anthonyyazdaniml/gliner-biomed-curated-corpus huggingface dataset:
Keloids are benign, fibroproliferative dermal tumours, often arising after trauma, that are more common in darker skin types. Numerous therapeutic options have been employed for the treatment of keloids; however, there is no one gold standard approach. Five-fluorouracil, a potent chemotherapeutic agent, has emerged as a promising therapeutic option. Therefore, this systematic review, using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, focused on providing a broad overview of the use of 5-fluorouracil for the management of keloids. Forty studies (2325 patients) met inclusion criteria and investigated 5-fluorouracil for keloid management, with 19 studies (1043 patients) including a 5-fluorouracil monotherapy group. Five-fluorouracil monotherapy demonstrated consistent keloid improvement with >254 keloids injected across various anatomical regions. Five-fluorouracil monotherapy was most often compared to intralesional triamcinolone acetonide, utilizing the Patient and Observer Scar Assessment Scale and the Vancouver Scar Scale. The most common keloid parameters assessed were height, size, volume, width, length, induration, pruritus, and erythema. Five-fluorouracil monotherapy exhibited substantial improvements, with weight averages of 73% of patients experiencing >25% improvement and 67% achieving >50% improvement. Relapse rate was 16% at 27 weeks after 5-fluorouracil monotherapy treatment. Limitations included potential selection bias, language restrictions, and heterogenous data analysis among studies. Overall, our findings underscore the potential effectiveness of 5-fluorouracil monotherapy in the management of keloids, with an encouraging safety profile. Larger prospective trials are needed to determine optimal therapy or combination therapy for the management of keloids. This detailed compilation of treatment protocols, outcomes, and relapse rates stand as a valuable resource for further research and clinical applications.
Epilepsy is a chronic neurological disorder affecting 50 million people worldwide. Patients suffer not only from recurring seizures, but also from cognitive deficits despite adequate treatment control. Cognitive remediation therapy (CRT) is a therapeutic intervention that has recently shown promise in improving cognitive impairment in many neuropsychological disorders. Transcranial direct current stimulation (tDCS) is a non-invasive method that modulates cortical excitability. It works by applying weak electrical currents to the scalp that induce acute modifications of neuronal membrane potentials, producing long-lasting changes in the bioelectric activity of underlying brain tissue. It is postulated that tDCS enhances benefit gained through cognitive remediation therapy. These interventions have yet to be combined with each other for the treatment of interictal dysfunction in patients with epilepsy. The goal of the study is to investigate whether the introduction of tDCS in addition to CRT is effective in the treatment of cognitive impairment in patients suffering from epilepsy.
Children who were admitted to the Pediatric Surgery Unit of Ege University Medical Faculty Hospital for circumcision operation and who met the inclusion criteria will be studied. After the circumcision operation is completed, the children are sent to their families after they wake up from anaesthesia in the recovery unit and their physiological parameters are stabilized. Children arriving in the recovery unit will receive intervention according to the group in which they were randomized. Children in the control group will be followed up to reflect on the clinic's routine functioning. However, children in the intervention group will wake up in the recovery unit with their primary caregivers. Between the 2 groups, the pain, wakefulness index and physiologic parameters of the children will be compared. Children enrolled in the study will continue to be administered routine analgesic doses during the operation or in the recovery unit. No child's medication will be changed due to the study.
Systems and methods for adjusting a long-term insulin dosage regimen for a subject are provided. An autonomous time stamped glucose measurement of the subject in the first dataset is used to identify a fasting event. The second data set from the one or more insulin pens for applying the long-term regimen includes records, each record including a time-stamped event specifying an amount of insulin medicament to be injected. Each fasting event is characterized as either compliant or non-compliant. The fasting event is compliant when the second data set includes one or more records that establish compliance with a long-term regimen over time and quantitatively during the fasting event. Conversely, fasting events are non-compliant when the second data set fails to establish compliance with the long-term regimen temporally and quantitatively. The dosage in the long-term regimen is adjusted using glucose measurements contemporaneous with the adhered fasting event and by excluding glucose measurements contemporaneous with the non-adhered fasting event.
