Miracle-dz/UniFAR-FTUs huggingface dataset:
Molekulare Pathogenese von Schilddrüsenknoten – Bedeutung für die klinische Versorgung

Zusammenfassung Schilddrüsenknoten stellen heterogene Tumore dar, mit unterschiedlichen molekularen Signaturen. Während benigne Schilddrüsenknoten poly- oder monoklonalen Tumoren entsprechen, sind Schilddrüsenkarzinome monoklonale und damit „echte“ Neoplasien. Ursächlich für die Neoplasien sind somatische Mutationen, welche zur konstitutiven Aktivierung spezifischer Signalkaskaden führen und den jeweiligen histologischen, teilweise auch den funktionellen Phänotyp des Schilddrüsentumors bestimmen. Eine Dedifferenzierung von Schilddrüsenkarzinomen geht mit dem Auftreten weiterer Mutationen in den Tumoren einher. Die Mutationslast der Schilddrüsenkarzinome korreliert mit deren biologischem Verhalten. Im klinischen Alltag kann die Kenntnis der ursächlichen somatischen Mutation in der zytologischen Differenzialdiagnose helfen. In der prognostischen Einschätzung von Schilddrüsentumoren hat der Nachweis von klassischen Onkogenmutationen (BRAF, RAS) wenig Relevanz. Andere genetische Veränderungen, insbesondere TERT Promoter Mutationen, die mit zunehmender Häufigkeit in fortgeschrittenen SD-Karzinomen auftreten, haben wahrscheinlich eine prognostische Bedeutung. Von großer Relevanz ist die molekulare Signatur jedoch für die Entwicklung und Anwendung passgenauer „zielgerichteter“ Therapien bei fortgeschrittenen Karzinomen (radioiodrefraktäres DTC, PDTC und ATC, metastasiertes medulläres Karzinom). Hierfür gibt es aus klinischen Studien sowie Einzelfallberichten zunehmend Hinweise, die das Konzept der „Oncogen-Addiction“ als pathogenetisch relevanten Mechanismus der SD-Tumorigenese und Karzinogenese unterstreichen.
[Emergency Keratoplasty with Porcine Xenografts in Necrotizing Keratitis].

Background The great shortage of donor material in Ukraine makes it necessary to find additional sources of transplant material. A possible suitable material are the porcine corneas, as they are similar in structure and biomechanical parameters to the human cornea. The purpose of our study was to analyze the results of therapeutic keratoplasty (KP) with keratoxenotransplants from cryolyophilized porcine corneas in patients with severe necrotizing keratitis. Methods A retrospective analysis of 32 xenotransplantations patients with severe necrotizing keratitis (17 lamellar, 6 stepped perforating, 4 perforating, 5 "biological coverage" according to Puchkovskaya) was completed. Results All eyes could be preserved, but the graft was rejected in all eyes. A semitransparent xenograft (XG) was achieved in 9 patients (33.3%). The best results were obtained after lamellar XKP with an XT diameter of 3.5 - 6.5 mm. Lamellar XTs with larger diameters (7.0 - 10.0 mm) were opaque. Postoperatively, the intensity of the inflammatory response after stepped XKP was slightly lower than that of the classical perforating XKP. A new KP with human corneas had to be performed in 5 patients, in one case combined with an antiglaucomatous operation and in another case with cataract extraction. Antiglaucomatous surgery had to be performed in 5 patients (15.6%). Conclusion In the absence of human donor corneas, a porcine keratoxenoimplant can be used as temporary therapeutic keratoplasty in case of emergency stop the inflammation process and to save the eye. In cases of keratoxenoimplant, a poor visual outcome is expected.
Disability and Poverty in Developing Countries: A Snapshot from the World Health Survey

