Miracle-dz/UniFAR-FTUs huggingface dataset:
Câncer na população feminina brasileira

Objetivou-se mostrar a importância do câncer enquanto causa de morte e morbidade para a populacao feminina brasileira. Foram analisados os dados das estatisticas de mortalidade do Ministerio da Saude e os disponiveis nos registros de câncer de base populacional existentes nos municipios em Belem, Fortaleza, Recife, Goiânia, Sao Paulo e Porto Alegre (Brasil). Em 1986 o câncer foi responsavel por 15,5% dos obitos em mulheres acima de quinze anos no Brasil. Os cânceres de mama e utero representaram quase um terco desses obitos. A comparacao internacional mostrou que os coeficientes de incidencia de câncer de colo de utero em Recife e Belem foram os mais altos do mundo e os de mama em Fortaleza e Sao Paulo sao proximos dos encontrados nas regioes de mais altas cifras como nos Estados Unidos e alguns paises da Europa. Sao discutidos os principais fatores de risco para os cânceres mais prevalentes entre as mulheres brasileiras, guardando as diferencas culturais, sociais e geograficas, bem como os programas de controle existentes. Conclui-se que os programas, de "screening" e de diagnostico precoce para o câncer de colo uterino tiveram coberturas muito baixas. Considerou-se que o estabelecimento de uma politica assistencial e de controle que inclua a prevencao e o diagnostico precoce para os cânceres de colo uterino e de mama nos programas de assistencia a mulher deveria ser uma das prioridades de saude publica, no Brasil.
Rhinosinusitis: management guidelines

Adults can present with up to 5 episodes of acute viral rhinosinusitis ('colds') per year, and school-going children with between 7 and 10 episodes per year. Rhinosinusitis is one of the most common reasons for consulting a general practitioner (GP). Chronic fatigue is a common symptom in patients with chronic rhinosinusitis (CRS), with studies showing up to 50% of patients with CRS complaining of fatigue.
Nosocomial Legionnaires' Disease Uncovered in a Prospective Pneumonia Study: Implications for Underdiagnosis

Most hospitals have yet to record a case of nosocomial legionnaires' disease; the importance of isolation of Legionella pneumophila in the water system of such an institution is unclear. We undertook a prospective pneumonia study in tandem at a veterans hospital where legionnaires' disease was known to be endemic and a community teaching hospital where legionnaires' disease had never been documented. Legionella serological tests were performed on all patients with pneumonia; selective culture media and direct fluorescent antibody testing for Legionella were made readily available. Simultaneous environmental surveys for Legionella were performed. At the community hospital, we discovered that 64% of sites in the water distribution system yielded L pneumophila and that 14.3% of nosocomial pneumonias were legionnaires' disease. The epidemiologic implications of these findings are discussed. Options concerning case detection and eradication measures in the face of hospital water contamination with L pneumophila are presented. ( JAMA 1983;249:3184-3188)
Public attitudes to the quality of psychiatric treatment, psychiatric patients, and prevalence of mental disorders.

Public opinion on mental disorders in Norway was investigated in September 1992 by interviewing a stratified random sample of the population (n=1063). The hypothesis was that psychiatric treatment and psychiatric patients were met with prejudice and that public opinion on these questions underestimated the prevalence of mental disorders. The study showed that the quality of psychiatric treatment was considered very low compared with the treatment of heart disease and cancer. One-third of the respondents thought there was a great difference between persons with mental disorders and ordinary people. Sixty per cent estimated the prevalence of mental disorders to be between 10% and 50%. The concern that at some time in life they might have a mental disorder was expressed by 27% of the respondents. The consequences of negative attitudes to psychiatric treatment and psychiatric patients are discussed, with regard to both outcome of individual treatment and the manner in which society gives priority to psychiatry.
The Role of Echocardiography in the Evaluation of Patients With Left Ventricular Assist Devices

