Miracle-dz/UniFAR-FTUs huggingface dataset:
Intestinal Perfusion in Hemorrhagic Shock

Dogs were bled to a mean arterial pressure of 35 mm. Hg and maintained at this level for 4 to 5 hours, or until 40 per cent of their maximum bleeding volume was taken back spontaneously. When the superior mesenteric artery was autoperfused at normal rates with arterial blood, only 2 of 22 animals survived. On the other hand, when a donor animal was included in the perfusion system, a significantly higher (P=0.03) fraction survived (5 out of 14). If the removed blood was not reinfused as soon as 40 per cent of the maximum bleeding volume was taken back but the hypertensive period was maintained for a full 5 hours, then only 1 dog out of 9 survived as long as 35 hours, despite the fact that all 9 dogs in this group were given additional transfusions equal to the “take-up” volume.
Pharmacology Review: Drug Therapy for Neonatal Seizures: Part 1

Immediate management of seizures includes stabilization, identification of the cause and specific treatment, and if needed, administration of an antiepileptic drug (AED) to prevent seizure recurrence. AED therapy is divided into standard (traditional) and alternative therapies. Alternative therapies include vitamins or cofactors specific for certain inborn errors of metabolism. Part 1 of this two-part Pharmacology Review examines some basic neonatal seizure concepts and the standard therapies (phenobarbital, phenytoin, fosphenytoin, and benzodiazepines); Part 2 reveiws alternative therapies and when to stop treatment. Seizures represent the most specific indication of neonatal neurologic insults. (1)(2) The incidence of neonatal seizures ranges from 1 to 5:1,000 live births. (2) It is vital to recognize neonatal seizures, determine their cause, and treat them because if they continue, they could interfere with supportive functions, such as respirations and feeding, and cause brain damage. (1)(2) Although seizures in an older child may be idiopathic or genetic, most neonatal seizures have a specific cause. In the series by Mizrahi and Kellaway, (3) the most common cause was hypoxic-ischemic encephalopathy (32%), followed by intracranial hemorrhage (17%), central nervous system infection (14%), infarction (7%), metabolic abnormalities (6%), inborn errors of metabolism (3%), and unknown (10%). The clinical manifestations of seizures may differ in the neonate compared with the older child and may not be as obvious. Volpe classified neonatal seizures as subtle or fragmentary seizures (more common in the preterm infant), clonic (focal or multifocal), tonic (focal or generalized), and myoclonic (focal, multifocal, or generalized). (1)(2) The generalized tonic-clonic seizure is unusual in the newborn, but it may be seen in genetic epilepsies. Electroencephalography (EEG) may be useful for confirming neonatal seizures when they are suspected. However, not all seizures have an EEG correlate, which makes diagnosis difficult. Mizrahi and Kellaway categorized seizures as …
Prevalence and Risk Factors for Symptoms Suggestive of Pre- Eclampsia in Indian Women

Prevalence and Risk Factors for Symptoms Suggestive of Pre-Eclampsia in Indian Women Pre-eclampsia is a serious health implication in pregnancy accounting for severe illness among women especially in LMICs. We examined the prevalence of symptoms suggestive of pre-eclampsia and associated maternal, behavioural, and socioeconomic and demographic risk factors in Indian women.
Low functional health literacy, misconceptions and risks regarding prevention of unintended pregnancy, STIs, HIV and AIDS

The risk of experiencing an unintended pregnancy, STIs, HIV and AIDS is exacerbated when low literacy level, low functional health literacy level and misconceptions prevail as barriers to accessing primary health care services and learning about the correct use of and adherence to medicine regimens. Sometimes the source of misconception on the risks regarding unintended pregnancy, STIs, HIV and AIDS are low literacy and health literacy. This study explored the experiences of females who utilise reproductive health promotion services and the experiences of reproductive health care providers regarding the provision of reproductive health services in a primary health care setting. A qualitative, descriptive phenomenological design was used. A sample of 36 participants (11 health care providers and 25 females) who utilise the primary health care facility, was drawn through purposive sampling. Individual and focus group interviews were conducted. Tesch’s data analysis method was used. Ethical principles were observed and trustworthiness was ensured. The themes that emerged confirmed that low health literacy levels were related to unsafe sex practices, specifically, unprotected sex. It is recommended that a health literacy assessment tool for reproductive health be developed to reduce reproductive health problems associated with low health literacy levels.
Infantile Pompe's disease, lipid storage, and partial carnitine deficiency

