anthonyyazdaniml/gliner-biomed-curated-corpus huggingface dataset:
BACKGROUND: Efforts to preoperatively risk stratify and optimize patients before pancreaticoduodenectomy continue to improve outcomes. This study aims to determine the impact of hypoalbuminemia on outcomes following pancreaticoduodenectomy and outline optimal hypoalbuminemia cut-off values in this population.
METHODS: The ACS-NSQIP (2016-2021) database was used to extract patients who underwent pancreaticoduodenectomy, comparing those with hypoalbuminemia (< 3.0 g/L) to those with normal albumin. Demographics and 30-day outcomes were compared. Multivariable modeling evaluated factors including hypoalbuminemia to characterize their independent effect on serious complications, and mortality. Optimal albumin cut-offs for serious complications and mortality were evaluated using receiver-operating characteristic curves.
RESULTS: We evaluated 25,848 pancreaticoduodenectomy patients with 2712 (10.5%) having preoperative hypoalbuminemia. Patients with hypoalbuminemia were older (68.2 vs. 65.1; p < 0.0001), and were significantly more likely to be ASA class 4 or higher (13.9% vs. 6.7%; p < 0.0001). Patients with hypoalbuminemia had significantly more 30-day complications and after controlling for comorbidities hypoalbuminemia remained a significant independent factor associated with 30-day serious complications (OR 1.80, p < 0.0001) but not mortality (OR 1.37, p = 0.152).
CONCLUSIONS: Hypoalbuminemia plays a significant role in 30-day morbidity following pancreaticoduodenectomy. Preoperative albumin may serve as a useful marker for risk stratification and optimization.
Prescribing sulfamethoxazole and trimethoprim tablets in the absence of a proven or strongly suspected bacterial infection or a prophylactic indication is unlikely to provide benefit to the patient and increases the risk of the development of drug-resistant bacteria. 

Sulfamethoxazole and trimethoprim should be given with caution to patients with impaired renal or hepatic function, to those with possible folate deficiency (e.g., the elderly, chronic alcoholics, patients receiving anticonvulsant therapy, patients with malabsorption syndrome, and patients in malnutrition states) and to those with severe allergies or bronchial asthma. In glucose-6-phosphate dehydrogenase deficient individuals, hemolysis may occur. This reaction is frequently dose-related (see CLINICAL PHARMACOLOGY and DOSAGE AND ADMINISTRATION).

Cases of hypoglycemia in non-diabetic patients treated with sulfamethoxazole and trimethoprim are seen rarely, usually occurring after a few days of therapy. Patients with renal dysfunction, liver disease, malnutrition or those receiving high doses of sulfamethoxazole and trimethoprim are particularly at risk.

Hematological changes indicative of folic acid deficiency may occur in elderly patients or in patients with preexisting folic acid deficiency or kidney failure. These effects are reversible by folinic acid therapy.

Trimethoprim has been noted to impair phenylalanine metabolism, but this is of no significance in phenylketonuric patients on appropriate dietary restriction.

As with all drugs containing sulfonamides, caution is advisable in patients with porphyria or thyroid dysfunction.
Both tolerance and physical dependence can develop during use of opioid therapy.

Tolerance is a physiological state characterized by a reduced response to a drug after repeated administration (i.e., a higher dose of a drug is required to produce the same effect that was once obtained at a lower dose).

Physical dependence is a state that develops as a result of a physiological adaptation in response to repeated drug use, manifested by withdrawal signs and symptoms after abrupt discontinuation or a significant dose reduction of a drug.

Withdrawal may be precipitated through the administration of drugs with opioid antagonist activity, (e.g., naloxone), mixed agonist/antagonist analgesics (e.g., pentazocine, butorphanol, nalbuphine), or partial agonists (e.g., buprenorphine). Physical dependence may not occur to a clinically significant degree until after several days to weeks of continued use.

Do not abruptly discontinue MS CONTIN in a patient physically dependent on opioids. Rapid tapering of MS CONTIN in a patient physically dependent on opioids may lead to serious withdrawal symptoms, uncontrolled pain, and suicide. Rapid discontinuation has also been associated with attempts to find other sources of opioid analgesics, which may be confused with drug-seeking for abuse.