Humans exposed to altitude hypoxia experience dysfunctions of the urinary system. As a non-invasive, easily manageable and informative biological sample, urine represents a relevant matrix for detecting clinical impairments of urinary system, as well as alterations of other systems and extracellular vesicles (EVs) biology during high-altitude expeditions. Nevertheless, gaps exist in the comprehensive assessment of dysfunction, molecular burden and EVs biology due to high-altitude acute exposure. This study aimed to find a biophysical and biochemical signature of urinary EVs for hypoxia-induced changes in urinary function, putatively accompanied by an oxinflammatory burden. Urine samples of 15 participants were sampled at low and high-altitude during an Alpine project (7 women and 8 men, aged 24-to-63 years and with BMI 17.93-to-30.76 kg/m2) and analysed for: creatinin and albumin, lipid peroxidation, IL6, NO derivatives; atomic force microscopy and Raman spectroscopy were carried out after urinary EVs were isolated through sucrose-gradient ultracentrifugation. Albumin-to-creatinin ratio increased at high altitude, as did IL6 and 8-isoprostane. AFM showed a globular and flattened shape of EVs, although several samples were characterized by a lot of contaminants and EVs lost their prototypal spherical shape; EVs comprehensively maintained their morphology at high altitude. Raman spectroscopy revealed some typical phospholipidic-like pattern, often masked by contaminants of spectra that most often refer to high-altitude samples. Collectively, short-term exposure to altitude hypoxia increased renal concentrating ability, produced non-pathological impairment or renal function, and triggered an oxyinflammatory burden with heterogeneous response of NO system. The combination of AFM and Raman spectroscopy revealed that EVs collected at high altitude more likely are fused together and incorporated into a sediment matrix, and contain contaminants peaks that make the purification process less efficient. The combination of analytical procedures as in the present study offers novel possibilities to detect the biological and clinical effects of high altitude on renal system.
The stimulation setting was exactly the same of the experimental group but the stimulation intensity was set according to a ramping up/ramping down method and delivered only in the first and last 30 seconds of each session. This stimulation paradigm is insufficient to produce a meaningful therapeutic effect, but it is necessary to guarantee the blind condition as it mimics the possible initial tingling sensation associated with active stimulation.
INTRODUCTION: Spinal cord ischemic reperfusion injury is characterized by an abrupt decline in neurological function and only a few cases have been published in literature. Herein, we present a white cord syndrome following anterior decompression cervical fusion.
CASE REPORT: A 54-year-old Jewish male patient was diagnosed with disc herniation among the intervertebral discs at C2, C3, C4, C6, and C7, along with ossification of the posterior longitudinal ligament, pressuring more to the right side of the spinal canal, ruling-out cervical myelopathy. Under general anesthesia and multimodal intraoperative monitoring, he underwent laminectomy surgery from C3 to C6 and cervical fixation from C3 to C7. No blood pressure fluctuations occurred during surgery, and complete pressure release was achieved on the spinal cord and the nerve roots. In addition, neuromonitoring did not indicate any nerve damage during the surgery. A neurologic exam in the post-anesthesia care unit revealed weakness in his right hand and leg. A brain computed tomography scan ruled out cerebrovascular accident, neck computed tomography revealed optimal implant position, and magnetic resonance imaging ruled out spinal cord distress or injury. We treated him with intravenous fluids, steroids, painkillers, and anticoagulants. Following surgery, we involved the occupational therapy department. After a few days, we observed a significant improvement in motor function in the right leg; however, there was no change in the right hand.
CONCLUSION: White cord syndrome likely arises from reperfusion injury subsequent to surgical decompression of a compressed spinal cord segment. Although infrequent, it is imperative for spine surgeons to recognize this potential complication and apprise patients of it prior to the procedure.
