Miracle-dz/UniFAR-FTUs huggingface dataset:
Evaluation of matrix metalloproteinase-2 and -9 in the cerebrospinal fluid of dogs with intracranial tumors.

OBJECTIVE To identify matrix metalloproteinase (MMP)-2 and -9 in CSF from dogs with intracranial tumors. SAMPLE CSF from 55 dogs with intracranial tumors and 37 control dogs. PROCEDURES Latent and active MMP-2 and -9 were identified by use of gelatin zymography. The presence of MMPs in the CSF of dogs with intracranial tumors was compared with control dogs that were clinically normal and with dogs that had idiopathic or cryptogenic epilepsy or peripheral vestibular disease. Relationships between MMP-9 and CSF cell counts and protein were also investigated. RESULTS Latent MMP-2 was found in CSF samples from all dogs, although active MMP-2 was not detected in any sample. Latent MMP-9 was detected in a subset of dogs with histologically documented intracranial tumors, including meningiomas (2/10), gliomas (3/10), pituitary tumors (1/2), choroid plexus tumors (5/6), and lymphoma (4/4), but was not detected in any control samples. Dogs with tumors were significantly more likely than those without to have detectable MMP-9 in the CSF, and the presence of MMP-9 was associated with higher CSF nucleated cell counts and protein concentration. CONCLUSIONS AND CLINICAL RELEVANCE Latent MMP-9 was detected in most dogs with choroid plexus tumors or lymphoma but in a smaller percentage of dogs with meningiomas, gliomas, or pituitary tumors. Detection of MMP in CSF may prove useful as a marker of intracranial neoplasia or possibly to monitor response of tumors to therapeutic intervention.
A novel user-friendly score (HAS-BLED) to assess 1-year risk of major bleeding in patients with atrial fibrillation: the Euro Heart Survey.

OBJECTIVE Despite extensive use of oral anticoagulation (OAC) in patients with atrial fibrillation (AF) and the increased bleeding risk associated with such OAC use, no handy quantification tool for assessing this risk exists. We aimed to develop a practical risk score to estimate the 1-year risk for major bleeding (intracranial, hospitalization, hemoglobin decrease > 2 g/L, and/or transfusion) in a cohort of real-world patients with AF. METHODS Based on 3,978 patients in the Euro Heart Survey on AF with complete follow-up, all univariate bleeding risk factors in this cohort were used in a multivariate analysis along with historical bleeding risk factors. A new bleeding risk score termed HAS-BLED (Hypertension, Abnormal renal/liver function, Stroke, Bleeding history or predisposition, Labile international normalized ratio, Elderly (> 65 years), Drugs/alcohol concomitantly) was calculated, incorporating risk factors from the derivation cohort. RESULTS Fifty-three (1.5%) major bleeds occurred during 1-year follow-up. The annual bleeding rate increased with increasing risk factors. The predictive accuracy in the overall population using significant risk factors in the derivation cohort (C statistic 0.72) was consistent when applied in several subgroups. Application of the new bleeding risk score (HAS-BLED) gave similar C statistics except where patients were receiving antiplatelet agents alone or no antithrombotic therapy, with C statistics of 0.91 and 0.85, respectively. CONCLUSION This simple, novel bleeding risk score (HAS-BLED) provides a practical tool to assess the individual bleeding risk of real-world patients with AF, potentially supporting clinical decision making regarding antithrombotic therapy in patients with AF.
Vitamin D deficiency and reduced lung function in connective tissue-associated interstitial lung diseases.

