Miracle-dz/UniFAR-FTUs huggingface dataset:
Ineffectiveness of probiotics in preventing recurrence after curative resection for Crohn ’ s disease : a randomised controlled trial with Lactobacillus

OBJECTIVE: The purpose of this study was to determine whether Lactobacillus, given by mouth for one year after resection, could prevent recurrent lesions or reduce their severity. METHODS: This was a randomized, placebo-controlled study of patients operated on for Crohn’s disease in whom all of the diseased gut had been removed. Patients were randomly allocated to receive 12 billion colony-forming units of Lactobacillus or identical placebo for one year. RESULTS: Thirteen of the 45 patients enrolled withdrew or were excluded from the trial. There were no significant differences in the rates of clinical or endoscopic recurrences or severity of recurrent lesions between the groups. Trends favored the placebo group. CONCLUSIONS: Lactobacillus seems neither to prevent endoscopic recurrence at one year nor reduce the severity of recurrent lesions in patients with Crohn’s disease. —THOMAS E. READ, M.D.
Evaluation of neuro-pharmacological activities in six homeopathic drugs

Farah-Saeed*, Noor-Jahan, Mehjabeen and Mansoor Ahmad Department of Pharmacognosy, Dow College of Pharmacy, Dow University of Health Sciences, Karachi-Pakistan. Department of Pharmacology, Dow College of Pharmacy, Dow University of Health Sciences, Karachi-Pakistan. Department of Pharmacology, Faculty of Pharmacy, Federal Urdu University of Arts Science and Technology, KarachiPakistan. Research Institute of Pharmaceutical Sciences, University of Karachi-Pakistan.
Lignes directrices éclairées par des données probantes sur l’activité physique à l’intention des Canadiens adultes

Résumé : Cet article fait le tour des dernières études scientifiques sur les fondements biologiques et psychosociaux du Guide d’activité physique canadien pour une vie active saine et porte une attention particulière à l’effet de l’activité physique sur la santé des adultes âgés de 20 à 55 ans. Nous exposons brièvement les directives provenant d’un peu partout dans le monde en matière d’activité physique à l’intention des adultes et nous les comparons aux directives canadiennes. Nous présentons l’épidémiologie descriptive de l’activité physique et de l’inactivité physique et nous analysons l’importance de la relation entre l’activité physique et certaines répercussions sur la santé en mettant l’accent sur les quantités minimale et optimale requises à cette fin. En conclusion, nous mentionnons des pistes de recherche particulières. En bref, les directives canadiennes et la plupart des directives issues des autres pays recommandent la pratique d’activité physique d’intensité modérée presque tous les jours de la semaine. L’activité physique diminue fort probablement le risque de souffrir de plus de 25 conditions chroniques, notamment la maladie coronarienne, l’accident cérébrovasculaire, l’hypertension, le cancer du sein, le cancer du côlon, le diabète de type 2 et l’ostéoporose. D’après les études recensées, si la population canadienne entière adhérait aux recommandations du Guide, on éviterait environ un tiers des décès associés à la maladie coronarienne, un quart des décès associés à l’accident cérébrovasculaire et à l’ostéoporose, un cinquième des décès associés au cancer du côlon, à l’hypertension et au diabète de type 2 et un septième des décès associés au cancer du sein. Il semble aussi que la prévention du gain de poids et le maintien de la perte de poids exigent de plus gros efforts que ne l’indiquent les recommandations actuelles.
Endoscopic Examination for Patients with Diarrhea after Allogeneic Stem Cell Transplantation