The program of physical exercise was a resistance and aerobic training, initiated at low intensity and with a slow progressing according to the patient's tolerance. In aerobic exercise, for greater effectiveness of the training, the literature recommends moderate intensity, which corresponds with 50 to 70% of the maximum heart rate. Patients were instructed to keep the most constant as possible the speed during exercise on treadmill or cycle ergometer. For muscle strengthening exercises, the number of repetitions varied from 1 to 4 sets of 10 to 15 repetitions.
NIK plays a crucial role in the noncanonical NF-κB signaling pathway associated with diverse inflammatory and autoimmune diseases. Our study presents compound 54, a novel NIK inhibitor, designed through a structure-based scaffold-hopping approach from the previously identified B022. Compound 54 demonstrates remarkable selectivity and potency against NIK both in vitro and in vivo, effectively suppressing pro-inflammatory cytokines and nitric oxide production. In mouse models, compound 54 protected against LPS-induced systemic sepsis, reducing AST, ALT, and AKP liver injury markers. Additionally, it also attenuates sepsis-induced lung and kidney damage. Mechanistically, compound 54 blocks the noncanonical NF-κB signaling pathway by targeting NIK, preventing p100 to p52 processing. This work reveals a novel class of NIK inhibitors with significant potential for sepsis therapy.
An isolated peptide of (a) or (b) is disclosed. The isolated peptide a) consists of less than 15 amino acids in length, comprising an amino acid sequence selected from the group consisting of SEQ ID NOs: 1, 5, 31 and 32 as defined in the complete specification. The isolated peptide c) of less than 15 amino acids in length, comprising an amino acid sequence in which one or two amino acid(s) are substituted, deleted, inserted or added to an amino acid sequence selected from the group consisting of SEQ ID NOs: 1, 5, 31 and 32 as defined in the complete specification to yield a modified peptide that retains the ability to bind to a human leukocyte antigen (HLA), and that retains cytotoxic T lymphocyte (CTL) inducibility, and the isolated peptide does not consist of a peptide having the amino acid sequence LYGRALRVL. An isolated polynucleotide encoding the above described peptide is also disclosed. An isolated antigen-presenting cell that presents on its surface a complex of an HLA antigen and the above described peptide is disclosed. An isolated cytotoxic T lymphocyte that targets the above described peptides is disclosed. A pharmaceutical composition comprises the above described peptide, polynucleotide, cytotoxic T lymphocyte or antigen-presenting cell for inducing an immune response against cancer in a subject, inducing cytotoxic T lymphocyte, or for treatment of an existing cancer, prophylaxis of a cancer and/or prevention of a postoperative recurrence of a cancer.
BACKGROUND: To estimate quality of life (QoL) in patients with paroxysmal atrial fibrillation (AF) using the SF-36 Health Status Survey.
MATERIALS AND METHODS: In a single-center study involving 6,630 patients, we defined a group of 97 patients having an incidental finding of atrial fibrillation (AF). The control group included 99 patients from the same primary cohort, but without paroxysmal AF. The two study groups matched closely in anthropometric parameters and comorbidity. All patients underwent standard laboratory and instrumental research methods. In the primary visit, at the time of AF detection, we evaluated the patients QoL using the classical SF-36 Health Status Survey. At the second visit (6±0.5 months follow-up) and third visit (12±0.5 months follow-up), we re-evaluated the QoL using the SF-36 Health Status Survey.
RESULTS: The absolute majority (95/97; 98%) of patients of the main group had a special variant of extrasystoles, namely the early atrial "P on T" type (versus 4.0% incidence in the control group) [OR 846 (382;187,000)]. The main group showed a significantly greater frequency of supraventricular extrasystoles. At the 1st visit, there was no group differences in QoL scores between the main and control groups (p>0.05). However, at 6 and 12 months follow-up, metrics of physical and mental health differed significantly between groups stratified by low and high QoL (p<0.05). The asymptomatic patients with paroxysmal AF and high compliance in oral anticoagulant therapy showed higher physical activity and social functioning.
CONCLUSIONS: Paroxysmal AF in asymptomatic patients is a predictor for declining QoL during 12 months follow-up in patients with cardiovascular pathology. The paroxysmal AF patients who had high compliance of oral anticoagulant therapy proved to have improved physical activity and social functioning.
