Miracle-dz/UniFAR-FTUs huggingface dataset:
Efeitos endócrinos e metabólicos das drogas antiepilépticas Endocrine and metabolic effects of antiepileptic drugs

The antiepileptic drugs (AED) have been widely used for a great deal of people - in the treat- ment of epilepsy and other diseases - throughout the world. Continuous and prolonged use of AED may be associated with adverse effects in different systems, including a variety of en- docrine and metabolic abnormalities. In this review, the relationship of AED with alterations in bone mineral metabolism, energy balance and body weight, gonadal function and thyroid metabolism was revised, as well as their clinical utility in the treatment of diabetic neuropathy.
Health Status and Access to Care for Homeless Adults with Problem Alcohol and Drug Use

&NA; Problem alcohol and drug use by adult homeless persons may put them at higher risk for other health problems and impact their access to health care. The purpose of this study was to determine if those with a positive screen for problem alcohol or drug use were at increased odds for having a lower health status and less access to care than those without problem alcohol or drug use. This was a secondary analysis of health survey data from a study related to the health of homeless adults. The survey included the Alcohol Use Disorders Identification Test (AUDIT) and the Drug Abuse Screening Test 10 (DAST‐10) for evaluating problem substance use; health related quality of life, health care utilization, and medical history were also included. The impact of problem alcohol use or drug use on the odds of reporting lower general health status, a history of physical or mental illness, use of the emergency department (ED), and problems getting health care when needed, were estimated using logistic regression. A total of 112 adult homeless participants completed the survey. Participants with problem alcohol use tended to be less likely to obtain health care when needed (OR = 2.3, p = 0.05). Those with problem alcohol or drug use were not at increased odds of reporting a lower general health status, a positive medical history, or ED use. Problem alcohol use was associated with decreased access to health care when needed. Screening for problem alcohol use among homeless adults may not only help to identify those in need of interventions related to alcohol use but also help to identify those in need of help in accessing general health care.
Nitrates and Left Ventricular Dysfunction

Use of beta-blockers and inhibitors of the renin angiotensin system (RAS) is established practice in the treatment of chronic heart failure (CHF). Clinical studies also suggest beneficial long-term effects of nitrates in CHF. In the Veterans Administration Heart Failure Trial (V-HeFT) I, the combined use of a nitrate and hydralazine reduced the mortality rate. However, it is not possible to determine the relative importance of nitrate therapy in that study. The main objective of this thesis was to study the long-term effects of nitrate therapy in patients with evidence of left ventricular (LV) dysfunction after acute myocardial infarction (AMI) already treated with standard heart failure (HF) therapy. Paper I. In a randomized, double-blind, placebo controlled trial, we evaluated the effects of a 60 mg dose of isosorbide-5-mononitrate (IS-5-MN) given daily to 47 patients with clinical or echocardiographic evidence of LV dysfunction after AMI. Forty-five patients received a placebo. No significant haemodynamic effects of IS-5-MN therapy were observed. We found that nitrate therapy resulted in lower plasma atrial natriuretic peptide (P ANP) levels and reduced the need for additional diuretics. Less LV dilatation was observed in patients with more severe LV dysfunction at baseline, indicating clinically beneficial effects, especially in patients with more reduced LV function after AMI. Paper II. The main finding of this study was that lipid peroxidation measured by plasma malondialdehyde (MDA) and 8-isoprostane were not increased in patients with LV dysfunction treated with standard HF therapy. No positive correlations to the markers of severity of HF were found. Long-term IS-5-MN therapy did not influence P-MDA concentrations. Results from many studies suggest that oxidative stress is increased in HF, but this may not be true for patients treated with beta-blockers and inhibitors of the RAS. Paper III. Chronic nitrate therapy did not significantly affect the neurohumoral status in patients with LV dysfunction after AMI, apart from a decrease in P-ANP. Some hormones were seen to be more closely associated with diastolic dysfunction/increased volume load, viz ANP and brain natriuretic peptide (BNP), while others were found to be more closely associated with systolic dysfunction, namely plasma renin activity (PRA), norepinephrine (NEPI) and aldosterone (Aldo). A temporal dissociation between these two groups of hormones occurred 1 year after the infarction: ANP and BNP decreased, while NEPI and Aldo showed slight increases. Paper IV. Isosorbide-5-mononitrate treatment and diastolic function were evaluated in patients with LV dysfunction after AMI. Chronic nitrate therapy did not significantly affect diastolic function evaluated by echocardiography. Changes in diastolic parameters during 1 year after AMI indicated improved diastolic function and/or reduced pre-load. Fewer factors indicating worse prognosis were demonstrated in patients with normal or slightly reduced LV ejection fraction (LVEF) 1 month after AMI, compared with patients with moderately or severely depressed LVEF. (Less)
Quality of diabetes care in U.S. academic medical centers: low rates of medical regimen change.

