Miracle-dz/UniFAR-FTUs huggingface dataset:
Eosinophilic inflammation in the airway is related to glucocorticoid reversibility in patients with pulmonary emphysema.

STUDY OBJECTIVES We examined the effects of glucocorticoids on airway inflammation and its association with the reversibility of airflow obstruction in response to oral glucocorticoid administration in patients with COPD. PATIENTS Twenty-four male patients with smoking-related stable pulmonary emphysema without alpha1-antitrypsin deficiency and nine normal healthy volunteers. MEASUREMENTS We measured the pulmonary function, the inflammatory cells, and the levels of eosinophil cationic protein (ECP), immunoreactive neutrophil elastase-alpha1-protease inhibitor (NE-alpha1-PI) complex, and interleukin (IL)-8 in sputum induced from patients with pulmonary emphysema in its stable phase before and after treatment with 20 mg oral prednisolone per day for 2 weeks. RESULTS The eosinophil and neutrophil counts and the concentrations of ECP, NE-alpha1-PI complex, and IL-8 in the sputum were significantly increased at baseline. The eosinophil count at baseline was significantly correlated with the reversibility of airflow obstruction following treatment, and the treatment also significantly reduced the eosinophil numbers and ECP level in the sputum. In contrast, the increased neutrophil number and the concentrations of NE-alpha1-PI complex and IL-8 at baseline did not correlate with the reversibility and were not affected by treatment. CONCLUSIONS These findings suggest that the eosinophilic inflammation, not neutrophilic inflammation, in the airway is involved in the reversible part of the airflow obstruction in response to glucocorticoids in patients with pulmonary emphysema.
Inhaled corticosteroid dose response using domiciliary exhaled nitric oxide in persistent asthma: the FENOtype trial.

BACKGROUND International guidelines advocate a standard approach to asthma management for all, despite its heterogeneity. "Personalized" treatment of inflammatory asthma phenotypes confers superior benefits. We wished to evaluate dose response to inhaled corticosteroids (ICSs) in patients with asthma with an elevated fractional exhaled nitric oxide (Feno) phenotype using domiciliary measurements. METHODS We performed a randomized, crossover trial in 21 patients with mild to moderate persistent asthma receiving ICSs with elevated Feno (>30 parts per billion [ppb]) that increased further (>10 ppb) after ICS washout. Patients were randomized to 2 weeks of either fluticasone propionate 50 μg bid (FP100) or 250 μg bid (FP500). The primary outcome was response in diurnal domiciliary Feno levels. Secondary outcomes included mannitol challenge, serum eosinophilic cationic protein (ECP), blood eosinophil count, and asthma control questionnaire. RESULTS We found significant dose-related reductions of diurnal Feno compared with baseline - morning Feno: baseline = 71 ppb (95% CI, 61-83 ppb); FP100 = 34 ppb (95% CI, 29-40 ppb), P < . 001; FP500 = 27 ppb (95% CI, 22-33 ppb), P < . 001; and significant dose separation for morning, P < . 05, and evening, P < . 001. Time-series Feno displayed exponential decay: FP100 R² = 0.913, half-life = 69 h (95% CI, 50-114 h); FP500 R² = 0.966, half-life = 55 h (95% CI, 45-69 h), as well as diurnal variation. The Asthma Control Questionnaire showed significant improvements exceeding the minimal important difference (>0.5) with values in keeping with controlled asthma (<0.75) after each dose: FP100 = 0.48 (95% CI, 0.24-0.71), P = . 004; FP500 = 0.37 (95% CI, 0.18-0.57), P = . 001. All other secondary inflammatory related outcomes (mannitol, ECP, and eosinophils) showed significant improvements from baseline but no dose separation. CONCLUSIONS There is a significant dose response of diurnal Feno to ICS in patients with asthma with an elevated Feno phenotype, which translates into well-controlled asthma. Further interventional studies are warranted using domiciliary Feno in this specific phenotype. TRIAL REGISTRY ClinicalTrials.gov; No.: NCT00995657; URL: clinicaltrials.gov.
Factores de riesgo para las enfermedades no transmisibles: Metodología y resultados globales de la encuesta de base del programa CARMEN (Conjunto de Acciones para la Reducción Multifactorial de las Enfermedades no Transmisibles)

