Miracle-dz/UniFAR-FTUs huggingface dataset:
Gulhane Military Medical Academy Training Hospital, the applicant Determination of Healthy Lifestyle Behaviors in Individuals Diagnosed Coronary Artery Disease -

AIM: The aim of the study, Coronary Artery Disease (CAD) diagnosed with identification of individuals in specific behaviors to improve health, health status and related factors to determine the levels of detection. METHODS: This descriptive study of data types of the Gulhane Military Medical Academy (GATA) Hospital cardiology clinic in December 2009 - February 2010 were collected. The study group, at least 6 months before the diagnosis of CAD area, between the ages of 20-65 individuals who accept and participate in the study (n = 300) formed. Sociodemographic characteristics and health behaviors of the personal information form for the 33-item, 52-item scale of a healthy lifestyle behaviors and health status of the single-item scale working group of the detection technique applied to the face-to-face interview. The aim of the study, Coronary Artery Disease (CAD) for the development of health behaviors in the case of individuals diagnosed with the identification, health status and related factors to determine the levels of detection. The statistical analysis techniques such as Mann Whitney U and Kruskal-Wallis were used for the comparison. RESULTS: Of the group 57,7% were males, 46,3% were 50-59 years of age and 56,3% were higher education graduates. As regard to total Health Promotion Life-Style Profile Scale scores statistically significant differences had been found between age, gender, education, disease period, occupation and chronic condition groups. As regard to the average PHSS scores statistically significant differences had been found between age, education, body mass index, disease period, occupation, chronic condition and CAD related course groups (p
Patients' costs associated with seeking and accessing treatment for drug-resistant tuberculosis in South Africa.

SETTING South Africa is one of the world's 22 high tuberculosis (TB) burden countries, with the second highest number of notified rifampicin-resistant TB (R(R)-TB) and multidrug-resistant TB (MDR-TB) cases. OBJECTIVE To estimate patient costs associated with the diagnosis and treatment of R(R)-TB/MDR-TB in South Africa. DESIGN Patients diagnosed with R(R)-TB/MDR-TB and accessing care at government health care facilities were surveyed using a structured questionnaire. Direct and indirect costs associated with accessing R(R)-TB/MDR-TB care were estimated at different treatment durations for each patient. RESULTS A total of 134 patients were surveyed: 84 in the intensive phase and 50 in the continuation phase of treatment, 82 in-patients and 52 out-patients. The mean monthly patient costs associated with the diagnosis and treatment of R(R)-TB/MDR-TB were higher during the intensive phase than the continuation phase (US$235 vs. US$188) and among in-patients than among out-patients (US$269 vs. US$122). Patients in the continuation phase and those accessing care as out-patients reported higher out-of-pocket costs than other patients. Most patients did not access social protection for costs associated with R(R)-TB/MDR-TB illness. CONCLUSION Despite free health care, patients bear high costs when accessing diagnosis and treatment services for R(R)-TB/MDR-TB; appropriate social protection mechanisms should be provided to assist them in coping with these costs.
Outcome of tuberculous meningitis in children: the first comprehensive retrospective cohort study in Indonesia.

BACKGROUND Tuberculous meningitis (TBM) is the most severe form of extra-pulmonary tuberculosis. OBJECTIVE To assess hearing, visual, motor function, neurological and mental development outcomes in paediatric TBM. METHODS A retrospective cohort study was conducted among 139 children with TBM registered and treated at the Department of Child Health, Dr Hasan Sadikin Hospital, Bandung, Indonesia, from January 2007 to December 2010. Hearing and visual function, appearance of optic disc, motor function, and neurological and mental development were evaluated. RESULTS Of a final 128 patients (10 died during hospitalisation, 1 was excluded), 34 (26.5%) died after hospital discharge, the addresses of 58 patients could not be found and 7 parents refused to participate. The remaining 29 patients (16 males, 13 females) were available for evaluation; the mean age was 44 months (range 7-162). Hearing loss and visual impairment were identified in respectively 11/28 and 10/25 patients. Most patients had motor disorders. Delayed neurological and mental development was observed in nearly three quarters of patients, 11 of whom had normal or borderline intelligence quotient. CONCLUSIONS TBM causes high mortality and sequelae involving hearing and visual impairment, and neurological and mental development.
Non-completion of latent tuberculous infection treatment among children in Rio de Janeiro State, Brazil.

