Miracle-dz/UniFAR-FTUs huggingface dataset:
Height and weight in cystic fibrosis: a cross sectional study

Cross sectional data reporting the height, weight, and body mass index of UK patients with cystic fibrosis are presented. During the first decade of life height and weight in patients with cystic fibrosis are maintained at about 0.5 SD below those of the general population, which reflects an improvement over earlier published observations. Postpubertal stature and weight maintenance in the cystic fibrosis population still show substantial deficits which may be related to treatment.
Influenza A H1NI (Pandemic 2009): How prepared are healthcare providers in Calabar, Nigeria?

In April 2009, an outbreak of influenza was reported in Mexico and California and within months, it spread to all continents of the world. An influenza pandemic has always posed a threat to global public health. The objective of this study was to assess the knowledge, attitude, reported practice and preparedness of health care providers in Calabar, Nigeria, regarding the H1N1 pandemic. This was a prospective study. A semi-structured questionnaire was administered on health care providers in Calabar, Nigeria. One hundred and forty-five (41.6%) respondents reported that the infection was transmitted from pigs to humans whereas 53 (15.1%) reported that it was transmitted from humans to humans. Two hundred and thirty-one (66.0%) respondents were not willing to work in a hospital unit where patients with Influenza A H1N1 are treated. One hundred and thirty-eight (39.4%) respondents were willing to receive vaccination against Influenza A H1N1 while majority, 212 (60.6%) were not willing. There are gaps in knowledge of respondents regarding H1N1 infection and their level of preparedness is low. Capacity building in emergency preparedness for infectious disease epidemic is recommended. Key words: Influenza, H1N1, pandemic, infections, Calabar, Nigeria. INTRODUCTION The Black Death of the 14
Identificação de fontes de ruído e de pressão sonora em unidade neonatal

This observational study identified noise sources in a neonatal unit and measured their sound pressure levels. The study was carried out in a public hospital in the city of Rio de Janeiro, RJ, Brazil, between June and November, 2009 with seventy identification sessions conducted in ten weeks. The noise events were recorded in an electronic instrument and noise levels were measured by a dosimeter. A descriptive analysis of the duration of noise emissions was conducted on the basis of source and associated noise levels. Conversation was present in 99% of the time in the morning shift and in 90% of the afternoon shift, which accounted for 3 to 9 decibels of background noise level. It is noteworthy that 57.6% of the continuous alarm events occurred while noise peak was above 80 decibels. Diminishing noise in neonatal units demands a change in the professional team’s behavior.
Outcome of planned vaginal delivery of twins

Objective The ideal mode of delivery of twins remains controversial. Common practice is to deliver twins vaginally if the leading twin is cephalic. This study analyzed the outcome of planned vaginal delivery for twins. Methods Outcomes of planned vaginal twin birth over a 2 year period at St Thomas' Hospital London were recorded. Data was collected from patient records and statistically analyzed. Results 151 sets of twins were studied. 51% of the women had successful vaginal births, while 49% required emergency caesarean section (ECS) including 7% for the second twin. 65% of vertex-vertex twins were delivered vaginally. Presentation of twins: both vertex in 54%; second twin was non-vertex in 30%; first twin was non-vertex in17%. The main indication for ESC was a non-vertex twin (36%) regardless of birth order (although 81% of first twins were non-vertex). 67% of breech twins underwent ESC; remaining had breech extraction. There was a 3 fold increased risk of a twin with a 5 min Apgar score <7 in the vaginal group versus those delivered via caesarean (p<0.07). Nulliparous women were more likely to deliver babies with lower Apgar scores (p<0.05). Conclusion There were no statistically significant differences in neonatal outcome between the two modes of delivery. This study showed 67% of breech twins were delivery via emergency CS, a higher rate than that expressed in other studies.12 A larger randomized study is necessary to justify a policy of routine elective CS delivery of twins.
Patients on Atypical Antipsychotic Drugs: Another high-risk group for type 2 diabetes

