Miracle-dz/UniFAR-FTUs huggingface dataset:
TREATMENT OF INTRAOCULAR HAEMORRHAGES WITH MANNITOL

K w i t k o and Costenbader (1962) recommend intravenous urea treatment of every case of hyphaema with fairly long-lasting increase in intraocular tension. They treated two cases of glaucoma following secondary hyphaema. I n one they observed dilution of the haemorrhage in the anterior chamber within one hour and in the other almost complete absorption of the haemorrhage within 36 hours. In the former case the haemorrhage recurred, and urea was administered again. The effect of the latter administration was not quite so convincing. Cole & Byron (1964) treated traumatic hyphaema with secondary glaucoma by intravenous administration of urea. I n several cases they have combined this treatment with fibrinolysin irrigation of the anterior chamber. In one instance they saw total hyphaema disappear almost completely after the institution of urea infusion. The effect of urea upon the intraocular tension is known. In the Eye Department of the Odense County and City Hospital we have used it successfully in cases of acute glaucoma. Unfortunately, its use involves certain side effects, int. al. thrombophlebitis, cutaneous necrosis, mental confusion, pulmonary oedema, and angina pectoris (Tarter & Linn (1961), Small (1960). Davis, Dzcchr & ]avid (1961), Ackerman (1961), and Oosterlzziis (1962)). Mannitol, like urea, is an osmotic substance, but it has fewer and less serious side effects, among others angina pectoris (Adams, Kirschner Rc Leopold (1963) and Smith & Drance (1962)). Cutaneous necrosis has not been observed, not even in cases where perivascular infusion has occurred (Weiss, Sclaaffer Rc W i s e (1962) and Smith SC Draizce (1962)). I n the presence of decompensated
US-guided percutaneous microwave ablation of renal cell carcinoma: intermediate-term results.

PURPOSE To retrospectively review intermediate-term (median, 20.1 months) clinical outcomes after microwave ablation (MWA) of renal cell carcinoma (RCC). MATERIALS AND METHODS This retrospective study was approved by the institutional review board. The results from 46 patients with 49 RCC nodules (diameter, 0.6-7.7 cm; mean, 3.0 cm ± 1.5 [standard deviation]) treated with ultrasonography (US)-guided percutaneous MWA with cooled-shaft needle antenna from April 2006 to December 2010 were reviewed. One antenna was used for tumors smaller than 2 cm; two, for tumors 2 cm or larger. The patients were followed up with contrast material-enhanced US and computed tomography or magnetic resonance imaging at 1, 3, and 6 months and every 6 months thereafter. The effect of changes in key parameters (including overall survival, disease-free survival, and local tumor progression rate) was statistically analyzed by using the log-rank test. RESULTS Technical effectiveness (complete ablation at follow-up enhanced imaging 1 month after MWA) was achieved in 48 of 49 (98.0%) tumors, and the metastasis-free rate was 100% (46 of 46). The 1-, 2-, and 3-year local tumor progression rates were 4.6%, 7.7%, and 7.7%, respectively. The cancer-specific survival rate was 100% (46 of 46), and 1-, 2-, and 3-year overall survival rates were 100%, 100%, and 97.8%, respectively. The 1-, 2-, and 3-year disease-free survival rates were 95.4%, 92.3%, and 92.3%, respectively. No major complications occurred. Multivariate analysis showed that tumor number (P = .046), tumor growth patterns (P = .003), and ablation time (P = .04) were independent unfavorable prognostic factors. CONCLUSION In the intermediate term, US-guided percutaneous MWA appears to be a safe and effective technique for the management of RCC, especially small RCC, in selected patients.
Cost analysis study of oral antihypertensive agents available in Indian market

Background: Hypertension is one of the major causes of morbidity, mortality and needs lifelong treatment. There is a wide range of variation in the prices of antihypertensive drugs marketed in India. Thus, a study was planned to find out price variations in the oral antihypertensive drugs available either singly or in combination and number of manufacturing companies for each, also to evaluate the difference in cost of different brands of same active drug by calculating percentage variation of cost. Methods: Cost of a particular drug being manufactured by different companies, in the same strength and dosage forms was obtained from “Current Index of Medical Specialties” July‑October 2013 and “Indian Drug Review” September 2013. The difference in the maximum and minimum price of the same drug manufactured by different pharmaceutical companies and percentage variation in price was calculated. Results: Percentage price variation of the commonly used drugs found was amlodipine (5 mg): 1128.57%, atenolol (12.5 mg): 683.53%, enalapril (10 mg): 394.67%, telmisartan (20 mg): 288.33%. Among the combination therapy, amlodipine + atenolol (5 + 50 mg): 673.79%, amlodipine + losartan (5 + 50 mg): 284.61%, telmisartan + hydrochlorothiazide (40 + 12.5 mg): 293.85%, losartan + hydrochlorothiazide (50 + 12.5 mg): 384.62% variation. Conclusion: The average percentage price variation of different brands of the same oral antihypertensive drug manufactured in India is very wide. The appraisal and management of marketing drugs should be directed toward maximizing the benefits of therapy and minimizing negative personal and economic consequences.
Survey of user preferences from a comparative trial of UpToDate and ClinicalKey.

