anthonyyazdaniml/gliner-biomed-curated-corpus huggingface dataset:
PURPOSE: Bleeding complication is a critical risk factor for outcomes of acute heart failure patients requiring mechanical circulatory support (MCS), including percutaneous catheter-type heart pumps (Impella). The Japanese registry for Percutaneous Ventricular Assist Device (J-PVAD) is an ongoing, large-scale, real-world registry to characterize Japanese patients requiring Impella. Here we analyzed bleeding complication profiles in patients who received Impella.
METHODS: All consecutive Japanese patients who received Impella from October 2017 to January 2020 were enrolled. The 30-day survival and bleeding complications were analyzed.
RESULTS: A total of 1344 patients were included: 653 patients received Impella alone, 685 patients received a combination of veno-arterial extracorporeal membrane oxygenation and Impella (ECPELLA), and 6 patients had failed Impella delivery. Overall 30-day survival was 67.0%, with Impella alone at 81.9% and ECPELLA at 52.7%. Overall bleeding/hematoma adverse events with a relation or not-excluded relation to Impella was 6.92%. Among them, the rates of hematoma and bleeding from medical device access sites were 1.41% and 4.09%, respectively. There was no difference between etiologies for these events.
CONCLUSION: This study represents the first 3-year survival and the safety profile focused on bleeding adverse events from the J-PVAD registry. The results show that the real-world frequency of bleeding adverse events for patients who received Impella was an expected range from previous reports, and future real-world studies should aim to expand this data set to improve outcomes and adverse events.
OBJECTIVE: Patients with diffuse cutaneous systemic sclerosis (dcSSc) frequently show spontaneous improvement of skin fibrosis. Our aim was to examine whether an improvement in skin fibrosis predicts lower likelihood of visceral organ progression and better survival.
METHODS: Patients from the European Scleroderma Trials and Research (EUSTAR) cohort with dcSSc, baseline modified Rodnan skin score (mRSS) ≥7, and valid mRSS at 12±3 months follow up were included. Regression/progression of skin fibrosis was defined as a decrease/increase in mRSS >5 points and ≥25% from baseline to follow up. The outcomes included progression of lung, renal, cardiac and gastrointestinal manifestations using consensus derived definitions and all-cause death. Regressive, stable and progressive patients were compared by univariate, Kaplan-Meier survival curve and Cox regression analysis.
RESULTS: Of 1257 included patients, 883 (70.2%) were stable, 282 (22.4%) regressive, and 92 (7.3%) progressive. Regressive patients, adjusted for baseline mRSS, baseline immunosuppression, baseline FVC, and disease duration, showed a significantly lower probability of FVC decline ≥10% than progressive patients (p=0.00003), lower probability of all-cause mortality during follow up (p=0.035) compared to progressive patients. .Improvement of skin fibrosis was not associated with progression of other organ manifestations.
CONCLUSION: We found that regression of skin fibrosis is associated with a lower probability of lung progression and better survival at follow up. The link between the disease course of skin and lung fibrosis in SSc can help to better stratify patients in clinical practice and enrich for ILD progressive patients in clinical trials.
<P>PROBLEM TO BE SOLVED: To provide a chemical synthetic method of various optical isomers of ergothioneine.  <P>SOLUTION: In the method, a salt, an optically active salt if required, of Nα,Nα-dimethylated histidine ester is synthesized or used. The salt is treated with an alkyl, an alkenyl or an aryl halogeno thionoformate, especially phenyl halogeno thionoformate, in the presence of a base. A sulfur-containing substituent in the obtained compound is protected, and the protected compound is converted into a trimethyl ammonium compound, which is subsequently subjected to saponification or acid hydrolysis to liberate the desired ergothioneine. The method improves the yield and offers an excellent optical purity.  <P>COPYRIGHT: (C)2006,JPO&NCIPI
Half of the health facilities will implement the intervention package. All mothers will be tested using PoC-VL at delivery and all HIV-exposed infants will be offered PoC-EID at birth and week 4-8. Newborns found to be HIV-positive will be offered immediate ART. Neonatal ART initiation will be supported at birth by trained nurses/midwives, and approved and supervised by local doctors from the affiliated HIV CTC. Following ART initiation infants will be referred for consolidated ART management to their paediatric HIV clinic following local procedures. Newborns testing HIV-negative will be offered postnatal prophylaxis (PNP) or enhanced postnatal prophylaxis (ePNP), depending on clinical risk factors, the maternal VL and country guidelines. Mothers with HIV-RNA \>1000 copies/mL will receive immediate referral information for ART initiation if not on ART or enhanced ART counselling, with follow up virologic testing and switch of ART regimen as applicable at their local HIV clinic.