When discontinuing MS CONTIN, gradually taper the dosage using a patient-specific plan that considers the following: the dose of MS CONTIN the patient has been taking, the duration of treatment, and the physical and psychological attributes of the patient. To improve the likelihood of a successful taper and minimize withdrawal symptoms, it is important that the opioid tapering schedule is agreed upon by the patient. In patients taking opioids for an extended period of time at high doses, ensure that a multimodal approach to pain management, including mental health support (if needed), is in place prior to initiating an opioid analgesic taper [see Dosage and Administration (2.6), Warnings and Precautions (5.14)].

Infants born to mothers physically dependent on opioids will also be physically dependent and may exhibit respiratory difficulties and withdrawal signs [see Use in Specific Populations (8.1)].
OBJECTIVES: Alkaptonuria is a rare inborn disorder of phenylalanine and tyrosine metabolism. It is characterized by an accumulation of homogentisic acid and its oxidation products, possibly resulting into connective tissue damaging. "Ochronosis" is a main feature, which is characterized by tissue discoloration and even alkaptonuric arthropathy. Cervical spine involvement is exceptional and there is a paucity of reports on surgical interventions in these patients. We explored the literature concerning cervical spine involvement in patients with alkaptonuria.
PATIENTS AND METHODS: We performed a review of the literature, in which patients with alkaptonuric degenerative changes of the cervical spine were examined. Articles were obtained from MEDLINE. Search terms included: "cervical", "alkaptonuria", "alkaptonuric changes" and "black disc". Additional studies were identified by checking reference lists. Furthermore, we present the case of a 46 year old patient with critical cervical spinal canal stenosis who underwent C6-C7 anterior cervical microdiscectomy and interbody fusion, in order to prevent myelopathic changes. CARE statement guidelines were followed.
RESULTS: Peroperatively, we did not encounter any macroscopic abnormalities of the skin, muscles or ligaments. A black discoloration of the nucleus pulposus was observed. Peroperative and postoperative course was uneventful.
CONCLUSION: Alkaptonuric degenerative abnormalities most commonly involve the lumbar spine, although the cervical spine can be affected in rare cases. Most frequently, the diagnosis of alkaptonuria can be made based on the clinical phenotype many years before symptoms secondary to ochronotic arthropathy develop. A retrospective diagnosis based on peroperative black discoloration of spinal structures has been described. A black discoloration of the intervertebral disc should encourage the neurosurgeon to further explore the possibility of alkaptonuria, even in the absence of a clear phenotype. Surgical results are mostly satisfactory. Further studies are required in order to better understand this pathology and its postoperative course.
PURPOSE:Finely-ground polyvalent metal salt of 2-mercaptopyridin-N-oxide useful as an antimicrobial composition, having improved dispersion stability, and improved adsorbability to the skin and hair, obtained by pulverizing particle diameters of the substance into <= a specific particle diameter distribution. CONSTITUTION:A polyvalent metal salt of 2-mercaptopyridin-N-oxide is stirred with a rigid medium such as Ottawa sand, glass, alumina, zircon having <=0.5mm. particle diameter to give finely-ground polyvalent metal salt of 2-mercaptopyridin-N-oxide comprising >=50wt% particles having <=0.2mu particle diameter. The polyvalent metal salt of 2-mercaptopyridin-N-oxide has preferable form of dispersion. EFFECT:Providing shampoo, hair rinse, etc. with improved antimicrobial action and suppressing action on dandruff. Composition can be prepared efficiently and in a short time.
Malaria remains a major public health threat despite regulatory approval of a partially effective pre-erythrocytic malaria vaccine. There is an urgent need to accelerate the development of a more effective multi-stage vaccine. Controlled human malaria infection (CHMI) has been shown to be an important tool for the assessment of the efficacy of novel malaria vaccines and drugs prior to field trials. CHMI also allows for the evaluation of immunity to malaria and parasite growth rates in vivo. This is particularly useful in individuals from endemic areas with a level of exposure and immunity to malaria. Thus CHMI in individuals with prior exposure to malaria could be a valuable tool to accelerate malaria vaccine development. In this study, the investigators aim to use CHMI in semi-immune adults to provide a comprehensive prioritization of antigens associated with blood-stage immunity for vaccine development. The investigators will comprehensively characterize immunity to malaria using \>100 antigens in up to 2,000 semi-immune adults, from known areas of malaria endemicity in Kenya, then select 200 individuals with a range of different immunological profiles, and conduct CHMI studies with serial quantitative polymerase chain reaction (PCR) to measure the parasite growth rate in vivo and relate this to host immunity. This will also involve analysing the relationship with functional immunity assessed by laboratory assays.
In this condition participants will engage in 8 hours of sitting, although the sitting will be interrupted every 20 minutes. During these interruptions participants will spend 2 minutes walking at an intensity equivalent to 30% of VO2peak.
A sustained release apparatus including at least one sustained release mini tablet implant is described. The implant includes a pharmaceutically active composition with at least one pharmaceutically active component and a carrier. The mini tablet implant is of the coated tablet or covered rod type, and approximately 0.1 to 0.5 times the length and/or diameter of a single immediate release tablet capable of providing the desired threshold blood level depending on the pharmaceutical active selected. It has a payload of approximately 30% to 70% by weight of the total payload of the single equivalent immediate release tablet conducted for an equivalent period. The sustained release apparatus when used provides zero order release of pharmaceutical active. Also described is a sustained release kit including at least one mini tablet implant packaged for delivery in a single treatment. It can further include a delivery apparatus such as one which includes an injector instrument for subcutaneous or intramuscular delivery of implants.
The study will be performed in 12 male subjects with stable psoriatic plaques. The study preparations and the comparator will be tested observer-blind. Treatments will be randomly assigned to the test fields. All subjects will receive all treatments, with intraindividual comparison of the treatments.

