Miracle-dz/UniFAR-FTUs huggingface dataset:
Angiotensin receptor blockers: RAAS blockade and renoprotection

ABSTRACT Introduction: Chronic kidney disease (CKD) is an increasingly prevalent public health concern and is associated with a high risk of adverse cardiovascular outcomes. Renal impairment is frequently associated with hypertension and there is compelling evidence of the benefits of antihypertensive therapy for reducing progression of kidney disease. The central role of the renin-angiotensin-aldosterone system (RAAS) in hypertension and renal disease has led to interest in the ability of RAAS-blocking agents to provide benefits beyond blood pressure control. Scope: This review explores the mechanisms involved in CKD development, assesses markers of CKD progression, explores the role of the RAAS in renal disease, and examines RAAS blockade as a therapeutic option for renoprotection. For this purpose, a non-systematic literature review was conducted using the Medline database. Findings: Studies in patients with diabetic renal disease have shown that RAAS blockade with angiotensin converting enzyme (ACE)-inhibitors or angiotensin receptor blockers (ARBs) reduces progression of renal disease. Similarly, several studies have demonstrated the benefits of ACE inhibitors in non-diabetic renal disease, although few studies have been conducted with ARBs in this setting. At present, there is little evidence to determine the relative merits of ARBs and ACE inhibitors in terms of clinical outcomes, although ARBs appear to have advantages in terms of renal haemodynamics and measures of renal function. Conclusions: The beneficial effects of ARBs, which result from a combination of antihypertensive, haemodynamic, antiproteinuric and pleiotropic mechanisms, provide a strong rationale for considering the use of these agents in the treatment of high-risk patients.
Psychosocial aspects of food and nutrition as a clinical issue in home health care

ences depend upon adequate nurturing of both body and mind. Infants may be characterized by an intense set of needs; they are eager to obtain calories, protein, and fluids in a world that is emotionally supportive in nature. Extensive studies by sociologists, anthropologists, and psychologists have addressed the relationship of food intake and social behaviors from birth to death. A general conclusion is that eating behavior is fundamentally linked to the need for security. ’ In work with severely disturbed children, Bettelheim observed that these children frequently chose starvation when food was offered under conditions that undermined the self-respect of the individual child. ’ Forced feedings do not necessarily restore children to good health, and the same may be true for adults. Therefore, socially oriented food programs such as food stamps and assisted-feeding programs may fail if the psychology of eating is not adequately applied. In a fundamental study of psychology, Abraham Maslow’s work with motivation and the hierarchy of needs, food is identified as one of the basic human needs, which takes priority over other needs. ’ At the next level of need, food may be consumed to achieve a sense of security and physical comfort, and at the third level it may provide a sense of belonging when family and social events or rituals are available. Self-esteem, at the fourth level of need, may require that children and adults adopt suitable measures in order to feed themselves. At the highest level, creative cooking and nutrition education may be attempted as ways of achieving personal fulfillment and satisfaction.
How to Fix the Premedical Curriculum

THE influence of the modern medical school on liberal-arts education in this country over the last decade has been baleful and malign, nothing less. The admission policies of the medical schools are at the root of the trouble. If something is not done quickly to change these policies, all the joy of going to college will have been destroyed, not just for that growing majority of undergraduate students who draw breath only to become doctors, but for everyone else, all the students, and all the faculty as well. The medical schools used to say they wanted applicants as broadly educated .
Indoor Air Pollution From Gas Cooking and Infant Neurodevelopment

Background: Gas cooking is a main source of indoor air pollutants, including nitrogen dioxide and particles. Because concerns are emerging for neurodevelopmental effects of air pollutants, we examined the relationship between indoor gas cooking during pregnancy and infant neurodevelopment. Methods: Pregnant mothers were recruited between 2004 and 2008 to a prospective birth cohort study (INfancia y Medio Ambiente) in Spain during the first trimester of pregnancy. Third-trimester questionnaires collected information about the use of gas appliances at home. At age 11 to 22 months, children were assessed for mental development using the Bayley Scales of Infant Development. Linear regression models examined the association of gas cooking and standardized mental development scores (n=1887 mother–child pairs). Results: Gas cookers were present in 44% of homes. Gas cooking was related to a small decrease in the mental development score compared with use of other cookers (−2.5 points [95% confidence interval=−4.0 to −0.9]) independent of social class, maternal education, and other measured potential confounders. This decrease was strongest in children tested after the age of 14 months (−3.1 points [−5.1 to −1.1]) and when gas cooking was combined with less frequent use of an extractor fan. The negative association with gas cooking was relatively consistent across strata defined by social class, education, and other covariates. Conclusions: This study suggests a small adverse effect of indoor air pollution from gas cookers on the mental development of young children.
Commentary: Preventing Noncommunicable Diseases—Beyond Lifestyle

