Miracle-dz/UniFAR-FTUs huggingface dataset:
Effect of phenolic compounds on the growth of selected probiotic and pathogenic bacteria

Fruit extracts from different tissues (pulp, seed and peel) have shown antimicrobial and prebiotic activities related to their phenolic profile, although structure‐specific evaluations have not been reported yet. The effect of five phenolic compounds (catechin and gallic, vanillic, ferulic and protocatechuic acids) identified in different fruits, particularly in mango, was evaluated on the growth of two probiotic (Lactobacillus rhamnosusGG ATCC 53103 and Lactobacillus acidophilusNRRLB 4495) and two pathogenic (Escherichia coli 0157:H7 ATCC 43890 and Salmonella enterica serovar Typhimurium ATCC 14028) bacteria. The minimal inhibitory concentration (MIC) and minimal bactericidal concentration (MBC) of phenolic acids ranged from 15–20 mmol l−1 and 20–30 mmol l−1 against E. coli and S. Typhimurium, respectively. For catechin, the MIC and MBC were 35 mmol l−1 and >35 mmol l−1 against E. coli and S. Typhimurium, respectively. The presence of catechin and gallic, protocatechuic and vanillic acids in MRS broth without dextrose allowed the growth of lactobacilli. Catechin combined with protocatechuic or vanillic acid mildly allowed the growth of both probiotics. In conclusion, phenolic compounds can selectively inhibit the growth of pathogenic bacteria without affecting the viability of probiotics.
Combined paediatric NAFLD fibrosis index and transient elastography to predict clinically significant fibrosis in children with fatty liver disease

Nonalcoholic fatty liver disease (NAFLD) encompasses a spectrum of disease from simple steatosis to steatohepatitis, to fibrosis and cirrhosis. The paediatric NAFLD fibrosis index (PNFI) and transient elastography (TE) are potential noninvasive markers for fibrosis.
Why do I treat HBeAg‐negative chronic hepatitis B patients with nucleos(t)ide analogues?

Products that are currently used in the treatment of chronic hepatitis B include interferon‐alpha (IFNa: standard or pegylated) (PEG‐IFNa) and nucleos(t)ide analogues (NAs). NAs are used in most HBeAg‐negative chronic hepatitis B patients for several reasons. They can be prescribed to all chronic HBV patients, even those with contraindications to IFNa; and even IFNa candidates are usually treated with NAs because of their advantages. Administration of NAs is easier (one oral tablet per day compared with subcutaneous IFNa injections), tolerance is excellent and the safety profile is good, whereas IFNa may have adverse events and often worsens the patients’ quality of life. The current first‐line NA options, entecavir (ETV) and tenofovir (TDV), have minimal or no risk of long‐term resistance and a virological response is achieved in almost 100% of adherent HBeAg‐negative patients, thus modifying the long‐term outcome. The need for long‐term, perhaps indefinite, treatment is the main limitation of NAs and the finite duration (48 weeks), the main advantage of IFNa, especially in young patients of reproductive age. However, at most 25% of IFNa‐treated HBeAg‐negative patients achieve a sustained off‐treatment response and therefore >75% of them will eventually receive NAs, even if they start with IFNa. As there will always be concerns about safety and family planning issues with long‐term NA therapy, NAs should be used carefully, particularly in young chronic hepatitis B patients with mild liver disease. Novel therapeutic options are needed to increase the rates of HBsAg loss and sustained off‐treatment responses.
Dynamics of shrub encroachment in an African savanna: relative influences of fire, herbivory, rainfall and density dependence

