Miracle-dz/UniFAR-FTUs huggingface dataset:
Obesity and the levels of liver enzymes (ALT, AST & GGT) in East Medinipur, India

Objective Obesity is a common disorder in our country. Most widely used method to gauge obesity is Body Mass Index (BMI) which is equal to weight in kilogram divided by height in meter square. The objective of our study was to find the levels of liver enzymes ALT, AST & GGT in two groups (overweight individuals and obese individuals). Methods: A total no of 156 individuals were selected for the study and they were categorized into three groups on the basis of BMI- Group I Normal, BMI 18.5 to 24.9 (n=72), Group II Overweight, BMI 25.0 to 29.9 (n=39) and Group III Obese, BMI >30 (n=45). Serum ALT, AST & GGT were estimated by Accurex AC 112 plus semi auto analyser and values were given in U/L. Results: Values of ALT, AST & GGT were with in the normal references range in all the three groups. Conclusion: No significant relation was found between ALT, AST & GGT in normal, overweight and obese individuals. DOI: http://dx.doi. org/10.3126/ajms.v6i1. 10147 Asian Journal of Medical Sciences Vol.6(1) 2015 40-42
Revealing potential bridge vectors for BTV and SBV: a study on Culicoides blood feeding preferences in natural ecosystems in Spain

Several species of Culicoides (Diptera: Ceratopogonidae) are vectors of pathogens, such as the bluetongue (BTV) and Schmallenberg (SBV) viruses, which cause important diseases in domestic and wild ruminants. As wild ruminants can contribute to overwintering and epizootics of both diseases, knowledge of the host‐feeding behaviour of Culicoides in natural ecosystems is important to better understand their epidemiology. Blood‐engorged Culicoides females trapped in natural areas inhabited by different wild ruminant species were genetically analysed to identify host species. The origin of bloodmeals was identified in 114 females of 14 species of Culicoides. A total of 104 (91.1%) Culicoides fed on mammals and 10 (8.9%) on birds. The most abundant host identified was red deer (66.7%), followed by humans (13%) and fallow deer (6.1%). Eleven of the 14 species of Culicoides fed exclusively on mammalian hosts. Among them, five are mammalophilic species considered to be important BTV and/or SBV vectors. The results of the present study confirm that Culicoides imicola, Culicoides obsoletus, Culicoides scoticus, Culicoides pulicaris and Culicoides punctatus fed on wild ruminants, and therefore support the hypothesis that these species can act as bridge vectors by facilitating the circulation of pathogens between wild and domestic ruminant communities.
Non‐Aspergillus fungal infections in chronic granulomatous disease

Chronic granulomatous disease (CGD) is a congenital immunodeficiency, characterised by significant infections due to an inability of phagocyte to kill catalase‐positive organisms including certain fungi such as Aspergillus spp. Nevertheless, other more rare fungi can cause significant diseases. This report is a systematic review of all published cases of non‐Aspergillus fungal infections in CGD patients. Analysis of 68 cases of non‐Aspergillus fungal infections in 65 CGD patients (10 females) published in the English literature. The median age of CGD patients was 15.2 years (range 0.1–69), 60% of whom had the X‐linked recessive defect. The most prevalent non‐Aspergillus fungal infections were associated with Rhizopus spp. and Trichosporon spp. found in nine cases each (13.2%). The most commonly affected organs were the lungs in 69.9%. In 63.2% of cases first line antifungal treatment was monotherapy, with amphotericin B formulations being the most frequently used antifungal agents in 45.6% of cases. The overall mortality rate was 26.2%. Clinicians should take into account the occurrence of non‐Aspergillus infections in this patient group, as well as the possibility of a changing epidemiology in fungal pathogens. Better awareness and knowledge of these pathogens can optimise antifungal treatment and improve outcome in CGD patients.
Clinical and tree hollow populations of human pathogenic yeast in Hamilton, Ontario, Canada are different