Patients with schizophrenia are more likely than the general population to develop diabetes, which contributes to a high risk of cardiovascular complications; individuals with schizophrenia are two to three times more likely to die from cardiovascular disease than the general population. The risk of diabetes, and hence cardiovascular disease, is particularly increased by some of the new atypical antipsychotic drugs. Individuals taking an atypical antipsychotic drug, particularly younger patients under 40 years of age (odds ratio 1.63, 95% CI 1.23-2.16), represent an underrecognized group at high risk of type 2 diabetes. The mechanisms responsible for antipsychotic-induced diabetes remain unclear. Hypotheses include these drugs' potential to cause weight gain, possibly through antagonism at the H(1), 5-HT(2A), or 5-HT(2C) receptors. Other mechanisms independent of weight gain lead to elevation of serum leptin and insulin resistance. Patients with psychoses have difficulties with diet and lifestyle interventions for diabetes and weight management. If hyperglycemia develops, withdrawal from antipsychotic medication will often be inappropriate, and a change to an atypical antipsychotic drug with lower diabetogenic potential should be considered, especially in younger patients. Management of psychoses should routinely include body weight and blood glucose monitoring and steps to promote exercise and minimize weight gain. Careful collaboration between the psychiatric and diabetology teams is essential to minimize the risk of diabetes in patients taking atypical antipsychotic medication and for effective management when it develops. This collaboration will also help minimize the already high risk of cardiovascular disease in individuals with schizophrenia.
Preventing Hamstring Injuries in Sport

HAMSTRING INJURIES CAN BE DEVASTATING FOR ATHLETES AND SPORTS TEAMS. RECENT ADVANCES IN TECHNOLOGY HAVE GREATLY ENHANCED OUR UNDERSTANDING OF HOW AND WHY HAMSTRING INJURIES OCCUR. BASED ON THIS INFORMATION, PROFESSIONAL SPORTS TEAMS HAVE IMPLEMENTED VARIOUS TRAINING INTERVENTIONS IN AN ATTEMPT TO REDUCE THE RATE OF HAMSTRING INJURIES WITH VARYING SUCCESS. REVIEWING THE RECENT LITERATURE ON HAMSTRING INJURIES AND THE STUDIES THAT HAVE REPORTED DECREASES IN INJURY RATES COULD GIVE FURTHER INSIGHT INTO HOW HAMSTRING INJURES CAN BE PREVENTED AND THUS IS THE FOCUS OF THIS ARTICLE.
Secondary gliosarcoma after diagnosis of glioblastoma: clinical experience with 30 consecutive patients.

OBJECT Gliosarcoma can arise secondarily, after conventional adjuvant treatment of high-grade glioma. The current literature on the occurrence of secondary gliosarcoma (SGS) after glioblastoma multiforme (GBM) is limited, with only 12 reported cases. The authors present a large series of histologically confirmed SGSs, with follow-up to describe the clinical and radiological presentation, pathological diagnosis, and treatment outcomes. METHODS Gliosarcoma cases were identified using the University of California, San Francisco's Departments of Neurological Surgery and Neuropathology databases. Through a retrospective chart review, cases of gliosarcoma were considered SGS if the following inclusion criteria were met: 1) the patient had a previously diagnosed intracranial malignant glioma that did not have gliosarcoma components; and 2) the histopathological tissue diagnosis of the recurrence confirmed gliosarcoma according to the most current WHO criteria. Extensive review of clinical, surgical, and pathology notes was performed to gather clinical and pathological data on these cases. RESULTS Thirty consecutive patients in whom SGS had been diagnosed between 1996 and 2008 were included in the analysis. All patients had previously received a diagnosis of malignant glioma. For the initial malignant glioma, all patients underwent resection, and 25 patients received both external-beam radiation and chemotherapy. Three patients received radiotherapy alone, 1 patient was treated with chemotherapy alone, and 1 patient's tumor rapidly recurred as gliosarcoma, requiring surgical intervention prior to initiation of adjuvant therapy. The median time from diagnosis of the initial tumor to diagnosis of gliosarcoma was 8.5 months (range 0.5-25 months). All but 1 patient (who only had a biopsy) underwent a second operation for gliosarcoma; 8 patients went on to receive radiotherapy (4 had brachytherapy, 3 had external-beam radiation, and 1 had Gamma Knife surgery); and 14 patients received additional chemotherapy. The median length of survival from the time of gliosarcoma diagnosis was 4.4 months (range 0.7-46 months). The median survival from the time of the original GBM diagnosis was 12.6 months (range 5.7-47.4 months). Patients who had received concurrent and adjuvant temozolomide for GBM had worse outcomes than those who had not (4.3 and 10.5 months, respectively; p = 0.045). There was no difference in time to diagnosis of gliosarcoma in these 2 groups (8 and 8.5 months; p = 0.387). Two patients who had not received radiation therapy for GBM had an anecdotally very prolonged survival (20.9 and 46.4 months). CONCLUSIONS The data underscore the difficulty associated with management of this disease. The strikingly poor survival of patients with SGS who had previously received combined radiation and temozolomide chemotherapy for GBM may reflect a unique molecular profile of GBM that eventually recurs as SGS. Further work will be required, controlling for multiple prognostic factors with larger numbers of patients.
Telomerase Activation and ATRX Mutations Are Independent Risk Factors for Metastatic Pheochromocytoma and Paraganglioma

