bluuebunny/crossref_metadata_2025_split huggingface dataset:
Validation of the Brief Cognitive Symptoms Index in Sjögren Syndrome
Authors: Segal Barbara M. , Rhodus Nelson , Moser Sivils Kathy L. , Solid Craig A. 
Published: September 2014

Objective.The Brief Cognitive Symptoms Inventory (BCSI) is a short, self-report scale designed to measure cognitive symptomatology in patients with rheumatic disease. To facilitate research and clinical practice, we tested the internal consistency and validity of the BCSI in patients with Sjögren syndrome (SS).Methods.Patients who met the American-European Consensus Group criteria for SS and healthy controls completed a questionnaire assessing symptoms including cognitive complaints. We calculated Cronbach’s alpha to assess internal consistency and Pearson correlation coefficients to test for association between BCSI, symptoms, and demographic variables. Total score distribution was analyzed to establish cutoff criteria for differentiation of case versus non-case. We compared neuropsychological outcomes of patients with SS above and below the threshold BCSI score to assess the association of cognitive symptoms with objective cognitive deficits.Results.Complete data were available on 144 patients with SS and 35 controls. Internal consistency of the BCSI was good. Scores were similar in all patient groups and patients reported more cognitive symptoms than controls (p < 0.0001). BCSI scores correlated moderately with pain, depression, anxiety, fatigue, and health quality. High scores for cognitive dysfunction were reported by 20% of the patients with SS and only 3% of controls. Patients with cognitive scores > 50 had more depression, fatigue, pain (effect size all > 1), and worse performance on multiple cognitive domains.Conclusion.The BCSI should be a useful tool for the study of cognitive symptoms in SS. Both self-report and standardized tests should be considered in screening for cognitive disorders in SS.
Drug-associated Cutaneous Vasculitis: Study of 239 Patients from a Single Referral Center
Authors: Ortiz-Sanjuán Francisco , Blanco Ricardo , Hernández José L. , Pina Trinitario , González-Vela María C. , Fernández-Llaca Héctor , Calvo-Río Vanesa , Loricera Javier , Armesto Susana , González-López Marcos A. , Rueda-Gotor Javier , González-Gay Miguel A. 
Published: September 2014

Objective.The 2012 International Chapel Hill Consensus Conference on the Nomenclature of Vasculitides defined drug-associated immune complex vasculitis as a distinct entity included within the category of vasculitis associated with probable etiology. In the present study we assessed the clinical spectrum of patients with drug-associated cutaneous vasculitis (DACV).Methods.Case records were reviewed of patients with DACV treated at a tertiary referral hospital over a 36-year period. A diagnosis of DACV was considered if the drug was taken within a week before the onset of the disease.Results.From a series of 773 unselected cutaneous vasculitis cases, 239 patients (30.9%; 133 men and 106 women; mean age 36 yrs) were diagnosed with DACV. Antibiotics (n = 149; 62.3%), mainly β-lactams and nonsteroidal antiinflammatory drugs (NSAID; n = 24; 10%) were the most common drugs. Besides skin lesions (100%), the most common clinical features were joint (51%) and gastrointestinal (38.1%) manifestations, nephropathy (34.7%), and fever (23.8%). The most remarkable laboratory data were increased erythrocyte sedimentation rate (40.2%), presence of serum cryoglobulins (26%), leukocytosis (24.7%), positive antinuclear antibodies (21.1%), anemia (18.8%), and positive rheumatoid factor (17.5%). Despite drug discontinuation and bed rest, 108 patients (45.2%) required medical treatment, mainly corticosteroids (n = 71) or immunosuppressive drugs (n = 7). After a median followup of 5 months, relapses occurred in 18.4% of patients, and persistent microhematuria or renal insufficiency in 3.3% and 5%, respectively.Conclusion.DACV is generally associated with antibiotics and NSAID. In most cases it has a favorable prognosis, although a small percentage of patients may develop residual renal damage.
John Kerry au Proche-Orient : de la diplomatie de la faiblesse à la diplomatie de l'espoir ?
Authors: Coppolani Antoine 
Published: September 2014

En 2013, Barack Obama et John Kerry ont difficilement réussi à pousser les dirigeants israéliens et palestiniens à reprendre les négociations de paix. Dans le même temps, Washington a renoué le dialogue avec Téhéran pour tenter de trouver une solution au problème du nucléaire iranien. Benjamin Netanyahou établissant un lien clair entre le dossier iranien et le conflit israélo-palestinien, le rapprochement Obama-Rohani a compromis les chances d’aboutir à un accord israélo-palestinien. politique étrangère
L'Union européenne au secours de l'Ukraine
Authors: Tolksdorf Dominik 
Published: September 2014

