Miracle-dz/UniFAR-FTUs huggingface dataset:
Kardiyovasküler hastalıklarda trombosit fonksiyon testleri: patofizyolojiden klinik yaklaşıma

Ozet Trombositler, tromboz, hemostaz ve inflamasyonda buyuk onemi olan hucrelerdir. Antitrombotik tedavi kardiyovaskuler hastaliklara bagli mortalite ve morbiditenin azaltilmasinda onemlidir. Son yillarda yapilan arastirmalarda, aspirin ve clopidogrel gibi antitrombotik ilaclara karsi direnc uzerinde siklikla durulmaktadir. Bu nedenle kardiyovaskuler hastaliklarda, antitrombotik ilaclarin etkisini test etmek icin trombosit fonksiyon testleri kullanmasi gerektirmektedir. Ancak in vivo trombosit fonksiyonlari ve ex vivo trombosit fonksiyon testlerinin sonuclari arasindaki iliski net olarak ortaya konulamamistir. Bu derlemede, kardiyovaskuler hastaliklarda kullanilan trombosit fonksiyon testleri, bu testlerin avantaj ve dezavantajlari, antitrombotik tedaviye hastalarin verdigi cevaplardaki cesitliligin incelenmesi ve direnc kanitlarinin tartisilmasi amaclanmistir. Anahtar sozcukler: Trombosit fonksiyon testleri, antitrombotik tedavi, antitrombotik tedaviye direnc Abstract Platelets have significant functions in thrombosis, hemostasis and inflammation. Antithrombotic therapy has been proven to be important in reduction of mortality and morbidity related to cardiovascular diseases. Recently, many studies have been focused on antithrombotic drug resistance. With this regard, platelet function tests have been gaining more popularity to test the effectiveness of antithrombotic drugs. However, correlation between in vivo and ex vivo platelet functions has not been documented clearly. In this review, we aimed to discuss platelet function tests used in the diagnosis of cardiovascular diseases, advantages and disadvantages of these tests, altered responses to antithrombotic therapy and resistance to antithrombotic therapy. Key words: Platelet function tests, antiplatelet treatment, resistance to antiplatelet treatment
Use of aldosterone antagonists in heart failure.

CONTEXT Aldosterone antagonists are recommended for patients with moderate to severe heart failure (HF) and systolic dysfunction. Prior studies suggest underuse of aldosterone antagonists in eligible patients as well as overuse in settings in which therapy may be harmful. OBJECTIVE To examine aldosterone antagonist prescription based on HF management guideline criteria, investigator-defined appropriateness criteria, and trends over time in patients hospitalized with heart failure. DESIGN, SETTING, AND PATIENTS Observational analysis of 43,625 patients admitted with HF and discharged home from 241 hospitals participating in the Get With The Guidelines-HF quality improvement registry between January 2005 and December 2007. MAIN OUTCOME MEASURES Prescription and predictors of use of aldosterone antagonists, based on guideline criteria. RESULTS Among 12,565 patients eligible for aldosterone antagonist therapy, 4087 (32.5%) received an aldosterone antagonist at discharge, and treatment increased modestly from 28% to 34% over the study period. There was also wide variation in aldosterone antagonist use among hospitals (0%-90.6%). Aldosterone antagonist use in eligible patients was associated with younger age (adjusted odds ratio [OR], 0.85; 95% confidence interval [CI], 0.82-0.88), African American race/ethnicity (adjusted OR, 1.17; 95% CI, 1.04-1.32), lower systolic blood pressure (adjusted OR, 0.94; 95% CI, 0.92-0.95), history of implantable cardioverter-defibrillator use (adjusted OR, 1.51; 95% CI, 1.34-1.69), depression (adjusted OR, 1.15; 95% CI, 1.01-1.30), alcohol use (adjusted OR, 1.23; 95% CI, 1.02-1.50), and pacemaker implantation (adjusted OR, 1.21; 95% CI, 1.06-1.38), and with having no history of renal insufficiency (adjusted OR, 0.85; 95% CI, 0.75-0.96). Applying serum creatinine and potassium appropriateness criteria, inappropriate and potentially inappropriate use of aldosterone antagonist therapy was low and did not change over the 3-year study period. CONCLUSIONS Less than one-third of eligible patients hospitalized for HF and participating in a quality improvement registry received HF guideline-recommended aldosterone antagonist therapy. Use of aldosterone antagonist therapy among patients with documented contraindications was low.
Impact of Ketamine on Neuronal Network Dynamics: Translational Modeling of Schizophrenia‐Relevant Deficits