Purpose: Pheochromocytomas and paragangliomas (PPGLs) are rare neuroendocrine tumors. Whereas most PPGLs are benign, up to 20% may become metastatic with SDHB- and FH-mutated tumors showing the higher risk. We aimed at determining the contribution of immortalization mechanisms to metastatic progression. Experimental Design: Immortalization mechanisms were investigated in 200 tumors. To identify telomerase (+) tumors, we analyzed genomic alterations leading to transcriptional activation of TERT comprising promoter mutations, hypermethylation and gain copy number. To identify tumors that activated the alternative lengthening of telomere (ALT) mechanism, we combined analyses of telomere length by slot blot, telomere heterogeneity by telomere FISH, and ATRX mutations by next-generation sequencing. Univariate/multivariate and metastasis-free survival (MFS) and overall survival (OS) analyses were carried out for assessment of risk factors and clinical outcomes. Results: Only 37 of 200 (18.5%) tumors achieved immortalization. Telomerase activation occurred in 12 metastatic tumors and was prevalent in SDHB-mutated paragangliomas (P = 2.42e−09). ALT features were present in 25 tumors, mostly pheochromocytomas, regardless of metastatic status or molecular group (P = 0.169), yet ATRX mutations were found preferentially in SDHB/FH-mutated metastatic tumors (P = 0.0014). Telomerase activation and ATRX mutations were independent factors of poor prognosis: MFS (hazard ratio, 48.2 and 33.1; P = 6.50E−07 and 1.90E−07, respectively); OS (hazard ratio, 97.4 and 44.1; P = 4.30E−03 and 2.00E−03, respectively) and were associated with worse MFS and OS (log-rank tests P < 0.0001). Conclusions: Assessment of telomerase activation and ATRX mutations could be used to identify metastatic PPGLs, particularly in tumors at high risk of progression.
The Prevalence of Musculoskeleta Disorders Among Diagnostic Medical Sonograhers

Work-related musculoskeletal disorders are a group of syndromes characterized by soft tissue discomfort caused or aggravated by workplace exposures. Previous research has shown an increasing concern about musculoskeletal symptoms among diagnostic medical sonographers. The authors' purpose, with this study, is to describe the prevalence of musculoskeletal disorders and related work and personal factors among diagnostic medical sonographers. Data were gathered through a survey distributed to randomly selected members of the professional sonographer registry in the United States. Eighty-one percent reported musculoskeletal pain or discomfort that they associated with the work tasks of scanning. The neck, shoulder, wrist, hand/fingers, and back were where pain was reported most often, and the specific activities of manipulating the transducer while sustaining applied pressure, shoulder abduction, and sustained twisting of the neck/trunk were the key activities that aggravated the pain and discomfort. Among those reporting pain and discomfort, a small minority were absent from work. The remainder reported working in pain. Respondents indicated increased work periods without rest breaks and an inability to control work flow to take breaks. However, they indicated general satisfaction with their work environment and corporate culture. Further analyses are required to investigate the strength of relation between musculoskeletal disorders, work, and personal factors.
ETHNOBOTANY OF ARGHAKHANCHI DISTRICT, NEPAL: PLANTS USED IN DERMATOLOGICAL AND COSMETIC DISORDERS