Les relations entre l’Ukraine et l’Union européenne se sont resserrées à l’occasion des récents événements. L’UE a rapidement reconnu le gouvernement intérimaire de Kiev, lui apportant une aide sous forme de mesures diverses, dont un financement d’au moins 11 milliards d’euros pour les prochaines années. La concrétisation de cette aide dépendra de la capacité du gouvernement ukrainien à mettre en œuvre les réformes de fond qu’appelle la situation du pays. politique étrangère
Syrie : Ankara contre Téhéran ?
Authors: Yilmaz Özcan 
Published: September 2014

Les dirigeants turcs aimeraient faire de leur pays le leader du Moyen-Orient. Cette ambition s’est heurtée à celle d’un autre acteur incontournable de la région : l’Iran. La rivalité entre Ankara et Téhéran s’est cristallisée sur le conflit syrien. La Turquie a appuyé l’opposition à Bachar el-Assad en pensant qu’un régime sunnite pourrait rapidement être mis en place. Elle a toutefois sous-estimé l’armée syrienne soutenue par l’Iran et se retrouve obligée de réviser sa stratégie. politique étrangère
Comprendre l'instabilité politique thaïlandaise : constitutionnalisme et coups d'État
Authors: Mérieau Eugénie 
Published: September 2014

Depuis 1932, la Thaïlande connaît régulièrement coups d’États et nouvelles constitutions, jusqu’en mai 2014. La convergence d’intérêts entre les militaires, les hauts fonctionnaires et l’institution monarchique, qui forment un État dans l’État, explique en partie cette instabilité politique. Mais se heurtent également dans le pays deux principes de légitimité : une légitimité procédurale découlant des élections et une légitimité substantielle fondée sur l’appréciation de la moralité des élus, chacune renvoyant aux intérêts de couches sociales différentes. politique étrangère
Relations internationales : le temps des anthropologues
Authors: Gaulme François 
Published: September 2014

La violence change, dans ses formes et dans ses acteurs. Les États ne sont plus les références centrales des conflits contemporains. On ne peut non plus les voir comme l’achèvement d’une histoire linéaire qui partirait des tribus pour en arriver aux structures politiques occidentales. Demain coexisteront des mondes différents : les anthropologues peuvent seuls nous aider à comprendre et à gérer les conflits dans des cadres ne correspondant pas à notre logique étatique. politique étrangère
Cytosolic Double-Stranded RNA Activates the NLRP3 Inflammasome via MAVS-Induced Membrane Permeabilization and K+ Efflux
Authors: Franchi Luigi , Eigenbrod Tatjana , Muñoz-Planillo Raúl , Ozkurede Ulas , Kim Yun-Gi , Chakrabarti Arindam , Gale Michael , Silverman Robert H. , Colonna Marco , Akira Shizuo , Núñez Gabriel 
Published: September 2014

Abstract
The nucleotide-binding oligomerization domain–like receptor pyrin domain–containing 3 (Nlrp3) inflammasome plays an important role in inflammation by controlling the maturation and secretion of the cytokines IL-1β and IL-18 in response to multiple stimuli including pore-forming toxins, particulate matter, and ATP. Although the pathways activated by the latter stimuli lead to a decrease in intracellular K+ concentration, which is required for inflammasome activation, the mechanism by which microbial RNA activates Nlrp3, remains poorly understood. In this study, we found that cytosolic poly(I:C), but not total RNA from healthy macrophages, macrophages undergoing pyroptosis, or mitochondrial RNA, induces caspase-1 activation and IL-1β release through the Nlrp3 inflammasome. Experiments with macrophages deficient in Tlr3, Myd88, or Trif, indicate that poly(I:C) induces Nlrp3 activation independently of TLR signaling. Further analyses revealed that the cytosolic sensors Rig-I and melanoma differentiation–associated gene 5 act redundantly via the common adaptor mitochondrial antiviral signaling (Mavs) to induce Nlrp3 activation in response to poly(I:C), but not ATP or nigericin. Mechanistically, Mavs triggered membrane permeabilization and K+ efflux independently of the inflammasome which were required for poly(I:C)-induced Nlrp3 activation. We conclude that poly (I:C) activates the inflammasome through an Mavs-dependent surveillance pathway that converges into a common K+ lowering step in the cytosol that is essential for the induction of Nlrp3 activation.
Helicobacter pylori Infection Activates Src Homology-2 Domain–Containing Phosphatase 2 To Suppress IFN-γ Signaling
Authors: Wang Yu-Chih , Chen Chia-Ling , Sheu Bor-Shyang , Yang Yao-Jong , Tseng Po-Chun , Hsieh Chia-Yuan , Lin Chiou-Feng 
Published: September 2014