Disability and poverty are dynamic and intricately linked phenomena. In developed countries, a large body of empirical research shows that persons with disabilities experience inter alia comparatively lower educational attainment, lower employment and higher unemployment rates, worse living conditions, and higher poverty rates. This study aims to contribute to the empirical research on social and economic conditions of people with disabilities in developing countries. Using comparable data and methods across countries, this study presents a snapshot of economic and poverty situation of working-age persons with disabilities and their households in fifteen developing countries. This research is relevant for several reasons. First, it contributes to a currently small body of empirical evidence on the economic status of persons with disabilities in developing countries. Second, by providing a baseline data on the economic well-being and the poverty status of working-age persons with disabilities and their households in 2003 in the countries under study, it can inform national disability policies. Finally, this study can also inform future data and research efforts on disability in developing countries. This study is structured as follows. Section two provides definitions and some background on disability and poverty. Section three describes the data and methods. Section four presents disability prevalence estimates in the fifteen developing countries under study and results on the economic well-being of working-age population at the individual and household levels. Section five gives results of an analysis of multidimensional poverty across disability status. Section six concludes definitions and some background information on disability and poverty, describes some of the linkages between them and reviews recent literature on the socioeconomic status of persons with disability.
A comparative study on the effects of Menstrogol and Mefenamic acid on postpartum after-pain

Background : After pain is one of the complications occurring during postpartum, this requires an appropriate analgesic to relieve the pain. The current study was designed to study and compare the analgesic effects of Menstrogol and Mefenamic acid on postpartum pain. Material and Methods : This study was a randomized single-blinded controlled clinical trial in which pregnant mothers having normal vaginal delivery and suffering from postpartum pain were studied. Volunteer (consented) pregnant women were randomly entered into two study groups of Menstrogol (containing 500 mg of dried extracts of celery, saffron and anise) and Mefenamic acid (250 mg) oral capsules. Using the visual analogue scale (VAS), after pain was determined during the first 2 hours after delivery and patients received drugs if a pain score ≥ 4 was expressed by patients. These women were administered 3-4 doses of drugs per day (every 6-8 hours). Severity and duration of pain were measured and recorded before and 1 hour after dosage administration. Data was analyzed using the Statistical Package for Social Scientists (SPSS version 13). Results : Results revealed that Mefenamic acid and Menstrogol both are effective in reducing the severity of postpartum pain (p<0/05). Comparison analyses showed that Menstrogol could not only result in a higher reduction in the pain and its severity in postpartum women but also its effect began faster than Mefenamic acid. In addition, incidence rate of adverse reactions was lower in the Menstrogol group compared to Mefenamic acid group (p<0/05). Conclusion: Our results show that Menstrogol is an effective and safe alternative for Mefenamic acid in women suffering from post partumpain. This is a confirmation for effectiveness of herbal medicines in contrast to chemical drugs.
The relationship between the thrombotic and infectious complications of central venous catheters.

OBJECTIVES To assess the frequency of thrombotic and infectious complications of long-term use of vascular catheters in cancer patients and to determine whether the two types of complication are related. DESIGN Case series. SETTING A 500-bed tertiary cancer center. PATIENTS Seventy-two cancer patients. INTERVENTIONS During a 16-month period, postmortem examinations of catheterized veins and contralateral uncatheterized veins were done on all patients with indwelling central venous catheters who met study criteria. MAIN OUTCOME MEASURES Catheter-related septicemia determined by clinical and microbiological data as well as postmortem pathology; venous pathological changes such as mural hemorrhage, thrombosis, calcification, ulceration, and inflammation. RESULTS Premortem clinical and microbiological data were obtained retrospectively on all patients. Pathological changes were noted in 35 catheterized veins (49%) compared with five contralateral control veins (9.2%) (P < .001). Mural thrombi were noted in 27 catheterized veins (38%) compared with only one contralateral control vein (1.4%) (P < .001). Other pathological changes consisted of four central venous catheter-related mural thrombi (5.6%) in the right atrium and four instances (5.6%) of nonbacterial thrombotic endocarditis, three involving the tricuspid and one the mitral valves. Seven patients had catheter-related septicemia. Of the 31 patients with mural thrombosis of the catheterized vein or right atrium, seven developed catheter-related septicemia, whereas none of the 41 patients with normal catheterized veins and atria developed catheter-related septicemia (P < .01). CONCLUSIONS Thrombotic complications are common in catheterized veins and are often associated with catheter sepsis.
Mental Illness and Labour Market Outcomes: Employment and Earnings

This paper investigates the effect of severe mental illness on the capacity to hold a job and to earn an income. We find that the employment rate is reduced with about 1/3 during the development of the disease. Hospital admission seems to stabilize employment for all diagnoses. The employment rate after hospital treatment is about 35% lower for cases than for controls and varies somewhat depending on diagnosis. On average, those who keep their jobs have 20% lower earnings compared to a control group. We use longitudinal data from labour market registers covering a 5% sample of the Danish adult population followed from 1976 to 1993 merged with data from the Central Psychiatric Case Register which covers all cases of hospitalizations with psychiatric disorders and their diagnoses since 1969. At the time of admission, we match all patients with people from the same cohort and gender. Both groups are then followed for several years before and after time of admission.
New group tracks hospitals' drug-resistant bugs.