A diagnosis of infantile Pompe's disease (glycogenosis type II) was made by muscle biopsy on a 6‐month‐old infant boy seen with hypotonia, weakness, and developmental regression. Histochemistry and electron microscopy revealed a vacuolar myopathy with massive glycoge accumulation associated with increased neutral lipid as demonstrated on Oil Red O reactions. Pleomorphic, hypertrophic mitochondria with distortion of cristae and electron‐dense deposits within the matrix were identified. Acid α−1,4‐glucosidase activity was absent but associated with increased neutral maltase activity and a variable compensatory rise in activity of other lysosomal enzymes. Biochemical studies demonstrated low free carnitine, normal acylcarnitine, increased activity of carnitine palmityl and acyl transferases, and other enzymes of β‐oxidation with the notable exception of low normal β‐hydroxyacyl‐CoA dehydrogenase activity. The explanation for the lipid accumulation is uncertain but is likely related to the combination of low carnitine concentration in muscle, low β‐hydroxyacyl CoA dehydrogenase, representing a rate limiting enzyme of β‐oxidation, and nonspecific defective mitochondrial function.
How to recognize the innocent vibratory murmur

The heart sounds of 807 children were recorded with a computer and an electronic stethoscope. The goal was an attempt to distinguish the innocent vibratory murmur from other systolic murmurs. In all 310 cases diagnosed with vibratory murmur the spectrogram showed a well defined area at 150 Hz range different from other systolic murmurs.
An epidemiological comparative study of weight and height parameters for nutritional assessment of adolescents in a rural area of North India

Research Question : What is the simplest way to assess the nutritional status of adolescents? Objectives: (1) To compare and identify the most appropriate method for rapid assessment of nutritional status of rural adolescents using height and weight parameters. (2) To assess whether EHPA chart is superior over the conventional method of using BMI for the nutritional assessment of adolescents or not. Study Design: Cross-sectional study. Study Setting: Eight registered schools in the field practice area of Rural Health Training Center, Bilaspur, Department of Community Medicine, Muzaffarnagar Medical College, Muzaffarnagar, U.P., INDIA. Sample size: 467 i.e., all the school going rural adolescents of both sexes (11-19 yrs of age). Study variables: Height and weight. Methodology: The weight and height of all the study subjects was recorded by portable dial weighing machine and stadiometer respectively with due permission of the school principal. Age of subjects were recorded from the school register as on their last birthday. The data were subjected to comparision for nutritional assessment by using two study tools i.e., conventional BMI and EHPA chart. Statistical analysis: Proportion and Chi square test by using epi info statistical package. Result: A total of 467 adolescents were examined. By using conventional BMI, 93.79% of adolescents were classified as underweight and 4.06% as normal; however with the help of EHPA chart it was found that 38.97% adolescents were underweight and 58.67% were normal. Conclusion: Existing norms of using conventional BMI for assessing nutritional status of adolescents is inappropriate as far too many normal adolescents fall in undernourished category, whereas EHPA chart prevents such fallacies.
Does regular aerobic training affect basal leptin level (difference between male and female)

There is discrepancy about the effects of regular exercise training on basal leptin level and most of the existing data have been collected from obese/thin subjects. In this study, the effects of one year aerobic exercise was investigated in normal weight untrained healthy volunteer male and female subjects. The sample included 60 non-athletes, male and female university students. First, all samples were randomly divided into four groups. The practice program including selected aerobic exercises and volleyball drills with specific intensity was applied. The blood samples of subjects were taken once 24 h before the first section of the exercise program and 24 h after the last section of the exercise program. Resting plasma leptin level was determined using ELISA method in pre and posttest and in paired sample T test, whereas one way and two way (factorial) ANOVA was used to analyze the data. Studies show that basal plasma leptin levels in healthy young non-athlete individuals in response to regular exercise in the long term did not fluctuate. Aerobic exercise for one year showed no significant effect on plasma leptin levels (that is about the role of fat tissue as the most significant source of leptin), and it seems that it occurs because fat tissue in subjects did not change.
Factores relacionados con la satisfacción laboral de enfermería en un hospital médico-quirúrgico