Yeast are among the most frequent pathogens in humans. The dominant yeast causing human infections belong to the genus Candida and Candida albicans is the most frequently isolated species. However, several non‐C. albicans species are becoming increasingly common in patients worldwide. The relationships between yeast in humans and the natural environments remain poorly understood. Furthermore, it is often difficult to identify or exclude the origins of disease‐causing yeast from specific environmental reservoirs. In this study, we compared the yeast isolates from tree hollows and from clinics in Hamilton, Ontario, Canada. Our surveys and analyses showed significant differences in yeast species composition, in their temporal dynamics, and in yeast genotypes between isolates from tree hollows and hospitals. Our results are inconsistent with the hypothesis that yeast from trees constitute a significant source of pathogenic yeast in humans in this region. Similarly, the yeast in humans and clinics do not appear to contribute to yeast in tree hollows.
The role of surgical debridement in different clinical manifestations of invasive aspergillosis

Invasive aspergillosis (IA) has a wide spectrum of clinical presentations and is associated with high mortality rates. Early initiation of systemic antimould therapy remains the most important measure to reduce mortality. Surgical debridement is an important additional therapeutic option mainly in cases of extrapulmonary IA. The main intention for surgical intervention in IA is to obtain material for diagnosis and antifungal susceptibility testing. There are, however, also therapeutic implications for surgical interventions in rare manifestation of IA such as endocarditis or mycotic aneurysm. Here, we will review the role of surgical interventions in the treatment of different clinical manifestations of IA.
Excerpts from the US Renal Data System 2009 Annual Data Report.

This 21st US Renal Data System Annual Data Report covers data through 2007, and again includes a section on chronic kidney disease (CKD) in the United States. Using NHANES and employer group health plan data, we estimate the relationship between kidney disease markers and mortality risk and the likelihood of blood pressure and lipid control by CKD stage; illustrate use of the new ICD-9-CM CKD diagnosis codes; and report on morbidity, mortality, care and costs during the transition to ESRD. New chapters address CKD patient care, the transition to ESRD, and acute kidney injury. In 2007, 111,000 patients started end-stage renal disease (ESRD) therapy, and the prevalent population reached 527,283 (including 368,544 dialysis patients); 17,513 transplants were performed, and 158,739 patients had a functioning graft at year’s end. Program expenditures reached $35.3 billion, with $23.9 billion from Medicare (accounting for 5.8% of total Medicare expenditures). The incident rate fell 2.1%, to 354 per million. Fistula use in prevalent patients declined 2.6 percent; catheter use continues to be a concern. The percentage of patients with hemoglobin levels above 13 g/dl has fallen since 2006, but levels in the incident population frequently exceed 12. First-year mortality and morbidity among hemodialysis patients—particularly the increasing rate of hospitalizations due to infections—continue to be major concerns, and pediatric patient survival has not improved. The public health impact of kidney disease is larger than previously appreciated, and early detection, education, intervention, and risk factor control need to address the heavy burden of cardiovascular disease and adverse events in this vulnerable population.
Best Practice Outcomes for Schizophrenia: Does Measurement of Medication Compliance Provide a Key?

Medication compliance based on regular monitoring and education of patients and carers is a major area of intervention which has the potential to stabilise schizophrenia, reduce relapse, reduce the rate of rehospitalisation, improve levels of disability, improve sociability and reduce the burden of care on families. These factors can in turn have a major impact on the cost of schizophrenia to the nation. The Patient Outcomes Research Team (PORT) recently published treatment recommendations for schizophrenia based on ‘exhaustive reviews of the treatment outcomes literature’ [1].
Conduct-Disordered Adolescents With Fetal Alcohol Spectrum Disorder

Youth with fetal alcohol spectrum disorders (FASDs) are in a perilous circumstance. FASD is associated with a high rate of self-regulation problems and trouble with the law and is underdiagnosed. Standard juvenile corrections-based interventions often do not meet the needs of these vulnerable youth. This article describes what is known about conduct-disordered adolescents with FASD and the neurocognitive deficits that directly affect emotional and behavioral self-control. The authors propose guidelines for the assessment of FASD within residential treatment settings and analyze interventions that show promise for inpatient treatment of youth with FASD.
Antifungal drug resistance among Candida species: mechanisms and clinical impact

The epidemiology of Candida infections has changed in recent years. Although Candida albicans is still the main cause of invasive candidiasis in most clinical settings, a substantial proportion of patients is now infected with non‐albicans Candida species. The various Candida species vary in their susceptibility to the most commonly used antifungal agents, and the intrinsic resistance to antifungal therapy seen in some species, along with the development of acquired resistance during treatment in others, is becoming a major problem in the management of Candida infection. A better understanding of the mechanisms and clinical impact of antifungal drug resistance is essential for the efficient treatment of patients with Candida infection and for improving treatment outcomes. Herein, we report resistance to the azoles and echinocandins among Candida species.
Candida glabrata – unique features and challenges in the clinical management of invasive infections

