Miracle-dz/UniFAR-FTUs huggingface dataset:
Fatores associados à procura por serviços de saúde numa perspectiva relacional de gênero

Male culture values involve risk behaviors to health, since the way men perceive and experience their masculinity is one of the most influential shapers of falling sick and dying. The scope of this study was to identify the factors associated with the demand for health services and differences between the sexes by selecting users of health services. The dependent variables were sex of the user (cultural indicator) and failure to seek out health services. Independent variables included socio-demographic and clinical-epidemiological characteristics. The Prevalence Ratio studied by univariate and multivariate analysis was used in the analysis of the association between variables. The factors associated with non-demand for health services included: being male, hours of operation of health care facilities, working hours of the user and not having any disease. By multivariate analysis the factors facilitating demand for health services (protection) were: being female aged 26 to 49 years. Effective consolidation of a health care model that questions the contradiction that exists between the epidemiological data regarding men's health and the position of the health services using common sense regarding the apparent invulnerability of men to falling sick is of great relevance.
Mortalidade infantil segundo raça/cor no Brasil: o que dizem os sistemas nacionais de informação?

This study analyzes the consistency of the Brazilian national information systems on mortality (SIM) and live births (SINASC) as data sources for evaluating health inequalities according to race/color. Infant mortality rates (IMRs) were obtained according to race/color from death and live birth certificates for the country as a whole and its regions, for the years 1999-2002. The IMR was also estimated according to race/ color, based on the incorporation of deaths and live births with race/color not reported by two criteria. The study compared the IMRs obtained in the study with those estimated by indirect methods. The IMR ratios were also calculated between race/color categories. A substantial reduction was observed during the period in the number of deaths and live births with race/color not recorded. In 2002, infant mortality in black children was 30.0% to 80.0% higher than that of white children and 40.0% to 80.0% higher than that of brown or mixed-race children (pardas); infant mortality in indigenous children was 40.0% to 90.0% higher than that of white or brown children. It is hoped that improved recording in the SIM and SINASC databases will allow a more in-depth discussion of health inequalities according to race, color, and ethnicity in Brazil.
Is bitemporal ECT more effective than bifrontal ECT in reducingthe symptoms of depression in adults

OBJECTIVE: The objective of this selective EBM review is to determine whether or not bitemporal ECT is more effective than bifrontal ECT in the treatment of adults with major depressive disorder. STUDY DESIGN: Review of three published randomized controlled trials, all English language. All RCTs were published after 1999 and studied patients older than 17 years old. DATA SOURCES: Three randomized control trials were found using PubMED, OVID, and Medline. Articles were selected based on relevance and that the outcomes of the studies mattered to patients. OUTCOME(S) MEASURED: Hamilton Rating Scale for Depression24 item completed by practitioner. RESULTS: The results of the Kellner study was that bitemporal ECT placement had an average change in HRSD-24 score of 22.4 points, from 33.7 to 11.3 (P<0.0001), and a remission rate of 64% (95% CI 53-75%). Bitemporal ECT was 3% more effective than bifrontal ECT for treating depression. 6 The Bailine study concluded that bitemporal ECT placement had an average change in HRSD-24 score of 22.7 points, from 27.7 to 5.0 and a remission rate of 95.8%. Bifrontal ECT was 4.2% more effective than bitemporal ECT for treating depression. 2 The Ranjkesh study reported that bitemporal ECT placement had an average change in HRSD-24 score of 24.3 points, from 32.1 to 7.8, and a remission rate of 100%. There was no difference in effectiveness when comparing bitemporal ECT to bifrontal ECT. CONCLUSIONS: The results of the three randomized controlled trials found that bitemporal ECT and bifrontal ECT are effective in the treatment of adults with major depressive disorder. The analysis of the three randomized controlled trials is inconclusive to whether bitemporal is more effective than bifrontal ECT in treating adults with major depressive disorder.
Using mixed methods to identify factors influencing patient flow