BACKGROUND Vitamin D is a steroid hormone with pleiotropic effects including immune system modulation, lung tissue remodeling, and bone health. Vitamin D deficiency has been implicated in the development of autoimmune diseases. We sought to evaluate the prevalence of vitamin D deficiency in a cohort of patients with interstitial lung disease (ILD) and hypothesized that vitamin D deficiency would be associated with an underlying connective tissue disease (CTD) and reduced lung function. METHODS Patients in the University of Cincinnati ILD Center database were evaluated for serum 25-hydroxyvitamin D levels as part of a standardized protocol. Regression analysis evaluated associations between 25-hydroxyvitamin D levels and other variables. RESULTS One hundred eighteen subjects were included (67 with CTD-ILD, 51 with other forms of ILD). The overall prevalence of vitamin D deficiency and insufficiency in the study population was 38% and 59%, respectively. Those with CTD-ILD were more likely to have vitamin D deficiency (52% vs 20%, P < .0001) and insufficiency (79% vs 31%, P < .0001) than other forms of ILD. Diminished FVC was associated with lower 25-hydroxyvitamin D(3) levels (P = .01). The association between vitamin D insufficiency and CTD-ILD persisted (OR, 11.8; P < .0001) after adjustment for potential confounders. Among subjects with CTD-ILD, reduced 25-hydroxyvitamin D(3) levels were strongly associated with reduced lung function (FVC, P = .015; diffusing capacity for carbon monoxide, P = .004). CONCLUSIONS There is a high prevalence of vitamin D deficiency in patients with ILD, particularly those with CTD-ILD, and it is associated with reduced lung function. Vitamin D may have a role in the pathogenesis of CTD-ILD.
The Dandy-Walker and Arnold-Chiari Malformations

To the Editor. — In an extensive article in the June 1975 issue of theArchives(32:393, 1975), the authors stated that the cause of the Dandy-Walker and Arnold-Chiari malformations is still unknown and, further, that the many associated defects cannot be explained by "hydrostatic" mechanisms. They stated that only two of their five patients with Dandy-Walker malformations had hydrocephalus, because the lateral ventricles were dilated in only these two. This overlooks the fact that the Dandy-Walker malformation is hydrocephalus that primarily affects the fourth ventricle, aqueduct, and third ventricle, whereas in the Arnold-Chiari malformation the opposite is true since there is compression of the fourth ventricle, aqueduct, and third ventricle, and the hydrocephalus is limited to the lateral ventricles. They suggested that in the Dandy-Walker malformation a primary mesodermal insult may be involved that arrests the descent of the tentorium; that it is not yet known whether the large posterior
Metformin and male reproduction: effects on Sertoli cell metabolism

Metformin, widely used for the treatment of type 2 diabetes, is increasingly becoming the subject of research in other areas of medicine. Apart form antihyperglycemic effect of metformin has an inhibitory effect on the proliferation of various tumor cells both in vivo and in vitro. Metformin is well established in the treatment of anovulatory infertility in polycystic ovary syndrome, while its influence male reproductive function are poorly understood.
Caracterización de la invalidez laboral en pacientes con artritis reumatoide en el Centro de Reumatología

A transversal descriptive study about Rheumatoid Arthritis patients with labor disability was performed in the National Center of Rheumatology from January 2011 to January 2012. The samples count 151 patients. Labor status, clinical activity, functional capacity and disability were classified. Results: Female was high (92.7 %), with middle age of 56.4 more or less 11.7 year old presentation. Outcome average of the disease was 9.67. The 31.12 % of patients were suffering from labor disability existing a proportional correlation between the labor status, illness outcome and functional disability. The 57.4 % of patients with labor disability were suffering from a complete disability and their educations were primary and high school and all of them were workers.
Effects of weather variables on thermoregulation of calves during periods of extreme heat.

OBJECTIVE To determine effects of ambient temperature, relative humidity, wind speed, relative barometric pressure, and temperature-humidity index (THI) on nasal submucosal and rectal temperatures in cattle during extreme summer conditions. ANIMALS 20 black crossbred beef heifers (mean body weight, 217.8 kg). PROCEDURES Nasal submucosal and rectal temperatures were monitored every 2 hours for 24 hours on 3 nonconsecutive days when ambient temperature was forecasted to exceed 32.2°C. Ambient temperature, relative humidity, wind speed, and relative barometric pressure were continuously monitored at a remote weather station located at the research facility. The THI was calculated and used in the livestock weather safety index (LWSI). Relationships between nasal submucosal or rectal temperature and weather variables were evaluated. RESULTS Nasal submucosal and rectal temperatures were related to all weather variables monitored. A positive relationship was determined for ambient temperature and THI with both nasal submucosal and rectal temperatures. A negative relationship was evident for nasal submucosal and rectal temperature with relative humidity, wind speed, and relative barometric pressure. Nasal submucosal and rectal temperatures increased with increasing severity of LWSI category. CONCLUSIONS AND CLINICAL RELEVANCE Effects of environmental conditions on thermoregulation in calves exposed to extreme heat were detected. The positive relationship between nasal submucosal temperature and ambient temperature and THI raised concerns about the efficacy of intranasal administration of temperature-sensitive modified-live virus vaccines during periods of extreme heat. Environmental conditions must be considered when rectal temperature is used as a diagnostic tool for identifying morbid cattle.
Predicting survival in pulmonary arterial hypertension: time to combine markers.