Altogether six test fields will be examined per subject (four active AN2728 creams of different concentrations: 2 %, 1 %, 0.3 %, 0.03 %, the active ingredient-free vehicle, and a marketed corticoid preparation). The test fields will be treated occlusively over a study period of 12 days. Topical application of approximately 200 uL of each assigned intervention is administered per treatment, for a total of 10 treatments over a 12-day treatment period.
A computerized pain assessment system, method, and non-transitory computer readable medium are described. A screen that includes a human body replica containing a known number of pixels is displayed, and then an area is indicated to represent a pain area. An indicated number of pixels representing the pain area divided by the known number of pixels defines a pain coverage. A pain intensity is indicated on a first scale depicting the pain intensity between minimum pain and maximum pain. The first scale corresponds to a first numeric scale for measuring the pain intensity. A depth of pain is indicated on a second scale depicting the depth of pain between superficial and deep. The second scale corresponds to a second numeric scale for measuring the depth of pain. An objective pain value is computed from the pain coverage multiplied by the pain intensity on the first numeric scale and multiplied by the depth of pain on the second numeric scale. The objective pain value is displayed.
Sarcopenia lowers the quality-of-life for millions of people across the world, as accelerated loss of skeletal muscle mass and function contributes to both age- and disease-related frailty. Physical activity remains the only proven therapy for sarcopenia to date, but alternatives are much sought after to manage this progressive muscle disorder in individuals who are unable to exercise. Mitochondria have been widely implicated in the etiology of sarcopenia and are increasingly suggested as attractive therapeutic targets to help restore the perturbed balance between protein synthesis and breakdown that underpins skeletal muscle atrophy. Reviewing current literature, we note that mitochondrial bioenergetic changes in sarcopenia are generally interpreted as intrinsic dysfunction that renders muscle cells incapable of making sufficient ATP to fuel protein synthesis. Based on the reported mitochondrial effects of therapeutic interventions, however, we argue that the observed bioenergetic changes may instead reflect an adaptation to pathologically decreased energy expenditure in sarcopenic muscle. Discrimination between these mechanistic possibilities will be crucial for improving the management of sarcopenia.
PURPOSE:To prevent the infection of cattle with Salmonella dublin, by administering the cattle with a specific strain derived from Salmonella dublin. CONSTITUTION:A Salmonella dublin-derived strain (P<->) devoid of the plasmid having a molecular weight of 50 mega-dalton is administered to cattle to prevent the infection of the cattle with Salmonella dublin. P<-> can be prepared by culturing Salmonella dublin in a medium containing ethidium bromide at the maximum concentration to enable the growth of the strongly toxic wild strain of Salmonella dublin. There is no particular restriction in the method of administration, and the agent can be administered by intramuscular injection, etc. as well as subcutaneous injection and intravenous injection. The dose can be determined properly. It can be administered at a high dose because of its high safety. P<-> is useful as a live vaccine for the prevention of Salmonella dublin infection.
Participants will apply 1.5 weighed g (± 0.1 g) of the study toothpaste to a wet toothbrush and brush their natural teeth twice daily for one timed minute. Participants will wear their mandibular partial denture with test specimens while brushing and continuously for 24 hours a day during each of the 4-week treatment periods.