In September 2011, the United Nations General Assembly convened a “momentous and historical” high-level summit on noncommunicable diseases. The purpose was to identify priorities for action in fighting the steep global surge in noncommunicable diseases. There was general agreement that cardiovascular diseases, cancers, diabetes, and chronic lung diseases constitute the largest burden of morbidity and death, and that 4 major causes (tobacco, unhealthy diet, lack of physical activity, and harmful use of alcohol) should be a central target for prevention. Any public health expert would agree with the importance of these diseases, and with the dangers of those causal risk factors. But the UN s focus on individual behavior and lifestyles leaves little room for risk factors that are not personally modifiable—factors such as environmental pollution, poverty, or genetic susceptibility. The UN s strong focus on lifestyle is perhaps not surprising given the extensive research literature that has emphasized this aspect. However, targeting changes in individual behavior may not be enough.
17β-Hydroxysteroid Dehydrogenase Type 1 Is an Independent Prognostic Marker in Breast Cancer

Estrogens have an important role in the development and progression of breast cancer. 17β-Hydroxysteroid dehydrogenase type 1 (17HSD1), type 2 (17HSD2), and type 5 (17HSD5) are associated with sex steroid metabolism in normal and cancerous breast tissue. The mRNA expressions of the 17HSD1, 17HSD2, and 17HSD5 enzymes were analyzed in 794 breast carcinoma specimens by using tissue microarrays and normal histologic sections. The results were correlated with the estrogen receptor α (ER-α) and β (ER-β), progesterone receptor, Ki67, and c-erbB-2 expressions analyzed by immunohistochemical techniques and with the Tumor-Node-Metastasis classification, tumor grade, disease-free interval, and survival of the patients. Signals for 17HSD1 mRNA were detected in 16%, 17HSD2 in 25%, and 17HSD5 in 65% of the breast cancer specimens. No association between the 17HSD1, 17HSD2, and 17HSD5 expressions was detected. A significant association was observed between ER-α and ER-β (P = 0.02; odds ratio, 1.96) expressions. There was also a significant inverse association between ER-α and 17HSD1 (P = 0.04; odds ratio, 0.53), as well as ER-α and 17HSD5 (P = 0.001; odds ratio, 0.35). Patients with tumors expressing 17HSD1 mRNA or protein had significantly shorter overall and disease-free survival than the other patients (P = 0.0010 and 0.0134, log rank). The expression of 17HSD5 was significantly higher in breast tumor specimens than in normal tissue (P = 0.033; odds ratio, 5.56). The group with 17HSD5 overexpression had a worse prognosis than the other patients (P = 0.0146). ER-α also associated with survival (P = 0.045). Cox multivariate analyses showed that 17HSD1 mRNA, tumor size, and ER-α had independent prognostic significance.
Retrospektive Studie der Fruchtbarkeitsaussichten bei Kühen nach Sectio caesarea

Bei der Abwagung, ob bei einer Kuh aufgrund einer Geburtsstorung ein Kaiserschnitt durchgefuhrt werden soll, spielen die weiteren Nutzungsaussichten eine zentrale Rolle. In dieser retrospektiven Studie sollten mogliche Einflussfaktoren auf die Fruchtbarkeitsaussichten festgestellt werden. In den Jahren 1998, 1999 und im ersten Halbjahr 2000 wurde bei 207 Kuhe eine Sectio caesarea durchgefuhrt. 68% der wiederbelegten Tiere, bei denen ein lebendes Kalb entwickelt wurde, wurden erneut tragend. War das Kalb bereits tot, wurden nur noch 46% erneut trachtig. Somit waren insgesamt 59% der wiederbelegten Kuhe erneut gravid. 2.5% von diesen abortierten. Auch das Auftreten einer Retentio secundinarum oder einer Endometritis hatte einen Einfluss auf die spatere Fertilitat, da nur 30% der Kuhe, die an einer Gebarmutterentzundung erkrankten, wieder tragend wurden. Die Endometritis-Erkrankungsrate war doppelt so hoch, wenn ein totes Kalb entwickelt wurde, als nach der Entwicklung eines lebenden Kalbes.
Surfactants, skin cleansing protagonists