2011;139;1263-1264 Chest Marc Humbert, David Montani and Rogerio Souza Hypertension : Time to Combine Markers Predicting Survival in Pulmonary Arterial http://chestjournal.chestpubs. org/content/139/6/1263.full. html services can be found online on the World Wide Web at: The online version of this article, along with updated information and ISSN:0012-3692 ) http://chestjournal.chestpubs. org/site/misc/reprints.xhtml ( written permission of the copyright holder. this article or PDF may be reproduced or distributed without the prior Dundee Road, Northbrook, IL 60062. All rights reserved. No part of Copyright2011by the American College of Chest Physicians, 3300 Physicians. It has been published monthly since 1935. is the official journal of the American College of Chest Chest
Direct comparison of three natriuretic peptides for prediction of short- and long-term mortality in patients with community-acquired pneumonia.

BACKGROUND Early and accurate risk stratification for patients with community-acquired pneumonia (CAP) is an unmet clinical need. METHODS We enrolled 341 unselected patients presenting to the ED with CAP in whom blinded measurements of N-terminal pro-B-type natriuretic peptide (NT-proBNP), midregional pro-atrial natriuretic peptide (MR-proANP), and B-type natriuretic peptide (BNP) were performed. The potential of these natriuretic peptides to predict short- (30-day) and long-term mortality was compared with the pneumonia severity index (PSI) and CURB-65 (confusion, urea plasma level, respiratory rate, BP, age over 65 years). The median follow-up was 942 days. RESULTS NT-proBNP, MR-proANP, and BNP levels at presentation were higher in short-term (median 4,882 pg/mL vs 1,133 pg/mL; 426 pmol/L vs 178 pmol/L; 436 pg/mL vs 155 pg/mL, all P < .001) and long-term nonsurvivors (3,515 pg/mL vs 548 pg/mL; 283 pmol/L vs 136 pmol/L; 318 pg/mL vs 103 pg/mL, all P < .001) as compared with survivors. Receiver operating characteristics analysis to quantify the prognostic accuracy showed comparable areas under the curve for the three natriuretic peptides to PSI for short-term (PSI 0.76, 95% CI, 0.71-0.81; NT-proBNP 0.73, 95% CI, 0.67-0.77; MR-proANP 0.72, 95% CI, 0.67-0.77; BNP 0.68, 95% CI, 0.63-0.73) and long-term (PSI 0.72, 95% CI, 0.66-0.77; NT-proBNP 0.75, 95% CI, 0.70-0.80; MR-proANP 0.73, 95% CI, 0.67-0.77, BNP 0.70, 95% CI, 0.65-0.75) mortality. In multivariable Cox-regression analysis, NT-proBNP remained an independent mortality predictor (hazard ratio 1.004, 95% CI, 1.00-1.01, P = .02 for short-term; hazard ratio 1.004, 95% CI, 1.00-1.01, P = .001 for long-term, increase of 300 pg/mL). A categorical approach combining PSI point values and NT-pro-BNP levels adequately identified patients at low, medium, and high short- and long-term mortality risk. CONCLUSIONS Natriuretic peptides are simple and powerful predictors of short- and long-term mortality for patients with CAP. Their prognostic accuracy is comparable to PSI.
Drug-Induced Glucose Alterations Part 1: Drug-Induced Hypoglycemia