BACKGROUND Children with latent tuberculous infection (LTBI) are particularly vulnerable to progression to active tuberculosis (TB), and are thus a priority target for isoniazid preventive therapy (IPT). However, adherence to IPT is poor. We hypothesised that children from poorer families, with reduced access to health care and lack of understanding about the disease are more likely to default from IPT. METHODS A questionnaire was administered to close child contacts or their parents at the time of prescribing IPT in three cities in Rio de Janeiro State. The children were followed prospectively. Treatment adherence was defined as taking 80% of prescribed doses. RESULTS Among 1078 children screened for LTBI, 97 (8.9%) did not return for tuberculin skin test (TST) reading; 332 (30.8%) were TST-positive; 115/332 (34.6%) were prescribed IPT, 6 of whom did not initiate treatment and 11 did not adhere during the first 2 months; 25 additional children did not complete IPT. Overall non-completion was four times more frequent among those with lower income. Health care access and knowledge did not improve treatment completion. CONCLUSIONS Substantial losses to follow-up occurred before IPT prescription; this should be further investigated. Among the children who started isoniazid, low income, but not difficult access or poor knowledge, increased the risk of treatment non-completion.
Inhibitory Effects of Active Compounds from Punica granatum Pericarp on Verocytotoxin Production by Enterohemorrhagic Escherichia coli O157 : H7

Punica granatum (P. granatum) Linn. pericarp has been commonly employed as a crude drug in Thai traditional medicines for the treatment of diarrhea. The antibacterial activity of extracts from P. granatum pericarp against different strains of enterohemorrhagic Escherichia coli (E. coli) O157 : H7 and other strains of enterohemorrhagic E. coli were investigated. Successive chloroform, 95% ethanol, and water extracts of the plant were examined. The ethanolic extract was found to be the most effective against all the strains examined. Both the ethyl acetate and n-butanol fractions of P. granatum pericarp were demonstrated to have high activity with the highest minimal inhibitory concentration (MIC) and minimal bactericidal concentration (MBC) values of 0.05 and 0.05 and 0.39 and 0.19 mg/ml, respectively. The inhibitory effects of both fractions on the production of verocytotoxin (VT)1 and VT2 by enterohemorrhagic E. coli O157 : H7 was observed at very low concentrations of 1/10 of the MIC value (0.05–0.09 mg/ml, respectively). Phytochemical screening of the ethanolic extracts demonstrated that they contain flavonoids, sterols, triterpenes, phenols, and tannins. Our findings suggest that an appropriate bioactive compound may be developed from P. granatum pericarp as alternative treatment for this E. coli O157 : H7 infection. The crude plant may also be administered to prevent VT production in the human intestine to solve the problem of subinhibitory effects from the use of antibiotics.
Rifampicin resistance after treatment for latent tuberculous infection: a systematic review and meta-analysis.

SETTING Treatment for latent tuberculous infection (LTBI) reduces the risk of tuberculosis (TB) disease. Shorter, rifamycin-containing regimens have been shown to be as effective as 6 months of isoniazid and superior with regard to safety and completion rate. It is unknown whether preventive therapy with rifamycins increases resistance to the drugs used. OBJECTIVE To determine whether treatment for LTBI with rifamycin-containing regimens leads to significant development of resistance against rifamycins. DESIGN Systematic review and meta-analysis. RESULTS We included six randomised-controlled trials of rifamycin-containing regimens for LTBI treatment that reported drug resistance. There was no statistically significant increased risk of rifamycin resistance after LTBI treatment with rifamycin-containing regimens compared to non-rifamycin-containing regimens (RR 3.45, 95%CI 0.72-16.56; P = 0.12) or placebo (RR 0.20, 95%CI 0.02-1.66; P = 0.13). CONCLUSION Preventive treatment with rifamycin-containing regimens does not significantly increase rifamycin resistance. Programmatic management of LTBI requires the creation of sound surveillance systems to monitor drug resistance.
Older adults' bodily changes and physician contact

The question of what motivates elders to seek medical advice is explored among a random sample of 467 persons aged 65 and over living in Ohio, USA. The effect of physical and psychological variables on an initial physician visit was analysed for particular bodily changes the subjects had experienced. Unlike the situation in many other utilization studies, these specific complaints could be identified as leading to physician contact in a causal sequence. Multiple regression revealed limited effects of self-assessed health, body awareness, depression and anxiety on the decision to consult a physician, but significant effect of the perceived seriousness of the complaint. The findings cast doubt on the utility of self-assessed health and psychological distress as predictors of physician use in major archival studies. This research is unique among utilization studies in that it provides a cross-sectional opportunity to explain a health behavior prospectively in the presence of a specific prior health problem.
Does research through Structured Operational Research and Training (SORT IT) courses impact policy and practice?