Objective: Intestinal graft-versus-host disease (GVHD) represents one of the most serious complications of allogeneic stem cell transplantation (allo-SCT). Endoscopic and histological proof is required due to the number of differential diagnoses manifesting as diarrhea. We investigated the safety of endoscopic biopsies, and the role of conducting biopsies and inspections of the terminalileum. Patients: Thirty two colonoscopic examinations and 29 biopsies were performed for 19 patients after allo-SCT in our institute between October 2011 and May 2015. Results: Endoscopic examinations and biopsies were performed safely under the policy of transfusing platelets for thrombocytopenia (3/μL). For biopsied cases, the diagnostic consistency rate with endoscopic findings was 60%, with a tendency toward negative correlations with early examinations after diarrhea onset (25% for 0 - 1 days; 62.5% for later) or low-grade GVHD according to Freiburg criteria (41.2% for grade 1, 66.7% for grade 2, 100% for higher). The terminal ileum was inspected with colonoscopy in 13 cases. Endoscopic diagnoses of the ileum were provided in 11 cases and histological diagnoses in 9 cases. Diagnostic consistency for diagnosis of the terminal ileum between endoscopy and histology was 77.8%. Conclusion: Because endoscopic and histopathological findings do not always match, caution is required when focusing on endoscopic findings alone, as there is a risk of misdiagnosis. Extensive inspection of the terminal ileum with biopsy appears useful to identify otherwise undetected lesions. Our data thus support invasive endoscopic examinations for gastrointestinal complications, including ileac inspection and biopsies under appropriate management.
Mechanisms of paracrine and endocrine actions of Angiotensin II

Adipose tissue expresses high levels of angiotensinogen ( agt), the only known precursor of Angiotensin II (Ang IQ and we have previously shown that this hormone plays a paracrine role in regulation of adipocyte metabolism by increasing activity and gene expression of two key lipogenic enzymes, fatty acid synthase (FAS) and glycerol-3-phosphate dehydrogenase (GPDH). However, molecular mechanisms by which Ang II regulates an adipocyte lipogenic gene, namely FAS and transcription factors mediating this regulation are largely unknown. Furthermore, signaling mechanisms whereby Ang II induces adiposity need to be further explored. Accordingly, our studies were designed to investigate transcriptional regulation of FAS gene by Ang II and determine signaling mechanisms of Ang II leading to activate FAS gene transcription. We demonstrated that Ang II responsive element is an E box within adipocyte FAS gene and the adipocyte determination and differentiation factorl/sterol-regulatory element binding protein le (ADDl/SERBPl c) functions as a transcription factor mediating these actions. Ang II induced FAS transcription as well as ADDI gene expression in a glucose-dependent manner. Using immunoprecipitation and western blot analyses, we found that Ang II regulates adipocyte metabolism via activation of insulin signaling molecules including IR�, IRS, PI-3K and Akt. This signaling mechanism was mainly mediated by angiotensin receptor type 1 receptors (ATl ) and in part by angiotensin receptor type 2 receptors (AT2). Next, with agt knockout (agt-/-, KO) and transgenic (Tg-KO mice expressing agt exclusively in adipose tissue and Tg-WT mice overexpressing agt in adipose tissue) mouse models, we examined changes in adipose tissue metabolism in vivo and renal gene regulation in these mice and further dissected endocrine effects of adipocyte agt. We found that compared with those of WT mice, body weight gain and fat pad weight were lower in response to high fat diet in KO mice exhibiting hypotension and renal
Preferences for Colorectal Cancer Screening Tests: Diﬀerences Between Insured and Uninsured Beneﬁciaries of Iranian Health Transformation Plan

Background: Study of individual preferences about diﬀerent aspects of colorectal cancer screening tests can improve the compliance of people for these tests. Objectives: This study aimed to explore the diﬀerences in the preferences of average risk populations with diﬀerent insurance coverage regarding the colorectal cancer (CRC) screening tests. Methods: Individual preferences were identiﬁed by a standard questionnaire that was completed by 500 people within the age of 50to75andreferredtoalargegovernmentteachinghospitalinTehranbetweenSeptember2016andJanuary2017. Standarddiscrete choice models and conditional logit were used for analysis. Results: The ﬁnal attributes were the test process, pain, place, sensitivity, interval, preparation, complications risk, reduced mortality rate, and cost. The result of conditional logit regression demonstrated that having complementary insurance coverage had a signiﬁcant eﬀect on individuals’ preferences. Conclusions: This study suggests that diﬀerent insurance coverage may lead to heterogeneity of preferences for CRC screening tests.
Commentaries on Cutting Edge Science

