et al. 1995). Contrary to the ample data available regarding anaemia in ESKD population, much less is known about the epidemiology of post-transplant anaemia (PTA), and only few studies have systematically investigated this issue (Saito, Fujiwara et al. 1998; Yorgin, Scandling et al. 2002; Mix, Kazmi et al. 2003; Vanrenterghem, Ponticelli et al. 2003). A successful renal allograft will correct not only the excretory functions of the kidney but also the endocrine functions (through the restored synthesis of erythropoietin and vitamin D) including the correction of anaemia. However, in the majority of transplant recipients, the renal graft does not function optimally. It is well known that renal excretory functions are not restored completely, but the extent to which renal endocrine functions are restored is only recently becoming better understood. A recent European survey of ten transplant centres revealed a prevalence of PTA as high as 42% (Molnar et al, 2011). PTA may occur at any time after renal transplantation. Early PTA (from the time of surgery until 3 months post-operatively) is most likely to be related to pre-transplant anaemia of ESKD, the surgery itself, iron deficiency, immunosuppression, inflammation or infection (Miles, Markell et al. 1997; Turkowski-Duhem, Kamar et al. 2005) or some combination of these. Later PTA is more likely to be related to consequences of long-term immunosuppression (particularly anti-metabolite medications) or a failing allograft. All the published large scale studies to date have focused mainly on late PTA (Miles, Markell et al. 1997; Vanrenterghem, Ponticelli et al. 2003; Turkowski-Duhem, Kamar et al. 2005), and there are a lack of studies looking at the management of early PTA, in particular, the optimal management of iron deficiency at the time of kidney transplantation. The importance of PTA is that it is one of the commonest complications after kidney transplantation, that it is strongly associated with cardiovascular morbidity (the primary cause of death of kidney transplant recipients, accounting for approximately one half of such deaths), and that its optimal treatment, either with iron, erythropoietin, or other agents, has yet to be determined by large-scale randomised controlled trials.
Atlas of Human Infectious Diseases

The comprehensive full-color maps show at a glance the areas with reported infections and outbreaks, and are accompanied by a concise summary of key information on the infectious agent and its clinical and epidemiological characteristics. Since infectious diseases are dynamic, the maps are presented in the context of a changing world, and how these changes are influencing the geographical distribution on human infections.
HIV-associated dementia and related disorders

HIV infection is associated with an increased risk of primary cognitive disorders. These can have important implications for quality of life and the care of people with the disease. In this paper, we review the concepts, terminology and diagnosis of HIV-associated dementia and related disorders. This is followed by discussion of their epidemiology, course and prognosis. The concept of HIV-associated minor cognitive impairment is considered, as well as the evidence for its presence in HIV symptomatic and asymptomatic individuals. The management of HIV-associated dementia is considered next, with discussion of pharmacological, psychological and social interventions. Finally, the question of the prevention of HIV-associated dementia is reviewed.