Candida glabrata is a pathogenic yeast with several unique biological features. This article provides an up‐to‐date review on current data and reasoning aspects of this clinically problematic organism. Haploidy, absence of pseudohyphae, facultative anaerobe growth of C. glabrata, as well as its intrinsically low susceptibility to azole antifungals require specific consideration in diagnosis and treatment approaches. As C. glabrata today represents a sizeable percentage of pathogens in candidaemia, the use of azole antifungals in upfront therapy of invasive yeast infections is discouraged by recent guidelines. While the selection of C. glabrata mutants with impaired susceptibility to echinocandins has been described, analyses of several clinical studies indicate an association of improved outcomes with the use of echinocandins as the primary treatment for invasive yeast infections with potential or documented involvement of C. glabrata.
Expression and Function of Cytokines and Chemokines in Neuropsychiatric Related Systemic Lupus Erythematosus

Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by multi-organ damage, and the neuropsychiatric complications of SLE (NPSLE) are associated with increased morbidity and mortality. In general, the diagnosis of NPSLE is difficult, because no single laboratory marker or imaging modality has been found which can serve as a gold standard, and the diagnosis is thus primarily clinical. The pathogenesis of NPSLE has not been fully elucidated. Focal symptoms are thought to more likely result from vascular lesions, whereas diffuse manifestations are more likely related to autoantibody- or cytokine-mediated impairment of neuronal function. However recent progress has provided evidence that a number of cytokines and chemokines, as well as autoantibodies, may be involved in the neuropsychiatric manifestations of SLE, because certain repertoires of cytokines/chemokines are detectable in the central nervous system of NPSLE patients during active disease. In addition, we have recently shown elevated levels of the soluble form of fractalkine, which is a newly described membrane-bound CX3C chemokine, in the cerebrospinal fluid of patients with active NPSLE. This review will discuss the involvement of cytokines and chemokines in the pathogenesis of NPSLE and the evaluation of their significance as a useful laboratory parameter of active neuropsychiatric disease.
The effect of anesthesia type on the postoperative complications of major lower extremity surgery

Amac: Major alt ekstremite cerrahisinde rejyonel anestezi genel anesteziye gore daha fazla tercih edilmektedir. Calismamizda rejyonel anestezinin major cerrahilerde genel anesteziye gore komplikasyon insidansi ile iliskisini arastirmayi amacladik. Yontemler: Bu calismada 1 Ocak 2009-31 Aralik 2012 tarihleri arasinda total diz protezi ve total kalca protezi geciren 372 olgunun dosyalari retrospektif incelendi. Genel anestezi uygulanan hasta sayisi 118, rejyonel anestezi uygulanan hasta sayisi 254 idi. Hasta birden fazla kalca veya diz replasmani gecirdiyse sadece ilk operasyon calismaya dahil edildi. Hastalarin operasyon sonrasi 30 gun suresince olan komplikasyonlari arastirildi. Hastalarin yasi, cinsiyeti, operasyon turu (unilateral, bilateral), ek hastaligi olup olmadigi, postoperatif komplikasyonlar bakildi. Bulgular: Hastalarin yasi, cinsiyeti, sahip olduklari ek hastaliklari bakimindan farklilik yoktu. total kalca protezi hastalarinin 92 sine genel anestezi 135 hastaya rejyonel anestezi uygulanirken, total diz protezi yapilmis olan hastalarin 26 sina genel anestezi, 119 una rejyonel anestezi uygulandigi goruldu (p=0,001). Postoperatif komplikasyonlar incelendiginde; kardiyak atak hicbir hasta grubunda yoktu. Pulmoner emboli ve eksitus genel anestezi uygulanan 7, rejyonel anestezi uygulanan 2 hastada tespit edildi. Cerrahi yeri enfeksiyonu genel anestezi uygulanan 9 hastada, rejyonel anestezi uygulanan 7 hastada saptandi ve bu farklar istatistiksel olarak anlamli bulundu. Sonuc: Klinigimizde major alt ekstremite cerrahisi geciren hastalarda rejyonel ve genel anestezi uygulamalarinda postop 1 aylik donem suresince komplikasyonlar bakimindan rejyonel anestezi lehine anlamli fark bulundu.
Prostaglandin E1 administration following orthotopic liver transplantation: A randomized prospective multicenter trial