The correct choice of cosmetic products and cleansers is very important to improve skin hydration, to provide moisturizing benefits and to minimize cutaneous damage caused by surfactants. In fact, surfactants may damage protein structures and solubilize lipids. Soaps, defined as the alkali salts of fatty acids, are the oldest surfactants and are quite aggressive. Syndets (synthetic detergents) vary in composition and surfactant types (anionic, cationic, amphotheric, non‐ionic). These new skin cleansing products also contain preservatives, fragrances, and sometimes emollients, humectants and skin nutrients. We present a revision of the literature and discuss recent findings regarding skin cleansers.
Cadmium Exposure and Incident Cardiovascular Disease

Background: Cadmium is a widespread toxic metal with potential cardiovascular effects, but no studies have evaluated cadmium and incident cardiovascular disease. We evaluated the association of urine cadmium concentration with cardiovascular disease incidence and mortality in a large population-based cohort. Methods: We conducted a prospective cohort study of 3348 American Indian adults 45–74 years of age from Arizona, Oklahoma, and North and South Dakota, who participated in the Strong Heart Study in 1989–1991. Urine cadmium was measured using inductively coupled plasma mass spectrometry. Follow-up extended through 31 December 2008. Results: The geometric mean cadmium level in the study population was 0.94 &mgr;g/g (95% confidence interval [CI] = 0.92–0.96). We identified 1084 cardiovascular events, including 400 deaths. After adjustment for sociodemographic and cardiovascular risk factors, the hazard ratios (HRs) (comparing the 80th to the 20th percentile of urine cadmium concentrations) was 1.43 for cardiovascular mortality (95% CI = 1.21–1.70) and 1.34 for coronary heart disease mortality (1.10–1.63). The corresponding HRs for incident cardiovascular disease, coronary heart disease, stroke, and heart failure were 1.24 (1.11–1.38), 1.22 (1.08–1.38), 1.75 (1.17–2.59), and 1.39 (1.01–1.94), respectively. The associations were similar in most study subgroups, including never-smokers. Conclusions: Urine cadmium, a biomarker of long-term exposure, was associated with increased cardiovascular mortality and increased incidence of cardiovascular disease. These findings support that cadmium exposure is a cardiovascular risk factor.
The impact of the pH value on skin integrity and cutaneous wound healing

The process of cutaneous wound healing comprises three overlapping major phases: inflammation, proliferation and tissue remodelling. However, while mechanisms are studied scientifically on the cellular and subcellular level, there is still a lack of knowledge concerning basic clinical parameters like wound pH or pO2. It could be proven that wound healing is affected by wound pH changes as they can lead to an inhibition of endogenous and therapeutically applied enzymes. Besides, the conformational structure of proteins and their functionality in wound healing is altered. Furthermore, the likelihood of bacterial colonization, which is a common problem in chronic wound pathogenesis, is affected by wound pH alterations. However, wound pH is rarely taken into account in current wound therapy strategies. A routinely performed monitoring of the wound pH and a subsequently adapted wound therapy would most possibly improve chronic wound therapy.
The Effect of Age on Dexamethasone Intravitreal Implant (Ozurdex®) Response in Macular Edema Secondary to Branch Retinal Vein Occlusion

ABSTRACT Purpose: To investigate the effect of age on dexamethasone intravitreal implant (Ozurdex®) response in macular edema secondary to branch retinal vein occlusion (BRVO). Methods: Seventy-three eyes of 73 patients with macular edema secondary to BRVO were recruited in the study. The patients in the study were divided into the following four groups according to their ages: group 1 (<60 years), group 2 (60–69 years), group 3 (70–79 years), and group 4 (≥80 years). Single-dose Ozurdex injection was applied to all patients. The effectiveness of Ozurdex treatment on macular edema is evaluated via optical coherence tomography (OCT) according to the age groups. Results: Two months after Ozurdex injection, mean reduction of central retinal thickness in groups 1, 2, 3, and 4 were –466.4 ± 149.6, –379.7 ± 238.7, –280.1 ± 233.0, and –180.5 ± 81.4 µm, respectively. This reduction of central retinal thickness decreased with aging (p = 0.001). Also, ages of patients were negatively correlated with the mean reduction of central retinal thickness for the whole study group (r = –0.439, p < 0.001). Conclusion: Our study revealed that the effectiveness of Ozurdex treatment decreases with aging.
Effects of Fetal Programming in the Inflammatory Response in Wistar Rats: A Systematic Review