Summary 1 Shrub encroachment has been widely observed in savanna regions. This study analysed the causes of shrub encroachment in the lowveld savanna of north-eastern Swaziland, southern Africa, and highlighted management regimes that can be used to reduce or prevent it. 2 The rates and dynamics of shrub encroachment were quantified for the period 1947–90 using aerial photographs, and for 1997 using a ground survey. Five similar areas with different land-use histories were compared to investigate the relative importance of fire, herbivory, rainfall, soil type and shrub density in driving shrub dynamics. 3 In the study area as a whole, shrub cover increased from a mean of 2% in 1947 to 31% in 1990. Dichrostachys cinerea accounted for most of the increase in cover, contributing 81% to total shrub cover during 1997. Shrub cover was strongly correlated with shrub density and weakly negatively correlated with tree cover. 4 Shrub encroachment varied across land-use fence lines. The key determinants of shrub dynamics were grazing, through its negative effect on fire frequency and an interaction between drought frequency and high shrub cover. Browsing pressure had a significant but minor impact on dynamics, while soil type had no significant effect. High grazing pressures through their effect on fire frequency were critical throughout the study period in promoting shrub encroachment, while the interaction between drought and high shrub cover produced declines in the later stages. Browsing had an impact on encroachment only in the early stages. 5 Frequent fires, facilitated by low grazing pressures, were capable of preventing shrub encroachment. When coupled with drought, frequent fires could reduce high shrub densities. 6 As cover and density were strongly correlated, it can be inferred from the negative correlation between change in cover (density) and initial cover (density) that the rate of shrub encroachment was cover (density)-dependent and that there was a shrub equilibrium of 40% cover, approximating to 2400 plants ha−1. Shrub population growth was driven by events (fire, drought) as well as continuous agents (density dependence, mean browsing and grazing pressure). 7 Bush encroachment can be reversed by a combination of management (frequent fires) and climatic events (drought). The implications for savanna management are discussed.
Cautious application of the hepatorenal syndrome criteria to critically ill patients with cirrhosis

To the Editor: In clinical practice, differential diagnosis of the main phenotypes of acute kidney injury (AKI) may be difficult in patients with cirrhosis because the precipitating factors as well as the clinical presentation may be very similar. Nevertheless, an algorithm to aid the process of differential diagnosis has been suggested based mainly on the more recent diagnostic criteria for hepatorenal syndrome (HRS) (1, 2). However, the practitioner should be cautious when applying these criteria to critically ill patients with cirrhosis. From August 2010 to April 2012, 181 critically ill patients with cirrhosis and ascites were retrospectively reviewed. After excluding patients with end-stage renal disease (7 cases), patients without previous renal function data (17 cases) and patients without urinalysis or renal echo data (2 cases), 155 patients were enrolled for analysis. We included 109 cases in the AKI group according to a modified diagnostic criterion, defined as an increase in the serum creatinine level of >26.4 lmol/L (0.3 mg/dl) or an increase by 50% from baseline (3) (Table 1). Of the patients with AKI, 38.5% (42 cases) had urinary tract infections (UTIs) and 62.4% (68 cases) were classified with renal parenchymal disease (RPCD) [according to HRS criteria: proteinuria >500 mg/day, microhaematuria (>50 red blood cell per high-power field) and/or abnormal renal ultrasonography]. After excluding patients with serum creatinine <1.5 mg/dl (36 cases), presence of RPCD (51 cases), improvement in serum creatinine level after
Evolution of neoadjuvant therapy for extended hepatic metastases—have we reached our (non‐resectable) limit?

Surgical resection offers the best chance for cure in patients with colorectal liver metastases; however, only 15–25% of them can benefit from surgery. To increase resectability a number of strategies have been developed in different fields including chemotherapy, surgery, and radiology. Bringing them together into an integrated framework has expanded the number of patients that can be treated with curative intent. This review focuses on recent oncosurgical changes, their impact, and future directions. J. Surg. Oncol. 2010;102:922–931. © 2010 Wiley‐Liss, Inc.
Evaluación de una intervención de farmacia clínica sobre el control de la presión arterial

