Miracle-dz/UniFAR-FTUs huggingface dataset:
Classification criteria and treatment modalities in primary Sjögren’s syndrome

Primary Sjögren’s syndrome is a systemic autoimmune disease, characterized by a lymphocytic exocrinopathy. Oral and ocular dryness, asthenia and pain represent hallmarks of the disease. Systemic manifestations concern a third of patients, including lymphoma in 5% of the patients. The American European Consensus Group classification criteria have been used in current practice and clinical trials since 2002. New classification criteria were recently proposed by the American Congress of Rheumatology. A group of international experts are currently working to reach a new consensus between the American European Consensus Group classification criteria and the American Congress of Rheumatology proposal for disease classification. In addition, international consensus disease activity scores were recently established. Regarding treatment modalities, symptomatic treatments remain the cornerstone of therapy in pSS, but new biologic treatments are currently evaluated.
Management of resistant Takayasu arteritis

Summary Takayasu arterititis (TA) is a relatively rare systemic vasculitis, mostly occuring in young patients, and involving mainly aorta and its primary branches. Since there are no placebo controlled, randomized clinical trials performed in TA, level of evidence of the data presented here for TA is low, generally reflecting the results of open studies and case series. The most commonly used agents for treatment of TA include corticosteroids and conventional immunsupressive agents, such as methotrexate and azathioprine. In patients who remain resistant and/or intolerant to these agents, due to adverse effects, tumour necrosis factor inhibitors seem to be promising. In selected cases, endovascular interventions or surgery may also be useful for the treatment of critical arterial occlusions. However, these interventions should be performed only after the supression of inflammation with systemic immunsupressive agents. Ozet Takayasu arteriti (TA) daha cok genclerde geliflen, aorta ve ondan
Crosstalk between dendritic cell subsets and implications for dendritic cell-based anticancer immunotherapy

Dendritic cells (DCs) are a family of professional antigen-presenting cells that have an indispensable role in the initiation of innate and adaptive immune responses against pathogens and tumor cells. The DC family is very heterogeneous. Two main types of naturally occurring DCs circulate in peripheral blood, each with its unique phenotypic and functional characteristics: myeloid DCs and plasmacytoid. There is an ample number of studies that have focused on the bi-directional crosstalk between DCs and natural killer cells or T cells. However, the crosstalk among the different DC subsets, in the context of infectious diseases and cancer, has until now not received much attention. Here, we review all available literature that has dealt with the crosstalk between plasmacytoid and myeloid DCs and the potential mode of action. Emphasis will be given to the therapeutic potential of the combination of DC subsets for DC-based immunotherapy.
Mental health services for children and youth: a survey of physicians' knowledge, attitudes and use of telehealth services

Summary Rural physicians in Ontario, whose practice included children, were surveyed on their awareness, attitudes and use of telemental health services for children and young people in their region. Of 95 rural physicians, 70 completed and returned the telehealth section of the survey (74% response rate). The survey comprised 14 questions. Only 27% of responders were aware of the available videoconferencing services. The proportion of physicians who reported having referred patients for the various mental health services through videoconferencing was 0–24%. The proportion of physicians who reported that they would refer patients through videoconferencing was 55–92%. Reduced travel time and care provided closer to home were seen as the primary benefits of referring patients to mental health services through videoconferencing. Unclear referral patterns and technology compromises were seen as limitations of referring patients to videoconferencing. Access to rural populations and improved access to patients were seen as benefits to practice, and undeveloped remuneration procedures as the primary limitation. Promotion may be important to successful implementation of telemental health services for children and young people.
Cost implications of introducing a telecardiology service to support fetal ultrasound screening