An effective method of identifying operational factors that influence patient flow can potentially lead to improvements and thus have huge benefits on the efficiency of hospital departments. This paper presents a new inductive mixed-method approach to identify operational factors that influence patient flow through an accident and emergency (A&E) department. Preliminary explorative observations were conducted, followed by semi-structured interviews with key stakeholders. A questionnaire survey of all medical, nursing, porter and clerical staff was then conducted. The observations provided factors for further exploration: skill-mix, long working hours, equipment availability, lack of orientation programmes, inefficient IT use and issues regarding communication structures. Interviewees highlighted several factors, including availability of medical supervision and senior nursing staff, nursing documentation issues, lack of morale due to overcrowding, personality differences and factors relating to the department layout. The questionnaire respondents strongly supported the importance of the previously identified factors. This paper demonstrates an effective mixed-method approach that can be replicated by other health-care managers to identify factors influencing patient flow. Further benefits include increased volume and quality of data, increased staff awareness for the influence of internal factors on patient flow and enhancing the evidence base for future decision making when prioritizing A&E projects.
The Characteristics of Helicobacter pylori infection and Clinical Outcomes of Patient with Upper Gastrointestinal Bleeding Admitted at Hospital Universiti Sains Malaysia

Upper gastrointestinal bleeding (UGIB) remains one of the most common clinical life threatening emergencies which are associated with a high morbidity and mortality. The main aim of this study was to determine the cause of Helicobacter pylori (H. pylori) infection and the use of non-steroidal anti-inflammatory drugs (NSAID) in upper gastrointestinal bleeding patients. A retrospective record review study was conducted among UGIB confirmed patients from January 2009 and December 2012 at Hospital Universiti Sains Malaysia. All patients who were admitted in hospital were recruited. Data collection included age, gender, Helicobacter pylori positivity, associated symptoms and Endoscopic findings. There were 46 patients with a mean age of 62 years. H. pylori was detected only in 2 (4.3%) both in Male among UGIB patients by Campylobacter-like organism (CLO) test. The prevalence of UGIB was higher in men than women 27(58.7%). The most common cause of UGIB was peptic ulcer (56.5%) and especially high amongst male patients (59.2%). The second common cause of UGIB was gastritis (19.6%). The majority of the patients are NSAID users 25 (54.3%). In conclusion, Peptic ulcer disease is the leading cause of UGIB and mainly common among males and H. pylori infection in upper gastrointestinal bleeding patients was low.
SERUM Lp(a) LEVELS IN PATIENTS OF DIABETES MELLITUS

The relationship between serum levels of lipoprotein (a) [Lp(a)] was studied in 50 patients of diabetes mellitus, aged 18-60 years, M:F 24:26, with duration of diabetes varying from six months to 25 years. They were taking various treatments (diet with oral hypoglycemic agents (OHA) and/or insulin). Metabolic status, prevalence of diabetes and various diabetic complications were assessed by detailed history, physical examination, laboratory and ECG analysis. Mean serum Lp(a) levels in diabetes mellitus patients were 44.2±35.8 mg/dl, which was significantly higher when compared to control cases (mean 21.1±11.2 mg/dl, p < 0.05). Significantly higher Lp(a) values were also observed in diabetic patients who had complications i.e. retinopathy (mean 52±41.8 mg/dl), neuropathy (mean 57.4±42.5 mg/dl) or nephropathy (mean 69.7±47.5 mg/dl). Serum Lp(a) was also higher in type 2 patients with coronary artery disease (CAD) (mean 65.5±46.8 mg/dl). Subjects with insulin requiring, type 2 diabetes (n=21) had significantly higher Lp(a) values (mean 82.9±42.7 mg/dl) when compared with type 2 patients who were on OHA (mean 31.7±27.0 mg/dl).
Gonadotrophin-releasing hormone analogues and endometriosis: current strategies and new insights