In the literature, the effects of myofascial release and instrument assisted soft tissue mobilization (IASTM) applications on individuals with pectoralis minor muscle are investigated, but the available evidence is insufficient. In a study conducted in asymptomatic individuals, self-myofascial release was found to be more effective than placebo application in increasing glenohumeral flexion joint range of motion (ROM), improving pectoralis minor length and advanced scapular posture. However, there was one study comparing the short-term effectiveness of the self-myofascial release method and IASTM methods on pectoralis minor length, glenohumeral total arch movement and skin temperature in individuals with short pectoralis minor, and the results of both applications were found to be similar. Despite these studies in the current literature, the amount of evidence examining the effectiveness of myofascial release technique performed under the guidance of a physiotherapist in individuals with short pectoralis minor is insufficient. However, the number of studies comparing the immediate and short-term effects of different myofascial release methods on the pectoralis minor muscle lengthening is few. Given the limited evidence available, different myofascial release methods may produce different short-term responses on the pectoralis minor muscle, with different results on muscle length, scapular position, glenohumeral total arch motion, and superficial skin temperature. Therefore, the aim of this study was to compare the effects of 3 different myofascial release techniques on pectoralis minor muscle length, rounded shoulder posture, glenohumeral joint total rotation ROM and skin temperature in asymptomatic individuals.
Accurate insect identification is critical to the estimation of time of colonization (TOC) and post-mortem interval (PMI) in medicolegal death investigations. DNA testing is advantageous because it enables the identification of immature specimens that may not be identified based on morphology alone. We describe here a simplified DNA barcoding method for identifying relevant species that may be implemented by forensic genetics laboratories. A cytochrome oxidase (COI) fragment is analyzed after PCR amplification with a single primer set. The method is effective for many species commonly encountered in death investigations in the USA: members of blowfly genera Calliphora, Chrysomya, Cochliomyia, Lucilia, and Phormia; members of the flesh fly genera Blaesoxipha, Oxysarcodexia, Ravinia, and Sarcophaga; and the scuttle fly Megaselia scalaris. We tested the method on specimens with verified identifications and used it to build a collection of reference sequences from specimens collected in Harris County, Texas. We show here the correct identification of larvae, pupae, and pupal exuviae from the medicolegal casework.
A computer system obtains a digital 3-dimensional model of a body surface, such as a human face. Portions of the surface correspond to reference points in the model. The system obtains image data of a personal care device in use as well as image data of the surface on which the model is based. The system calculates a relative location of the device relative to the reference points based on the image data of the surface. The system determines a true position of the device with respect to the surface based on the image data of the device in use, known physical dimensions of the device, and its relative location, even when the device is partially occluded from view. The system may, based on the true position of the device, cause device to perform actions such as application of a cosmetic or administration of a skin therapy.
This study was designed to include patients with newly diagnosed unresectable (Arm A) and resectable (Arm B) malignant glioma. Three dose levels of AdV-tk were evaluated with a fixed dose level of valacyclovir prodrug. AdV-tk was delivered to tumor cells by stereotactic injection into the tumor at the time of biopsy (Arm A) or injection into the tumor bed following resection (Arm B). Oral valacyclovir began 1-3 days after the AdV-tk injection and continued for 14 days. Standard radiation therapy began 3-7 days following the AdV-tk injection to maximize synergy with radiation. Standard temozolomide could be administered after completion of valacyclovir.