A district hospital in south-east England used a telecardiology service for fetal cardiac diagnosis alongside an existing arrangement for referring pregnant women directly to perinatal cardiologists in London for detailed fetal echocardiography. Women were identified for referral according to local protocols when having a second trimester anomaly scan. For the telemedicine referrals, the sonographers video-recorded images from the anomaly scans for transmission during monthly videoconferences. The cost of the women's antenatal care was calculated from the specialist assessment until delivery, while family costs were collected in a postal survey. Over 15 months, telemedicine was used in 52 cases, while 24 women were seen in London. The London women were more likely to have had an ultrasound abnormality (29% v 10%, P = 0.047). A telemedicine assessment of 5 min duration was more costly than an examination in London (mean cost per referral of £206 v £74, P < 0.001). However, the telecardiology service was cost neutral after 14 days and for the extended period until delivery. Travel costs for London women averaged £37 compared with £5.50 for the telemedicine referrals. Telemedicine may be useful to support perinatal cardiologists in the UK whose workloads are expanding in response to improved standards in antenatal ultrasound screening.
Vascular Effects of Bradykinin and Sodium Nitroprusside During Pregnancy in the Rat

The vascular reactivity of pregnant rats to vasodilator agents was determined by measuring their in vivo and in vitro responses to bradykinin (BK) and sodium nitroprusside (SNP) at mid-term (9 days) and at term-pregnancy (21 days), by comparison to non-pregnant rats. In conscious, unrestrained and catheterized rats, the dose-response curves of bolus SNP and BK injections were progressively shifted to the left in both groups of pregnant rats, but this increased sensitivity reached significance only in term-pregnant rats. The baroreceptor reflex influence on blood pressure response to these agents was similar in the three groups of rats and cannot explain the increased response to the vasodilators observed. The in vitro vasorelaxation produced by SNP on NE (6 × 10-6 M) pre-contracted mesenteric bed was not changed in mid-term and term-pregnant rats. In contrast, the vasorelaxant responses of BK were significantly reduced in the pre-contracted mesenteric bed of term-pregnant animals in comparison to non-preg.
Treatment of granulomatosis with polyangiitis (Wegener’s)

Granulomatosis with polyangiitis is a systemic necrotizing vasculitis characterized by granulomatous inflammation of small vessels and is associated with autoantibodies to neutrophil cytoplasmic proteases, mainly proteinase 3. Potentially lethal if not promptly diagnosed and treated, most patients with granulomatosis with polyangiitis can achieve remission with the current treatment modalities, with fewer side effects compared to three decades ago. However, the risk of relapse remains high, necessitating prolonged maintenance immunosuppressive therapy whose optimal duration remains undetermined. We review herein the treatment modalities for granulomatosis with polyangiitis and how they have evolved over the past decades. The findings of the most important and recently completed therapeutic studies, including on rituximab for maintenance, are summarized, before describing the main ongoing studies aimed at further optimizing treatment strategies.
Adding value to figures: a web-based European public health information system

In 2008 a prototype, web-based system was launched which provided information for different user groups interested in European public health topics. The EUPHIX system contained scientifically sound data, with presentations as well as textual information. The information was structured according to the European Community Health Indicators (ECHI) shortlist. The information included different types of data presentations (tables, interactive graphs and maps), explanatory texts and overviews of the data sources and the literature used. The content was produced by a network of European experts according to a structured, peer-reviewed editorial process. Thus EUPHIX provided an easily accessible, comprehensive, state-of-the-art information source. To ensure that it will continue, financial support will be needed. Co-ownership by the European Commission and the Member States seems an appropriate solution.
Negotiating food waste: Using a practice lens to inform design

Ecological sustainability is becoming of increasing concern to the HCI community, though little focus has been given yet to issues around food waste. Given the environmental impact of food waste, there is potential to make a significant difference. To understand everyday domestic practices around food and waste, we took a “practice” lens and carried out a study in 14 households that involved interviews, in-home tours and, in five of the households, a FridgeCam technology probe. The analysis highlights that food waste is the unintended result of multiple moments of consumption dispersed in space and time across other integrated practices such as shopping and cooking, which are themselves embedded in broader contextual factors and values. We highlight the importance of respecting the complex negotiations that people make within given structural conditions and competing values and practices, and suggest design strategies to support dispersed as well as integrated food practices, rather than focusing on waste itself.
Treating to target in axial spondyloarthritis: defining the target and the arrow