Non-invasive assessment of cerebral haemodynamics using Transcranial doppler ultrasonography has recently gained importance. Essentially, TCD measures flow velocity in the insonated vessel and the changes in flow velocity can be taken to reflect the changes in blood flow, assuming that the diameter of the insonated vessel remains constant. As TCD is easy to use and gives reproducible measurements, it has become a widely accepted method of assessing the cerebrovascular reactivity to carbon dioxide (CRCO2), cerebral autoregulation, estimated CPP, and CrCP. In patients with neurological disorders, impairment in both cerebral autoregulation and cerebral vascular reactivity has been shown to predict poor neurological outcome. Knowledge of the effects of normal pregnancy and pre-eclampsia on cerebral haemodynamics is essential for appropriate management of these patients undergoing anaesthesia or in labour, particularly when vasoactive medications are administered. The effects of pregnancy and/or pre-eclampsia on MCAFV have been studied by other investigators. Ikeda and colleagues found little change in mean MCAFV during the first two trimesters but reduced values in the third trimester. Williams and Wilson showed that MCAFV fell significantly with advancing gestational age. In another study, Williams and Wilson used TCD to assess cerebral haemodynamics in 17 non-pregnant women, 17 normotensive pregnant women, 20 pregnant women with pre-existing hypertension, and 21 pre-eclamptic women. The pregnant women were all in their third trimester. There was no difference in mean MCAFV in healthy pregnancy compared with non-pregnant women and a small, but non-significant, increase in mean MCAFV in the hypertensive and pre-eclamptic women. Demarin and colleagues studied pre-eclamptic women before and after delivery and found a progressive increase in MCAFV during late pregnancy. Ohno and colleagues compared MCAFV in 35 healthy pregnant and 17 pre-eclamptic women. In this study, the mean MCAFV was significantly higher in the pre-eclamptic group. It has been suggested that these increases in MCAFV are because of a degree of vasospasm. The differences between the findings of various studies with regards to the changes in MCAFV in pre-eclampsia might be explained by the differences in the severity of pre-eclampsia between the studies. Some investigators have reported increased MCAFV in symptomatic, compared with asymptomatic pre-eclamptics.
In the presence of head injury or other intracranial lesions, the respiratory depressant effects of codeine and other narcotics may be markedly enhanced, as well as their capacity for elevating cerebrospinal fluid pressure. Narcotics also produce other CNS depressant effects such as drowsiness, that may further obscure the clinical course of the patients with head injuries.

Codeine or other narcotics may obscure signs on which to judge the diagnosis or clinical course of patients with acute abdominal conditions.

Codeine is habit-forming and potentially abusable. Consequently, the extended use of this product is not recommended.

Acetaminophen and codeine phosphate tablets contain sodium metabisulfite, a sulfite that may cause allergic-type reactions including anaphylactic symptoms and life-threatening or less severe asthmatic episodes in certain susceptible people. The overall prevalence of sulfite sensitivity in the general population is unknown and probably low. Sulfite sensitivity is seen more frequently in asthmatic than in nonasthmatic people.
PURPOSE: To efficiently obtain spiro [isoquinoline-4(1H), 3'pyrrolidine]1,2',3,5'(2H) tetrone useful as an aldose reductase inhibitor, etc., by allowing 2-bromobenzoic acid, etc., as starting material to react with dimethyl malonate, etc.  
     CONSTITUTION: A compd. of formula I (where R 1  is H or a halogen) is allowed to react with dimethyl malonate and sodium hydride in the presence of a catalytic amt. of copper bromide to form a compd. of formula II. This compd. is allowed to react with thionyl chloride and treated with a compd. of the formula R 2 NH 2  (where R 2  is a dihalogen substd. benzyl or methyl) in an ordinary solvent in the presence of triethylamine to form a compd. of formula III. This compd. is allowed to react with bromoacetonitrile in an ordinary solvent in the presence of potassium carbonate to form a compd. of formula IV. This compd. is allowed to react with gaseous HCl in methanol and diethyl ether and the resultant compd. of formula V is allowed to react with a base in an ordinary solvent to obtain the objective compd. of formula VI. 