Abstract BACKGROUND & AIMS: Prostaglandin E1 (PGE1) has been used after orthotopic liver transplantation (OLT) based on limited clinical data suggesting PGE1 infusion improves immediate hepatic allograft function. The aim of this study was to conduct a randomized double-blinded multicenter trial to evaluate the effect of PGE1 on early hepatic and renal function in patients undergoing OLT. METHODS: One hundred eighteen patients were randomized to receive either PGE1 or crystalloid placebo intravenously after allograft revascularization. Primary end points were incidence of primary allograft nonfunction (PNF) or severe renal dysfunction. RESULTS: The incidence of PNF was 6.7% (4 of 60) and 6.9% (4 of 58) in the control and PGE1 groups, respectively. PGE1 infusion was, however, associated with improved early renal function (mean peak creatinine level of 1.4 +/- 1.0 and 2.0 +/- 1.0 in patients treated with PGE1 and placebo, respectively; P
The effect of geniglossal advancement on airway flow using a computational flow dynamics model

Obstructive sleep apnea (OSA) is a sleep disorder caused by partial or complete collapse of the pharyngeal airway. Genioglossal advancement (GGA) is a well‐tolerated surgical procedure intended to address hypopharyngeal collapse, yet there are few studies that monitor changes in airflow dynamics at this site. Computation fluid dynamics (CFD) utilizes airflow simulation to predict changes in airflow after anatomic manipulation.
Maintaining Addiction: Tobacco Cessation Policy and Substance Abuse Treatment for Youth

ABSTRACT This research project examines how institutions, which are part of the substance abuse treatment industry, address the connection between tobacco and other drugs in youth. A survey was sent to 628 substance abuse treatment programs. Results suggest that the majority of treatment programs are routinely assessing tobacco use of the youth in their care, but only a small proportion follow through with tobacco cessation as an integral part of treatment planning. Results suggest there is no consistent reason for including tobacco cessation in treatment planning, nor consistency in the methods used to treat tobacco addiction. Additionally, some outside policy forces appear to be related to whether or not tobacco cessation is assessed and treated.
Use of (1→3)‐β‐d‐glucan for diagnosis and management of invasive mycoses in HIV‐infected patients

People living with HIV (PLHIV) are highly vulnerable to invasive fungal infections (IFIs) due to their immune dysfunction. Diagnosis and treatment of IFIs remain challenging due to the requirement of deep tissue sampling to visualise and culture fungi before initiating treatment. Such techniques are less practical in resource‐limited settings due to their cost and requirement of relatively invasive procedures. Hence, identification of surrogate markers for the early diagnosis and therapeutic monitoring of IFIs is required. Recent studies have shown that (1→3)‐β‐d‐glucan (BDG), a major fungal cell wall antigen, represents a promising soluble marker for the presumptive diagnosis and therapeutic monitoring of IFIs in HIV‐infected patients. Herein, we review findings on the merits of BDG assays in the diagnosis of IFIs and monitoring of antifungal therapies for PLHIV. Conversely to other types of immunocompromised patients, HIV infection is associated with gut damage and subsequent bacterial and fungal translocation leading to elevated BDG plasma levels.
Maternal-Fetal Nutrition during Pregnancy and Lactation