Objective: To compare short and long term blood pressure control with clinical pharmacy specialist involvement to traditional physician management. Setting: A non-profit health maintenance organization in the United States covering approximately 385,000 lives. Methods: This analysis utilized a prospective parallel design. Adult patients with a baseline Blood pressure≥140/90 mmHg and receiving at least one antihypertensive medication were eligible for the study. Eligible hypertension management patients at one medical office were referred to the office’s clinical pharmacy specialist (intervention cohort) while at another comparable medical office they received usual physician-directed care (control cohort). The primary outcome measure was achievement of a goal BP (<140/90 mmHg) during a six month follow-up. Medical records were also reviewed approximately 1.5 years post enrollment to assess long-term BP control after clinical pharmacy-managed patients returned to usual care. Multivariate analyses were performed to adjust for baseline cohort differences. Results: One hundred-thirteen and 111 subjects in the intervention and control cohorts completed the study, respectively. At the end of the follow-up period, clinical pharmacy-managed subjects were more likely to have achieved goal BP (64.6%) and received a thiazide diuretic (68.1%) compared to control subjects (40.7% and 33.3%, respectively) (adjusted p=0.002 and p<0.001, respectively). The proportion of clinical pharmacy-managed subjects with controlled BP decreased to 22.2% after returning to usual care (p<0.001). Conclusion: Clinical pharmacy involvement in hypertension management resulted in increased BP control. Loss of long-term control after discontinuation of clinical pharmacy management supports a change in care processes that prevent patients from being lost to follow-up. Investigación original Evaluación de una intervención de farmacia clínica sobre el control de la presión arterial An Evaluation of a Clinical Pharmacy-Directed Intervention on Blood Pressure Control Caroline E. KICKLIGHTER, Kent M. NELSON, Tammy L. HUMPHRIES, Thomas DELATE. Kicklighter CE, Nelson KM, Humphries TL, Delate T. Evaluación de una intervención de farmacia clínica sobre el control de la presión arterial. Pharmacy Practice 2006; 4(3): 110-116. www.pharmacypractice. org 111
Surgery‐induced immunomodulation in breast cancer

Boomsma et al. [1] determined endocrine and immune responses to surgery in 27 patients with breast cancer and concluded that surgical procedure produced substantial immunomodulation. The study was well designed and conducted, while we have some concern about its data interpretation. In this study, cytokines produced by peripheral blood mononuclear cells (PBMC) upon mitogenic or inflammatory stimulation rather than levels of T helper (Th)1/Th2 cytokines in the sera were detected to identify the surgery-related changes of serum cytokines [1]. As a result, the authors revealed a pro-inflammatory status indirectly induced by breast cancer surgery, whereas the direct surgery-related immunomodulation was not shown. In this regard, the results would be more convincing if the authors could detect the serum levels of Th1 and Th2 cytokines. Th1 cells predominantly secrete interferon (IFN)-g and tumor necrosis factor (TNF)-a while Th2 cells predominantly secrete interleukin (IL)-4, IL-5, IL-10, and IL-13 [2]. Although IL-12 is crucial to induce Th1 cells and polarize a Th1 response, it is not a Th1 cytokine, since it is primarily produced by antigen presenting cells such as macrophages and dendritic cells [3–7]. Similarly, IL-6 is a classic proinflammatory cytokine but not a typical Th2 cytokine [7]. We are also eager to know if there is any correlation between perioperational cytokine/cortisol alteration and breast cancer staging. If so, surgery-induced immunomodulation might also be confounded by cancer stages because more tumor cells may shed into circulation in cases with more advanced cancer. It is also the case if the authors concluded that no cortisol response occurred after breast cancer surgery, because breast cancer surgery is a minor type of surgery. Another potential confounding factor is peri-operational infection, especially with regard to unexpected increase in Th1 cytokines (IL-2 and TNF-a) 5 days after surgery, contrary to former findings [8]. Therefore, any subject with peri-surgical fever indicating infections should be excluded from the study. In summary, surgical procedure produces of breast cancer, although conventionally considered minor, may induce substantial immunomodulation. Further studies are needed to either utilize or prevent this immunoregulatory effect. Xue-Bo Chen, MD Xue-Dong Fang, MD, PhD* Department of General Surgery, the Second Hospital of Jilin University, Jilin University, Changchun, China
The insulin gene variable number of tandem repeats (INS VNTR) genotype and sleep disordered breathing in childhood obesity