Many pharmacological agents commonly used in clinical practice affect glucose homeostasis, interfering with the body's balance between insulin, glucagon, catecholamines, growth hormone, and cortisol. Drug-induced serum glucose alterations manifested as hyperglycemia or hypoglycemia and ranging from mild to moderate to severe symptoms either appearing acutely or chronically, have perpetual effects on the body, particularly in patients with diabetes. This article and a second one that will appear in the next issue of this journal review drug-induced serum glucose alterations in a two-part series. In this article, we review pertinent clinical information on the incidence of drug-induced hypoglycemia and discuss the underlying pathophysiological mechanisms involved. Hypoglycemia is clinically defined as a serum glucose concentration low enough to cause the signs and symptoms differentiated in Table 1.1–4 Depending on the severity, hypoglycemic symptoms include irritability, impaired concentration, neurological deficits, seizures, coma, and even neuronal death.5 However, clinical manifestations vary from individual to individual, and some report hypoglycemic symptoms even when serum glucose levels do not reflect hypoglycemia or vice versa. Although definitions of hypoglycemia differ in the literature, many trials will differentiate between hypoglycemia (asymptomatic and symptomatic low serum glucose levels) and severe hypoglycemia. This article will cover and report both when applicable. The American Diabetes Association (ADA) Workgroup on Hypoglycemia has defined and classified hypoglycemia based on the severity of symptoms in patients diagnosed with diabetes as outlined in Table 2.2 In general, severe hypoglycemia develops when a reduction in blood glucose is enough to require assistance from another person to actively administer carbohydrate, glucagon, or other corrective actions.2 Severe hypoglycemia is a serious clinical syndrome that continues to be the most common endocrine emergency faced by health care providers and remains the limiting factor in effective diabetes management for many patients.6 …
The National Diabetes Education Program, Changing the Way Diabetes Is Treated Comprehensive diabetes care

The National Diabetes Education Program (NDEP) was initiated in 1997 jointly by the National Institutes of Health and the Centers for Disease Control and Prevention to promote early diagnosis and to improve the treatment and outcomes for people with type 1 and type 2 diabetes. This partnership now involves over 200 public, voluntary, and private organizations dedicated to improving the lives of people with diabetes. Because of the Diabetes Control and Complications Trial (DCCT) findings that improved blood glucose control markedly reduces the risk for retinopathy, nephropathy, and neuropathy, the NDEP initially focused on blood glucose control (1,2). This month, the NDEP and its partners are launching an expanded initiative to promote optimal control of lipids and blood pressure, in addition to optimal control of blood glucose. The impact of cardiovascular disease on mortality and morbidity in people with diabetes has been known for years. Approximately two-thirds of people with diabetes die from cardiovascular disease (coronary heart disease, stroke, and other vascular diseases). Recently, data from the National Health and Nutrition Examination Survey showed that over the past 30 years there was a 27% decline in age-adjusted heart disease mortality in women without diabetes, but in women with diabetes, there was a 23% increase (3). In men without diabetes, there was a 36% decline compared with a 13% decline in men with diabetes. …
The factors affecting women's contraceptive choices

The purpose of this study is to investigate the factors affecting women’s contraceptive choices. In this study, we included 507 subjects, of whom 108 were nulliparous and 399 of whom were multiparous. All were married women who were between 15-49 years old and had applied to the Ministry of Health Konya Eregli Hospital Obstetric and Gynaecology Polyclinic. An inquiry form was filled in during a face-to-face conversation which included their contraceptive choices, the factors affecting them, the reasons for leaving previous methods they had used, their working and educational status and their knowledge about the contraceptive methods. The mean age of the study group was 33.6±7. While 85.21% (n=432) women were using modern methods, 14.79% (n=75) women were using traditional methods. When the contraceptive methods being used were examined, it was detected that the condom was the most used method with 30.18% (n=153) and the use of once-in-three months progesterone (n=2), levonorgestrel-releasing intrauterine devices (n=2) and lactation (n=2) had the lowest percentages (0.40%). Among the study group, 65.50% of the women were influenced by their husbands about the choice of contraceptive, 52.27% were counselled by a physician and 35.70% were affected by their neighbourhood. The most frequently given reason for leaving the previous contraception method was losing confidence and becoming pregnant. In the study group, only 48.32% of the women had knowledge about their contraceptive methods. It was thought that the women were affected by their husbands and their neighbourhood in their choice of contraception and they were almost unconsciously using their chosen methods. Counselling by physicians to make women more conscious of their choice and choose the most appropriate contraceptive method is recommended. J. Exp. Clin. Med., 2012; 29:6-8
Respiratory manifestations of malaria.