The treat-to-target concept is currently proposed in axial spondyloarthritis and aims for remission to be reached and maintained. Consensual definitions of remission and flare of the disease are currently lacking but are needed to validate this strategy and to confirm the window of opportunity hypothesis. The discovery of new therapeutic targets, such as IL-23 and IL-17, will enable and enlarge the possibility of targeted therapies in axial spondyloarthritis.
Myeloid-derived suppressor cells in immunity and autoimmunity

Myeloid-derived suppressor cells (MDSCs) play a critical role in suppressing immune responses in patients with cancer or severe inflammation. Recent studies have focused on the strong relationship between MDSCs and autoimmune diseases, such as autoimmune hepatitis, inflammatory bowel disease and experimental autoimmune encephalomyelitis. Interestingly, MDSCs appear to serve multifaceted functions in autoimmunity, playing both protective and pathogenic roles. Therefore, although MDSCs may be a functional target for the therapy of autoimmune diseases, the disorders that accompany such treatments should be noted. In this manuscript, we summarize the functions and molecular regulation of MDSCs in immunity and autoimmune disease.
HIV immunotherapy comes of age: implications for prevention, treatment and cure

ABSTRACT Antiretroviral therapy (ART) has reshaped the lives of millions of individuals infected with human immunodeficiency virus (HIV). Patients initiating ART early in the course of infection benefit from a considerable reduction in the risks of acquired immune deficiency syndrome (AIDS) and HIV-related inflammatory events. However, the absence of cure and lifelong requirements of treatment highlight the need of a vaccine and an immunotherapeutic strategy. Like for cancer, a paradigm shift has occurred with the contribution of immune activation and microbial translocation priming aberrant systemic immunity in restricting the ability of the host to mount an effective immune response. The approaches of implementing an effective vaccine to prevent infection and inhibition of immune activation with breakage of viral latency followed by vaccination should lead to an HIV-free generation.
Progress in understanding and utilizing TNF-α inhibition for the treatment of psoriatic arthritis

ABSTRACT The improved recognition of pathogenetic molecular mechanisms has led to the use of drugs targeting cytokines in different inflammatory arthropathies as well psoriatic arthritis (PsA). In particular, the progress in knowledge on tumor necrosis factor (TNF)-α in the pathogenesis of PsA has changed the therapeutic approach by use of direct and receptor cytokine antagonists. Currently, infliximab (IFX), adalimumab, etanercept, golimumab and certolizumab pegol represent the five anti-TNF-α available for the treatment of PsA. This review describes evidence on treatment aimed at neutralizing TNF-α in PsA patients, from the first study in 2000 until today, mainly derived from randomized clinical trials. In comparison with traditional therapies, anti-TNF-α agents have shown to have more efficacy both in treating clinical aspects, including enthesitis, dactylitis, joint pain and swelling, axial involvement, nail and skin lesions, and in reducing radiographic progression. Moreover, anti-TNF-α agents have been demonstrated to be reasonably safe in PsA, as confirmed by data derived by different registries.
Percepción diferenciada de salsa de tomate transgénica en el sur de Chile

The present study considers the debate generated in developed countries by genetically modified foods, the importance of this variable to consumers in Temuco (Araucania Region, Chile) when purchasing tomato sauce and different market segments were studied through a personal survey administered to 400 people. Using conjoint analysis, it was determined that the presence of genetic modification in food was generally more important than the brand and purchase price. Using cluster analysis, three segments were distinguished, with the most numerous (49.3%) placing the greatest importance on the presence of genetic modification (GM) in food and rejecting the transgenic product. The second group (39.4%) gave the greatest importance to the brand and preferred tomato sauce with genetically modified ingredients. The smallest segment (11.3%) placed the greatest value on price and preferred transgenic tomato sauce. The three segments prefer the national brand, reject the store brand and react positively to lower prices. The segment sensitive to the presence of GM in food comprised mainly those younger than 35 years of age, single and with no children. The absence of GM in food of vegetable origin is desirable for young consumers in the Araucania Region, but a significant proportion accepts genetic modification in food (50.7%).
Relevance of a 5-grass sublingual tablet for immunotherapy of patients with grass pollen allergy in North America