Aim of our study is to verify the association between the genetic predisposition to hyperinsulinism due to the presence of the insulin gene (INS) I/I genotype and the development of sleep-related breathing disorders (SRBD) in obese children and adolescents. Two hundred and fifty-six obese children and adolescents (125 girls) have been investigated. As initial screening all subjects’ mothers filled out the Sleep Disturbances Scale for Children (SDSC). The Sleep-Disordered Breathing (SDB) scale has been taken into account. Successively, a subgroup of 34 patients belonging to the first (14 children) and the last (20 children) SDB score quintiles underwent an overnight polysomnography and the apnea-hypopnea index (AHI) was evaluated. All subjects were genotyped for the INS VNTR and fasting insulin levels were evaluated. The population was divided into two groups according to the genotype: the first group was comprehensive of patients homozygotes for class I allele and the second group was composed by class III allele heterozygotes and homozygotes patients. Subjects I/I showed statistically significant higher insulin levels (p<0.001) and SDB scores (p<0.001). Moreover, in the subgroup of patients investigated with polysomnography, class I homozygous subjects showed higher AHI compared to those patients carrying class III allele (p<0.001). Our data support the hypothesis that INS VNTR is associated with the development of SDB among obese children and adolescents.
Review of Swedish regulation and monitoring of aquaculture

Summary The aquaculture industry is governed by national Acts, ordinances and regulations. Provisions for the industry have been slightly modified since Sweden entered the EU in 1995. Swedish environmental legislation is applied when potential farmers ask for permission to cultivate. The Acts regulate farming sites, the discharge of water from farms and the species and strains that are permitted to be cultivated. The application procedure for fish farming is comprehensive and judged with regard to the Swedish Acts. Supervision of the aquaculture industry is performed by the County Administrative Board and sometimes also by the Local Administration. All farming units producing stocking material are strictly controlled in an elaborate scheme. Sweden has adopted European Community (EC) directives for shellfish, fish and water quality. Criteria for classifying water quality for concentrations of organic compounds and metals in blue mussels are worked out, and toxins in blue mussels are monitored. EC directives for fresh water quality which aim to sustain fish stocks are adopted as Swedish conditions.
Management of HCV transplant patients with triple therapy

Hepatitis C virus (HCV) infection is one of the leading causes of end‐stage liver disease and the main indication for liver transplantation (LT) in most countries. All patients who undergo LT with detectable serum HCV RNA experience graft reinfection. Between 20 and 30% of patients have developed cirrhosis at 5 years post‐LT. The outcome of transplant patients with cirrhosis on the graft is severe, with a rate of decompensation at 1 year of approximately 40%. To date, retransplantation is the only option in patients with decompensated liver disease. Until 2011, standard antiviral therapy with pegylated interferon (PEG‐IFN) and ribavirin (RBV), was the only effective therapy. Obtaining a sustained virological response (SVR) in patients with LT greatly improves overall and graft survival but this only occurs in 30% of transplanted patients. Direct acting antivirals (DAAs) such as protease inhibitors (PI), polymerase or other non‐structural proteins inhibitors represent a new era in HCV associated liver disease. Although their use in the field of LT will certainly be essential there are some limitations because of safety and tolerance. One limitation is the potential interaction with calcineurin inhibitors. We describe the results of triple therapy with boceprevir (BOC) or telaprevir (TVR) for efficacy and safety and comment on future therapeutic strategies in liver transplant recipients.
Holmium laser enucleation of the prostate is safe in patients with prostate cancer and lower urinary tract symptoms--a retrospective feasibility study.

OBJECTIVE To evaluate the outcome of holmium laser enucleation of the prostate (HoLEP) in the known presence of prostate cancer (PCa) and concomitant lower urinary tract symptoms (LUTS). PATIENTS AND METHODS We retrospectively identified 62 patients who underwent HoLEP for LUTS in the known presence of PCa at our center. Perioperative data were assessed including complications, functional outcomes, and quality of life (QoL). Giving respect to different disease characteristics, patients were stratified according to treatment strategy setting into palliative (I), radiation (II), and surveillance (III) groups and compared accordingly. RESULTS Median follow-up (FU) of the entire study cohort was 27 months (range 2-65 mos). Medians of functional parameters (International Prostate Symptom Score): 18.5 vs 4.5, QoL: 4 vs 1, maximal flow rate: 9.0 vs 18.8 mL/s and residual urine: 100 vs 0 mL, all P<0.05) improved significantly in all groups. Perioperative complications were low and without any statistically significant difference between the groups. Postoperatively, voiding was successful in 90.3% of all patients; at last FU, 17% had some degree of urinary incontinence. Treatment strategy groups showed comparable functional outcomes after HoLEP. CONCLUSION In the presence of PCa and LUTS, HoLEP represents a feasible, safe, and effective treatment option for patients unfit or without indication for radical prostatectomy. This applies as well in a palliative situation of advanced, obstructive PCa as for patients with LUTS who are scheduled for radiation therapy or surveillance in presumably indolent disease.
The clinical research office of the endourological society ureteroscopy global study: indications, complications, and outcomes in 11,885 patients.