OBJECTIVE To assess both standard and novel diabetes quality measures in a national sample of U.S. academic medical centers. RESEARCH DESIGN AND METHODS This retrospective cohort study was conducted from 10 January 2000 to 10 January 2002. It involved 30 U.S. academic medical centers, which contributed data from 44 clinics (27 primary care clinics and 17 diabetes/endocrinology clinics). For 1,765 eligible adult patients with type 1 or type 2 diabetes with at least two clinic visits in the 24 months before 10 January 2002, including one visit in the 6 months before 10 January 2002, we assessed measurement and control of HbA(1c), blood pressure, and cholesterol and corresponding medical regimen changes at the most recent clinic visit. RESULTS In this ethnically and economically diverse cohort, annual testing rates were very high (97.4% for HbA(1c), 96.6% for blood pressure, and 87.6% for total cholesterol). Fewer patients were at HbA(1c) goal (34.0% <7.0%) or blood pressure goal (33.0% <130/80 mmHg) than lipid goals (65.1% total cholesterol <200 mg/dl, 46.1% with LDL cholesterol <100 mg/dl). Only 10.0% of the cohort met recommended goals for all three risk factors. At the most recent clinic visit, 40.4% of patients with HbA(1c) concentrations above goal underwent adjustment of their corresponding regimens. Among untreated patients, few with elevated blood pressure (10.1% with blood pressure >130/80 mmHg) or elevated LDL cholesterol (5.6% with LDL >100 mg/dl) were started on corresponding therapy. Patients with type 2 diabetes were no less likely to be intensified than patients with type 1 diabetes. CONCLUSIONS High rates of risk factor testing do not necessarily translate to effective metabolic control. Low rates of medication adjustment among patients with levels above goal suggest a specific and novel target for quality improvement measurement.
A rational approach to orthodontic anchorage

The outcome of orthodontic treatment is often compromised by the loss of anchorage. Yet surprisingly, forces acting on the anchorage unit that bring about the loss have received very little interest. This paper discusses the biologic background for anchorage control; specifically, the impact of the orthodontic force systems and of occlusal forces on the cellular responses of periodontal tissues supporting the anchorage teeth. Also discussed is the influence of various anchorage devices on the interaction between vertical and sagittal directions of dentofacial development. The importance of taking the vertical forces into consideration is stressed. A rational approach to orthodontic anchorage is suggested. We advocate the use of intra-oral and extra-dental devices when possible, as well as rigid appliances that stimulate the patient's sensation of occlusion. Clinical cases are presented to demonstrate the clinical application of this new approach.
Paediatric prehospital trauma

The commonest cause of death in children is trauma, yet few studies have been undertaken to study their needs in the prehospital setting. This article examines the problems associated with seriously traumatized children in the prehospital setting and reviews their management with reference to the specific differences between adults and children. A systematic review of the primary survey is made. Other important aspects of their care including equipment, analgesia, child abuse and accident prevention are also discussed. The need for further research in this field to allow children to enjoy the standard of care afforded adults is emphasized.
Vaccination with a Hybrid 1 (H1) fusion protein combined with a liposomal adjuvant (CAF01) induced antigen specific T-cells 3 years post vaccination in a human clinical trial. (VAC7P.971)