RESUMEN Objetivo: analizar el grado de satisfaccion laboral de los profesionales de enfermeria que trabajan en un hospital medico-quirurgico y establecer los factores sociodemograficos y profesionales relacionados con la misma. Metodologia: estudio transversal y descriptivo. Se seleccionaron aleatoriamente 75 profesionales de enfermeria (total: 510) del Hospital Medico Quirurgico de la Ciudad Sanitaria “Virgen de las Nieves”, de Granada, Espana, se autoadministra un cuestionario anonimo, compuesto por el Font-Roja (mide la satisfaccion laboral) y variables socio-demograficas y laborales. Resultados: la edad media de los encuestados es de 42,9 anos; 72% mujeres, 64,9% casados, 73,3% vinculados en propiedad, 58,7% son del bloque de hospitalizacion y 67,6% tiene turno rotatorio. El grado de satisfaccion global del Font Roja resulta medio (69,92 ± 10,48), recorrido entre 24 y 120. La dimension mejor valorada es la «relacion interpersonal con los companeros» (3,82 ± 0,86) y la peor valorada la «promocion profesional» (2,28 ± 0,75). El bloque o lugar de trabajo es un elemento predictor de la satisfaccion laboral (s=-0,297, p=0,018). Analisis y discusion: un entorno de trabajo que garantice mas satisfaccion laboral para los profesionales de enfermeria redundaria en mejoras de calidad en los cuidados recibidos por los pacientes de parte de este tipo de personal.
THE APPLICATION OF RESEARCH SYNTHESIS AND BAYESIAN METHODS TO EVALUATE THE ACCURACY OF DIAGNOSTIC TESTS FOR SALMONELLA IN SWINE

This thesis presents the results of three complementary studies which were carried out to evaluate the accuracy of diagnostic tests for Salmonella in pigs. First, a research synthesis method approach, which included a systematic review, meta-analysis and meta-regression, was used to map out existing primary research investigating the accuracy of bacterial culture, antibody or antigen -capture ELISA, and PCR for Salmonella in pigs under field conditions. Large statistical variability, limited methodological soundness and reporting precluded a quantitative synthesis of findings from multiple studies. The meta-regression identified significant factors, such as variations in test protocols, which explained much of the variability of reported estimates of test accuracy. The need for consistent use of a standard reference test is essential to ensure comparability of results generated in future studies. In the second study, the accuracy of a bacterial culture, real-time (RT) PCR, and a mixELISA for Salmonella in were evaluated in western Canadian nursery and grow-finish pigs using traditional and Bayesian statistical methods. Ten farrow-to-finish pig farms from Alberta and Saskatchewan were purposively selected based on their presumptive Salmonella status. Bacteriological culture, RT-PCR and a mix-ELISA were performed on feces and blood samples collected from grow-finish (n=294) pigs and pens. Bayesian estimates of test sensitivity (Se) and specificity (Sp) at the individual pig level were similar to traditional statistical estimates. Sensitivity of culture and RT-PCR ranged from 65-75%, PCR Sp was 98-99% and ELISA Se and Sp at a cutoff of OD≥20% ranged from 59-63% and 84-87%, respectively. In the third study, Salmonella serovar distribution and risk factors for Salmonella shedding were investigated in breeding, nursery, and grow-finish pigs using the same 10 herds. Among 418 Salmonella isolates, most common serovars were Derby (28.5%), Typhimurium, var. Copenhagen (19.1%), and Putten (11.8%). More Salmonella were detected in pooled pen than individual pig samples,
Estudio clínico-epidemiológico sobre pediculosis capitis en escolares de Coro, estado Falcón, Venezuela.