PURPOSE To assess the current indications for ureteroscopy (URS) treatment, outcome in terms of stone-free rate, and intra- and postoperative complications using the modified Clavien grading system. PATIENTS AND METHODS The Clinical Research Office of the Endourological Society collected prospective data as part of the URS Global Study for consecutive patients treated with URS at centers around the world for 1 year. URS was performed according to study protocol and local clinical practice guidelines. The stone size and location were recorded and postoperative outcome and complications, graded according to the modified Clavien grading system, reported. RESULTS Between January 2010 and October 2012, 11,885 patients received URS at 114 centers in 32 countries; 1852 had only renal stones, 8676 had only ureteral stones, and 1145 patients had both types of stone. Fragmentation was performed principally using a laser device (49.0%) or a pneumatic device (30.3%); no device was used in 17.9% of the patients. A high stone-free rate (85.6%) was achieved. The large majority of patients did not receive any further treatment for renal or ureter stones (89.4%). The postoperative complication rate was low (3.5%). The most frequent complication was fever (1.8%); a blood transfusion was required in 0.2% of patients. The majority of complications were Clavien grade I or II (2.8% of patients). CONCLUSION URS is an established minimal invasive treatment for urinary stones with a high success rate and low morbidity. Recent advances have expanded the indication for urinary stones, which now ranges from treatment of smaller sized distal ureter stones by semirigid URS to larger sized renal pelvis stones treated by flexible URS.
Where are the protests?

Had I, before the road crash that killed our daughter, pushed my imagination to the limit I might, just might, have got a sense of the devastating impact of losing a loved one in such a way; a life crushed and gone without so much as a goodbye. But I could never have imagined just how long the effects of that day would last. Eight and a half years after our young daughter died, the lives of my wife and me have still not returned to normal. And I can now say with certainty that they never will. > Police investigations of road death are often indifferent and court sanctions are usually paltry There has been a massive shift in how we view the world. Our whole frame of reference has moved: what was once funny is no longer amusing, what was once enjoyable is best avoided and friends and …
Oncofetal protein, IMP‐3, a potential marker for prediction of postoperative peritoneal dissemination in gastric adenocarcinoma

The aim of this study was to determine the expression of insulin‐like growth factor‐II messenger RNA (mRNA)‐binding protein‐3 (IMP‐3) and its clinical significance in gastric cancers, as well the prognostic value of its expression in the peritoneal lavage fluid after surgery.
The coagulation system in patients with end‐stage liver disease

In patients with cirrhosis, routine laboratory tests for primary hemostasis and coagulation usually show anomalies that are associated with excess bleeding in other settings, in particular low platelet counts and prolonged prothrombin time. However, under conditions similar to those in vivo, primary hemostasis and thrombin production do not appear to be decreased in patients with cirrhosis, particularly when the platelet count is above 75 000/μl. Furthermore, there is laboratory and epidemiological evidence of a mild procoagulant and prothrombotic state in patients with cirrhosis. Bleeding is mainly because of portal hypertension rather than defective hemostasis. There is some evidence that anticoagulation therapy is not associated with an excess of severe bleeding and that it could improve the outcome in patients without portal vein thrombosis. At present, there is no clear evidence that portal vein thrombosis is responsible for the progression of liver disease and that anticoagulation therapy would improve the outcome of patients with portal vein thrombosis.