Recent work by Wahlquist et al1 showed miR-25 to reduce levels of rco/endoplasmic reticulum calciumATPase (SERCA) 2a during heart failure, whereas therapeutic inhibition of this microRNA (miRNA) was able to reverse pre-established heart failure in a mouse model of pressure overload. Although these data suggest that miR-25 might be a drug target for the treatment of heart failure, further in vivo analysis is required before we can consider miR-25 inhibition for clinical application.
A Qualitative Longitudinal Exploration of the Lived Experience of Laparoscopic Adjustable Gastric Banding Surgery

Objectives: In the United Kingdom, laparoscopic adjustable gastric banding (LAGB) surgery is an option for obese individuals who meet the National Institute for Health and Clinical Excellence criteria. Despite the many benefits of LAGB, there is a paucity of literature exploring the long-term impact on individuals. The present study explored how people make sense of the experience of being banded from preto five years post-surgery.
FEVER MANAGEMENT

Fever in the neurocritical care setting is very common and has a negative impact on outcome of all disease types. Meta-analyses have demonstrated that fever at onset and in the acute setting after ischemic brain injury, intracerebral hemorrhage, and cardiac arrest has a negative impact on morbidity and mortality. Data support that the impact of fever is sustained for longer durations after subarachnoid hemorrhage and traumatic brain injury. Recent advances have made eliminating fever and maintaining normothermia feasible. However, currently no prospective randomized trials demonstrate the benefit of fever control in these patient populations, and important questions regarding indications and timing remain. The purpose of this chapter is to analyze the data surrounding the impact of fever across a range of neurologic injuries to better understand the optimal timing and duration of fever control. Prospective randomized trials are needed to determine whether the beneficial impact of secondary injury prevention is outweighed by the potential risks of prolonged fever control.
Studying Mechanistic Links Between Pollution and Heart Disease

Environmental factors are considered key determinants of cardiovascular disease. Although lifestyle choices such as smoking, diet, and exercise are viewed as major environmental influences, the contribution of pollutants and environmental chemicals is less clear. Accumulating evidence suggests that exposure to pollutants and chemicals could elevate the risk of cardiovascular disease. Many epidemiological studies report that exposure to fine particles present in ambient air is associated with an increase in cardiovascular mortality. Statistically significant relationships between particulate air pollution and ischemic heart disease, arrhythmias, and heart failure have been reported. Animal studies show that exposure to ambient air particles increases peripheral thrombosis and atherosclerotic lesion formation. Exposures to arsenic, lead, cadmium, pollutant gases, solvents, and pesticides have also been linked to increased incidence of cardiovascular disease. Mechanistically, these effects have been attributed to changes in the synthesis or reactivity of nitric oxide that may be caused by environmental oxidants or increased endogenous production of reactive oxygen species. Additional studies are urgently needed to: identify the contribution of individual pollutants to specific aspects of cardiovascular disease; establish causality; elucidate the underlying physiological and molecular mechanisms; estimate the relative susceptibility of diseased and healthy individuals and that of specific population groups; and determine whether pollutant exposure are risk correlates, that is, whether they influence major risk factors, such as hypertension, cholesterol, or diabetes, or whether they contribute to the absolute risk of heart disease. Collectively, these investigations could contribute to the emergent field of environmental cardiology. (Circ Res. 2006;99:692-705.)
Transgenic CaMKII C Overexpression Uniquely Alters Cardiac Myocyte Ca

Ca /calmodulin-dependent protein kinase II (CaMKII) is the predominant cardiac isoform, and the C splice variant is cytoplasmic. We overexpressed CaMKII C in mouse heart and observed dilated heart failure and altered myocyte Ca regulation in 3-month-old CaMKII C transgenic mice (TG) versus wild-type littermates (WT). Heart/body weight ratio and cardiomyocyte size were increased about 2-fold in TG versus WT. At 1 Hz, twitch shortening, [Ca ]i transient amplitude, and diastolic [Ca ]i were all reduced by 50% in TG versus WT. This is explained by 50% reduction in SR Ca content in TG versus WT. Peak Ca current (ICa) was slightly increased, and action potential duration was prolonged in TG versus WT. Despite lower SR Ca load and diastolic [Ca ]i, fractional SR Ca 2 release was increased and resting spontaneous SR Ca release events (Ca sparks) were doubled in frequency in TG versus WT (with prolonged width and duration, but lower amplitude). Enhanced Ca spark frequency was also seen in TG at 4 weeks (before heart failure onset). Acute CaMKII inhibition normalized Ca spark frequency and ICa, consistent with direct CaMKII activation of ryanodine receptors (and ICa) in TG. The rate of [Ca 2 ]i decline during caffeine exposure was faster in TG, indicating enhanced Na -Ca exchange function (consistent with protein expression measurements). Enhanced diastolic SR Ca leak (via sparks), reduced SR Ca -ATPase expression, and increased Na -Ca exchanger explain the reduced diastolic [Ca ]i and SR Ca 2 content in TG. We conclude that CaMKII C overexpression causes acute modulation of excitation-contraction coupling, which contributes to heart failure. (Circ Res. 2003;92:904-911.)
Role of Kruppel-Like Transcription Factors in Endothelial Biology Forkhead Factors in Cardiovascular Biology