Entre marzo-julio de 2003, se realizo un trabajo para estudiar aspectos epidemiologicos y clinicos de la pediculosis capitis en 327 (175 varones y 152 mujeres) escolares de un sector de la ciudad de Coro, estado Falcon, Venezuela. El diagnostico ectoparasitologico se realizo por observacion directa de huevos, estados imaginales y/o pre-imaginales sobre el cuero cabelludo y/o pelo de la cabeza. Los resultados revelaron una prevalencia de pediculosis capitis del 28,8% (94/327), con porcentajes de infestacion significativamente mayores en las ninas (84,0 vs. 15,9%) [Odds Ratio (OR) = 11,4; p = 0,0001] y los escolares con longitudes de cabello mayores de 3 cm (OR = 11,0; p = 0,0001), sin embargo, no fueron diferentes entre grupos de edades, razas, color o tipos de pelo (P > 0,05). Se detecto un predominio de liendres (85,1%) ubicadas mayormente entre 3 y 5 cm del cuero cabelludo (27,7 y 21,3%), en todas las regiones de la cabeza (39,4%). Los sintomas significativamente asociados a pediculosis fueron el prurito (18% en ninos infestados y 9,5% en los no infestados), con predominio nocturno (19,2% de los casos), y las adenomegalias (7,3% en ninos infestados y 5,5% en los no infestados) que prevalecieron en la region cervical (14,9%) (p = 0,0001). Dentro de otros posibles factores de riesgo significativamente involucrados en la dinamica de transmision y mantenimiento de la infestacion, resaltan el bajo estrato social (OR = 2,4; p = 0,02), el hacinamiento (³ 2 persona/cama; OR = 18,4; p = 0,0001), el intercambio de peines (OR = 3,8; p = 0,0001), tener convivientes con pediculosis (OR = 2,8; p = 0,0001), y haber tenido una infestacion anterior (OR = 9,5; p = 0,0001).
Epilepsy and Cerebral Palsy*

The two conditions epilepsy and palsy in its many forms are amongst the earliest syndromes recorded in history. The association between epilepsy and cerebral palsy in childhood is a matter of everyday experience, and this association is of scientific interest as throwing light on the nature of cerebral palsy and, more particularly, of epilepsy. It is also of practical importance in view of recent efforts to make more adequate provision for those children with cerebral palsy who are educable. The existence of the two conditions in one child constitutes a double handicap. The present tendency in our educational system is for ever-increasing subdivision of educational 'types', and any child who is difficult to fit into one of the artificial categories thus constructed is in danger of remaining outside the educational system altogether. Epilepsy and cerebral palsy make a difficult administrative problem. Teachers do not much like to have epileptics in their class as they find that the fits are liable to disrupt the work of the class, and epileptic colonies tend to insist on children being able-bodied when admitted for instruction. So the child with both disabilities may be refused admission to one of the few schools for cases of cerebral palsy and also to an epileptic colony. From both the scientific and the practical aspect, then, it is interesting to examine the correlation between these two conditions and to investigate the significance in patients with cerebral palsy of the presence of an epileptic tendency as well. In considering this problem I propose to draw largely on information available about mental defectives, but I believe that what I have to say about these children applies in large measure to others who have not been classed as mentally defective. I have in mind the fact that a child with this double disability is very liable to be classed as mentally defective in any event, irrespective of any further investigation of his mental ability.
Aspectos relacionados aos efeitos da desigualdade de renda na saúde: mecanismos contextuais

Brazil is one of the most unequal countries in income distribution. The influence of this factor on people's health is controversial. This article reviews the contextual effects and possible pathways linking income inequality to health. Contextual effect studies need well-developed multilevel theories, identifying the roles of variables in the explaining model, especially the role of individual level variables and the level of aggregation of contextual variables. Four explanations for the relationship between income inequality and health were identified: (1) statistical artifact; (2) social comparison; (3) underinvestment in social police; (4) social capital. The relative contribution of each of these mechanisms has not been well evaluated yet. We concluded that part of the heterogeneity found in the studies results may be explained by different pathways. Alternatively, income inequality may be a proxy for social stratification and less investment in public policies, but the Gini coefficient may be an unsuitable marker for such constructs in certain circumstances. More powerful designs to ascertain cause relationship should be applied. One possibility is to study the effect of intervention policies aimed at income redistribution.
A Randomized, Double-blind Clinical Trial Comparing Cefepime Plus Metronidazole With Imipenem-Cilastatin in the Treatment of Complicated Intra-abdominal Infections