The growing population of heart failure patients and the corresponding increase in demand for donor hearts has led to the need of alternate medical therapies. The availability of donor hearts is scarce, transplant is expensive, and many patients are too ill to withstand the transplant operation. Left ventricular assist devices (LVADs) have aided in the treatment leading up to heart transplantation and the recovery of reversible myocardial damage. With the increasing use of LVADs, echocardiography has become an extensive diagnostic aid in the evaluation of patients with LVADs. Because of this growing use of LVADs, it is necessary for sonographers to have a complete and current awareness of these devices. This literature review aims to expand the echocardiographer's knowledge of LVADs and to offer suggestions and techniques that may help in the evaluation of a patient with an LVAD.
Leg ulceration: An exploration of the role of socio-economic factors in the epidemiology, access to health care and outcomes.

Background Tackling health inequalities has been a priority policy area for the NHS since the 1990’s. To date there has been scant research addressing this area in relation to leg ulcers, despite there being some evidence of inequalities in leg ulcer prevalence. The overarching aim of this thesis is to examine the relationship between the epidemiology, management and outcomes of leg ulcers in relation and socio-economic factors. Methods The epidemiology and management of leg ulcers was examined using the GPRD and THIN primary care databases. Regression models were undertaken to quantify the relationship between variables and leg ulcer rates. Multilevel logistic models were undertaken to examine three aspects of guideline recommended care in the cohort of patients diagnosed with incident venous leg ulcers; initial assessment using Doppler ultrasound, provision of compression bandaging and referrals. Analysis conducted using the THIN database adjusted for Townsend deprivation fifth rank of each patient, a proxy measure of socio-economic position. Analyses of patient management using the GPRD adjusted for practice level deprivation. Second, the relationship between socio-economic position with leg ulcer outcomes including healing and adverse events was investigated using two recently completed leg ulcer treatment RCTs. Results Socio-economic gradients were found in rates of incident venous and prevalent venous and arterial leg ulcers. The reported management of most patients fell short of standards recommended by leg ulcer guidelines although there were wide variations between practices. Only the initial assessment of patients was found to have a relationship with deprivation. Patients living in or attending practices in the most deprived areas had reduced odds of having a record of receiving Doppler assessment of their leg. No relationship was observed between deprivation and healing or adverse outcomes in the clinical trials. Conclusions There are health inequalities evident in leg ulcer development and some aspects of management. The wider implementation of guideline recommendations for care may have the potential to ameliorate some of these health inequalities as results demonstrated that low socio-economic position patients were no less likely to achieve positive leg ulcer outcomes when provided with high quality care.
Profile and clinical features of HIV positive patients attending Integrated Counseling and Testing Centre in a Medical College Hospital of Hassan, Karnataka -

Background: HIV infection is a major public health problem as it has dramatically increased the global burden of disease. HIV infected patients experience a variety of clinical signs and symptoms. Objective: Our objective was to study the profile of clinical features and opportunistic infections in HIV infected patients attending a tertiary care medical college hospital in Hassan, Karnataka. Materials and Methods: A total of 124 HIV infected patients attending the ART Centre and the ICTC of Hassan Institute of Medical Sciences, Hassan, Karnataka were enrolled in the study, after obtaining informed consent. Clinical symptoms were recorded by direct questioning. Documented opportunistic infections were noted from patient records. Results: 80 (64.5%) HIV positive patients were males and 44 (35.5%) females. Mean age of the patients was 36.5 ± 6.0 years. The common symptoms were lethargy and fatigue 90 (72.5%), prolonged fever 86 (69.3%), weakness 84 (67.7%), body-ache and joint pain 84 (67.7%), loss of appetite 82 (66.1%), weight loss 80 (64.5%), cough (44.5%), chronic diarrhoea 68 (54.8%) and Nausea and Vomiting 64 (51.6%). The overall proportion of symptomatic patients was significantly higher than the number with etiologically documented opportunistic infections (41.9%). Pulmonary tuberculosis (37.9%) was the most frequently documented opportunistic infection. Conclusion: Affordable high quality laboratory diagnostic facilities for the diagnosis of opportunistic infections under the public health program will help to obtain an accurate picture of the range of opportunistic infections in HIV patients in India.
CONTRIBUTIONS Laparoscopic Sleeve Gastrectomy Improves Olfaction Sensitivity in Morbidly Obese Patients