Background: In the last decades, chronic non communicable diseases are becoming the main cause of disability and mortality among adults. The risk factor surveillance and management is the most efficient mean of reducing the impact of these diseases. Aim: To report the results of a non communicable disease risk factor surveillance program in Valparaiso, Chile. Material and methods: A random samples of people aged 25 to 64 years old living in Valparaiso, Chile was studied. Subjects were questioned about smoking and physical activity habits. Blood pressure, height and weight were measured using standardized techniques at their homes and blood samples were obtained to measure serum lipid levels and oral glucose tolerance test at the nearest outpatient clinic. Results: Of the initial 3852 homes selected, 752 individuals did no agree to answer the inquiry, therefore 3120 subjects were finally interviewed. Of these, 40.6% were smokers, 15% drank alcohol in two or more occasions per month, 84.6% were physically inactive, 19.7% had a body mass index over 30 kg/m2, 11.1% had high blood pressure, 3.9% were diabetic and 46.9% had high serum cholesterol levels. Conclusions: The basal survey for the CARMEN program shows a high prevalence of cardiovascular risk factors among Chileans.
Virus papiloma humano y cáncer cérvico-uterino;

Molecular, clinical and epidemiological studies have established beyond doubt that human papiloma viruses (HPV) cause cervical cancer. The virus is also associated with genital warts and other less common cancers in oropharynx, vulva, vagina and penis. Worldwide, VPH genotypes 16 and 18 are the most common high risk genotypes, detected in near 70% of women with cervical cancer. The discovery of a cause-effect relationship between several carcinogenic microorganisms and cancer open avenues for new diagnostic, treatment and prevention strategies. In this issue of Revista Medica de Chile, two papers on HPV are presented. Guzman and colleagues demonstrate that HPV can be detected in 66% to 77% of healthy male adolescents bypolymerase chain reaction and that positivity depends on the site of the penis that is sampled. These results support the role of male to female transmission of high risk HPVs in Chile and should lead to even more active educational campaigns. The second paper provides recommendations for HPV vaccine use in Chile, generated by the Immunization Advisory Committee of the Chilean Infectious Disease Society. To issue these recommendations, the Committee analyzes the epidemiological information available on HPV infection and cervical cancer in Chile, vaccine safety and effectiveness data, and describes cost-effectiveness studies. Taking into account that universal vaccination is controversial, the Committee favors vaccine use in Chile and it's incorporation into a national program. However, there is an indication that the country requires the implementation of an integrated surveillance approach including cross matching of data obtained from HPV genotype surveillance, monitoring of vaccination coverage, and surveillance of cervical cancer. The final decision of universal vaccine use in Chile should be based on a through analysis of information.ev Mid Chile
Endothelial dysfunction in children with obstructive sleep apnea is associated with epigenetic changes in the eNOS gene.