Objective: To evaluate the safety and efficacy of cefepime hydrochloride plus metronidazole vs the combination of imipenem and cilastatin sodium in the treatment of complicated intra-abdominal infections in adult patients. Design: Prospective, randomized, double-blind multicenter study. Setting: University-affiliated hospitals in the United States and Canada. Patients: Three hundred twenty-three patients with complicated intra-abdominal infections in whom an operative procedure or percutaneous drainage was required for diagnosis and management. Intervention: Cefepime, 2 g, was administered intravenously every 12 hours (n=164) in addition to metronidazole, 500 mg (or 7.5 mg/kg) intravenously every 6 hours. Imipenen—cilastatin sodium, 500 mg, was administered intravenously every 6 hours (n= 159). Surgical infection management was determined by the patients' surgeons. Main Outcome Assessments: Clinical cure, defined as elimination of all signs and symptoms relevant to the original infection; and treatment failure, defined as persistence, increase or worsening of signs and symptoms resulting in an antibiotic change, requirement of an additional surgical procedure to cure the infection, or a wound infection with fever. Results: Of the initial isolates, 84% were susceptible to cefepime and 92% were susceptible to imipenemcilastatin. Among the 217 protocol-valid patients, those treated with cefepime+metronidizole were deemed clinical cures (88%) more frequently than were imipenemcilastatin—treated patients (76%) (P=.02). Using multivariate analysis to adjust for identified clinical risk factors for an adverse outcome (severity of presenting illness, isolation of enterococcus, type of infection, and duration of prestudy hospitalization), there was a trend (P=.06) toward a higher cure rate favoring cefepime+metronidazole. Pathogens were eradicated in significantly (P=.01) more patients treated with combined cefepime and metronidazole (89%) than with imipenem-cilastatin (76%). Conclusion: The combination of cefepime plus metronidazole is safe and effective therapy for patients with severe intra-abdominal infections. Arch Surg. 1997;132:1294-1302
Clinical pharmacogenomics: patient perspectives of pharmacogenomic testing and the incidence of actionable test results in a chronic disease cohort.

Aim This study aimed to examine pharmacogenomic test results and patient perspectives at an academic cardiovascular medicine clinic. Patients & methods Test results for three common cardiovascular drug-gene tests (warfarin-CYP2C9-VKORC1, clopidogrel-CYP2C19 and simvastatin-SLCO1B1) of 208 patients in the Ohio State University-Coriell Personalized Medicine Collaborative were examined to determine the incidence of potentially actionable test results. A post-hoc, anonymous, patient survey was also conducted. Results Potentially actionable test results for at least one of the three drug-gene tests were determined in 170 (82%) patients. Survey responses (n = 134) suggested that patients generally considered their test results to be important (median of 7.5 on a 10-point scale of importance) and were interested (median of 7.3 on a 10-point scale of interest) in a Clinical Pharmacogenomic Service. Conclusion Attitudes toward pharmacogenomic testing were generally favorable, and potentially actionable test results were not uncommon in this cardiovascular medicine cohort.
Prevalence of Cardiovascular Risk Factors in a Low Income Semi-Urban Community in the North-East Nigeria

AIM: Adoption of western lifestyles with alterations in diet and activity patterns has been implicated in the increasing risks for cardiovascular disease in low income countries. This study investigated the prevalence of prehypertension, hypertension, overweight and obesity as modifiable cardiovascular risk factors in a low income semi-urban community in the Northeast Nigeria. METHOD: 1004 adults who were 20 years and older were recruited through a multi-stage cluster sampling technique. Definition of prehypertension and hypertension were based on the World Health Organization (WHO) /International Society of Hypertension guidelines while the WHO body mass index (BMI) cut-points were used to define overweight and obesity. RESULTS: The mean age, BMI and blood pressure of the participants were 41.5 ± 13.5 years, 22.2±3.73Kg/m2 and 125/78mmHg respectively. The prevalence of prehypertension, hypertension, overweight and obesity were 40.3, 25.2, 15.4 and 3.8% respectively. The Odds Ratio (95% Confidence Interval) for the hypertension among the obese persons compared with normal weight and overweight participants was 2.75 (1.25–6.04) and 1.62 (0.068–3.82) respectively. CONCLUSION: Prehypertension and hypertension sequentially were the most prevalent cardiovascular risk factors in the study population. The relative risk for hypertension among obese participants was about three times that of normal weight and about two times that of the overweight participants.