Subanesthetic doses of the psychomimetic, ketamine, have been used for many years to elicit behavioral effects reminiscent of schizophrenia in both healthy humans and in animal models of the disease. More recently, there has been a move toward the use of simple neurophysiological measures (event‐related potentials, brain oscillations) to assay the functional integrity of neuronal circuits in schizophrenia as these measures can be assessed in patients, healthy controls, intact animals, and even in brain slices. Furthermore, alterations of these measures are correlated with basic information processing deficits that are now considered central to the disease. Thus, here we review recent studies that determine the effect of ketamine on these measures and discuss to what extent they recapitulate findings in patients with schizophrenia. In particular, we examine methodological differences between human and animal studies and compare in vivo and in vitro effects of ketamine. Ketamine acts on multiple cortical and subcortical sites, as well as on receptors other than the N‐methyl‐d‐aspartate receptor. Acute ketamine models' changes correlated with psychotic states (e.g. increased baseline gamma‐band oscillations), whereas chronic ketamine causes cortical circuit changes and neurophysiological deficits (e.g. impaired event‐related gamma‐band oscillations) correlated with cognitive impairments in schizophrenia.
Measure for measure. Outcome assessment of arthritis treatment in clinical practice

Objective: To investigate (i) the performance and agreement between various activity indices and response criteria in TNF-blockade of RA; (ii) the predictive ability of different response criteria and disease activity states regarding continuation of anti-TNF treatment of RA; (iii) Euro-QoL-5-dimensions utility development during TNF blockade of RA, PsA and SpA. Also, (iv) to develop a simple, utility-based outcome measure, the number needed to treat per quality adjusted life year gained (NNQ) and apply it in RA, PsA and SpA patients on anti-TNF treatment. Methods: Data were retrieved from the South Swedish Arthritis Treatment (SSATG) register. In patients with RA, PsA and SpA commencing treatment with adalimumab, etanercept or infliximab, date of treatment start and stop, core set variables and EQ-5D were recorded, and various activity indices, responses and EQ-5D utility were calculated. Descriptive statistics and completer analysis were used. The NNQ was calculated as the inverted value of the area under the utility gain curve for one year. Results: Agreement between RA response criteria was poor at the individual level, except at the ACR20/overall level. Disease states exhibited moderate or good agreement at all levels and for most criteria sets, except for remission. Response at ACR20/overall and ACR50/good/major level was found to significantly predict treatment continuation, for most indices already after 6 weeks. EQ-5D utilities improved rapidly (at 2 weeks in RA and PsA) and remained stable over 5 years in TNF blockade of RA, PsA and SpA. NNQ for TNF blockade of RA, PsA and SpA and was found to be 4-6, irrespective of diagnosis and treatment course order. Conclusions: Response criteria are less suitable for use in individual patients in routine care than disease activity states in RA. By contrast, they are often useful as predictors of continued TNF blockade. EQ-5D utility rises almost instantaneously in TNF blockade and remains stable in RA, PsA and SpA patients remaining on therapy. NNQ is easy to calculate and understand and performs well across 3 diagnostic entities.
Haemolytic anaemia in a pony associated with a perivascular abscess caused by Clostridium perfringens

Summary A 5-year-old Welsh Pony mare presented with a history of dullness and inappetence and a large swelling on the left side of the neck extending to the pectoral region. Flunixin meglumine had been administered intravenously 10 days previously for treatment of laminitis. The pony was anaemic at presentation. Clostridium perfringens was isolated from an abscess overlying the left external jugular vein. Treatment consisted of supportive treatment, drainage of the abscess and administration of sodium benzyl penicillin G intravenously. A marked improvement in the mare's demeanour and a gradual increase in packed cell volume over a period of one month were observed. The historical, clinical and clinicopathological findings were consistent with immune-mediated haemolysis associated with C. perfringens infection.
Clinical observation on improving somnipathy of cancer-related fatigue patient by warming and settling method combing with exercise.