An attempt was made to explore, identify, and document medicinal plants used in dermatological and cosmetic disorders by the people of Arghakhanchi district of western Nepal. The study was conducted during 2006-2008 using semi-structured, open-ended questionnaires, informal interviews, and group discussion with traditional healers and persons of different age and occupation having knowledge about plants and plant based remedies. A total of 31 plant species belonging to 24 families were identified and documented. Arghakhanchi district has a rich repository of medicinal plants. The indigenous traditional knowledge has been transmitted orally for years is becoming extinct, with the introduction of modern and alternative facilities of treatments in the district. Hence, these traditional practices need proper documentation and this reinforces the need for screening new active compounds. These documented plant species may be used for development of new, cheep, and effective medicines in future. DOI: http://dx.doi. org/10.3126/ijasbt.v1i2. 8199 Int J Appl Sci Biotechnol, Vol. 1(2): 27-32
International External Validation Study of the 2014 European Society of Cardiology Guidelines on Sudden Cardiac Death Prevention in Hypertrophic Cardiomyopathy (EVIDENCE-HCM)

Background: Identification of people with hypertrophic cardiomyopathy (HCM) who are at risk of sudden cardiac death (SCD) and require a prophylactic implantable cardioverter defibrillator is challenging. In 2014, the European Society of Cardiology proposed a new risk stratification method based on a risk prediction model (HCM Risk-SCD) that estimates the 5-year risk of SCD. The aim was to externally validate the 2014 European Society of Cardiology recommendations in a geographically diverse cohort of patients recruited from the United States, Europe, the Middle East, and Asia. Methods: This was an observational, retrospective, longitudinal cohort study. Results: The cohort consisted of 3703 patients. Seventy three (2%) patients reached the SCD end point within 5 years of follow-up (5-year incidence, 2.4% [95% confidence interval {CI}, 1.9–3.0]). The validation study revealed a calibration slope of 1.02 (95% CI, 0.93–1.12), C-index of 0.70 (95% CI, 0.68–0.72), and D-statistic of 1.17 (95% CI, 1.05–1.29). In a complete case analysis (n= 2147; 44 SCD end points at 5 years), patients with a predicted 5-year risk of <4% (n=1524; 71%) had an observed 5-year SCD incidence of 1.4% (95% CI, 0.8–2.2); patients with a predicted risk of ≥6% (n=297; 14%) had an observed SCD incidence of 8.9% (95% CI, 5.96–13.1) at 5 years. For every 13 (297/23) implantable cardioverter defibrillator implantations in patients with an estimated 5-year SCD risk ≥6%, 1 patient can potentially be saved from SCD. Conclusions: This study confirms that the HCM Risk-SCD model provides accurate prognostic information that can be used to target implantable cardioverter defibrillator therapy in patients at the highest risk of SCD.
Use of Calcium Channel Blockers and Breast Cancer Risk in the Women's Health Initiative

Background: Use of calcium channel blockers (CCBs) has been associated with increased risk of breast cancer in some, but not all, studies. Differences in reported associations from prior studies may be due, in part, to inadequate control of confounding factors. Methods: Participants were 28,561 postmenopausal women from the Women's Health Initiative who reported use of either CCBs or other antihypertensive medications (AHMs) at baseline; 1,402 incident breast cancer cases were diagnosed during 12 years of follow-up. Adjusted Cox regression models were used to estimate HRs and 95% confidence intervals (CI) for the associations between CCB use relative to other AHM use and breast cancer risk. Results: Use of CCBs was not associated with breast cancer risk (HR, 1.06; 95% CI, 0.94–1.20) relative to use of other AHMs. Associations approximated the null value when CCBs were considered by duration of use, length of action, or drug class. Conclusions: We provide additional evidence that CCBs do not influence breast cancer risk in postmenopausal women. Impact: The results from this study, which includes strong control for potential confounding factors, cast doubt on increases in risk with CCBs. Cancer Epidemiol Biomarkers Prev; 26(8); 1345–8. ©2017 AACR.
‘What do these words mean?’: A qualitative approach to explore oral health literacy in Vietnamese immigrant mothers in Australia