El objetivo de este trabajo fue revisar la literatura sobre los efectos de la programacion fetal en la respuesta inflamatoria en ratas Wistar. Se realizo una busqueda en las bases de datos: PubMed, MEDLINE, PUBMED, Science Direct, SCOPUS, LILACS, SpringerLink. Los terminos principales de la busqueda fueron la malnutricion y la inflamacion y se buscaron en portugues e ingles. Se incluyeron articulos originales de ratas albinas y se excluyeron los articulos de revision, las relacionadas con los seres humanos o animales, y de ratas en los articulos relacionados a la desnutricion, que no era el intrauterina y que no se referian al concepto de la programacion fetal. Los articulos encontrados en mas de una base de datos se contaron una sola vez. Encontramos 16 articulos en PUBMED, 16 en SCOPUS, 4 en MEDLINE, 341 en Science Direct, 8 SciELO, LILACS y 1 de cada 77 en SpringerLink, dando un total de 463 articulos. Despues de la aplicacion de la inclusion y exclusion de criterios fueron seleccionados 4 articulos para el analisis. La programacion fetal parece interferir con la respuesta inflamatoria en los descendientes adultos de ratas Wistar, pero sus mecanismos siguen siendo inciertos.
miR-155: On the Crosstalk Between Inflammation and Cancer

MicroRNAs are short non-coding RNAs that posttranscriptionally modulate the expression of multiple target genes and are thus implicated in a wide array of cellular and developmental processes. miR-155 is processed from BIC, a non-coding transcript highly expressed in both activated B and T cells and in monocytes/macrophages. miR-155 levels change dynamically during both hematopoietic lineage differentiation and the course of the immune response. Different mouse models developed recently indicate that miR-155 plays a critical role during hematopoiesis and regulates lymphocyte homeostasis and tolerance. A moderate increase of miR-155 levels is observed in many types of malignancies of B cell or myeloid origin, and transgenic over-expression of miR-155 in mice results in cancer. While the high levels of miR-155 reached transiently during the course of the immune response remain unharmful for the organism, the reason why a moderate up-regulation of miR-155 can lead to cancer remains obscure. As prolonged exposure to inflammation can lead to cancer, the permanent up-regulation of miR-155 might be a link between the two. Therefore, designing miR-155 based therapies will require a better understanding of the molecular basis of its action as well as of how miR-155 levels are regulated in a cell-specific manner.
Blood flow structure in patients with coronary heart disease

Blood flow structure was studied by PC integrated video camera with following slide by slide analysis. Volumetric blood flow velocity was supporting on constant level (1 ml/h). Silicone tube of diameter comparable with coronary arteries diameter was used as vessel model. Cell-cell interactions were studied under glucose and anticoagulants influence. Increased adhesiveness of blood cells to tube walls was revealed in patient with coronary heart disease (CHD) compare to practically healthy persons (PHP). In patients with stable angina pectoris of high functional class and patients with AMI shear stress resistant erythrocyte aggregates were predominating in blood flow structure up to microclots formation. Clotting and erythrocytes aggregation increase as response to glucose solution injection, sharply defined in patients with CHD. Heparin injection (10 000 ED) increased linear blood flow velocity both in patients with CHD and PHP. After compare our results with other author's data we can consider that method used in our study is sensible enough to investigate blood flow structure violations in patients with CHD and PHP. Several differences of cell-cell interaction in flow under glucose and anticoagulant influence were found out in patients with CHD and PHP.
AID Biology: A pathological and clinical perspective

ABSTRACT Activation-induced cytidine deaminase (AID), primarily expressed in activated mature B lymphocytes in germinal centers, is the key factor in adaptive immune response against foreign antigens. AID is responsible for producing high-affinity and high-specificity antibodies against an infectious agent, through the physiological DNA alteration processes of antibody genes by somatic hypermutation (SHM) and class-switch recombination (CSR) and functions by deaminating deoxycytidines (dC) to deoxyuridines (dU), thereby introducing point mutations and double-stranded chromosomal breaks (DSBs). The beneficial physiological role of AID in antibody diversification is outweighed by its detrimental role in the genesis of several chronic immune diseases, under non-physiological conditions. This review offers a comprehensive and better understanding of AID biology and its pathological aspects, as well as addresses the challenges involved in AID-related cancer therapeutics, based on various recent advances and evidence available in the literature till date. In this article, we discuss ways through which our interpretation of AID biology may reflect upon novel clinical insights, which could be successfully translated into designing clinical trials and improving patient prognosis and disease management.
Grundlagen der forensischen Psychotherapie