Objective:To evaluate the effect of warming and settling method combining with exercise on cancer-related fatigue patient with sleep disorder. Methods:40 cancer-related fatigue patients which were determined with somnipathy by Pittsburgh sleep quality figure(PSQ1) (PSQI7) and Brief Fatigue Inventory(BFI )(BFI4) were divided into warming-settling method group and warming-settling method combining with quantity sufficient exercise group randomly. The warming-settling group was treated with warming-settling method,the other group were treated with warming-settling method combining with exercise 3 times per week,20-30min per time,the physiological load of exercise was requested to reach stabs 65% heart rate and the ratings of perceived exertion(REP) extent did not exceed 16. After 8 weeks treatment,evaluation by Pittsburgh sleep quality figure(PSQ1) and Brief Fatigue Inventory(BFI) was carried out. Results:After treatment,the fatigue score and PSQI score decreased distinctly compared to those before treatment(P0.05) . Simultaneously,the score of sleep quality,sleep latency,sleep duration,sleep efficiency and sleep disturbance improved obviously(P0.05) . Conclusion:Warming-settling method can improve the patient's sleep disorder and fatigue condition,and quantity sufficient exercise maybe helpful to improve the effect.
Stress at work--an independent risk factor for coronary heart disease?

In their recent study, Chandola et al. add to the body of evidence linking work stress with the development of coronary heart disease (CHD) in British civil servants, and examine potential mechanisms.1 Similar findings have been reported in cohort studies across Europe; for example, in the Job Stress, Absenteeism and Coronary Heart Disease in Europe study (JACE), a multicentre study in four European countries, in working populations from a broad range of occupational groups and also from the general population.2 In 2004, a review showed that fewer than half of the 17 longitudinal studies and eight cross-sectional studies included showed a significant association between perceived work stress and subsequent CHD.3 In 2006, a meta-analysis of 14 prospective cohort studies examined the contributions of three models of work stress—job strain, effort–reward imbalance, and organizational injustice—to subsequent risk of CHD. Overall the studies suggested an excess risk of 50% for subsequent CHD following exposure to chronic work stress, but only the organizational injustice model remained statistically significant following adjustment for classical risk factors and potential mediators.4 Most of us would experience stress at work at some point in time, but we would recognize its subjective nature and variability. Devising an instrument to capture the experience, particularly of chronic work stress, … *Corresponding author. Tel: +44 28 90632746; Fax: + 44 28 90231907. Email: j.yarnell{at}qub.ac. uk
Risk factors for myocardial infarction in women and men: insights from the INTERHEART study.

AIMS Coronary heart disease (CHD) is a leading cause of death among men and women globally. Women develop CHD about 10 years later than men, yet the reasons for this are unclear. The purpose of this report is to determine if differences in risk factor distributions exist between women and men across various age categories to help explain why women develop acute MI later than men. METHODS AND RESULTS We used the INTERHEART global case-control study including 27 098 participants from 52 countries, 6787 of whom were women. The median age of first acute MI was higher in women than men (65 vs. 56 years; P < 0.0001). Nine modifiable risk factors were associated with MI in women and men. Hypertension [2.95(2.66 -3.28) vs. 2.32(2.16-2.48)], diabetes [4.26(3.68-4.94) vs. 2.67(2.43-2.94), physical activity [0.48(0.41-0.57) vs. 0.77(0.71-0.83)], and moderate alcohol use [0.41(0.34-0.50) vs. 0.88(0.82-0.94)] were more strongly associated with MI among women than men. The association of abnormal lipids, current smoking, abdominal obesity, high risk diet, and psychosocial stress factors with MI was similar in women and men. Risk factors associations were generally stronger among younger individuals compared to older women and men. The population attributable risk (PAR) of all nine risk factors exceeded 94%, and was similar among women and men (96 vs. 93%). Men were significantly more likely to suffer a MI prior to 60 years of age than were women, however, after adjusting for levels of risk factors, the sex difference in the probability of MI cases occurring before the age of 60 years was reduced by more than 80%. CONCLUSION Women experience their first acute MI on average 9 years later than men. Nine modifiable risk factors are significantly associated with acute MI in both men and women and explain greater than 90% of the PAR. The difference in age of first MI is largely explained by the higher risk factor levels at younger ages in men compared to women.
Inhibitory Effect of Bcl‐xL Gene on Toxicity Induced by Sodium Nitroprusside in SH‐SY5Y cells