Background: Endometriosis is an estrogen-dependent chronic inflammatory disease affecting 5% to 10% of women in reproductive age and has been reported also in adolescents. Its main clinical presentations are chronic pelvic pain and infertility. Objective: To provide a comprehensive review of the recently published data concerning the mechanism of action of gonadotrophin-releasing hormone analogues (GnRHas) as well as to analyze their role in the management of endometriosis-associated pain and infertility in addition to its value in adolescent cases. Furthermore, to provide practical recommendations and new insights based on the best available information. Methods: Systematic search was performed of the Cochrane Library and Medical Literature Analysis and Retrieval System Online database looking for the different trials, reviews and various guidelines relating to GnRHas usage in the management of endometriosis-associated pain, infertility and in adolescent cases. Results: From a pathophysiological perspective, there is a growing scientific evidence that GnRHas exert its therapeutic effects by their classical pituitary downregulation and via a direct effect on the endometrial cells themselves. Accordingly, they represent an important medical option for the management of different aspects of this enigmatic disease. Conclusion: GnRHas have a valuable strategic role in treatment of endometriosis-associated pain and infertility as well as in adolescents above 16 years.
The effect of counseling on sterilization acceptance by high-parity women in Nigeria

To inform women of the risks associated with high parity and to increase understanding of birth control methods especially voluntary surgical contraception the University of Benin Teaching Hospital launched a family planning and education program for pregnant women who had had 4 or more previous deliveries. More than 1000 high-parity women admitted for prenatal care during a 19-month period were randomly allocated either to a treatment group exposed to 4 individualized counseling sessions on family planning methods and the health risks associated with high parity or to a control group that received only the standard family planning information provided at the prenatal clinic. Overall 71% of the women in the treatment group were using an effective method of birth control at 6 weeks postpartum compared with 51% of the women in the control group. About 40% of women in both groups had indicated at admission that they did not want more children but women in the treatment group were significantly more likely to choose female sterilization as their postpartum contraceptive method than women in the control group--13% compared with 3%. By age the proportions sterilized in the treatment group ranged from 4% of those younger than 30 to 28% of those 35 and older; comparable proportions for the control group were 2% and 9% respectively. 6% of women in the treatment group who had 4 living children underwent sterilization compared with 46% of those with 7 or more living children. Among control patients the proportions were 0 and 5% respectively. (authors) (summaries in ENG FRE SPA)
Avascular necrosis significantly impairs quality of life in sickle cell disease

Introduction: Quality of life (QoL) assessment has become an integral component of the assessment of the holistic care of patients with chronic diseases, including sickle cell disease (SCD). Objective: To evaluate the quality of life in patients with SCD managed in our centre. Patients and Methods: Eighty consecutive patients with confirmed hemoglobin SS or SC were recruited. Age and sex-matched volunteers served as controls. Ethical approval was obtained from the Institutional Review Board and all participants gave informed consent. Information on socio-demographic, quality of life and clinical variables, including the presence of complications were recorded in a modified version of the WHO Quality of Life Brief version (WHOQOL-BREF) questionnaire. Data was analyzed using Microsoft Excel and SPSS 17 computer softwares. Descriptive statistics were used to represent socio-demographic variables while the Student t-test was used to explore relationship between the variables and the quality of life domains. Results: Significantly fewer participants with SCD are married compared to their age- and sex-matched controls (P = 0.01). Similarly, participants with SCD scored significantly lower in the physical and psychological domains as well as in overall QoL and general health domains compared to controls (P = 0.001). Avascular necrosis of the femur significantly affected the overall QoL and general health of participants with SCD, respectively while the means of the QoL assessment domains were not significantly different in participants with SCD with and without complications, except in the general health domain (P < 0.001). Conclusion: Avascular necrosis of the femoral head significantly affects overall QoL in participants with SCD.
Comportamento dos amebócitos circulantes de moluscos planorbídeos frente ao parasitismo por larvas de Schistosoma mansoni, inoculação de tinta nanquim e fratura da concha