It has become increasingly clear that the Notch signaling pathway plays a critical role in the development and homeostasis of the cardiovascular system. This notion has emerged from lossand gain-of-function analysis and from the realization that several hereditary cardiovascular disorders originate from gene mutations that have a direct impact on Notch signaling. Current research efforts are focused on determining the specific cellular and molecular effects of Notch signaling. The rationale for this has stemmed from the clinical importance and therapeutic potential of modulating vascular formation during various disease states. A more complete appreciation of Notch signaling, as it relates to vascular morphogenesis, requires an in-depth knowledge of expression patterns of the various signaling components and a comprehensive understanding of downstream targets. The goal of this review is to summarize current knowledge regarding Notch signaling during vascular development and within the adult vascular wall. Our focus is on the genetic analysis and cellular experiments that have been performed with Notch ligands, receptors, and downstream targets. We also highlight questions and controversies regarding the contribution of this pathway to vascular development. (Circ Res. 2007;100:1556-1568.)
Comparative Aspects of Osteosarcoma

Canine osteosarcoma bears striking resemblance to osteosarcoma in humans. Similarities include the following: male sex predilection, large patient size, 75% or more affecting the appendicular site, metaphyseal location, generally unknown etiology, less than 10% of patients have documented metastasis at presentation, over 90% of tumors show high-grade histology, 75% of tumors show aneuploidy, the metastatic rate is 80% or more with amputation alone, the lung is the most common site of metastasis, and there is improved survival with adjuvant chemotherapy. The major differences are age of onset, with dogs being affected in middle age; greater frequency in the dog, with over 8000 new cases per year, and time to metastasis being faster in the dog than man. Canine osteosarcoma is a readily available and highly comparable spontaneously occurring cancer that should be useful in a better understanding of the same disease in humans.
Effects of 10 Weeks of Periodized Resistance Training on Sarcopenia Classification in Older Women

Sarcopenia is defined as the progressive, age related loss of lean muscle mass, which in turn has been associated with osteoporosis, decreases in physical function, and loss of independence. Newly established sarcopenia classification criteria include measures of appendicular lean mass (ALM), grip strength, and gait speed. Periodized resistance training (PRT) has been investigated in older adults, however the impact of PRT, particularly daily undulating periodized resistance training (DUP) on current sarcopenia classification criteria is unknown. The aim of this randomized controlled trial was to investigate the effects of a 10-week DUP intervention on sarcopenia classification in older women. Inactive women (n=25) aged 72.3±4.6 years, who were sarcopenic or symptomatic, were randomized to a DUP group or an active control group (CON) and trained three days per week for 10 weeks. Measures of ALM, grip strength, and gait speed were recorded at baseline and post-intervention and sarcopenia was classified using established criteria. Other measures included upper and lower body strength, and global physical functioning. A McNemar’s test found no significant withinor between-group changes in sarcopenia classification. Mixed models analyses found both groups significantly improved gait speed (DUP: p=0.001, CON: p<0.001) but DUP significantly increased grip strength compared to CON (p=0.036). There were no significant changes in ALM for either group. Both groups significantly improved upper and lower body strength (p<0.001) and global physical function (DUP: p=0.039, CON: p=0.008). Results indicate DUP increases strength and function, but does not significantly alter sarcopenia classification compared to CON. However, results are limited by sample size and demonstrate the need for future research to investigate trials in larger samples with longer durations.
Ankle Arthroplasty with Preoperative Coronal Plane Deformity