Background Olfactory abilities of the patients are known to be altered by eating and metabolic disorders, including obesity. There are only a number of studies investigating the effect of obesity on olfaction, and there is limited data on the changes in olfactory abilities of morbidly obese patients after surgical treatment. Here we investigated the changes in olfactory abilities of 54 morbidly obese patients (M/F, 22/32; age range 19–57 years; body mass index (BMI) range 30.5–63.0 kg/m) after laparoscopic sleeve gastrectomy. Method A laparoscopic sleeve gastrectomy was performed by the same surgeon using five-port technique. Olfactory abilities were tested preoperatively and 1, 3, and 6 months after the surgery using a standardized Sniffin’ Sticks Extended Test kit. Results Analyses of variance indicated statistically significant improvement in T, D, and I scores of morbidly obese patients within time factors (preoperative vs. 1, 3, and 6 months; 1 vs. 3 and 6 months; and 3 vs. 6 months; p<0.001 for all). There was a statistically significant improvement in overall TDI scores with an increase from 25 to 41 during the 6 months follow-up period (p<0.001 for all). Conclusions Here, for the first time in literature, we were able to show the significant improvement in olfactory abilities of morbidly obese patients after laparoscopic sleeve gastrectomy.
Parents’ perceptions of home injury risk and attitudes to supervision of pre-school children: a qualitative study in economically deprived communities

Aim The study sought to explore parents’ views of the injury risks to young children at home and their perceptions of supervision, targeting families living in economically deprived areas, including those living in black and minority ethnic communities. Background Unintentional injury is a leading cause of death and disability in young children; most injury occurs in and around the home, and children from more deprived families are more vulnerable. Inadequate supervision is often cited as an important risk factor in childhood injury. Methods Qualitative semi-structured interviews were carried out with 34 families (23 white, 6 black, 5 South Asian) in economically deprived communities in Bristol, UK from September 2005 to July 2006. Findings The four main interview themes were perceptions of risk, coping with kitchen hazards, attitudes to supervision, and learning strategies. No major differences were seen between different ethnic groups in perceptions expressed or methods used by parents to keep children safe. The common practice of barring children from entering the kitchen when cooking by using stair gates is discussed. Reduced use of safety equipment and a perceived risk of burns from irons in the South Asian communities are highlighted. Constant supervision and learning by experience are common strategies employed by these parents to keep their children safe in often adverse living conditions. Parents need to be aware of the link between child development and injury risk, and also of differences in injury rate as a function of the child’s individual temperament and ability.
Lower urinary tract symptoms in women with and without urinary incontinence

Although most women are aware of the more severe end of the spectrum of urinary symptoms, incontinence, there are a myriad of other symptoms that can affect women's quality of life. The aim of this study is to compare lower urinary tract symptoms (LUTS) and associated factors in women with and without urinary incontinence. This descriptive study compared LUTS and associated factors between 367 incontinent and 401 continent women. LUTS were evaluated with Bristol Female Lower Urinary Tract Symptoms (BFLUTS) questionnaire. LUTS were more common among incontinent women with higher BFLUTS scores, indicating more severe complaints. Filling and voiding symptoms were also common among continent women. The most common symptoms in both groups were urgency, bladder pain, frequency, hesitancy and intermittency. Incontinent women with history of ≥4 pregnancy/birth and ≥4 kg fetus had the highest scores. Recurrent infection and flatus were associated with higher scores in both groups. History of diabetes, hypertension and haemorrhoid increased scores among continent women, while pulmonary disease was the only significant medical condition among incontinent women. Overweight and history of ≥10 kg weight gain were associated with higher scores among incontinent women. Women with ‘history of incontinence in mother’ had higher scores in continent women while ‘incontinence in relatives' had more significant effects on BFLUTS scores of incontinent women. LUTS with or without incontinence were common, especially in women with increased parity, high birth weight, chronic diseases diabetes, obesity and family history.
Probiotics in primary care: A survey of health professionals