BACKGROUND Obstructive sleep apnea (OSA) is a highly prevalent disorder that has been associated with an increased risk for cardiovascular morbidity, even in children. However, not all children with OSA manifest alterations in endothelial postocclusive hyperemia, an endothelial nitric oxide synthase (eNOS)-dependent response. Since expression of the eNOS gene is regulated by epigenetic mechanisms and OSA may cause epigenetic modifications such as DNA hypermethylation, we hypothesized that epigenetic modifications in the eNOS gene may underlie the differential vascular phenotypes in pediatric OSA. METHODS Age-, sex-, ethnicity-, and BMI-matched prepubertal children with polysomnographically confirmed OSA and either normal (OSAn) or abnormal (OSAab) postocclusive hyperemic responses, assessed as the time to attain peak reperfusion flow (Tmax) by laser Doppler flowmetry, were recruited. Blood genomic DNA was assessed for epigenetic modifications in the eNOS gene using pyrosequencing. Children with no evidence of OSA or endothelial dysfunction served as a control group. RESULTS The study comprised 36 children with OSA (11 with OSAab and 25 with OSAn) and 35 children in the control group. Overall, the mean age was 7.5 ± 2.4 years, 65% were boys, and 30% were obese; mean apnea-hypopnea index was 18 ± 8.6/h of sleep for the children with OSA. Tmax was 66.7 ± 8.8 s in the OSAab group and 30.1 ± 8.3 s in the OSAn group (P < .001). Pyrosequencing of the proximal promoter region of the eNOS gene revealed no significant differences in six of the seven CpG sites. However, a CpG site located at position -171 (relative to transcription start site), approximating important transcriptional elements, displayed significantly higher methylation levels in the OSAab group as compared with the OSAn or control groups (81.5% ± 3.5%, 74.8% ± 1.4%, and 74.5% ± 1.7%, respectively; P < .001). eNOS mRNA expression levels were assessed in a separate group of children and were significantly reduced in the OSAab group in comparison with the OSAn group. CONCLUSIONS The presence of abnormal eNOS-dependent vascular responses in children with OSA is associated with epigenetic modifications in the eNOS gene.
Hematologic and plasma biochemical findings in cold-stunned Kemp's ridley turtles: 176 cases (2001-2005).

OBJECTIVE To document hematologic and plasma biochemical values for a large number of cold-stunned Kemp's ridley turtles at the beginning of rehabilitation, to investigate differences in hematologic and plasma biochemical values of turtles that ultimately survived versus those that died, and to compare values of survivors during convalescence with initial values obtained at the time of admission. DESIGN Retrospective case series. ANIMALS 176 stranded, cold-stunned Kemp's ridley turtles hospitalized between 2001 and 2005. PROCEDURES Hematologic and plasma biochemical values obtained at the time of admission were compared retrospectively for turtles that died versus turtles that survived. Initial results for survivors were compared with convalescent results obtained later in rehabilitation. RESULTS Turtles that died had significantly greater plasma concentrations of sodium, chloride, potassium, calcium, phosphorus, and uric acid than did turtles that survived. For survivors, values obtained during convalescence for BUN concentration and plasma calcium concentration were significantly greater than initial values obtained at the time of admission, whereas values obtained during convalescence for glucose, sodium, and uric acid concentrations were significantly lower than initial values. CONCLUSIONS AND CLINICAL RELEVANCE Cold-stunned Kemp's ridley turtles may be affected by electrolyte derangements, dehydration, and decreased renal function. Hematologic and plasma biochemical evaluation of such turtles provided useful clinical and prognostic information during the rehabilitation process.
Sclerosing Ductal Carcinoma In Situ

he advent of modern screening and diagnostic T mammography has substantially increased the frequency with which a diagnosis of ductal carcinoma in situ (DCIS) is made. It is generally assumed that many, but not all, cases of DCIS, left untreated, will progress to invasive ductal carcinoma (IDC). The propensity for this progression and the rapidity with which it occurs correlates closely with the degree of nuclear pleomorphism and the presence of necrosis. We report herein a case of low-nuclear-grade DCIS without necrosis, followed untreated for a decade, which seems to be undergoing involution rather than progression to IDC.
Ageing, Health and Retirement in Europe the AGIR Project - Final Report on Scientific Achievements

A question increasingly raised in recent years is whether the trend towards longer life expectancy has been accompanied by comparable increases in the expectancy of life in good health (active or disability-free life expectancy). Formulating an answer to this question is of essential importance for projecting health expenditure and for forecasting retirement patterns over the coming decades. The AGIR research project aimed essentially at exploring all available information to illustrate whether people are not only living longer but also ageing in better health. Emerging from the AGIR project is, first of all, a pressing need to distinguish more clearly than is done in most of the public debate on population ageing between the ‘known’ and ‘the unknown’. More precisely, this implies distinguishing between the features of past, current and future developments, which can be considered as relatively certain or known with only a small margin of uncertainty, and features that depend essentially on ‘assumptions’ or scenario calculation, which are surrounded by substantial margins of uncertainty. Despite these remaining uncertainties the AGIR project unambiguously confirmed that ensuring at the same time the sustainability and adequacy of health care and retirement income for the population in EU member states over the coming decades is a task requiring action at all levels of society, government, firms and households. For public policy the issues at stake are not ‘only’ to undertake appropriate changes in the parameters of welfare systems but to reconsider the balance between public and private initiatives, and notably to thoroughly analyse to what extent the future necessary adjustments can be achieved through the play of market forces and to what extent policy intervention is required.
An In-Depth Sports Medicine Profile of Women College Tennis Players