ABSTRACT Grass pollen allergy is common and clinically consequential in North America. While it is frequently treated with subcutaneous or sublingual immunotherapy, debate remains regarding whether allergen immunotherapy is best carried out using a single representative or multiple cross-reactive allergen(s). Patients are commonly exposed to pollens from multiple allergenic grass species belonging to the Pooideæ subfamily. Beyond the known IgE cross-reactivity, considerable molecular heterogeneity exists with respect to allergen content among grass species, with further evidence that these molecular variants can be detected by the patients’ immune system. These observations provide a compelling scientific rationale for the use of mixed pollen allergen extracts to broaden the allergen repertoire, with the aim of reorienting inappropriate immune responses in allergic patients.
The role of Bruton’s tyrosine kinase in autoimmunity and implications for therapy

ABSTRACT Bruton’s tyrosine kinase (BTK) mediates B cell signaling and is also present in innate immune cells but not T cells. BTK propagates B cell receptor (BCR) responses to antigen-engagement as well as to stimulation via CD40, toll-like receptors (TLRs), Fc receptors (FCRs) and chemokine receptors. Importantly, BTK can modulate signaling, acting as a “rheostat” rather than an “on-off” switch; thus, overexpression leads to autoimmunity while decreased levels improve autoimmune disease outcomes. Autoreactive B cells depend upon BTK for survival to a greater degree than normal B cells, reflected as loss of autoantibodies with maintenance of total antibody levels when BTK is absent. This review describes contributions of BTK to immune tolerance, including studies testing BTK-inhibitors for treatment of autoimmune diseases.
Evaluation of a telemedical care programme for patients with Parkinson's disease

We reviewed a telemedicine-based care model for drug optimization in Parkinson's disease. In this model patients send video recordings made in the home to the treating team via the Internet. These serve as the basis for making therapeutic decisions, in particular drug adjustments. Data from 78 patients were analysed with respect to outcome, method acceptance and management of the procedure. During the 30-day telemedicine programme, the patients recorded an average of 3.2 videos per day. The patients’ motor score on the Unified Parkinson's Disease Rating Scale (UPDRS) was 31 points at enrolment and three months after ICP termination it was significantly lower at 24 points (P < 0.01), i.e. there was less impairment. The patients rated their condition better at the end than at the beginning of the programme: on a 6-point scale, the mean rating at the beginning was 3.2 and the mean rating at the end was 2.8 (P < 0.001). A blinded investigator rated the patients’ videos on the same scale: at the beginning the mean score was 3.0 and at the end it was 2.8 (P < 0.05). The information from the questionnaire showed overall acceptance and practicability of the method. Both patients’ and neurologists’ use of the method was high. The method seems to be feasible for therapy optimization in Parkinson's disease, and of particular interest for patients with complex conditions who do not necessarily have to undergo hospital treatment.
The technological mediation of the nursing-medical boundary

Norwegian medical emergency communication (AMK) centres are staffed by nurses, who administer requests for ambulance services or access to a doctor. The central position of nurses and the fact that they communicate with doctors by telephone and radio, make this a setting where the doctor-nurse relationship is highly visible. A two-year study of AMK centres showed that much of the work of these centres proceeds quite independently of doctors, as nurses function as competent suppliers of advice or ‘medical oracles’. The doctor-designed Index for Medical Emergency Assistance is deficient as a tool for guiding nurses’ decisions, since it fails to take account of the dynamics of real nursing practice, which is based on experiential knowledge, support from colleagues and collective learning. Data on nursing work in the AMK centres suggest that these nurses have more influence and autonomy in the nurse-doctor interaction than most past studies have indicated.
Irritant Rhinitis in Allergic, Nonallergic, Control and Chronic Fatigue Syndrome Populations