In December of 2011, the A. T. Still Memorial Library at the A. T. Still University of Health Sciences was invited to be a beta test site for ClinicalKey, a major new point-of-care and research platform recently introduced by Elsevier. The advance marketing for ClinicalKey implied its use as a point-of-care-product for physicians. Over the past several years, library staff had been exploring an institutional subscription to UpToDate, so we decided to conduct a side-by-side trial of the two products and to survey participants about their experiences and preferences if the library were able to subscribe to only one of the two. Survey questions were designed to ascertain not only the participants' overall preference, but to provide detailed information to the library staff concerning the basis of this preference, including ease of access and use and the relative value of the two products in the students' didactic and clinical years. ClinicalKey is a new product launched by Elsevier in April 2012. It brings together the content from a number of Elsevier's medically related products, including MD Consult, First Consult, Procedures Consult, over 500 clinical journals, and more than 950 medical electronic books. It is being marketed to physicians as “Faster, more relevant clinical answers, so you can spend less time searching and more time caring for patients,” in an apparent attempt to compete with UpToDate as a point-of-care clinical tool. UpToDate is a point-of-care physician evidence/decision tool developed in 1992. In 2008, it was purchased by Wolters Kluwer, a large global information services and publishing company. It provides detailed, clinically related information written by physicians for physicians to use in clinical settings. It has been heavily marketed directly to physicians and is considered by many physicians as the key evidence-based, point-of-care online tool. There have been numerous studies on the value of UpToDate in clinical settings 1–5. This brief communication adds to this literature by presenting the results of a side-by-side trial of these two products based on reports by undergraduate medical students and their faculty.
Origins and introgression of polyploid species in Mentzelia section Trachyphytum (Loasaceae).

UNLABELLED PREMISE OF THE STUDY Polyploid speciation has been important in plant evolution. However, the conditions that favor the origination and persistence of polyploids are still not well understood. Here, we examine origins of 16 polyploid species in Mentzelia section Trachyphytum. • METHODS We used phylogeny reconstructions based on DNA sequences from plastid regions and the nuclear gene isocitrate dehydrogenase (idh) to construct hypotheses of introgression and polyploidization. • KEY RESULTS Molecular data suggest that homoploid hybridization has been surprisingly common in Trachyphytum. Diploid species had unequal involvement in polyploid origins, but most polyploid taxa had allopolyploid origins from extant progenitors. A few polyploids with extreme phenotypes did not appear to have extant progenitors. We infer that the progenitors of these species were derived from extinct diploid lineages or ancestral lineages of multiple extant diploids. In agreement with other recent studies, we recovered molecular evidence of multiple phylogenetically distinct origins for several polyploid taxa, including the widespread octoploid M. albicaulis. • CONCLUSIONS Evidence of high levels of introgression and allopolyploidy suggests that hybridization has played an important role in the evolution of Trachyphytum. Although idh sequences exhibited complicated evolution, including gene duplication, deletion, and recombination, they provided a higher percentage of informative characters for phylogeny reconstruction than the most variable plastid regions, allowing tests of hypotheses regarding polyploid origins. Given the necessity for rapidly evolving low-copy nuclear genes, researchers studying hybridization and polyploidy may increasingly turn to complex sequence data.
Screening for eating pathology in the pediatric field.

OBJECTIVE To develop normative data for the children's version of the eating disorder examination questionnaire (ChEDE-Q) for adolescents of different weight status and sexes, and to investigate the usefulness of the ChEDE-Q in overweight youngsters by making a comparison with the ChEDE. METHODS The subjects were 1 291 adolescents from 12 to 18 years old (429 of them were overweight). The ChEDE-Q and data on height and weight were carried out for all youngsters. For the validity study, 235 overweight subjects were invited to participate in a clinical interview (ChEDE). RESULTS Each of the subscales of the ChEDE-Q was significantly correlated with the corresponding subscale of the ChEDE and no significant difference was found between the interview and questionnaire with regard to the overall proportion of youngsters who reported binge eating and excessive exercising and those who did not. CONCLUSIONS The results demonstrate the importance of taking into account sex and weight status when interpreting ChEDE-Q test results. Furthermore, a comparison with the ChEDE indicates that the ChEDE-Q may serve as a reliable instrument for the screening of binge eating episodes among overweight youngsters.
Hyperglycemic Crises in Adult Patients With Diabetes

Diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS) are the two most serious acute metabolic complications of diabetes. Most patients with DKA have autoimmune type 1 diabetes; however, patients with type 2 diabetes are also at risk during the catabolic stress of acute illness such as trauma, surgery, or infection. Table 1 outlines the diagnostic criteria and electrolyte and fluid deficits for both disorders. The mortality rate in patients with DKA is <5% in experienced centers, whereas the mortality rate of patients with HHS still remains high at ∼11% (1–8). Death in these conditions is rarely due to the metabolic complications of hyperglycemia or ketoacidosis but rather relates to the underlying precipitating illness. The prognosis of both conditions is substantially worsened at the extremes of age and in the presence of coma and hypotension (7,9–11) This consensus statement will outline precipitating factors and recommendations for the diagnosis, treatment, and prevention of DKA and HHS in adult subjects. It is based on a previous technical review and more recently published peer-reviewed articles since 2001, which should be consulted for further information. Although the pathogenesis of DKA is better understood than that of HHS, the basic underlying mechanism for both disorders is a reduction in the net effective action of circulating insulin coupled with a concomitant elevation of counterregulatory hormones, such as glucagon, catecholamines, cortisol, and growth hormone (1,3,4,8–13). DKA and HHS can fall anywhere along the disease continuum of diabetic metabolic derangements. At one extreme, pure DKA without significant hyperosmolarity typically indicates the total or relative absence of insulin (seen in type 1 diabetes). At the other extreme, HHS without ketoacidosis typically occurs with lesser degrees of insulin deficiency, as seen in type 2 diabetes. However, …
The evaluation of bedside teaching - an instrument for staff evaluation and student experience: A pilot study at a South African University

Background. Bedside teaching is the core teaching strategy in the clinical study years of the medical undergraduate degree at the University of the Witwatersrand. The quality of this teaching strategy has not been formally evaluated by students as other teaching strategies have been. Method. A quantitative, descriptive study was undertaken in the final year of study of the graduate entry medical programme (GEMP). The sample comprised medical students who were completing their surgical block during September and November 2008. There were approximately 30 students in each of these 2 blocks. A bedside teaching evaluation questionnaire was developed, based on previously validated peer review questionnaires used in evaluating small group formal classroom-based lectures. The purpose of the study was to determine the reliability of the instrument for evaluating bedside teaching. Results. A sample of 112 evaluations was obtained and the constructs and sub-constructs were subjected to an analysis using Cronbach’s alpha. Conclusion. The overall Cronbach’s alpha was 0.9627, demonstrating that the instrument is reliable and can be used to evaluate bedside teaching.
The state off 3-D technology and evaluation

SummaryIn recent years the application of 3-D video endoscopic systems in clinical use especially in the field of laparoscopic surgery has increased steadily. Compared to the number of established traditional 2-D video endoscopic systems, the number of 3-D video endoscopic systems used in the operating theatre today is obviously lower. This slow application can be mainly explained by the lack of evaluation of these new technologies concerning their influence on the surgical procedure and on patient benefit as well as by the need for specific economic analysis. The starting point for our investigations was to analyse the influence of 3-D video endoscopy on endoscopically guided manipulations in general. In order to achieve quantitative statements we performed laboratory experiments using human factor analysing methods. In the next step we performed clinical field studies of the application of 3-D video endoscopic systems for a side-by-side comparison of 2-D and 3-D systems. These studies showed that the us.
Infections in myelodysplastic syndromes

Myelodysplastic syndromes are associated with a risk of severe infections. While neutropenia is likely to be the main predisposing factor, several other immune defects have been reported, including impaired neutrophil function, B-, T- and NK-cell defects and the possible consequences of iron overload due to red blood cell transfusions. The advanced age of most patients, their frequent comorbidities, and the fact that drugs such as hypomethylating agents and lenalidomide, which are effective in myelodysplastic syndromes but can transiently worsen neutropenia, may increase the risk of infection and their severity in this context. The majority of infections in myelodysplastic syndromes are bacterial, while the incidence of fungal infections is not well known and viral infections seem to be rare. No prophylactic measures against infections have demonstrated efficacy in myelodysplastic syndromes. However, pending more data, we propose here some recommendations for the management of patients with myelodysplastic syndromes. In the future, an important contribution can be made by prospective trials testing the efficacy of prophylactic and therapeutic approaches to infection in these patients, especially in the context of the new drugs available for myelodysplastic syndromes.
Effect of Training the Correct Methods of Child's Carrying and Positioning on Quality of Life of Mothers of Children with Cerebral Palsy