Approximately one third of the world’s population is infected with Mycobacterium tuberculosis. Developing novel vaccines to protect against pulmonary tuberculosis is a public health priority. In this study, a Hybrid 1 (H1) subunit vaccine containing a recombinant fusion protein of Ag85B and ESAT-6 was paired with a two-component CAF01 liposomal adjuvant system developed and manufactured by Statens Serum Institut. A phase I clinical study was performed to evaluate H1:CAF01 in healthy non-BCG vaccinated adult male and female subjects between the ages of 18 and 55 years old. The subjects were randomized into four groups including H1 alone or H1 with 125/25µg, 313/125µg or 625/125µg CAF01 and were vaccinated on study days 0 and 56. PBMCs harvested approximately 150 weeks post vaccination were used to assess antigen specific responses by a 13-color intracellular cytokine staining assay. Vaccination with H1:CAF01 resulted in statistically significant Ag85B-specific CD4 polyfunctional CD154+ T cells compared to H1 alone. ESAT-6 stimulation resulted in detection of CD4 polyfunctional CD154+ T cells responses that were not elevated to a statistically significant extent compared to H1 alone. This is the first demonstration of the persistence of an antigen-specific cellular immune response up to 3 years after vaccination in a clinical trial using H1:CAF01 vaccination.
Muscle regeneration is disrupted by cancer cachexia without loss of muscle stem cell potential

Cancer cachexia is a severe, debilitating condition characterized by progressive body wasting associated with remarkable loss of skeletal muscle weight. It has been reported that cancer cachexia disturbs the regenerative ability of skeletal muscle, but the cellular mechanisms are still unknown. Here, we investigated the skeletal muscle regenerative process in mouse colon-26 (C26) tumor cell-bearing mice as a C26 cancer cachexia model. Although the proliferation and differentiation abilities of muscle stem cells derived from the C26 tumor cell-bearing mice were sustained in vitro, the proliferation and differentiation were severely impaired in the cachexic mice. The numbers of both macrophages and mesenchymal progenitors, which are critical players in muscle regeneration, were reduced in the cancer cachexic mice, indicating that the skeletal muscle regeneration process was disrupted by cancer cachexia. Furthermore, the number of infiltrated neutrophils was also reduced in cancer cachexia mice 24 hours after muscle injury, and the expression of critical chemokines for muscle regeneration was reduced in cancer cachexia model mice compared to control mice. Collectively, although the ability to regeneration of MuSCs was retained, cancer cachexia disturbed skeletal muscle regenerative ability by inhibiting the orchestrated muscle regeneration processes.
Recovery of Mycobacteria from Clinical Specimens and Assessing Drug Susceptibility Test of Mycobacterium Tuberculosis Specimens by Mycobacteria Growth Indicator Tube (MGIT)

Background: Tuberculosis is a disease of global importance. Indeed, the lack of sensitive methods for the diagnosis and inappropriate therapy may lead to increased multidrug-resistance (MDR) cases. However, early detection and identification of acid fast bacilli (AFB) in clinical specimens can lead to effective intervention. Materials and Methods: The sputum specimens from 156 clinically suspected tuberculosis patients and 40 non- tuberculosis patients were digested, examined microscopically for acid- fast bacilli, and inoculated into “Mycobacterium Growth Indicator Tube” (MGIT), BACTEC –12B vial and onto Lowenstein- Jensen slants by standard procedures. Results: The result showed that smear was positive in 82(52.5%) and negative in 74 (47.5%) of 156 clinically suspected tuberculosis patients. The culture positive rate with Lowenstein- Jensen, MGIT, and BACTEC-12B vial were 122(78%), 136(87%), and 143(91%), respectively. Thereafter, MGIT indirect and direct susceptibility tests were performed on 15 sputum-positive specimens and the results were compared with proportional method. The results have revealed that accordance with proportional method was higher in MGIT indirect (83.5%) than direct (75%) susceptibility test, the difference was significant (p< 0.05). In another set of experiments, the indirect MGIT drug susceptibility test in 25 mycobacterium tuberculosis isolates were performed and compared with proportional method. The results showed that MGIT could correctly detect susceptibility to streptomycin, ethambutol, rifampin and isoniazid for 77.8%, 33%, 77.2% and 80%, respectively. Also, the agreement with proportional method for resistance were 88% for streptomycin, 80% for ethambutol, 80% for rifampin and 89% for isoniazid. Furthermore, by combining MGIT technology with L.J media, the mean time required for culture to grow for identification test was reduced from 22-28 to 12-16 days (p<0.05). Conclusion: MGIT is an efficient system to be used in center/ referral mycobacteriology laboratories of developing countries along with routine solid or liquid culture media. (Tanaffos 2002; 1(3): 35-44)
Massage and modality effects on treatment of sub-acute and chronic non specific low back pain