Objective: This study, nested within a large cohort study, sought to explore how well Vietnamese mothers with pre-school children understood the dental health education material commonly available in New South Wales, Australia. Design: Qualitative research. Setting: Home-based interviews. Method: Vietnamese-speaking mothers (n = 24) with young children were provided with two dental leaflets which gave advice on health behaviours in English and Vietnamese for comparison. Interviews were recorded, transcribed verbatim and analysed using a thematic coding. Results: Mothers generally reported that the English leaflets were difficult to read due to their lower levels of English literacy skills. Although the mothers preferred leaflets in their native language, they noted that it did not completely reflect the Vietnamese culture. Mothers recommended pictorial presentations for immigrants to improve understanding. Conclusions: The consistency of our findings suggest that health education leaflets should be provided to parents in their first language with use of illustrations to improve understanding, and that producers of health education leaflets should consider cultural differences in translation.
Comparison of the Short-Term Biological Effects of 7α-[9-(4,4,5,5,5-pentafluoropentylsulfinyl)-nonyl]estra-1,3,5, (10)-triene-3,17β-diol (Faslodex) versus Tamoxifen in Postmenopausal Women with Primary Breast Cancer

7Alpha-[9-(4,4,5,5,5-pentafluoropentylsulfinyl)-nonyl]estra-1,3,5, (10)-triene-3,17beta-diol (ICI 182,780; Faslodex) is a novel steroidal antiestrogen. This partially blind, randomized, multicenter study compared the effects of single doses of long-acting ICI 182,780 with tamoxifen or placebo on estrogen receptor (ERalpha) and progesterone receptor (PgR) content, Ki67 proliferation-associated antigen labeling index (Ki67LI), and the apoptotic index in the primary breast tumors of postmenopausal women. Previously untreated patients (stages T(1)-T(3); ER-positive or -unknown) were randomized and received a single i.m. dose of ICI 182,780 50 mg (n = 39), ICI 182,780 125 mg (n = 38), or ICI 182,780 250 mg (n = 44) or oral tamoxifen 20 mg daily (n = 36) or matching tamoxifen placebo (n = 43) for 14-21 days before tumor resection surgery with curative intent. The ER and PgR H-scores, together with the Ki67LI were determined immunohistochemically in the matched pretreatment biopsy and the posttreatment surgical specimens. The apoptotic index was determined by terminal deoxynucleotidyltransferase-mediated dUTP-biotin nick end labeling on the same samples. The effects of treatment on each of these parameters were compared using analysis of covariance. ICI 182,780 produced dose-dependent reductions in ER and PgR H-scores and in the Ki67LI. The reductions in ER expression were statistically significant at all doses of ICI 182,780 compared with placebo (ICI 182,780 50 mg, P = 0.026; 125 mg, P = 0.006; 250 mg, P = 0.0001), and for ICI 182,780 250 mg compared with tamoxifen (P = 0.024). For PgR H-score, there were statistically significant reductions after treatment with ICI 182,780 125 mg (P = 0.003) and 250 mg (P = 0.0002) compared with placebo. In contrast, tamoxifen produced a significant increase in the PgR H-score relative to placebo, and consequently, all doses of ICI 182,780 produced PgR values that were significantly lower than those in the tamoxifen-treated group. All doses of ICI 182,780 significantly reduced Ki67LI values compared with placebo (ICI 182,780 50 mg, P = 0.046; 125 mg, P = 0.001; 250 mg, P = 0.0002), but there were no significant differences between any doses of ICI 182,780 and tamoxifen. ICI 182,780 did not alter the apoptotic index when compared with either placebo or tamoxifen. Short-term exposure to ICI 182,780 reduces the ERalpha in breast tumor cells in a dose-dependent manner by down-regulating ER protein concentration. The reductions in tumor PgR content by ICI 182,780 demonstrate that ICI 182,780, unlike tamoxifen, is devoid of estrogen-agonist activity. Reductions in tumor cell proliferative activity (as indicated by Ki67LI) show that ICI 182,780 is likely to have antitumor activity in the clinical setting.
Combined Aneurysm and Infrahepatic Stenosis of the Inferior Vena Cava

Aneurysms of the major veins are rare, and those involving the inferior vena cava (IVC) are extremely rare. The etiology of IVC aneurysms remains unknown, and they can have variable presentation. Although many aneurysms are found incidentally, others are diagnosed after complications develop. Thrombosis is a frequent presentation, and serious sequelae, such as lethal pulmonary embolism and Budd-Chiari syndrome, may result. Therapeutic alternatives range from watchful waiting to surgical management. Development of complications such as rupture has been described and may require surgery. In this article, we report the discovery of an IVC aneurysm in a patient who had chronic renal failure associated with renal hypoperfusion and severe cardiac insufficiency.