Nitric oxide (NO) at physiological concentration is an intracellular messenger molecule in central nervous system (CNS). It plays a pivotal role in maintaining normal physiological function. While excessive NO produced by inducible NO synthase may lead to a variety of neurological diseases, such as Alzheimer’s disease, Parkinson’s disease, multiple sclerosis and cerebral vascular disease, and so on [1,2]. It has been demonstrated that neural damage triggered by NO donor sodium nitroprusside
Overview on Molecular Markers to Implement Cervical Cancer Prevention: Challenges and Perspectives

A decline in the incidence and mortality of cervical cancer has been observed in most Western countries since the first third of the past century. This may be mainly attributed to the introduction of Pap test, that is considered one of the milestones in medicine. Nevertheless, worldwide burden of cervicocarcinoma is still enormous. This fact is well known among the scientific community, and has led to an extensive search for optional screening tools and predictive markers, currently under testing in different countries.
Corticospinal Function and Voluntary Movement

1. The background relationships between structure and function 2. Anatomical substrates for movement performance: Cerebral cortex and the corticospinal tract 3. Correlations between corticospinal connections and function 4. Corticospinal influences on the spinal cord machinery for movement 5. Output functions of the motor cortex 6. Inputs from peripheral receptors to motor cortex neurones 7. Motor functions of non-primary cortical motor areas 8. Dynamic nature of cortical organization 9. Synthesis: Corticospinal function and voluntary movement References and index
Blunt traumatic haematoma of the left anterior descending artery: intravascular findings.

A 27-year-old male was transferred to the Emergency Department after blunt chest trauma caused by motor cycle accident. Initial electrocardiogram showed a right bundle branch block (RBBB). On physical examination, the patient had non-severe facial injuries and anterior chest wall pain. Transthoracic echocardiography demonstrated mild anterior hypokinesia with …
Pomegranate (Punica granatum L). Ancient seeds for modern cure? Review of potential therapeutic applications

Pomegranate ( Punica granatum L ), in addition to its ancient historical uses, has been used in several systems of medicine for a variety of ailments. Pomegranate juice is a polyphenol-rich juice with high antioxidant capacity. In studies of human and murine models, pomegranate juice has been shown to exert significant antiatherogenic, antioxidant, anti-carcinogenic, and anti-inflammatory effects. In the past decade, numerous studies on the antioxidant, anti-carcinogenic, and anti-inflammatory properties of pomegranate constituents have been published, focusing on the treatment and prevention of cancer, cardiovascular disease, diabetes, dental conditions, and ultraviolet radiation-induced skin damage. Other potential applications include infant brain ischemia, male infertility, Alzheimer's disease, arthritis, and obesity. The aim of the present review is to discuss the cumulative evidence, which suggests that pomegranate consumption possesses a diverse array of biological actions and may be helpful in the prevention of some inflammatory-mediated diseases, including cancer. The search strategy included Pubmed, using terms 'pomegranate' or ' Punica granatum' . Citations relevant to the topic were screened.
Prescripción inadecuada de transfusión sanguínea en un hospital de referencia de Lima, Perú

Objectives. To determine frequency and clinical criteria associated to the inadequate indication of blood products. Materials and methods. A cross-sectional study was performed between June and October 2002. Clinical charts and the laboratory tests from patients receiving blood transfusions were examined. A blood transfusion guideline was elaborated based on published consensus, and used to determine whether the indications for blood products transfusion was adequate or inadequate. Results. A total of 311 blood transfusions were evaluated. The global prevalence of inappropriate indication was of 33.8 %. Red blood cells (RBC) were used inappropriately in 25 %, fresh frozen plasma (FFP) in 59 %, platelets in 13 % and cryoprecipitate in 88 %. From surgery related transfusions half of the indications were inadequate. In internal medicine, ICU and emergency related transfusions, approximately one third of the indications were inadequate. The FFP is the worst used blood product. Conclusions. We found a high frequency of inadequate blood transfusion. The identification of the specific clinical criteria used in inadequate indications transfusions will help in designing a better educational strategy towards a more rational use of the blood products.
Fundamentals of Musculoskeletal Ultrasound