     COPYRIGHT: (C)1993,JPO
BACKGROUND: Whether pain, jaw function and quality of life are correlated with disc positions is controversial, and similar studies evaluating disc positions by magnetic resonance imaging (MRI) are very limited.
OBJECTIVE: This study evaluated the pain, mandibular function and quality of life of the temporomandibular disorders (TMDs) patients with different disc positions according to MRI, and the relationship among them.
METHODS: Three hundred and thirty-five participants were included. Patients completed questionnaires included the Numeric Rating Scale (NRS), Jaw Functional Limitation Scale 8-item (JFLS-8), the Generalised Anxiety Disorder 7-item (GAD-7), Patient Health Questionnaire 9-item (PHQ-9) and Oral Health Impact Profile for TMD (OHIP-TMD). MRI was conducted to evaluate these diagnoses, resulting in the identification of three distinct categories: normal positioning (NP), disc displacement with reduction (DDwR) and disc displacement without reduction (DDwoR).
RESULTS: Participants had the mean age of 28.55 ± 11.10 years (80.90% women). DDwR and DDwoR had a higher percentage of females compared with NP. Significant differences existed among patients in all questionnaires. The DDwoR group had significantly the highest pain, functional limitation and the worst quality of life. Moreover, they experienced the most difficulties in chewing tough foods, yawning, experiencing pain and psychological discomfort. Moreover, the multivariate regression showed that age, female gender, diagnosis as DDwoR, GAD-7 and PHQ-9 were significantly linked to higher functional limitation. Worse quality of life was associated with age, diagnosis as DDwoR, GAD-7 and PHQ-9.
CONCLUSIONS: Among patients with different disc positions, DDwoR showed the highest pain, functional limitation and the worst quality of life. Also, NP showed a proportion of chronic pain. Physical pain, psychological discomfort and chewing tough food were regarded as the most impaired. Women who experience anxiety and depression tended to have a higher propotion of dysfunction and a lower quality of life.
Osteopathia Striata with Cranial Sclerosis (OSCS) is a rare genetic condition primarily characterized by metaphyseal striations of long bones, bone sclerosis, macrocephaly, and other congenital anomalies. It is caused by pathogenic variants in AMER1, a tumor suppressor and a WNT signaling repressor gene with key roles in tissue regeneration, neurodevelopment, tumorigenesis, and other developmental processes. While somatic AMER1 pathogenic variants have frequently been identified in several tumor types (e.g., Wilms tumor and colorectal cancer), whether OSCS (i.e., with AMER1 germline variants) is a tumor predisposition syndrome is not clear, with only nine cases reported with tumors. We here report the first case of neuroblastoma diagnosed in a male child with OSCS, review all previously reported tumors diagnosed in individuals with OSCS, and discuss potential tumorigenic mechanisms of AMER1. Our report adds to the accumulating evidence suggesting OSCS is a tumor predisposition condition, highlighting the importance of maintaining a high index of suspicion for the associated tumors when evaluating patients with OSCS. Importantly, Wilms tumor stands out as the most commonly observed tumor in OSCS patients, underscoring the need for regular surveillance.
Calcium supplements derived from ocean algae. One dose equals 3 capsules containing 180 mg calcium each.
Reduced vagally mediated heart rate variability (VmHRV) has been reported in patients with chronic pain. In healthy persons, breathing with longer expiration relative to inspiration increases VmHRV at 12 breaths per minute. The present study aimed to determine the immediate effect of breathing with longer expiration relative to inspiration on VmHRV and mood states in patients with chronic pain. Fifty patients with chronic pain aged between 20 and 67 years were prospectively randomized as two groups with an allocation ratio of 1:1. The interventional group practiced breathing with metronome based visual cues, maintaining an inspiration to expiration ratio of 28:72 (i/e ratio, 0.38) at a breath rate of 12 breaths per minute. The average i/e ratio they attained based on strain gauge respiration recording was 0.685 (SD 0.48). The control group, which looked at the metronome without conscious breath modification had an average i/e ratio of 0.745 (SD 0.69). The VmHRV, respiration and self-reported mood states (using the Brief Mood Introspection Scale (BMIS)) were assessed. There was a significant increase in HF-HRV and RMSSD during low i/e breathing (repeated measures ANCOVA, Bonferroni adjusted post-hoc test, p < 0.05; in all cases). Self-reported mood states changed as follows: (i) following low i/e breathing positive-mood states increased while the aroused mood state decreased whereas (ii) following the control intervention the aroused mood state increased (repeated measure ANOVA, p < 0.05; in all cases). Hence breathing with prolonged expiration is possibly useful to increase VmHRV and improve self- reported mood states in patients with chronic pain.