Wesentliche Grundlagen der Arbeit in der forensischen Psychiatrie sind Deliktbezogenheit, Arbeit mit erlittenen wie anderen zugefügten Traumatisierungen und eine Identifikation der Therapeuten sowohl mit der Subjektivität der Täter wie derjenigen der Partner und Opfer. Strafeund Rachephantasien sollten analysiert werden. Supervisionen sind in der forensischen Psychotherapie unabdingbar. Der Beitrag zeigt, wie stark sich aktuelle kognitiv-behaviorale Konzepte auf lange bekannte psychoanalytische Ansätze stützen. Der Verhaltenstherapie mit multimodalen Ansätzen verdanken wir in den letzten Jahren empirisch gesicherte Befunde darüber, dass und was in der forensischen Therapie wirkt [1]. Die psychoanalytische Beschäftigung mit straffällig gewordenen Patienten hat eine lange Tradition und vermittelt Handlungsempfehlungen für alle Berufsgruppen. Mit ihrer Betonung der Einmaligkeit jeder biographischen Entwicklung und der Sinngebung auch pathologischer Prozesse wirkt sie einer einseitig strafenden Haltung entgegen, die durch Ausschließung Grenzüberschreitungen sowohl bei potenziellen Tätern als auch bei täterüberwachenden Gruppen wie Justizbeamten und Therapeuten fördert. Die gruppenanalytisch geprägte therapeutische Gemeinschaft vereinigt soziologische wie psychoanalytische Methoden und Befunde. Sie entstand in Großbritannien und Frankreich und analysiert die individuellen ebenso wie die gesellschaftlichen Ebenen psychischen Erlebens und Scheiterns. In Strafwie Maßregelvollzugseinrichtungen findet sie immer mehr Anwendung, ihre Ergebnisse werden zunehmend empirisch evaluiert [2].
Can We Measure Prior Postmenopausal Estrogen/Progestin Use? The Postmenopausal Estrogen/Progestin Interventions Trial

The objective of this study was to assess: 1) the accuracy of a single self-report question about postmenopausal estrogen use; and 2) the performance and repeated measures agreement of a standardized hormone use interview. Women (n = 863) in the Postmenopausal Estrogen/Progestin Interventions Trial (PEPI) completed a self-report baseline questionnaire (BQ) at enrollment and a History of Hormone Use interview (HHU) at the 3-month follow-up visit (HHU 3mos ). A subsample of 101 women completed a second HHU interview 3 years later (HHU 3yrs ). As determined by the HHU 3mos , 479 (56%) of women had ever used postmenopausal estrogen and 261 (30%) had ever used postmenopausal progestin. The mean number of years since last estrogen or progestin use was 2.2 and 1.3 years, respectively. Overall, there was 95% agreement between self-reported estrogen use on the BQ and the HHU 3mos (kappa = 0.91). Using the HHU 3mos as the criterion standard, the BQ misclassified 2.3% of women as false positives and 6.3% as false negatives. The average duration of estrogen use in the false-negative classifications was 1.9 years (range: 1-9 years). On the HHU 3mos , 39.7% of participants could not recall at least one of the specific details of estrogen use (preparation, dose, route, or starting or stopping year); similar patterns of recall were found for progestin use. Factors associated with discordant reporting of ever-use of ERT (BQ vs. HHU 3mos) or incomplete reporting of estrogen/progestin use on the HHU 3mos were: route of administration, recency of hormone use, duration of hormone use, and race. Age, years since menopause, education, income, and hysterectomy status were not related to discordant and/or incomplete reporting. Agreement between the HHU 3mos and HHU 3yrs for ever-use of estrogen was 85.2% (kappa = 0.71). In sum, a single self-report question was adequate to ascertain ever-use of postmenopausal estrogen. When a structured interview form was used, details of postmenopausal estrogen and progestin use were not well remembered. Some features of hormone use and participant characteristics were associated with completeness of recalled hormone use, which suggests the potential for differential misclas sification.