Foi estudado o comportamento dos amebocitos circulantes de Biomphalaria glabrata e Biomphalaria tenagophila mediante a infeccao pelo Schistosoma mansoni, a inoculacao de tinta Nanquim e a fratura da concha. Foi realizada contagem diferencial de amebocitos na hemolinfa, dando-se enfase aos tipos de celulas encontradas em cada amostra; avaliacao histopatologica dos moluscos submetidos a exposicao aos miracidios de S. mansoni; e analise da morfologia dos amebocitos atraves de microscopia de fase. Foi verificada correlacao entre a variacao do numero de amebocitos circulantes e a reacao tecidual. Em Biomphalaria tenagophila somente houve aumento do numero de amebocitos estrelados quando os moluscos eram infectados por S. mansoni, o que sugere a especificidade da reacao ao parasitismo. Comparando os resultados obtidos em B. glabrata e B. teganophila, concluiu-se que esses moluscos apresentam comportamentos amebocitarios diferentes frente aos diversos estimulos utilizados.
Indicadores das ações municipais para a notificação e o registro de casos de violência intrafamiliar e exploração sexual de crianças e adolescentes

A informacao e essencial para o enfrentamento da violencia contra criancas e adolescentes e a restauracao de seus direitos. Este estudo apresenta indicadores para avaliacao de acoes municipais para a notificacao e o registro de casos de violencia intrafamiliar e exploracao sexual de criancas e adolescentes formulados a partir de metodologias participativas e de consenso: Tecnica Grupo Nominal (TGN) e Metodo Delphi. O marco referencial foi o acervo de politicas nacionais voltadas para a tematica. Participaram do estudo, especialistas das cinco macrorregioes brasileiras. Foram obtidos a partir da analise de consenso dois cenarios de analise incluindo, respectivamente, 3 e 20 indicadores.
Água de consumo humano como fator de risco à saúde em propriedades rurais

OBJETIVO: Verificar a qualidade higienico-sanitaria da agua de consumo humano em propriedades rurais por meio da contagem de indicadores microbiologicos de potabilidade. METODOS: Foram colhidas 180 amostras de agua utilizada para consumo humano das fontes, reservatorios e ponto de consumo em 30 propriedades rurais, situadas na regiao Nordeste do Estado de Sao Paulo. Determinou-se o numero mais provavel de coliformes totais, Escherichia coli e o numero de microrganismos mesofilos. Foi verificada a presenca de medidas de protecao das fontes de abastecimento. RESULTADOS: Os resultados evidenciaram que 90% das amostras de agua das fontes, 90% dos reservatorios e 96,7% de agua de consumo humano, colhidas no periodo de chuvas, e 83,3%, 96,7% e 90%, daquelas colhidas respectivamente nos mesmos locais, durante a estiagem, estavam fora dos padroes microbiologicos de potabilidade para agua de consumo humano. CONCLUSOES: A agua utilizada nas propriedades rurais foi considerada um importante fator de risco a saude dos seres humanos que a utilizam. A adocao de medidas preventivas, visando a preservacao das fontes de agua, e o tratamento das aguas ja comprometidas sao as ferramentas necessarias para diminuir consideravelmente o risco de ocorrencia de enfermidades de veiculacao hidrica.
Fatores associados à interrupção do aleitamento materno exclusivo de lactentes nascidos com baixo peso assistidos na atenção básica

This study aimed to identify factors associated with interruption of exclusive breastfeeding (EBF) in low birth weight infants receiving primary care. This was a cross-sectional study of 170 infants treated at primary care units on the urban periphery of Sao Paulo, Brazil. The sample included infants with birth weight ≤ 2,500g (including twins) and 5-minute Apgar ≥ 7, followed until the third month of life, and excluded infants/mothers with complications that would impede EBF, besides infant/maternal deaths. Data were collected from forms completed during consultations and patient records. Prevalence ratios were obtained by Poisson regression. The following factors were associated with interruption of EBF in the first three months of life: maternal age ≤ 18 years; informal employment (protective factor); alcohol intake during pregnancy; < 6 prenatal visits; multiple gestations; birth weight ≤ 2,000g; difficulty breastfeeding in the first month; complaints in breastfeeding during the first month; and use of pacifiers in the first two months. Prior knowledge of these factors can help plan measures and policies to increase EBF rates among low birth weight infants.
Upper Limb Standards in Newborns