The treatment of coronal plane deformity during total ankle arthroplasty is understood poorly. This study tests the hypotheses that preoperative coronal plane malalignment and incongruence of the ankle can be corrected and maintained for 2 years with total ankle replacement, and that factors can be identified that place ankles at risk of having progressive edge-loading develop. Of 86 consecutive patients who had total ankle replacement, 35 had preoperative coronal plane alignment ≥ 10°. Lateral ligament reconstruction was done in seven patients and superficial deltoid release was done in four patients at the time of ankle replacement. Ankles with talar and tibial deformities improved talar and tibial alignment toward a neutral weightbearing axis postoperatively. Ankles with only a talar deformity improved the talar alignment toward a neutral weightbearing axis postoperatively. No changes in alignment were shown during the subsequent 2 years. Postoperative ankle articulations were congruent. Patients with preoperative incongruent joints are 10 times more likely to have progressive edge-loading develop than patients with congruent joints. Surgeons must be attentive to coronal plane alignment during and after ankle replacement. Longer followup is needed to assess the longevity of the correction and the impact of minor malalignment on implant wear.
Interruptions and Medication Errors

An estimated 450 000 preventable medication-related adverse events occur in the United States every year, with estimated costs of $3.5 billion. A provocative editorial recently proposed that our health care system may suffer from a widespread lack of respect for the medication administration processes. Yet, when nurses administer medications, they are the last link in the safety net to prevent errors and potential patient harm. Many nurses pride themselves for their multitasking skillsVsomewhat like a benchmark for professionalism. Emerging evidence suggests that more medication errors may be preventable if we solve the dilemma of so many interruptions. The clinical nurse specialist (CNS) is poised to influence these safety improvements in the health care system, which could potentially lead to thousands of saved lives. Clinical nurse specialist role skills include the ability to study known evidence and close some of the gaps between research and practice. The purpose of this article is to review some of the evidence and suggest strategies for possible solutions. A second related article will be published in this column in the future that describes cognitive effects of interruptionsVhow the brain processes multitasking demands. Whereas medication errors are concerning because of the gamut of detrimental patient outcomes that may result, the effects can also be devastating to health care providers involved in errors. Nurses play a particularly important role in medication safety because they are typically at the ‘‘sharp end’’ of patient care delivery, meaning they perform the final safety checks intended to identify and intercept errors before medications are administered. It can feel like a personal failure on the part of the nurse should an error reach a patient, even if the error originated much earlier in the medication process and passed through other people and processes without being identified and corrected. To build a clinical culture aimed at averting errors, efforts must continue to identify and minimize risks to medication safety, learn from errors, and support staff involved in medication errors resulting from process and system failures.
Prevalence of bacteremia among febrile children with severe malnutrition in North Western Nigeria

Background: Malnutrition affects many children in Africa predisposing them to infection especially bacterial. Although malnutrition is highly prevalent among Nigerian children little is known about bacterial infection which is believed to adversely affect their outcome. Materials and Methods: This was a cross-sectional study. Ninety febrile children with severe Protein Energy Malnutrition aged 6–59-month based on modified wellcome classification were enrolled as individuals and; 90 febrile well-nourished children age- and sex-matched as controls. It was conducted at the emergency pediatrics unit of Aminu Kano Teaching Hospital from May to October 2013. Bacteremia was diagnosed using automated BACTEC method and Kirby-Bauer disk diffusion technique was used for antibiotic sensitivity. Results: Bacteremia occurred in 45.6% of the individuals which was significantly higher than 23.3% in the control group (odds ratio = 2.56, confidence interval = 1.45–5.22). Staphylococcus aureus(41.5%), Escherichia coli (17.1%), and Salmonella typhi (12.2%) were the most frequent isolates in the individuals. 87.8% of the isolates in the individuals were sensitive to ciprofloxacin, 85% to ceftriaxone, 51% to gentamicin, but very low sensitivity to amoxicillin (22%) and cotrimoxazole (12.1%). Conclusion: Bacteremia is highly prevalent among the malnourished children and the commonest isolate was S. aureus. The isolates were most sensitive to ciprofloxacin and ceftriaxone.