ABSTRACTBackground: Irritation symptoms after exposure to “nonspecific” stimuli are often attributed to nonallergic rhinitis (vaso-motor rhinitis). This is a heterogeneous syndrome of exclusion based on nasal symptoms with negative allergy skin tests.Method: Control (n = 114) and Chronic Fatigue Syndrome (CFS, n = 120) subjects scored the severity of nasal congestion and rhinorrhea sensations that they attributed to 9 irritants. The sum was the “Irritant Rhinitis Score” (IRS maximum 72). A positive IRS of > 19 defined “Irritant Rhinitis. ” Demographic, allergy skin test and other assessments were done to characterize the Irritant Rhinitis population.Results: Irritant Rhinitis was present in 11% of control and 47% of CFS subjects. In multivariate analysis, positive IRS was correlated with a history of rhinitis complaints, systemic complaints such as fatigue, sensations of congestion and rhinorrhea induced by meteorological conditions, tobacco smoke, odors, perfumes, and other volatile materials, and diagnos.
AGGRESSIVE PROSTATE CANCER IN PATIENTS WITH LOW PSA AGRESIVNí k ARCINOm PROSTATy u PACIENTů S Nízkým PSA

Celkem 202 pacientů podstoupilo biopsii prostaty celkovým PSA < 4 ng/ml. Ve skupině s nízkým PSA byl záchyt 18,8 %. Ve skupině s PSA vyšším než 4 ng/ml byl záchyt 30,7 % (p < 0,001). Ve všech pozitivních výsledcích biopsie prostaty byl patologem popsán acinární adenokarcinom. Ve skupině s PSA < 4 ng/ml bylo stadium T1c určeno u 57,8 % nemocných, 36,8 % T2a–c a 5,4 % pacientů s podezřením na T3a–b. V biopsii byl v 65,8 % popsán středně diferencovaný karcinom Gleasonovo skóre (GS) 2+3 nebo 3+3. V 26,3 % bylo popsáno GS 7 a ve 7,9 % GS 8 a více. V definitivním vyšetření pacientů, kteří podstoupili radikální retropubickou prostatektomii (RP), bylo 75,8 % karcinomů lokalizovaných a 24,2 % pokročilých. V 9,7 % bylo zjištěno metastatické postižení uzlin nebo skeletu. Zhoršení klinických stadií je na hranici statistické významnosti (p = 0,06). V preparátu po RP bylo u 32,2 % pacientů popsáno GS 6, u 50 % GS 7 a v 27,8 % bylo popsáno GS 4+5. Celkové zvýšení GS bylo statisticky významné (p = 0,005).
Estratificación de una ciudad hiperendémica en dengue hemorrágico

La gran heterogeneidad ambiental de viviendas y barrios en los centros urbanos donde se cria Aedes aegypti, principal vector del dengue, junto con la escasez de recursos y de personal entrenado en el control de mosquitos constituyen retos para cualquier iniciativa destinada a controlar el dengue hemorragico (DH). Una adecuada vigilancia epidemiologica puede servir de base para comenzar a estratificar los centros urbanos e identificar las zonas criticas donde deben concentrarse las tareas de control. En este estudio, se estratifico una ciudad hiperendemica en dengue hemorragico (Maracay, Venezuela) con la ayuda de un sistema de informacion geografica (SIG) y el analisis de la persistencia, la incidencia y la prevalencia del dengue mediante diagnosticos clinicos registrados de 1993 a 1998. Maracay tiene cerca de un millon de habitantes que viven en unos 349 barrios de 6 poblaciones que integran el Area Metropolitana, donde se notificaron 10 576 casos de dengue, 2 593 casos de DH y 8 defunciones. La incidencia de DH mostro una relacion directa con la incidencia del dengue, el numero de habitantes y la densidad poblacional. El patron espacial de la incidencia del dengue fue estable durante los anos estudiados y se encontraron relaciones positivas y significativas de la incidencia del dengue por barrio entre pares de anos. La persistencia del dengue se relaciono directamente con la incidencia mensual por barrio. Estos patrones espaciales facilitaron la estratificacion de la ciudad en tres estratos: 68 barrios sin dengue aparente, 226 barrios con baja persistencia y prevalencia, y 55 barrios con alta persistencia y prevalencia. Se recomienda otorgar alta prioridad de control a estos 55 barrios que ocupan 35% del area urbana y presentaron 70% de todos los casos de dengue.