Those assigned to the CBT-AD \[cognitive behavioral therapy for adherence and depression) condition, will have up to 8 additional sessions delivered by the study clinic nurse. Additionally, those assigned to CBT-AD will have the procedures available to those assigned to ETAU.
PURPOSE:To obtain the titled compound useful as a carcinostatic agent having high bioactivity, without using organic solvent, by dissolving a hydrophilic polypeptide rich in hydrophobic amino acid and having a specific molecular weight and an anthracycline antineoplastic substance in water and mixing and bonding both compounds in water. CONSTITUTION:A hydrophilic polypeptide rich in hydrophobic amino acid and having a molecular weight of 10,000-15,000 and an anthracycline antineoplastic substance are dissolved in water and mixed with each other to obtain the objective compound wherein hydrophilic polypeptide is bonded with the anthracycline antineoplastic substance through hydrogen bond and/or hydrophobic bond. The anthracycline antineoplastic substance is preferably an aglycon of formula (R1 is H or OH; R2 is H, OH, OCH3, etc.; R3 is OH or OCH3; R4 is H or OH; R5 is H or OH; R6 is H or OCH3; R7 is COCH2OH, etc.; R8 is H, OH, etc.; R9 is H or OH).
OBJECTIVES: Hereditary cancer has implications not only for patients but also for their at-risk relatives (ARRs). In current clinical practice, risk disclosure to ARRs involves collaboration between patients and healthcare providers (HCPs). However, the specific responsibilities of each party are intertwined and at times unclear. In this study, we explored public attitudes regarding moral and legal responsibilities to disclose familial risk information to uninformed ARRs.
DESIGN: In an online cross-sectional survey, participants were prompted with a hypothetical scenario where a gender-neutral patient learnt about their familial risk of colorectal cancer. The patient was advised to regularly undergo colonoscopy screening, and this recommendation was extended to both their siblings and cousins. While the patient informed their siblings, they had not spoken to their cousins in 20 years and did not want to contact them. The survey assessed respondents' views on the patient's and HCPs' ethical responsibility and legal obligation to inform the cousins (ARRs).
PARTICIPANTS: A random selection of 1800 Swedish citizens 18-74 years of age were invited. Out of those, 914 (51%) completed the questionnaire.
RESULTS: In total, 75% believed that HCPs had a moral responsibility to inform ARRs, while 59% ascribed this moral responsibility to the patient. When asked about the ultimate responsibility for risk disclosure to ARRs, 71% placed this responsibility with HCPs. Additionally, 66% believed that HCPs should have a legal obligation to inform ARRs, while only 21% thought the patient should have such an obligation. When prompted about a scenario in which the patient actively opposed risk disclosure, a majority believed that HCPs should still inform the ARRs.
CONCLUSION: Our study indicates that the Swedish public ascribes moral responsibility for informing ARRs to both the patient and HCPs. However, contrary to current practice, they believe HCPs hold the ultimate responsibility. The majority of respondents support disclosure even without patient consent.
In the last decade, an incredible improvement has been made in elucidating the genetic bases of cardiomyopathies. Here we report the impact of either the European Society of Cardiology (ESC) guidelines or the use of whole exome sequencing (WES) in terms of a number of variants of uncertain significance (VUS) and missed diagnoses in a series of 260 patients affected by inherited cardiac disorders. Samples were analyzed using a targeted gene panel of 128 cardiac-related genes and/or WES in a subset of patients, with a three-tier approach. Analyzing (i) only a subset of genes related to the clinical presentation, strictly following the ESC guidelines, 20.77% positive test were assessed. The incremental diagnostic rate for (ii) the whole gene panel, and (iii) the WES was 4.71% and 11.67%, respectively. The diverse analytical approaches increased the number of VUSs and incidental findings. Indeed, the use of WES highlights that there is a small percentage of syndromic conditions that standard analysis would not have detected. Moreover, the use of targeted sequencing coupled with "narrow" analytical approach prevents the detection of variants in actionable genes that could allow for preventive treatment. Our data suggest that genetic testing might aid clinicians in the diagnosis of inheritable cardiac disorders.