Abstract
Helicobacter pylori infection not only induces gastric inflammation but also increases the risk of gastric tumorigenesis. IFN-γ has antimicrobial effects; however, H. pylori infection elevates IFN-γ–mediated gastric inflammation and may suppress IFN-γ signaling as a strategy to avoid immune destruction through an as-yet-unknown mechanism. This study was aimed at investigating the mechanism of H. pylori–induced IFN-γ resistance. Postinfection of viable H. pylori decreased IFN-γ–activated signal transducers and activators of transcription 1 and IFN regulatory factor 1 not only in human gastric epithelial MKN45 and AZ-521 but also in human monocytic U937 cells. H. pylori caused an increase in the C-terminal tyrosine phosphorylation of Src homology-2 domain–containing phosphatase (SHP) 2. Pharmacologically and genetically inhibiting SHP2 reversed H. pylori–induced IFN-γ resistance. In contrast to a clinically isolated H. pylori strain HP238, the cytotoxin-associated gene A (CagA) isogenic mutant strain HP238CagAm failed to induce IFN-γ resistance, indicating that CagA regulates this effect. Notably, HP238 and HP238CagAm differently caused SHP2 phosphorylation; however, imaging and biochemical analyses demonstrated CagA-mediated membrane-associated binding with phosphorylated SHP2. CagA-independent generation of reactive oxygen species (ROS) contributed to H. pylori–induced SHP2 phosphorylation; however, ROS/SHP2 mediated IFN-γ resistance in a CagA-regulated manner. This finding not only provides an alternative mechanism for how CagA and ROS coregulate SHP2 activation but may also explain their roles in H. pylori–induced IFN-γ resistance.
A Technique for Closed Interlocking Nailing of Midshaft Tibial Fractures without Image Intensification
Authors: Dhillon Mandeep , Mathew Manoj , Gakhar Harinder 
Published: September 2014

ABSTRACT

Objective
In this study, we evaluated the reliability, reproducibility and final outcome of our techniques for performing image independent tibial interlocking nailing.

Design
Prospective.

Setting
Tertiary teaching hospital (level I trauma center).

Patients/participants
A total of 29 patients were selected for the study (21 males and 8 females patients).

Intervention
Locked tibial intramedullary nailings were performed in the selected subjects, using the standard AO interlocking nail (SynthesTM, Switzerland), utilizing our improvisations of the standard technique.

Main outcome measurements
The successful completion of the technique was the prime parameter evaluated. Total surgical time, time taken for placement of each distal bolt, fluoroscopy time (when used) and postoperative alignment and reduction were evaluated. The patients were followed at 4 weekly intervals.

Results
The average duration of the surgery was 78.6 minutes. The mean distal locking time was 16.2 ± 1.4 minutes. Fluoroscopy had to be used in three cases, when the distal locking by the ‘nail-over-nail’ technique failed. In one case, the intra-medullary position of the guidewire had to be verified. Thus, 26 out of 30 (86.7%) cases were performed without any imaging assistance. In two cases, the fracture site had to be opened after difficulties were encountered in achieving closed reduction. Thus, 24 out of 30 procedures (80%) were successfully completed by our technique. The fractures were followed to union and the long-term results were comparable to the results of tibial fracture operated by image assistance.

Conclusion
The technique described here can come handy in situations of image intensifier failure. Routine use of part of the steps can assist in reducing radiation exposure during interlocking nailings.

How to cite this article
Mathew M, Dhillon MS, Gakhar H. A Technique for Closed Interlocking Nailing of Midshaft Tibial Fractures without Image Intensification. J Postgrad Med Edu Res 2014;48(3):111-116.
Awareness among Patients with T2DM regarding the Disease at a Tertiary Care Referral Center
Authors: Bhansali Anil , Pathak Pragya , Kaur Sukhpal , Mandal Lata , Nair Priya , Kaur Narinder 
Published: September 2014

ABSTRACT

Objective
To assess the knowledge of patients with T2DM regarding their disease at a tertiary care referral centre.