FOR SEVERAL years, infectious disease specialists and public health officials have warned of the onslaught of antibiotic-resistant pathogens. But with little in the way of active, national surveillance, tracking microbial susceptibility patterns has been difficult at best. Now early findings from a new nongovernmental surveillance network confirm some fears and soothe others. "The most serious problem we have is vancomycin-resistant enterococcus," says Richard Wenzel, MD, MSc, professor and chair of internal medicine at the Medical College of Virginia, Richmond, and a director of the Surveillance and Control of Pathogens of Epidemiologic Importance (SCOPE) network. Many of the findings "are consistent with data generated over the past decade" by the Centers for Disease Control and Prevention (CDC), Atlanta, Ga, adds Michael Pfaller, MD, also a SCOPE director and codirector of clinical microbiology laboratories at the University of Iowa College of Medicine, Iowa City. Trends in Resistance Tracking SCOPE began collecting data
The Costs of Adverse Drug Events in Hospitalized Patients

Objective. —To assess the additional resource utilization associated with an adverse drug event (ADE). Design. —Nested case-control study within a prospective cohort study. Participants. —The cohort included 4108 admissions to a stratified random sample of 11 medical and surgical units in 2 tertiary-care hospitals over a 6-month period. Cases were patients with an ADE, and the control for each case was the patient on the same unit as the case with the most similar pre-event length of stay. Main Outcome Measures. —Postevent length of stay and total costs. Methods. —Incidents were detected by self-report stimulated by nurses and pharmacists and by daily chart review, and were classified as to whether they represented ADEs. Information on length of stay and charges was obtained from billing data, and costs were estimated by multiplying components of charges times hospital-specific ratios of costs to charges. Results. —During the study period, there were 247 ADEs among 207 admissions. After outliers and multiple episodes were excluded, there were 190 ADEs, of which 60 were preventable. In paired regression analyses adjusting for multiple factors, including severity, comorbidity, and case mix, the additional length of stay associated with an ADE was 2.2 days (P=.04), and the increase in cost associated with an ADE was $3244 (P=.04). For preventable ADEs, the increases were 4.6 days in length of stay (P=.03) and $5857 in total cost (P=.07). After adjusting for our sampling strategy, the estimated postevent costs attributable to an ADE were $2595 for all ADEs and $4685 for preventable ADEs. Based on these costs and data about the incidence of ADEs, we estimate that the annual costs attributable to all ADEs and preventable ADEs for a 700-bed teaching hospital are $5.6 million and $2.8 million, respectively. Conclusions. —The substantial costs of ADEs to hospitals justify investment in efforts to prevent these events. Moreover, these estimates are conservative because they do not include the costs of injuries to patients or malpractice costs.
Arthritis gene therapy trial resumes.

diatric 30, 50, and 70 responses (60%, 59%, and 56%, respectively) compared with placebo patients (35%, 35%, and 28%, respectively). Also, patients receiving adalimumab had significantly fewer flare-ups than patients in the placebo group. Following the study, investigators monitored patients who continued to receive adalimumab, finding substantial and sustained improvement during 2 years of treatment.
Epidémiologie de la leptospirose aux Antilles françaises : apports du diagnostic par biologie moléculaire dans l'étude des facteurs de risques, des facteurs pronostiques et de l'incidence