Osteoporosis is a common disease of bone loss. The reduced bone strength predisposes an increased risk for fractures in older individuals. It can affect people from different ethnicity. Many factors increase the risk of osteoporosis, including age, postmenopausal state, glucocorticoid use, low body weight, calcium, vitamin D, immobility, and chronic inflammation. Patients with multiple sclerosis are at high risk of developing osteoporosis due to chronic inflammation and their medications. Patients' knowledge and awareness about osteoporosis are essential for early detection, implementation of lifestyle changes, and treatment compliance. This study aimed to investigate osteoporosis awareness and knowledge about osteoporosis in patients with diabetes mellitus.
INTRODUCTION: The Package of Essential Noncommunicable Disease Interventions-Plus (PEN-Plus) is a strategy decentralising care for severe non-communicable diseases (NCDs) including type 1 diabetes, rheumatic heart disease and sickle cell disease, to increase access to care. In the PEN-Plus model, mid-level clinicians in intermediary facilities in low and lower middle income countries are trained to provide integrated care for conditions where services traditionally were only available at tertiary referral facilities. For the upcoming phase of activities, 18 first-level hospitals in 9 countries and 1 state in India were selected for PEN-Plus expansion and will treat a variety of severe NCDs. Over 3 years, the countries and state are expected to: (1) establish PEN-Plus clinics in one or two district hospitals, (2) support these clinics to mature into training sites in preparation for national or state-level scale-up, and (3) work with the national or state-level stakeholders to describe, measure and advocate for PEN-Plus to support development of a national operational plan for scale-up.
METHODS AND ANALYSIS: Guided by Proctor outcomes for implementation research, we are conducting a mixed-method evaluation consisting of 10 components to understand outcomes in clinical implementation, training and policy development. Data will be collected through a mix of quantitative surveys, routine reporting, routine clinical data and qualitative interviews.
ETHICS AND DISSEMINATION: This protocol has been considered exempt or covered by central and local institutional review boards. Findings will be disseminated throughout the project's course, including through quarterly M&E discussions, semiannual formative assessments, dashboard mapping of progress, quarterly newsletters, regular feedback loops with national stakeholders and publication in peer-reviewed journals.
INTRODUCTION: The ULTRA-trial investigated effectiveness of ultra-early administration of tranexamic acid (TXA) in subarachnoid hemorrhage (SAH) and showed that TXA reduces the risk of rebleeding without concurrent improvement in clinical outcome. Previous trials in bleeding conditions, distinct from SAH, have shown that time to start of antifibrinolytic treatment influences outcome. This post-hoc analysis of the ULTRA-trial investigates whether the interval between hemorrhage and start of TXA impacts the effect of TXA on rebleeding and functional outcome following aneurysmal SAH.
PATIENTS AND METHODS: A post-hoc comparative analysis was conducted between aneurysmal SAH patients of the ULTRA-trial, receiving TXA and usual care to those receiving usual care only. We assessed confounders, hazard ratio (HR) of rebleeding and odds ratio (OR) of good outcome (modified Rankin Scale 0-3) at 6 months, and investigated the impact of time between hemorrhage and start of TXA on the treatment effect, stratified into time categories (0-3, 3-6 and >6 h).
RESULTS: Sixty-four of 394 patients (16.2%) in the TXA group experienced a rebleeding, compared to 83 of 413 patients (19.9%) with usual care only (HR 0.86, 95% confidence interval (CI): 0.62-1.19). Time to start of TXA modifies the effect of TXA on rebleeding rate (p < 0.001), with a clinically non-relevant reduction observed only when TXA was initiated after 6 h (absolute rate reduction 1.4%). Tranexamic acid treatment showed no effect on good outcome (OR 0.96, 95% CI: 0.72-1.27) with no evidence of effect modification on the time to start of TXA (p = 0.53).