β The present study assists the clinician in determining an abnormal upper limb in the newborn. To define standards for upper limb measurements in the newborn, 198 term and preterm infants (gestational age range, 27 to 41 weeks) were examined. In every case, the gestational age was determined chronologically and clinically, and the total length of the arm, upper extremity and forearm lengths, and total hand and middle finger lengths were measured by two observers using standard techniques. Normal values were determined by plotting the mean ± 2 SDs for each gestational weekvthe gestational age. (Am J Dis Child1983;137:829-832.
Hospital-Acquired Diarrhea in Adults: A Prospective Case-Controlled Study in Mexico

Abstract Objective: To know the incidence, etiology, risk factors, morbidity, and mortality of nosocomial diarrhea in adults. Design: Nested case-control study, matched by service, length of stay, date of admission, and presence of leukopenia and/or the acquired immunodeficiency syndrome (AIDS). Cases were those who developed nosocomial diarrhea. Controls were those who did not develop nosocomial diarrhea during a comparative period nor during the next ten days. Stool samples were processed in search for parasites, yeasts, bacteria, and rotavirus. Setting: Third-level referral center, in Mexico City, Mexico, for general internal medicine and surgical problems. Patients: Eligible subjects were all new admissions to the hospital from November 1987 to September 1988. Reasons for exclusion were presence of chronic diarrheal disease or melena. There were 115 cases and 111 controls. Results: Overall risk of acquiring nosocomial diarrhea was 5.5%, or 1.8 episodes per 100 patient-weeks. A potential pathogen was found in 59%. Yeasts and Entamoeba histolytica were the most frequently isolated pathogens. Mortality in cases was 18%, as compared with 5% in controls (p<.01). Multivariate analysis showed enteral feeding, recent enemas, presence of Candida species, use of antacids/Hz-blockers, and presence of nasogastric tubes as significant risk factors for nosocomial diarrhea. Conclusions: Diarrhea is a common complication in hospitalized patients. It occurs more often than previously suspected and is linked with a substantial mortality, The spectrum of etiologic agents is different from that reported in pediatric hospitals. Given that nosocomial diarrhea may constitute, at least, a marker of severity of illness, it should receive more attention in general hospitals.
Active Role Models at the Core of Active Secondary School Cultures Des modèles de vie active au cœur de la culture d'écoles secondaires actives

With the increasing costs and time associated with community-based sport, it is essential that schools be active environments for students. At the core of active school cultures are the teachers and administrators who devise and defend the physical activity practices and policies that guide students. In order to explore the degree of influence school leaders have on a secondary school’s culture of physical activity, eight teachers and four administrators were asked about their beliefs regarding this relationship. Participants believed that teachers who consistently modeled healthy behaviors to students and staff could overcome the challenges of the daily timetable and diminishing new teacher interest in extracurricular leadership. However, the lack of active lifestyle role models and scattered lines of communication between administration, teachers and students restricted the value of daily physical activity to a select few rather than an expectation for all.
Prevalence of Sexually Transmitted Infections (STIs) among Attendees of AFRH Centre in Ibadan, Southwestern Nigeria

2 Abstract: In a cross-sectional study, 200 patients attending the Association for Reproductive Family and Health (AFRH) Centre in Ibadan, Nigeria from August 2011 to October 2011 were screened randomly to determine the prevalence of common sexually transmission infections (STIs) among them, using conventional methods. One hundred and ten (55.0%) of the subjects harboured various agents of STIs and 21 (10.5%) harboured other bacterial isolates. The study showed that Candida albican 54(27.0%) was the most predominant organisms among these subjects. This was followed by Gardnerella vaginalis 21(10.5%) and Trichomonas vaginalis 3(1.5%). Other isolates include Staphylococcus aureus 4(2.0%), E. coli 1(0.5%), coliforms 1(0.5%) and normal genital flora 15(7.5%). However, Trepanema pallidium (syphilis), Neisseria gonorrhea and Chlamydia trachomatis were not detected. Risk factors associated with significant STI were young age, sex and marital status. The importance of routine STI screening in sexually active patients especially among the young and singles is advocated. It is recommended that routine screening for STIs should be incorporated into hospital care.