Leptospirose est la zoonose bacterienne la plus repandue dans le monde et son incidence est plus forte dans les regions tropicales ou le taux de mortalite peut exceder 10%. Un diagnostic rapide est fondamental car le traitement a plus de chance d’etre efficace lorsqu’il est precoce. Nous avons utilise le diagnostic par biologie moleculaire (RT-PCR) pour contribuer a mieux connaitre l’epidemiologie de la leptospirose aux Antilles. Dans les deux premiers articles, nous rapportons pour la premiere fois en Martinique la survenue de cas groupes de leptospirose apres des evenements sportifs (course a pied, canyoning). La presence d’abrasions cutanees a ete identifiee comme facteur de risque de l’infection et ces travaux ont mis en evidence l’interet du diagnostic par RT-PCR pour informer rapidement les personnes exposees et debuter tot les antibiotiques. Le troisieme travail est une etude de cohorte prospective portant sur 102 patients et nous rapportons l’association entre l’elevation de la concentration sanguine de leptospires mesuree a l’admission et la severite de la maladie. Les principaux elements cliniques initiaux associes a la severite etaient l’hypotension, les anomalies auscultatoires, l’ictere et l’anurie. L’identification de l’espece Leptospira interrogans, le serovar Icterohaemorrhagiae /Copenhageni, et la presence de rats a domicile etaient aussi associes a la severite. L’utilisation du diagnostic par biologie moleculaire nous a permis de contribuer a l’etude de facteurs de risque et des facteurs pronostiques de la leptospirose, mais aussi a mieux connaitre le poids reel de la maladie aux Antilles.
Lifestyle intervention and metformin for treatment of antipsychotic-induced weight gain: a randomized controlled trial.

CONTEXT Weight gain, a common adverse effect of antipsychotic medications, is associated with medical comorbidities in psychiatric patients. OBJECTIVE To test the efficacy of lifestyle intervention and metformin alone and in combination for antipsychotic-induced weight gain and abnormalities in insulin sensitivity. DESIGN, SETTING, AND PATIENTS A randomized controlled trial (October 2004-December 2006) involving 128 adult patients with schizophrenia in the Mental Health Institute of the Second Xiangya Hospital, Central South University, China. Participants who gained more than 10% of their predrug weight were assigned to 1 of 4 treatment groups. INTERVENTIONS Patients continued their antipsychotic medication and were randomly assigned to 12 weeks of placebo, 750 mg/d of metformin alone, 750 mg/d of metformin and lifestyle intervention, or lifestyle intervention only. MAIN OUTCOME MEASURES Body mass index, waist circumference, insulin levels, and insulin resistance index. RESULTS All 128 first-episode schizophrenia patients maintained relatively stable psychiatric improvement. The lifestyle-plus-metformin group had mean decreases in body mass index (BMI) of 1.8 (95% confidence interval [CI], 1.3-2.3), insulin resistance index of 3.6 (95% CI, 2.7-4.5), and waist circumference of 2.0 cm (95% CI, 1.5-2.4 cm). The metformin-alone group had mean decreases in BMI of 1.2 (95% CI, 0.9-1.5), insulin resistance index of 3.5 (95% CI, 2.7-4.4), and waist circumference of 1.3 cm (95% CI, 1.1-1.5 cm). The lifestyle-plus-placebo group had mean decreases in BMI of 0.5 (95% CI, 0.3-0.8) and insulin resistance index of 1.0 (95% CI, 0.5-1.5). However, the placebo group had mean increases in BMI of 1.2 (95% CI, 0.9-1.5), insulin resistance index of 0.4 (95% CI, 0.1-0.7), and waist circumference of 2.2 cm (95% CI, 1.7-2.8 cm). The lifestyle-plus-metformin treatment was significantly superior to metformin alone and to lifestyle plus placebo for weight, BMI, and waist circumference reduction. CONCLUSIONS Lifestyle intervention and metformin alone and in combination demonstrated efficacy for antipsychotic-induced weight gain. Lifestyle intervention plus metformin showed the best effect on weight loss. Metformin alone was more effective in weight loss and improving insulin sensitivity than lifestyle intervention alone. Trial Registration clinicaltrials.gov Identifier: NCT00451399.
ABCA1 gene mutations, HDL cholesterol levels, and risk of ischemic heart disease.