Part I. Nutritional Regulation and Requirements for Pregnancy and Fetal Growth: 1. Maternal adaptations to pregnancy and the role of the placenta Leslie Myatt and Theresa Powell 2. Pregnancy and feto-placental growth: macronutrients Laura Brown, Tim Regnault, Paul Rozance, James Barry and William W. Hay Jr 3. Mineral requirements of the mother and conceptus Lorraine Gambling and Harry J. McArdle 4. Individualized growth curves and size at birth Eve Blair 5. Maternal diets in the developing world Shobha Rao and Chittaranjan Yajnik 6. Pre-eclampsia Fergus McCarthy and Louise Kenny Part II. Nutritional Regulation and Requirements for Lactation and Infant Growth: 7. Macronutrients for lactation and infant growth Thibault Senterre and Jacques Rigo 8. Changes in nutrient requirements with age after birth Christopher H. Knight 9. Comparison between preterm and term infants Mary Fewtrell and Sirinuch Chomtho 10. Influences of timing and duration of formula feeding on infant growth William C. Heird 11. Maternal and offspring benefits of breastfeeding Alison C. Tse and Karin B. Michels Part III. Specialized Requirements: 12. Teenage pregnancies Annie S. Anderson and Wendy Wrieden 13. Vegetarians and vegans during pregnancy and lactation Rana Conway and Adrienne Cullum 14. Hyperemesis in pregnancy James D. Paauw and Alan T. Davis 15. Multiple pregnancy Barbara Luke 16. Mineral and vitamin supplementation before, during and after conception Y. Ingrid Goh 17. Determinants of egg and embryo quality: long term effects of maternal diet and assisted reproduction Kevin D. Sinclair and Wing Yee Kwong 18. Nutrition, environment and epigenetics Ian M. Morison and Wolf Reik Index.
Neuromodulation techniques, complications, and troubleshooting

Spinal cord stimulation has become one of the mainstays of chronic treatment for patients in pain units. It is a safe, effective, and reversible technique, although the rate of complications is approximately 30%-40%. The most common complication, despite technological breakthroughs and advances in equipment, continues to be electrode migration, which currently occurs in approximately 13% of cases. The most serious complication is related to neurologic problems after infections in the epidural space. A review of technique-related complications is performed, classifying them into mechanical and biological complications, including the strategies to avoid them, mainly through careful patient selection, correct surgical technique, and good selection of the programmed electrical parameters.
Intravitreal plasmin without associated vitrectomy as a treatment for refractory diabetic macular edema.

OBJECTIVE To determine the effectiveness of a low-dose intravitreal injection of autologous plasmin enzyme (APE), without the performance of a vitrectomy, as a treatment for refractory diffuse diabetic macular edema (DDME). DESIGN Prospective, comparative, interventional case series. PATIENTS Sixteen patients with bilateral DDME who had not responded to prior laser photocoagulation. All patients received an injection in 1 eye, while the other eye served as a control. INTERVENTION Intravitreal 0.2 mL APE injection under topical anesthesia. The APE was obtained using a simplified method. MAIN OUTCOME MEASURES Central macular thickness (CMT) at 1 and 6 months, determined by optical coherence tomography (OCT) and best corrected visual acuity (BCVA). RESULTS All patients underwent a 1-month follow-up. Prior to injection, CMT in the eye about to receive the injection was 541 +/- 79 microm (mean +/- standard deviation [SD]) versus 535 +/- 76 microm in the control eye. One month after injection, CMT was 241 +/- 47 microm in injected eyes and 530 +/- 85 microm in control eyes (P < 0.001, bilateral Wilcoxon test for paired samples). The macular edema (ME) improved in all injected eyes (100%), with complete resolution in 7 patients (44%). The mean BCVA of treated eyes was 0.618 +/- 0.27 (mean +/- SD) at baseline and 0.45 +/- 0.24 four weeks after injection (paired samples t-test, P < 0.001). No adverse effects were observed in any of the patients. BCVA and CMT were stable when evaluated at 6-month follow-up (0.43 +/- 0.242 and 244 +/- 46 microm, respectively). CONCLUSIONS Intravitreal APE injection effectively reduces macular thickening due to DDME in cases that fail to respond to conventional laser photocoagulation, and improves visual acuity in a short term, and this results remain stable in a medium term what is very important. Further investigation is warranted in order to assess long-term efficacy and safety.
The nonrecurrent laryngeal nerve: Anatomic and electrophysiologic algorithm for reliable identification

The recurrent laryngeal nerve (RLN) intraoperative monitoring (IONM) provides a new functional dynamic that adds to visual identification of the RLN to optimize its intraoperative management. Intraoperative monitoring has been applied to the initial identification of the RLN. We now apply IONM to the identification of the nonrecurrent laryngeal nerve (NRLN) and provide electrophysiologic and anatomic parameters to facilitate this technique of neural identification for the NRLN, which is at increased risk of injury during thyroid surgery.