SETTING Structured Operational Research and Training Initiative (SORT IT) courses are well known for their output, with nearly 90% of participants completing the course and publishing in scientific journals. OBJECTIVE We assessed the impact of research papers on policy and practice that resulted from six SORT IT courses initiated between July 2012 and March 2013. DESIGN This was a cross-sectional study involving e-mail-based, self-administered questionnaires and telephone/skype/in-person responses from first and/or senior co-authors of course papers. A descriptive content analysis of the responses was performed and categorised into themes. RESULTS Of 72 participants, 63 (88%) completed the course. Course output included 81 submitted papers, of which 76 (94%) were published. Of the 81 papers assessed, 45 (55%) contributed to a change in policy and/or practice: 29 contributed to government policy/practice change (20 at national, 4 at subnational and 5 at hospital level), 11 to non-government organisational policy change and 5 to reinforcing existing policy. The changes ranged from modifications of monitoring and evaluation tools, to redrafting of national guidelines, to scaling up existing policies. CONCLUSION More than half of the SORT IT course papers contributed to a change in policy and/or practice. Future assessments should include more robust and independent verification of the reported change(s) with all stakeholders.
The utility of oesophageal pH monitoring in diagnosing gastroesophageal reflux disease-related chronic cough.

INTRODUCTION Chronic cough is a common medical complaint, which may deteriorate patients' quality of life and cause many complications. Gastroesophageal reflux disease (GERD) is one of the frequent reasons for chronic cough. Oesophageal pH monitoring is one of the diagnostic methods performed to confirm diagnosis of GERD-related cough. The aim of the study was to analyse the utility of oesophageal pH monitoring in diagnosing GERD-related cough and to identify the most sensitive pH monitoring parameters for diagnosing GERD-related cough. MATERIAL AND METHODS 24-hour oesophageal pH monitoring was performed in 204 patients suffering from chronic cough. The group consisted of 65% females and the median age was 59 years. An acid reflux episode was defined as a rapid drop in pH to a value below 4 for at least 12 seconds. The diagnosis of GERD was based on total fraction time of pH < 4, upright or supine fraction time of pH < 4, or DeMeester score. The diagnosis of GERD-related cough was made if cough episodes, marked by the patients, appeared within 2 minutes after the reflux. The association between reflux episode and appearance of cough was analysed using two parameters: symptom index (SI ≥ 50%) and/or symptom association probability (SAP ≥ 95%). RESULTS Based on results of pH monitoring, 135 patients (135/204, 66%) were diagnosed with GERD. Among them, 117 patients (117/135, 87%) were diagnosed based on DeMeester score. Among patients with GERD, 61 patients met the criteria of GERD-related cough (61/135, 45%), i.e. 30% of the group as a whole. Thirty-six patients (36/61, 59%) were diagnosed based on SAP, 12 patients (20%) based on SI, and 13 (21%) based on both parameters. Spearman rank correlation coefficient for SAP ≥ 95% and SI ≥ 50% was 0.46 (p < 0.05). CONCLUSIONS Based on pH monitoring results, GERD was diagnosed twice as often as GERD-related cough. SAP index is more sensitive than SI for the diagnosis of GERD-related cough.
Sleep disordered breathing in group 1 pulmonary arterial hypertension.

STUDY OBJECTIVES To determine the prevalence and clinical predictors of sleep disordered breathing (SDB) and impact on outcomes in a cohort of patients with WHO group 1 pulmonary arterial hypertension (PAH). METHODS A retrospective, cross-sectional review of 52 consecutive subjects with known WHO group 1 PAH referred for assessment of possible SDB. Subjects had overnight polysomnography within 6 months of right heart catheterization performed as part of a routine clinical protocol. RESULTS SDB was present in 71% of the PAH patients: 56% had OSA and 44% CSA. Older age and subjective sleepiness as assessed by the Epworth Sleepiness Scale score > 10 were predictive of SDB. A high prevalence of OSA occurred in both male (50%) and female (60%) subjects. No differences in cardiopulmonary hemodynamics or survival between those with and without SDB were observed. CONCLUSIONS This high prevalence of SDB in the PAH population suggests that systematic screening and testing is important in this group. Further studies are necessary to determine the pathophysiological effect of SDB and potential impact of SDB treatment in this population. CITATION Minic M; Granton JT; Ryan CM. Sleep disordered breathing in group 1 pulmonary arterial hypertension.
A genome-wide association study of caffeine-related sleep disturbance: confirmation of a role for a common variant in the adenosine receptor.