Background:Children with Cerebral palsy need to be cared like other children, the same as other children do. Usually the primary caregivers of children are their mothers who experience several problems due to this prolonged care. Objectives: This research aimed to investigate the effect of education of the correct ways of carrying and positioning to mothers of children with cerebral palsy on mothers’ quality of life (QOL). Patients and Methods: This randomized clinical trial was conducted on 20 mothers of children with cerebral palsy who were referred to rehabilitation centers of Ahvaz school of rehabilitation sciences. They were randomly assigned to two groups of ten. The correct ways of carrying and positioning were instructed in two sessions to experimental group and then QOL in both groups was assessed at baseline, after second session, and after four weeks. The data were analyzed by the SPSS version 16. Results: The mean differences in three domains of QOL including the physical health, psychological health, and environmental health, were significant between groups (P 0.05). Conclusions: Since the difference between groups was significant in three domains of QOL, it can be concluded that the training could influence the QOL of mothers of children with cerebral palsy. Training the parents by experts is recommended.
A Case-Based Approach to Noninvasive Positive Pressure Ventilation

Abstract Noninvasive positive pressure ventilation (NIPPV) has revolutionized the concept of mechanical ventilation with the major benefit of avoiding invasive mechanical ventilation in specific situations, thereby preventing associated complications. Noninvasive positive pressure ventilation has emerged as the first line of management of hypercapnic respiratory failure (due to chronic obstructive pulmonary disease and neuromuscular weakness) and cardiogenic pulmonary edema in addition to standard therapy in the acute setting. There is improvement in gas exchange, relief of respiratory muscle fatigue, and clinical outcome with reduced morbidity and mortality. Nevertheless, contraindications and failures need to be identified early, as delaying endotracheal intubation is associated with increased morbidity and mortality. Despite overwhelming evidence to support its use, NIPPV is underused. Residents and hospitalists need to identify NIPPV as a treatment option in acute respiratory failure.
Googling Service Boundaries for Endovascular Clot Retrieval Hub Hospitals in a Metropolitan Setting: Proof-of-Concept Study

Background and Purpose— There is great interest in how endovascular clot retrieval hubs provide services to a population. We applied a computational method to objectively generate service boundaries for such endovascular clot retrieval hubs, defined by traveling time to hub. Methods— Stroke incidence data merged with population census to estimate numbers of stroke in metropolitan Melbourne, Australia. Traveling time from randomly generated addresses to 4 endovascular clot retrieval–capable hubs (Royal Melbourne Hospital [RMH], Monash Medical Center [MMC], Alfred Hospital [ALF], and Austin Hospital [AUS]) estimated using Google Map application program interface. Boundary maps generated based on traveling time at various times of day for combinations of hubs. Results— In a 2-hub model, catchment was best distributed when RMH was paired with MMC (model 1a, RMH 1765 km2 and MMC 1164 km2) or with AUS (model 1c, RMH 1244 km2 and AUS 1685 km2), with no statistical difference between models (P=0.20). Catchment was poorly distributed when RMH was paired with ALF (model 1b, RMH 2252 km2 and ALF 676 km2), significantly different from both models 1a and 1c (both P<0.05). Model 1a had the greatest proportion of patients arriving within ideal time of 30 minutes followed by model 1c (P<0.001). In a 3-hub model, the combination of RMH, MMC, and AUS was superior to that of RMH, MMC, and ALF in catchment distribution and travel time. The method was also successfully applied to the city of Adelaide demonstrating wider applicability. Conclusions— We provide proof of concept for a novel computational method to objectively designate service boundaries for endovascular clot retrieval hubs.
The effects of feedback on energy conservation: A meta-analysis.

Feedback has been studied as a strategy for promoting energy conservation for more than 30 years, with studies reporting widely varying results. Literature reviews have suggested that the effectiveness of feedback depends on both how and to whom it is provided; yet variations in both the type of feedback provided and the study methodology have made it difficult for conclusions to be drawn. The current article analyzes past theoretical and empirical research on both feedback and proenvironmental behavior to identify unresolved issues, and utilizes a meta-analysis of 42 feedback studies published between 1976 and 2010 to test a set of hypotheses about when and how feedback about energy usage is most effective. Results indicate that feedback is effective overall, r = . 071, p < . 001, but with significant variation in effects (r varied from -.080 to .480). Several treatment variables were found to moderate this relationship, including frequency, medium, comparison message, duration, and combination with other interventions (e.g., goal, incentive). Overall, results provide further evidence of feedback as a promising strategy to promote energy conservation and suggest areas in which future research should focus to explore how and for whom feedback is most effective.