This article presents the results of a survey of primary care professionals, including practice nurses, into their understanding and use of probiotics. While probiotics were recommended by 56.8% of the practice nurses who responded, probiotic recommendation was even higher in dietitians (91.2%) and GPs (78%). The main reasons for recommending probiotics were: during and after a course of antibiotics; irritable bowel syndrome; diarrhoea; for patients run down and susceptible to infection; constipation; diverticulitis; ulcerative colitis; before travel abroad; for older persons; and mothers or babies in families with allergic tendencies. Formulating evidence-based decisions for this category might be difficult, however, as 32.5% of practice nurses said they had a poor or non-existent understanding of probiotics. As scientific evidence for probiotics continues to accumulate, with positive results reported in a wide range of health areas, health professionals need to keep up to date so that they can advise pa.
Concentrations of Some Biochemical Parameters in Breast Milk of a Population of Nigerian Nursing Mothers Using Hormonal Contraceptives

3 Abstract: Breast milk contains the entire essential nutrients needed by neonates for growth, development and maintenance of healthy tissue. However, previous reports suggest that several classes of contraceptives induce changes in the concentrations of protein, carbohydrate and lipid macromolecules to varying degrees thus raising serious concerns on the safety and possible detrimental consequences on neonatal well- being. Breast milk obtained from eighty-two (82) lactating mothers using hormonal contraceptives (test) and one hundred (100) lactating mothers not using any hormonal contraceptive devices (control) aged 26-46yrs in two selected facilities in Ibadan, South West, Nigeria were analyzed for glucose, phosphate, Triglyceride (TG), Zinc (Zn), Copper (Cu), Lead (Pb), Cadmium (Cd), Chromium (Cr), Iron (Fe), Manganese (Mn) and Selenium (Se) concentrations using standard methods. Results obtained from this study showed significant decrease in means of glucose (p<0.01) and phosphate (p<0.01) content of breast milk obtained from of mothers in the test group was observed when compared with values from the corresponding controls. Significant increase in means of calcium and albumin were observed in the breast milk of lactating mothers using hormonal contraceptives when compared with the respective means of corresponding control. However, no significant changes in means of TG, Zn, Cu, Pb, Cd, Cr, Fe, Mn and Se in the breast milk samples of test subjects were seen when values were compared with respective corresponding control. Significant reduction in breast milk glucose in lactating mothers using hormonal contraceptives could negatively impact infants thriving on exclusive breast feeding.
Effects of Patellar Taping on Patellar Position in the Open and Closed Kinetic Chain: A Preliminary Study

Although patellar taping has been advocated in the treatment of patellofemoral pain syndrome to decrease pain, to enhance vastus medialis control, and to facilitate patellar alignment, limited radiological data exist to support the use of patellar taping. The purpose of this study was to determine the effects of patellar taping on patellar position in the open and closed kinetic chains (OKC and CKC) and to quantify the effect of taping on patellar pain. Nine subjects (10 knees; 7 female, 2 males) with patellofemoral pain syndrome were x-rayed in the OKC and CKC at a 45° angle of knee flexion with and without tape applied. Subjects also completed a visual analog pain scale after performing an 8-in. step-down both pre- and posttaping. Results revealed a significant increase in lateral patellofemoral angle with patellar taping in the CKC, which indicates a more medially tilted patella. No change occurred in the patellofemoral congruence angle. Pain was reduced 45% with patellar taping during the 8-in. step-d.
Can the poor afford ‘free’ health services? A case study of Tanzania