Respiratory distress develops in up to 25% of adults and 40% of children with severe falciparum malaria. Its diverse causes include respiratory compensation of metabolic acidosis, noncardiogenic pulmonary edema, concomitant pneumonia, and severe anemia. Patients with severe falciparum, vivax, and knowlesi malaria may develop acute lung injury (ALI) and ARDS, often several days after antimalarial drug treatment. ARDS rates, best characterized for severe Plasmodium falciparum, are 5% to 25% in adults and up to 29% in pregnant women; ARDS is rare in young children. ARDS pathophysiology centers on inflammatory-mediated increased capillary permeability or endothelial damage leading to diffuse alveolar damage that can continue after parasite clearance. The role of parasite sequestration in the pulmonary microvasculature is unclear, because sequestration occurs intensely in P falciparum, less so in P knowlesi, and has not been shown convincingly in P vivax. Because early markers of ALI/ARDS are lacking, fluid resuscitation in severe malaria should follow the old adage to "keep them dry. " Bacteremia and hospital-acquired pneumonia can complicate severe malaria and may contribute to ALI/ARDS. Mechanical ventilation can save life in ALI/ARDS. Basic critical care facilities are increasingly available in tropical countries. The use of lung-protective ventilation has helped to reduce mortality from malaria-induced ALI/ARDS, but permissive hypercapnia in unconscious patients is not recommended because increased intracranial pressure and cerebral swelling may occur in cerebral malaria. The best antimalarial treatment of severe malaria is IV artesunate.
Effect of preoperative administration of erythromycin or flunixin meglumine on postoperative abomasal emptying rate in dairy cows undergoing surgical correction of left displacement of the abomasum.

OBJECTIVE To determine whether preoperative administration of erythromycin or flunixin meglumine altered postoperative abomasal emptying rate, rumen contraction rate, or milk production in dairy cattle undergoing surgical correction of left displacement of the abomasum (LDA). DESIGN Nonrandomized, controlled clinical trial. ANIMALS 45 lactating Holstein-Friesian cows with LDA. PROCEDURES Cows were alternately assigned to an erythromycin (10 mg/kg [4.5 mg/lb], IM), flunixin (2.2 mg/kg [1.0 mg/lb], IV), or control group (n = 15/group). Treatments were administered once 1 hour before surgical correction of LDA. D-Xylose solution (50%; 0.5 g/kg [0.23 g/lb]) was injected into the abomasal lumen during surgery, and venous blood samples were periodically obtained to determine time to maximum serum D-xylose concentration. RESULTS Abomasal emptying rate was significantly faster in cows treated with erythromycin (mean +/- SD time to maximum serum D-xylose concentration, 149 +/- 48 minutes) than in control cows (277 +/- 95 minutes) but was not significantly different between cows treated with flunixin (230 +/- 49 minutes) and control cows. Cows treated with erythromycin had significantly greater milk production, relative to production before surgery, on postoperative days 1 and 2 than did control cows. Cows in the erythromycin and flunixin groups had a significantly higher rumen contraction rate on the first postoperative day than did control cows. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that preoperative administration of a single dose of erythromycin increased abomasal emptying rate, rumen contraction rate, and milk production in the immediate postoperative period in cows undergoing surgical correction of LDA.
Common at its Core: HIV-Related Stigma Across Contexts

HIV and AIDS-related stigma and discrimination together have long been recognized as one of the main obstacles to the prevention care and treatment of HIV and AIDS. Yet little has been done on a large scale to combat them. There are many reasons for this inaction including the belief of many policymakers that stigma is hard to define and measure making it difficult to design and implement interventions. Stigma it is believed is too cultural too context-specific and too sensitive to be addressed meaningfully. This report a synthesis of findings from research in four countries presents evidence suggesting that HIV and AIDS-related stigma is far less varied and context-specific than may have been imagined. In fact there are many more similarities than differences across these contexts in the key causes of stigma the forms stigma takes and the consequences of stigma. This finding opens a number of important avenues for intervention. It is time to make a concerted effort against stigma and discrimination in order to progress in the fight against HIV and AIDS. The report begins by defining stigma and in Section 2 providing background about the projects. Next it discusses that in spite of different contexts the four countries where the studies took place share key features that shape the nature and forms of HIV-related stigma. Section 3 presents findings focusing on the similarities across the four different country contexts and is broken down into the following sub-sections: (1) understanding the root causes of HIV-related stigma; (2) an overview of the main expressions or forms that stigma takes; and (3) the consequences or impact of HIV-related stigma. Section 4 concludes with a discussion of the way forward and an overview of the two anti-stigma toolkits that grew out of the projects findings: one that is suitable to many African settings; and one adapted from the first which is tailored for Vietnam but suitable for adaptation elsewhere in the Asian region. (excerpt)