Background: Low back pain (LBP) is the second most common medical complaint. It’s estimated that about 70-85% of the population will suffer at least one episode of LBP during their life. The aim of present study was to compare the effects of massage and modality in patient with sub-acute and chronic non-specific LBP Methods: In this clinical trial study 30 women (MeanAge: 33.96±10.93) with sub-acute and chronic non-specific LBP (Mean pain-duration:9.68±3.38 )were included in the study and randomized into two equal groups; massage and modality. Patients in both group underwent 10 sessions treatment period. Pain (numerical-pain-scale,NRS), functional disability index (oswestry-disability-index,ODI) and lumbar-flexion(modified-schober-test)were recorded before and immediately after treatment period. Data was analyzed using paired t-test and independent sample t-test. Results: Significant improvement showed in both groups separately in pain-intensity, disability level, and flexion after treatment (P<0.001). Statically significant improvement was seen in massage group in comparison to modality group for NRS & ODI after treatment (PNRS=0.015, PODI=0.013). There was a not significant change in point of lumber flexion between two groups Conclusion: The results showed that both massage and modality had beneficial effects on the improvement of pain, functional disability and lumbar flexion in patients with non-specific LBP. It seems that massage is better than modality for non-specific LBP in a short period of time.
Massive Fluid Resuscitation Does Not Affect Intra-Abdominal Pressure in Patient after Crushed Lower Limb Reconstruction Complicated By Massive Hemorrhage – Case Report

An increase in intra-abdominal pressure (IAP) can lead to multiorgan failure. Increased IAP values are likely to result from intra-abdominal pathology or aggressive fluid therapy. The aim of the present report was to analyze the IAP changes after the surgical stabilization of lower limb crush fractures complicated by massive intraoperative hemorrhage. IAP was measured before surgery, immediately after its completion and during the early postoperative period. The highest (over threefold) increase in IAP was observed during the first postoperative hours. On postoperative day 2, IAP values were similar to those found before surgery. After treatment, the patient was discharged in good general condition.
Factors that facilitate and barriers towards the implementation of health educational programmes in primary education schools of the prefecture of Achaia, Greece

Aim: The purpose of this study was to explore the factors that facilitate and barriers towards the implementation of health education programmes in primary education schools of the prefecture of Achaia, Greece. Methods: The sample of the study included 141 educators from a total population of 218 educators who dealt with the implementation of health education programmes in Achaia prefecture during the school period of 2009–2010. The survey method was used to collect data by means of an anonymous questionnaire. Furthermore, at the beginning of the research process a semi-structured interview was carried out with four teachers to help in the development of the questionnaire items. Two factor analyses were conducted: one for the factors that facilitate and one for the barriers towards the implementation of health education programmes. Results: Findings indicated that the most significant factor that facilitates the implementation of innovative health education programmes is ‘Knowledge and skills of the Health Education Officer and the teachers’, which refers to the scientific knowledge, organizational skills, initiatives and the communicative skills of the Health Education Officer as well as to the teachers’ autonomy to select appropriate teaching methods and educational materials. On the other hand, the most important barrier in implementing health education programmes is ‘Limited experience and attitudes of teachers’, which refers to limited teaching experience in health education issues, as well as to professional burnout and the negative attitudes towards these innovative programmes. Conclusions: The Health Education Officer plays an important role in programme coordination by supporting, counselling, giving feedback and providing training/educational materials to teachers.
Mirror therapy in patients with causalgia (complex regional pain syndrome type II) following peripheral nerve injury: two cases.