The purpose of this study was to provide an in-depth sports medicine profile of women college tennis players and determine the relationships among an array of performance and clinical variables. Thirty-eight non-resistance-trained women from NCAA Divisions I and III collegiate tennis teams participated. A comprehensive battery of performance tests was conducted on each subject, including measurements of dynamic, isometric, and isokinetic strength; joint laxity and flexibility; speed; agility; power and power endurance; peak oxygen consumption; body composition; and ball velocities of the serve, forehand, and backhand. It was found that no single variable strongly explains tennis performance. The low amount of shared variance of strength measures with ball velocities suggests that tennis skills play a large role in producing peak ball velocities in this group. Due to the large range observed in profiled variables, individual evaluation is needed for clinical and conditioning recommendations.
Medical students beliefs about treatment and rehabilitation of persons with mental illness

Advances in treatment and rehabilitation of persons with mental illness (PWMI) have generally improved their well-being. However, some people, most especially the lay public and no-psychiatric health workers still hold a lot of reservation about the effectiveness of such management interventions. Thus, this study set out to explore medical students’ beliefs about treatment and rehabilitation of PWMI. A descriptive and cross-sectional study carried out among medical students of the College of Medicine of the University of Lagos (CMUL), Lagos, Nigeria. Subjects were selected through multistage and systematic random sampling techniques, with age and sex-matched controls selected among dental students. They were evaluated with a questionnaire adapted from an instrument earlier used by Sechrest et al. (1973) on cross-cultural study of attitude to mental illness among university students. A total of 130 medical students (subjects) and 57 controls (dental students) were studied. The mean age of subjects was 23.2 ± 3.0 years. Varying beliefs about mental illness (MI) were expressed by both subjects and controls. One hundred and seventeen (90%) of subjects and 46 (80.7%) of controls believed PWMI can be effectively treated and most of them believed orthodox treatment to be the important one. On rehabilitation, 8 (6.2%) of subjects and 3 (5.3%) of controls believed treated PWMI should not be allowed to marry (X2 =9.28, DF=4, p=0.05*). Ninety eight (75.4%) of subjects and 40 (70.2%) of controls believed treated PWMI should have chance of securing jobs. When stratified to pre-clinical and clinical levels of study, 68 (65.4%) of preclinical and 24 (10.9%) clinical students believed PWMI should be kept away from the community (X2=24.90, DF=4, p<0.01*). The study has found varying beliefs of the subjects about treatment and rehabilitation of PWMI, most of which are favourable. However, there is still need to emphasize on anti-stigma education on the subjects over their perceived negative beliefs about psychiatry. Key words: Beliefs; treatment and rehabilitation; mental illness; medical students, Nigeria
Formation of thrombus and thromboembolism after the bidirectional Glenn anastomosis, total cavopulmonary connection and the Fontan operation