Chapter 1: Introduction Chapter 2: Basic Pathology Concepts Chapter 3: Shoulder Ultrasound Chapter 4: Elbow Ultrasound Chapter 5: Wrist and Hand Ultrasound Chapter 6: Hip and Thigh Ultrasound Chapter 7: Knee Ultrasound Chapter 8: Ankle, Foot, and Lower Leg Ultrasound Chapter 9: Interventional Techniques
Autoimmune Disease: Treatment

In recent years, substantial progress has been made in understanding the mechanisms of inflammation and autoimmunity, providing new targets for the development of new treatment principles. Tumour necrosis factor α (TNFα) antagonists have been proven as a major progress in the treatment of different rheumatic and chronic inflammatory bowel diseases. The interleukin 1 (IL-1) receptor antagonist has considerably improved our medication for the systemic juvenile arthritis and periodic fever syndromes, an anti-IL-6 receptor monoclonal antibody might be of value as well as abatacept, a cytotoxity lymphocyte-associated antigen 4Ig (CTLA-4Ig) fusion protein for the treatment of patients with rheumatic diseases who do not respond to TNF antagonists. The same is true for rituximab, a chimeric anti-CD20 antibody. Key concepts Mode of action and indications for the treatment with traditional and new (cyclooxygenase II, COX-II, inhibitors), Nonsteroidal anti-inflammatory drugs (NSAIDs). Mode of action and indications of steroids for the treatment of autoimmune and chronic inflammatory diseases. Disease modifying and immunosuppressive drugs, there are different modes of action. The limitation of surgical approaches in the treatment of autoimmune and chronic inflammatory diseases such as thymectomy, splenectomy and synovectomy. The limitation of radiotherapy and total lymphoid irradiation for the treatment of autoimmune diseases. The limitation of plasmapheresis and leucapheresis as treatment principles for autoimmune diseases. Cellular and juvenile targets for immune intervention in autoimmune and chronic inflammatory diseases. Biologics for the treatment of autoimmune and chronic inflammatory diseases, modes of actions. Monoclonal antibodies and fusion proteins for targeting T cells, B cells, cytokines and adhesion molecules. Mechanisms that could help to reestablish self-tolerance as well as the ultimate therapeutic goal in autoimmune diseases. Keywords: immunomodulatory therapy; autoimmune disease; monoclonal antibody therapy; cytokine antagonism; tolerance induction; modulation of T cells
Comparison of antiarrhythmic drug therapy and radiofrequency catheter ablation in patients with paroxysmal atrial fibrillation: a randomized controlled trial.

CONTEXT Antiarrhythmic drugs are commonly used for prevention of recurrent atrial fibrillation (AF) despite inconsistent efficacy and frequent adverse effects. Catheter ablation has been proposed as an alternative treatment for paroxysmal AF. OBJECTIVE To determine the efficacy of catheter ablation compared with antiarrhythmic drug therapy (ADT) in treating symptomatic paroxysmal AF. DESIGN, SETTING, AND PARTICIPANTS A prospective, multicenter, randomized (2:1), unblinded, Bayesian-designed study conducted at 19 hospitals of 167 patients who did not respond to at least 1 antiarrhythmic drug and who experienced at least 3 AF episodes within 6 months before randomization. Enrollment occurred between October 25, 2004, and October 11, 2007, with the last follow-up on January 19, 2009. INTERVENTION Catheter ablation (n = 106) or ADT (n = 61), with assessment for effectiveness in a comparable 9-month follow-up period. MAIN OUTCOME MEASURES Time to protocol-defined treatment failure. The proportion of patients who experienced major treatment-related adverse events within 30 days of catheter ablation or ADT was also reported. RESULTS At the end of the 9-month effectiveness evaluation period, 66% of patients in the catheter ablation group remained free from protocol-defined treatment failure compared with 16% of patients treated with ADT. The hazard ratio of catheter ablation to ADT was 0.30 (95% confidence interval, 0.19-0.47; P < .001). Major 30-day treatment-related adverse events occurred in 5 of 57 patients (8.8%) treated with ADT and 5 of 103 patients (4.9%) treated with catheter ablation. Mean quality of life scores improved significantly in patients treated by catheter ablation compared with ADT at 3 months; improvement was maintained during the course of the study. CONCLUSION Among patients with paroxysmal AF who had not responded to at least 1 antiarrhythmic drug, the use of catheter ablation compared with ADT resulted in a longer time to treatment failure during the 9-month follow-up period. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT00116428.