Patients and methods
Using purposive sampling technique, a total of 200 patients of diabetes were enrolled. The pretested questionnaire consisting of 40 items with maximum score of 40 was administered to the participants after appropriate validation. Information was obtained regarding the demographic variables, presenting symptoms of diabetes, and awareness of the subjects regarding their disease. The data was analyzed by using SPSS version 16.

Results and conclusion
Mean age of the subjects was 54.2 ± 1.2 years with the range of 16 to 80 years. More than half (52.5%) were women and 54.5% were in the age group of 41 to 60 years, and 50.5% belonged to urban locality. Majority were married (96.5%). Polyuria was the presenting symptoms in 43.5% of patients. The mean knowledge score was 26.0 ± 8.9 out of 40 (maximum attainable score) with the range of 3 to 39. More than half (63%) of the patients achieved good (≥60%) and above category of knowledge score. The patients with higher education status, male, and with positive family history of diabetes had significantly more knowledge score (r = 0.3, – 0.2, – 0.2, p < 0.01 for all).

Conclusion
In the present study, almost two third of the patients with T2DM had good knowledge about the disease; however, more efforts are required to further improve the knowledge among them.

How to cite this article
Kaur S, Mandal L, Nair P, Kaur N, Pathak P, Bhansali A. Awareness among Patients with T2DM regarding the Disease at a Tertiary Care Referral Center. J Postgrad Med Edu Res 2014;48(3):117-122.
Analysis of the Chemical Composition of Urinary Calculi using Fourier Transform Infrared Spectroscopy: A Preliminary Study
Authors: Sharma Gaurav , Bhattacharyya Shalmoli , Mandal Arup Kumar , Singh Shrawan Kumar 
Published: September 2014

ABSTRACT

Background
The etiology of primary and recurrent stone formation in the urinary tract remains obscure in spite of intensive research. The formation of renal calculi is a multifactorial disorder resulting from the combined influence of epidemiological, biochemical and genetic risk factors which disturb the lithogenous salt profile in the body.

Materials and methods
In the present study, 52 stone samples have been analyzed for their stone composition by Fourier transform infrared spectroscopy (FTIR). The samples were made in a potassium bromide pellet and analyzed to identify the stone components.

Results
Stone formation was more prevalent in males and the incidence increased with age. Majority of stones were oxalate and mixed stones. The components of mixed stones were identified by spectrum analysis.

Conclusion
Specific dietary factors can affect the urinary composition and supersaturation, which in turn, can affect the process of crystallization and stone formation. The same chemical components may crystallize in different forms during stone formation. Hence, proper analysis has to identify not only the molecular species present in the calculus, but also the crystalline form. So, quantitative evaluation of all components of the calculi is necessary for effective prevention or reduction of stone recurrences.

How to cite this article
Bhattacharyya S, Sharma G, Mandal AK, Singh SK. Analysis of the Chemical Composition of Urinary Calculi using Fourier Transform Infrared Spectroscopy: A Preliminary Study. J Postgrad Med Edu Res 2014;48(3):128-131.
Drugs Implicated, Mortality and Use of Corticosteroids in Toxic Epidermal Necrolysis Cases: A Systematic Review of Published Case Reports and Case Series
Authors: Dogra Sunil , Malhotra Samir , Pandhi Promila , Kaur Sharonjeet , Rajagopalan Sujit , Shafiq Nusrat , Srinivasan Anand 
Published: September 2014

ABSTRACT

Background
Toxic epidermal necrolysis (TEN) is a rare idiosyncratic mucocutaneous reaction associated with high mortality. Drugs are most commonly implicated in TEN. The treatment constitutes stopping the offending drug, along with symptomatic management. In this study, we searched for case reports/series of TEN and analyzed data to find the most commonly implicated drugs in TEN, effects of use of corticosteroids on mortality in TEN patients, changing trends in mortality over the past 3 decades and difference in mortality rates in both developing and developed countries.

Materials and methods
We searched for case reports/series of TEN to evaluate most commonly implicated drugs in TEN, effects of use of corticosteroids on mortality in TEN patients, changing trends in mortality over the past three decades and difference in mortality rates in both developing and developed countries.