This research was concerned with the feasibility of government charges for health services. The aim was to test the validity of charging individuals not using special facilities and to determine acceptable and equitable charges for specified services. Surveys were conducted for: 1) 29518 prescriptions dispensed at 28 health units in 7 different regions; 2) 892 outpatients at 3 referral hospitals 2 regional hospitals and 4 district hospitals; and 3) 1820 households in 3 urban cities or in locations between mission and government hospitals in 26 rural districts and 15 regions. Current medical services reach 93% of the population within 10 km and 72% within 5 km. Health services are free except for charges for patients in special or private wards at referral and regional hospitals for dental appointments and for immunization for travel. Public expenditure has been declining and there is underfinancing for drugs medical equipment and vehicles building maintenance salaries support staff and an information system. Findings are presented for hospital waiting timetravel costs choices of facilities (traditional services mission services and government services) costs admissions and costs reasons for choice of services willingness to pay improvements desired financial constraints and rationale for charges. The justification for government charges stems from concerns about frivolous use the presence of charges at mission facilities and improvements to services. It is argued that long waiting lines are sufficient to stop frivolous use. Patients used missions because of access to drugs. Government services were used because of inexpense and convenience. Most were willing to pay for services at hospitals if there were improvements in drug and food availability for instance; i.e. about 50% would pay Tsh 200 (Tanzanian shillings) at referral and regional hospitals and Tsh 100 at district hospitals. Waiting times could be 3-4 hours. 84% of rural patients and 55% of urban patients walked to facilities. Travel costs were Tsh 673 at the lowest and Tsh 4741 at the highest; the mean cost for a consultation was Tsh 440. 59% in the outpatient survey were willing to pay Tsh 200.
Well‐being and dementia – how can it be achieved?

Purpose – It is now widely accepted that many people with dementia can report in a consistent and valid way on their quality of life. This review aims to identify modifiable factors associated with quality of life in people with dementia, which can then form the basis for interventions enhancing quality of life.Design/methodology/approach – The review draws together findings in dementia care on interventions with those on quality of life.Findings – Cognitive function is not associated with quality of life in people with dementia, although paradoxically, some cognition‐focused approaches do appear to lead to improvements in quality of life. Depression is most consistently associated with lower quality of life. Also important are quality of relationships with carers, staff attitudes, family involvement and avoidance of use of anti‐psychotic medication. Potentially effective interventions are available in relation to each of these factors.Practical implications – Hope regarding what can be achieved with peop.
Health Promotion Strategies Derived from a Metropolitan Police Weight Loss Competition with Weight Loss Comparisons by Gender and BMI Category

Background: Weight management is critical in police work. It can have both legal and life-saving implications as it is linked to the health and physical readiness of the officers. A weight loss competition is one way to address weight management in police work. Among the factors to consider is gender impact, as females forge forward within a male environment. Also, assessing weight loss among obesity categories is essential for designing effective programing. Purpose: To compare mass changes among body mass index (BMI) categories and between genders at biweekly weigh-ins during a 12-week competition with recommendations for professionals. Methods: Before the competition began, the participants were instructed that those teams recording greatest percentage loss won. Body mass (body weight) comparisons were made between genders and among BMI categories. Results: Mean body mass lost for the 225 officers was 5.26 kg. Genders had similar mass losses. Normal and overweight BMI classes had significantly (p ≤ 0.05) less body mass changes than obese classes. In weeks 2 to 4, the extreme obese category experienced greatest losses. No differences were found in amount of loss among any of the groups from weeks 6 to 12. Conclusion: This multiple-site, large-scale and low-cost intervention specific to police was successful. The program had equivalent gender impact in terms of mass lost. In the second half of the program, the higher BMI groups did not lose significantly more than the lower BMI groups indicating physiological and/or motivational effects to be addressed in future programs.