Simvastatin 40 mg on Day 1. Cilostazol 100 mg twice a day for 6 days. Simvastatin 40 mg and Cilostazol 100 mg twice a day on Day 8.
First, we selected two districts that have similar characteristics and are adjacent to each other. Both districts have a total of 72 kebeles (the smallest administrative unit), 36 in each district. Then, we chose 20, 10 from each district, kebeles on the boundary of the two districts to act as a buffer zone, to prevent information contamination between the intervention and control clusters. Finally, 26 kebeles in the Dedo district will be assigned to the intervention group while 26 kebeles in the Seka Chekorsa district are assigned to control clusters. Allocation concealment will not be done for study participants, as they would certainly know if they are in the intervention group or not. However, data collectors will be blinded to the allocation assignment by not being informed about it, not being part of the trial implementers, and not being inhabitants of any of the kebeles. Moreover, data analysts will be blinded to group allocation.
Head and neck cancer is the sixth most common cancer worldwide. Radiotherapy is an important measure to control tumor recurrence. Although radiotherapy has been widely used in patients with head and neck cancer, the 2-year local recurrence rate of patients with locally advanced disease is still as high as 50%-60%. This is associated with a lower radiosensitivity in head and neck cancer. High doses of reirradiation (\>60 Gy) are associated with severe late complications and treatment-related mortality. Therefore, finding an appropriate sensitizer to improve the radiosensitivity is the key to improve the survival of recurrent patients. Our preclinical study confirmed that copper accumulation can lead to radioresistance in vitro and in vivo, and the results were published in J Hepatol (IF=25.7). Penicillamine is a commonly used copper chelator in clinical practice and can reduce the concentration of copper in the body. Based on this, the investigators plan to carry out a prospective interventional phase II clinical trial to explore the safety and efficacy of penicillamine as a radiosensitizer in the treatment of recurrent head and neck cancer.
Human experience of acute overdose with atazanavir is limited. Single doses up to 1200 mg (three times the 400 mg maximum recommended dose) have been taken by healthy subjects without symptomatic untoward effects. A single self-administered overdose of 29.2 g of atazanavir in a patient with HIV-1 infection (73 times the 400 mg recommended dose) was associated with asymptomatic bifascicular block and PR interval prolongation. These events resolved spontaneously. At atazanavir doses resulting in high atazanavir exposures, jaundice due to indirect (unconjugated) hyperbilirubinemia (without associated liver function test changes) or PR interval prolongation may be observed [see Warnings and Precautions (5.1, 5.8) and Clinical Pharmacology (12.2)].

  


Treatment of overdosage with atazanavir should consist of general supportive measures, including monitoring of vital signs and ECG, and observations of the patient’s clinical status. If indicated, elimination of unabsorbed atazanavir should be achieved by emesis or gastric lavage. Administration of activated charcoal may also be used to aid removal of unabsorbed drug. There is no specific antidote for overdose with atazanavir. Since atazanavir is extensively metabolized by the liver and is highly protein bound, dialysis is unlikely to be beneficial in significant removal of this medicine.
In the morning this group brushed with Tartarase for 30 seconds, filled a dental tray with Tartarase and applied it to the 6 lower front teeth and left it for 30 minutes, spit but did not rinse then brushed with Tartarase for another 30 seconds, spit, but did not rinse. In 30 minutes they brushed with Crest. Before bed they brushed with Crest alone. This routine was repeated daily for 4 weeks.
The CIT addressed forced use of the affected UE and restricted the unaffected UE during training. Shaping skills were delivered while participants were forced to use their affected UE in the mass practice of functional tasks, such as drinking water and opening a jar. Participants wore a mitt on their unaffected hand and wrist for 6 hours/day during the 3-week training and reported their compliance in a daily log. Participants were also asked to wear glasses with a patch on the right lens to block the visual stimuli from the right side and force them to receive the stimuli from the left-side visual field.