Results
Antibiotics (28.6%) followed by antiepileptics (17.4%) and nonsteroidal anti-inflammatory drugs (9.6%) are most commonly implicated. There was nonsignificant decrease in mortality among steroids users as compared to nonusers (OR = 2.0, CI 0.96-4.24). During the period between 1980 and 1989 the reported mortality in TEN cases was approximately 33.4%, which decreased to 27% in the next two decades. There was a nonsignificant difference in mortality in develo- ping countries as compared to developed countries (OR: 0.70, CI 0.32-1.53).

Conclusion
Corticosteroids have been associated with non significant reduction in the mortality. Apart from this, mortality did not differ over years together in both developing and developed countries.

How to cite this article
Kaur S, Rajagopalan S, Shafiq N, Dogra S, Srinivasan A, Pandhi P, Malhotra S. Drugs Implicated, Mortality and Use of Corticosteroids in Toxic Epidermal Necrolysis Cases: A Systematic Review of Published Case Reports and Case Series. J Postgrad Med Edu Res 2014;48(3):132-138.
Duodenal Gastrointestinal Stromal Tumor: A Rare Cause of Massive Upper GI Bleed managed with Segmental Resection of Duodenum
Authors: Umapathi Lohith , Bagaria Dinesh , Attri Vishal , Kaman Lileswar 
Published: September 2014

ABSTRACT
Duodenal gastrointestinal stromal tumors (GIST) are relatively rare tumors and account for less than 5% of all cases of GIST, but still represents approximately 30% of primary duodenal tumors. Surgery is the only curative approach for duodenal GIST, but the optimal surgical procedure for duodenal GIST is not yet established. At present, there are no established guidelines regarding management of duodenal GIST. Various procedures including pancreaticoduodenectomy, pancreas-sparing duodenectomy, segmental duodenectomy, or wedge local resection have been described, but oncologic outcomes have not been evaluated. Buchs et al evaluated the role of segmental duodenal resection in the management of duodenal GIST and concluded that segmental resection is adequate for localized tumor where negative resection margins are obtainable. Here we present a case of duodenal GIST with massive upper GI bleed which was treated with segmental resection of the duodenum.

How to cite this article
Umapathi L, Bagaria D, Attri V, Kaman L. Duodenal Gastrointestinal Stromal Tumor: A Rare Cause of Massive Upper GI Bleed managed with Segmental Resection of Duodenum. J Postgrad Med Edu Res 2014;48(3):148-150.
Von Willebrand Disease in Pregnancy
Authors: Varma Subhash , Malhotra Pankaj , Gainder Shalini , Ahluwalia Jasmina , Arora Aashima , Bagga Rashmi , Jangid Akanksha 
Published: September 2014

ABSTRACT
Von Willebrand disease (vWD) is the most common inherited bleeding disorder. It is due to deficiency of von Willebrand factor (vWF) which may be either quantitative or qualitative. There are 3 types of vWD out of which Type III is the rarest but the most severe. We report a 27 years second gravida diagnosed with vWD in her index pregnancy. Though her antenatal period was uneventful, she developed complications in the perioperative period following a caesarean section. However, with a multidisciplinary team effort, the maternal and fetal outcome were favourable.

How to cite this article
Bagga R, Jangid A, Gainder S, Malhotra P, Varma S, Ahluwalia J, Arora A. Von Willebrand Disease in Pregnancy. J Postgrad Med Edu Res 2014;48(3):157-158.
O TEATRO ITALIANO GROTESCO DO PRIMEIRO NOVECENTO
Authors: MASSI ALBANESE CAROLINA 
Published: September 2014

Em 29 de maio de 1916 é representada A Máscara e o Vulto, que o autor luigi Chiarelli define como "um grotesco". Nos anos seguintes, vêm à ribalta peças de Rosso di San Secondo, Antonelli, etc. Fala-se de uma nova escola teatral italiana àqual é dado o nome da feliz expressão adotada por Chiarelli: ''grotesco". Os comediógrafos em questão rejeitam esta classificíção, afirmando cada um sua própria independência.A poética de cada autor, de fato, apresenta caracteres distintos; há, todavia, um elemento que permite reunir esta produção.- por caminhos diferentes é executada a mesma ação de ruptura com a tradição verista. A temática agora muda; protagonista da comédia não é mais a vida cotidiana, e sim o momento da insegurança que põe em dúvida tanto a validade do mundo externo, quanto a compacidade da própria personalidade.Um dos expedientes mais eficazes para promover esta ação crítica é o personagem, coro ou eu'épico, que comenta o drama desvendando as ações e os sentimentos, para descobrir o verdadeiro significado ou a ausência de significado.