OBJECTIVE To describe the use of mirror therapy in 2 patients with complex regional pain syndrome type II following traumatic nerve injury. DESIGN Two case reports. SUBJECTS Two patients with complex regional pain syndrome type II. METHODS Two patients received mirror therapy with the painful hand hidden behind the mirror while the non-painful hand was positioned so that, from the perspective of the patient, the reflection of this hand was "superimposed" on the painful hand. Pain was measured with a visual analogue scale. RESULTS The first case had developed a severe burning and constant pain in the hand due to a neuroma. In this patient, a strong reduction in pain was found during and immediately after mirror therapy. As a result, the patient was able to perform active exercises that were previously too painful. However, despite the pain relief during and directly after the exercises, the overall level of pain did not decrease. The second patient also had severe burning pain following a glass injury. In this patient, repeated mirror therapy for a 3-month period strongly decreased pain due to causalgia. CONCLUSION The presented cases demonstrate that the use of mirror therapy in patients with causalgia related to a neuroma is worthy of further exploration as a potential treatment modality in patients with causalgia.
The effectiveness of 8-week aerobic exercise and drug modification on metabolic indices in women with type 2 diabetes

Abstract Background: The purpose of this study was to investigate the effects of aerobic training with and without drug modification on some blood metabolites and substrates in women with type 2 diabetes. Methods: Forty-nine women with type 2 diabetes were randomly divided into four groups as following: training-full drug, training-half drug, no training-full drug, and no training-half drug. Training intervention included three aerobic activities per week for eight weeks. Fasting blood glucose, blood glucose 2h after meal, triglyceride, cholesterol, LDL, HDL, urea, and creatinine were measured before and after intervention in all groups. Results: In the training-full drug group, fasting blood glucose, blood glucose 2h after meal, triglyceride, and urea decreased significantly after the intervention. In the training-half drug group, the only significant change was a decrease in fasting level of blood glucose. In the no training-full drug group, significant increases were observed in fasting blood glucose, blood glucose 2h after meal, and urea. In the no training-half drug group, fasting blood glucose, blood glucose 2h after meal, triglyceride, and creatinine increased significantly. Conclusion: Physical activity can lead to better control of blood sugar, decreased urea and triglyceride levels in women with type 2 diabetes. Optimal results will be obtained if the training be conducted in conjunction with the full drug intervention. Drug treatment alone, could not help this patients regarding metabolic indices. A proper physical training is important in the treatment process. However, reduction in drug use, without any training could have harmful consequences for these patients.
A new lipoglycopeptide: telavancin

The increase in infections caused by resistant Gram-positive organisms has led to an urgent need for new antibiotics. Telavancin is a rapidly bactericidal lipoglycopeptide with multiple mechanisms of action, including concentration-dependent inhibition of bacterial cell wall synthesis and disruption of the functional integrity of the cell membrane. Telavancin is active against a wide variety of Gram-positive organisms including Staphylococcus aureus with resistance to methicillin, reduced susceptibility to vancomycin, and full resistance to vancomycin. Telavacin is approximately 90% protein bound; it has a serum half-life of around 8 h and a prolonged postantibiotic effect, allowing once daily administration. Telavancin is eliminated principally through the urine, requiring dose adjustment in patients with renal impairment. The efficacy and safety of telavancin was demonstrated in a large program of patients with complicated skin and skin structure infections. Development of resistance has not been detected in clinical strains. Adverse events include taste disturbance, nausea and vomiting; a small proportion of patients experienced reversible increase in serum creatinine. Two large Phase III studies in patients with healthcare associated pneumonia were recently completed. Telavancin has the potential to become an important therapeutic option to treat serious infections produced by resistant Gram-positive cocci, particularly those caused by methicillin-resistant S. aureus.