DISCUSSION AND CONCLUSIONS: This study suggests that the effect of TXA on rebleeding is modified by time to treatment, providing a protective, albeit clinically non-relevant, effect only when started after 6 h. No difference in functional outcome was seen. Routine TXA treatment in the aneurysmal SAH population, even within a specified time frame, is not recommended to improve functional outcome.
This randomized control trial will compare buprenorphine to morphine, two currently used medications for the treatment of NOWS, to determine whether the use of buprenorphine for NOWS treatment will reduce the number of days of pharmacological treatment. After an infant is born they will be monitored for signs of NOWS. Once an infant reaches treatment thresholds, they will be randomized using a double dummy design to either the buprenorphine or morphine treatment arm. After randomization infants will receive a syringe with either morphine or placebo every 4 hours and every 8 hours infant will receive 1 sublingual application of buprenorphine or placebo. To maintain the blind infants enrolled in the study will receive both interventions. During the study medication doses will be weaned by 10% of the stabilization dose. Study intervention will continue until 20 percent of the maximal dose has been reached. Use of a second line drug will be permissible after randomization and after an infant has had 2 consecutive escalations. Second line drug will be phenobarbital, in addition to the study drug. Infants in both groups will be evaluated and scored for NOWS symptoms to determine if weaning study medication is permissible each day. NOWS scores that do not reach the threshold for escalation will wean in accordance with standard clinical practice. If NOWS symptoms increase during treatment, infants will have the dose of the study drug increased by 10% to the previous day's dose. When stable for 24 hours, the weaning process will continue. The NICU Network Neurobehavioral Scale (NNNS) will be administered prior to starting study medication and once off study medication but prior to discharge to examine proportion of infants in each medication arm for the abnormal NNNS profiles which has been associated with atypical early childhood outcomes including behavior problems and low IQ scores. Development at 18 months of age will also be assessed to examine any differences in both arms of the study.
There are no generally accepted values for taVNS (transcutaneous auricular vagus nerve stimulation) application parameters (amplitude, frequency, intensity, duration, side); therefore, there are heterogeneous applications in studies. In a meta-analysis on the safety profile of taVSS, local skin irritation (18. 2%), headache (3.6%), nasopharyngitis (1.7%), dizziness (1.4%) and nausea (1.1%) were reported and taVSS treatment was reported as an effective and safe treatment with these side effects, most of which were transient and did not require additional intervention.

During taVNS, autonomic activities increase in favour of the parasympathetic system and this results in an increase in heart rate variability (HRV). Although an increase in HRV has been demonstrated by different studies, the factors that can predict the change in HRV are not clear. In a study by Geng et al. using taVSS, it was observed that HRV indicators representing vagal nerve activity increased significantly when stimulation was performed in the morning, but evening stimulation did not yield similar results. In addition, they found that improvements in measures of autonomic balance were more pronounced in the presence of lower vagal activity; they also found that by increasing the duration of stimulation, the effect of taVNS on HRV was not regulated by duration. In other words, HRV changes had the best effect only at the beginning of stimulation.
Participants in this group will engage in the Philips 66 Brainstorming Technique as part of their case-based learning sessions. This structured method involves dividing participants into smaller groups of 6, with each group discussing a topic for 6 minutes, aimed at enhancing critical thinking and clinical judgment skills in nursing students.
Physiologically active oil-core particles, and a method of making physiologically active oil-core particles that include a hydrophobic core material, a hydrophobic drug dissolved or suspended in the core material, and a layer of amphipathic lipids surrounding the hydrophobic core. An optional continuous phase can be an oil-immiscible solution. In one aspect, the method involves the use of a volatile solvent that is removed after the formation of the suspension. The suspension can be used substantially as created, or the particles formulated as a solid dosage form. In another aspect, the particles are formed substantially simultaneously with the volatilization of a propellant, for example, by spraying through an atomizing actuator. The resulting particles have superior particle size distribution and yield properties. The method is appropriate for use with physiologic agents that would be sensitive to heating during the encapsulating process, and also allows aseptic processing by filtration without heating the solutions used in processing.