would not expect a change in our results. Regarding the use of self-reported data on family history, prior studies have found self-reported information on family history of cancer in first-degree relatives to be valid. Underreporting tends to be the most common source of error in family history reports. This misclassification would tend to attenuate any association of family history of colorectal cancer on patient survival. Moreover, the prevalence of family history of colorectal cancer among study participants was consistent with other studies. We agree that people who are aware of a family history of colorectal cancer might adopt a more health-conscious lifestyle and may be more likely to be diagnosed at earlier stages. However, we did not observe any significant differences in T stage (invasion through the bowel wall), N stage (number of positive lymph nodes), tumor differentiation, performance status, or postoperative serum carcinoembryonic antigen between patients with or without a family history. Furthermore, a significant association between a family history and disease-free survival persisted even after adjusting for predictors of cancer recurrence or death as well as in stratified analyses of patients according to T and N stage. Regarding preferential responsiveness to chemotherapy, all patients were randomized to standardized chemotherapy protocols, and there were no differences in survival according to treatment group. Because we did not assess family size or sex of the affected family member, we are unable to examine family history according to sex of the affected relative or personyears of exposure. However, we are unaware of data demonstrating that risk of developing colorectal cancer is influenced by the sex of an affected first-degree relative and have no reason to suspect that sex of the relative would influence survival. We did examine whether the effect of family history varied according to the age at which the firstdegree relative was diagnosed with colorectal cancer. As reported, we found no difference in the adjusted hazard ratio for disease-free survival among patients whose relative was diagnosed with colorectal cancer at an age younger than 50 years compared with 50 years or older.
Monoterapia con antiandrógenos en cáncer avanzado de próstata: variaciones de la testosterona sérica y de la histología testicular.

El tratamiento hormonal es la terapia de elección del adenocarcinoma avanzado de próstata (8). Conociendo que los resultados serán sólo paliativos, puesto que la dependencia hormonal es una propiedad que poseen sólo una parte de las células que componen la neoplasia prostática (5), los urólogos recurrimos de todas formas a la anulación androgénica, obteniendo respuestas positivas en más del 90% de los casos, porperíodos que oscilan entre los 6 meses y 3 años (1. 3). Ya descriptos por Huggins (4), la castración quirúrgica o el suministro de estrógenos (en dosis que hoy reconocemos en 3 mg de dietilestilbestrol o valores equivalentes de otras drogas) logran un descenso de la testosterona plasmática en un 95% de los valores basales (12). En la década del '80, otra forma de castración, denominada química, ha sido incorporada al arsenal terapéutico antineoplásico: los agonistas del factor liberador de la hormona luteinizante logran, mediante la reiteración y el mantenimiento de inyecciones subcutáneas, los mismos efectos que la orquiectomía bilateral (9,2,11).
[Impact of Case Numbers on the 5-Year Survival Rate of Unicondylar Knee Replacements in Germany].

BACKGROUND Reported survival rates of unicondylar knee arthroplasty (UKA) vary considerably. The influences of patient characteristics and the type of implant have already been examined. This analysis investigated the influence of hospital volume on 5-year-survival rate, using administrative claims data of Germany's largest health insurance provider. METHODS We analysed administrative claims data for 20,946 UKAs covered by the German local healthcare funds (Allgemeine Ortskrankenkasse, AOK) between 2006 and 2012. Survival rates were estimated using Kaplan-Meier analysis. The influence of hospital case numbers on 5-year survival was analysed by means of multivariable Cox regression adjusted for patient characteristics. We estimated hazard ratios (HR) with 95% confidence intervals for five hospital volume categories: < 12 cases, 13 - 24 cases, 25 - 52 cases, 53 - 104 cases, > 104 cases (per hospital and year). RESULTS The overall 5-year Kaplan-Meier survival rate was 87.8% (95%-CI: 87.3 - 88.3%). This increased with hospital volume (< 12 cases: 84.1% vs. > 104 cases: 93.2%). The analysis identified low hospital volume as an independent risk factor for surgical revision (< 12 cases: HR = 2.13 [95%-CI 1.83 - 2.48]; 13 - 24 cases: HR = 1.94 [95%-CI: 1.67 - 2.25]; 25 - 52 cases: HR = 1.66 [95%-CI: 1.41 - 1.96]; 53 - 104 cases: HR = 1.51 [95%-CI: 1.28 - 1.77]; > 104 cases: reference category). DISCUSSION Our analysis revealed a significant relationship between hospital case numbers and 5-year survival rate, which increases with hospital volume. The risk of surgical revision within 5 years in hospitals with fewer than 25 UKAs per year is approximately twice as high as in hospitals with more than 104 cases.