Abstract Although patients undergoing surgery with the Fontan procedure or its modifications are increasingly recognised to be at risk for thromboembolism, further knowledge is needed to minimise this complication and its sequels. To address this issue, we reviewed 100 patients operated with the Fontan procedure, the bidirectional Glenn anastomosis and/or the total cavopulmonary connection to describe our incidence and clinical characteristics of postoperative formation of thrombus. Symptomatic thrombosis or cerebrovascular accidents were found in 5 patients. Asymptomatic thrombus were found in another 5 patients. Three patients had venous thrombi. In 6 patients the thrombosis was found on the arterial side. In all these cases, the thrombus was located in the stump of the divided pulmonary trunk. In 3 of these patients, sudden onset of hemiparesis preceded the diagnosis of the thrombus while the remaining 3 patients were asymptomatic. In 3 cases, the formation of thrombus in the stump of the divided pulmonary trunk occurred after a bidirectional Glenn anastomosis. One patient developed severe neurological symptoms 2 months after a total cavopulmonary connection. No thrombus was found, but the patient had a small right-to-left shunt and embolization could not be excluded. The incidence of thrombosis after Fontan-type surgery in this study is 10%. Although not all episodes of thrombosis are symptomatic, there is a significant risk of severe sequels due to embolization to the pulmonary or cerebral circulations. The stump of the divided pulmonary trunk is one of the main sites for intracardiac formation of thrombus, even after a bidirectional Glenn anastomosis.
Niveles aumentados de estrés oxidativo se asocian a disfunción endotelial periférica y respuesta vascular pulmonar disminuida frente a vasodilatadores en pacientes con hipertensión pulmonar

Resumen:Introduccion: La Hipertension arterial pulmonar (HP) se caracteriza por remodelado vascular y disfuncion endotelial. Evidencia experimental muestra que el estres oxidativo juega un rol importante en la patogenesis de la HP. El rol del estres oxidativo, su relacion con la funcion endotelial periferica y con la respuesta vascular pulmonar a vasodilatadores en pacientes con HP no esta aclarada. Objetivo: evaluar parametros de estres oxidativo y funcion endotelial periferica en pacientes con HP y estu-diar su relacion con la respuesta vascular pulmonar frente a vasodilatadores. Metodos : estudio transversal. Se incluyeron 14 pacientes con HP y 14 controles pareados por edad y sexo. En todos los sujetos se midieron: niveles plasmaticos de malondialdehido (MDA), superoxi-do dismutasa ligada a endotelio (eSOD) y xantino oxidasa (eXO). Vasodilatacion dependiente de endo-telio mediada por flujo en arteria braquial fue usada como marcador de funcion endotelial (FDD). Funcion ventricular derecha y reactividad del lecho vascular pulmonar frente a iloprost inhalado fueron evaluadas ecocardiograficamente en los pacientes con HP.
Psychology in rehabilitation of older adults

Whilst clinical psychologists and a few fellow professionals have long known the importance of psychology in rehabilitation, it has recently been formally acknowledged as an essential professional discipline in such settings. In relation to stroke care for example, the recently published National Service Framework for Older Adults, England (NSFOA) specifies (Standard Five) that multidisciplinary stroke rehabilitation teams should include clinical psychologists, a view that is echoed in the Royal College of Physicians’ ‘Guidelines for Stroke Care’. The NSF is not yet universal to all areas of the UK, however, this article will reflect the English NSF as appropriate standards for health care across the country.
Valuable Assistance or Missed Opportunities?

Do shelters help battered women navigate the welfare system and access waivers under the Family Violence Option (FVO)? Data on sheltered battered women's experiences with the New York State welfare system suggest that the answer is both yes and no. Sheltered women are granted waivers at a far higher rate than the general welfare population in New York State, and sheltered women report that shelter staff assistance makes it easier to apply for welfare. However, even sheltered women report problems with the FVO screening, referral, and waiver processes and complain about the problems of linking shelter with welfare.
Mycophenolate mofetil in myasthenia gravis: the unanswered question

Myasthenia gravis (MG) is an autoimmune disease that leads to muscular weakness, which can significantly affect the patient's daily functions. If left untreated, the mortality rate can be as high as 30%. Effective immunosuppression is the cornerstone of treatment of MG, although most currently available immunomodulatory drugs are associated with unacceptable side effects, delayed onset of therapeutic action, or both. Mycophenolate mofetil (MMF) might be better tolerated than other immunosuppressants and many case reports and uncontrolled trials have indicated that it is effective in MG. However, two recently concluded clinical trials failed to demonstrate the efficacy of MMF in MG. This paper critically reviews the existing evidence on the efficacy of MMF in MG and provides the authors' view of its role in current practice.