The invention provides methods and means for enhancing the epidermal, transdermal and dermal permeation of a topically applied pharmacologically active agent (e.g., a drug or medicament) which has a low rate of skin penetration in the absence of a permeation enhancer and which is unstable and degrades during long-term storage with particular permeation enhancers. Also provided by the invention are methods and means to increase the skin penetration of a pharmacologically active agent which has a normally low rate of skin permeation and causes the instability and degradation of a permeation enhancer with which it is combined over a long period of time. Provided by the invention are at least one first composition containing a drug, a pharmaceutically acceptable salt, chemical derivative or formulation thereof, in a dermatologically acceptable vehicle, and at least one second composition containing a permeation enhancer in an acceptable vehicle. The compositions are physically separated until application to a body or skin surface and are topically applied, either at the same time, or sequentially within a short time of each other, and mixed or blended to form a final active composition, preferably on the skin. In addition, a premixture of the compositions can be made and applied to the skin in accordance with the invention. The invention allows a therapeutically effective amount of drug to be delivered into the skin and systemic circulation and provides significant enhancement of a drug's otherwise low level of skin permeation by the action of permeation enhancer in the active composition at the point of use.
Patients receive experimental consolidation therapy, experimental interim maintenance therapy, and standard DI therapy, followed by maintenance therapy. Therapies are given by mouth, injection, and infusion for up to 2 or 3 years.
Spastic paraplegia type 4 (SPG4) is the most common type of autosomally inherited spastic paraplegia. Its main clinical features include typical simple hereditary spastic paraplegia, with neurological impairments limited to lower limb spasticity, hypertonic bladder dysfunction, and mild weakening of lower limb vibration sensation, without accompanying features such as nerve atrophy, ataxia, cognitive impairment, seizures, and muscle tone disorders. SPAST is the main pathogenic gene underlying SPG4, and various pathogenic SPAST variants have been discovered. This disease has featured a high degree of clinical heterogeneity, and the same pathogenic variant can have different age of onset and severity among different patients and even within the same family. There is a lack of systematic research on the correlation between the genotype and phenotype of SPG4, and the pathogenic mechanism has remained controversial. This article has provided a review for the clinical characteristics, pathogenic gene characteristics, correlation between the genotype and phenotype, and pathogenic mechanism of this disease, with an aim to provide reference for its clinical diagnosis and treatment.
Overdiagnosis and overtreatment resulting from mammographic screening have been estimated to be as high as 1 in 4 patients diagnosed with breast cancer although the absence of standard definitions for measuring overdiagnosis has led to much uncertainty around this estimate. The national health care expenditure resulting from false positive mammograms and breast cancer overdiagnosis has been estimated to approach $4 billion annually. There is general consensus that much of this burden derives from the treatment of DCIS; for those estimated 40,000 women per year whose DCIS may never have progressed even without treatment, medical intervention can only harm. In those women who undergo surgical management of DCIS, there is risk of developing persistent pain at the surgical site, with estimates ranging from 25-68%. Importantly, persistent pain after lumpectomy may be as prevalent as that after total mastectomy. Persistent postsurgical pain is rated by patients as the most troubling symptom, leading to disability and psychological distress, and is often resistant to management. Although prospective population-based data have demonstrated significant patient and surgical focus on pain with remarkably high levels of chronic pain 4 and 9 months after breast surgery, much of these data have been collected in women with invasive cancer, with little data directly relevant to patients with DCIS.

The overarching hypothesis of the study is that management of low-risk DCIS using an active monitoring (AM) approach does not yield inferior cancer or quality of life outcomes compared to surgery.