OBJECTIVES To identify common genetic variants that predispose to caffeine-induced insomnia and to test whether genes whose expression changes in the presence of caffeine are enriched for association with caffeine-induced insomnia. DESIGN A hypothesis-free, genome-wide association study. SETTING Community-based sample of Australian twins from the Australian Twin Registry. PARTICIPANTS After removal of individuals who said that they do not drink coffee, a total of 2,402 individuals from 1,470 families in the Australian Twin Registry provided both phenotype and genotype information. MEASUREMENTS AND RESULTS A dichotomized scale based on whether participants reported ever or never experiencing caffeine-induced insomnia. A factor score based on responses to a number of questions regarding normal sleep habits was included as a covariate in the analysis. More than 2 million common single nucleotide polymorphisms (SNPs) were tested for association with caffeine-induced insomnia. No SNPs reached the genome-wide significance threshold. In the analysis that did not include the insomnia factor score as a covariate, the most significant SNP identified was an intronic SNP in the PRIMA1 gene (P = 1.4 × 10⁻⁶, odds ratio = 0.68 [0.53 - 0.89]). An intergenic SNP near the GBP4 gene on chromosome 1 was the most significant upon inclusion of the insomnia factor score into the model (P = 1.9 × 10⁻⁶, odds ratio = 0.70 [0.62 - 0.78]). A previously identified association with a polymorphism in the ADORA2A gene was replicated. CONCLUSIONS Several genes have been identified in the study as potentially influencing caffeine-induced insomnia. They will require replication in another sample. The results may have implications for understanding the biologic mechanisms underlying insomnia.
DUAL OREXIN RECEPTOR ANTAGONIST ALMOREXANT INDUCES SLEEP The Dual Orexin Receptor Antagonist Almorexant Induces Sleep and Decreases Orexin-Induced Locomotion by Blocking Orexin 2 Receptors

Study Objectives: Orexin peptides activate orexin 1 and orexin 2 receptors (OX 1 R and OX 2 R), regulate locomotion and sleep-wake. The dual OX 1 R/OX 2 R antagonist almorexant reduces activity and promotes sleep in multiple species, including man. The relative contributions of the two receptors in locomotion and sleep/wake regulation were investigated in mice. Design: Mice lacking orexin receptors were used to determine the contribution of OX 1 R and OX 2 R to orexin A-induced locomotion and to almorex-ant-induced sleep. Setting: Interventions: Intracerebroventricular orexin oral dosing of almorexant. Measurements and Results: Almorexant attenuated orexin A-induced locomotion. As in other species, almorexant dose-dependently increased rapid eye movement sleep (REM) and nonREM sleep in mice. Almorexant and orexin A were ineffective in OX 1 R -/- / OX 2 R -/- mice. Both orexin A-induced locomotion and sleep induction by almorexant were absent in OX 2 R -/- mice. Interestingly, almorexant did not induce cataplexy in wild-type mice under conditions where cataplexy was seen in mice lacking orexins and in OX 1 R -/- / OX 2 R -/- mice. Almorexant dissociates very slowly from OX 2 R as measured functionally and in radioligand binding. Under non equilibrium conditions in vitro , almorexant was a dual antagonist whereas at equilibrium, almorexant became OX 2 R selective. Conclusions: In vivo , almorexant specifically inhibits the actions of orexin A. The two known orexin receptors mediate sleep induction by almorex ant and orexin A-induced locomotion. However, OX 2 R activation mediates locomotion induction by orexin A and antagonism of OX 2 R is sufficient to promote sleep in mice. almorexant and orexin-induced by blocking orexin receptors.
Short sleep duration combined with obstructive sleep apnea is associated with visceral obesity in Korean adults.

STUDY OBJECTIVES To determine whether short sleep duration alone or combined with obstructive sleep apnea (OSA) is associated with regional body fat including abdominal visceral fat area (VFA) among Korean adults. DESIGN Cross-sectional study. SETTING Ansan, South Korea. PARTICIPANTS There were 838 community participants age 40-69 y from the Korean Genome and Epidemiology Study. MEASUREMENTS AND RESULTS Subjective habitual sleep duration and OSA were defined based on a structured sleep questionnaire and a home portable sleep study, respectively. Abdominal VFA and hepatic fat components were assessed by computed tomography. Adjusted mean VFA and hepatic fat were highest in the shortest sleep duration group (< 5 h) and decreased linearly with increasing sleep duration. Individuals with OSA (apnea-hypopnea index ≥ 5) had a higher body mass index, waist circumference, percent body fat, VFA, and hepatic fat than those without OSA after adjusting for age and sex. The adjusted odds ratio (OR) for visceral obesity (VFA ≥ 100 cm2) was 2.05 (95% confidence interval [CI], 1.09-3.86) in individuals sleeping less than 5 h compared with those sleeping longer than 7 h, and 1.57 (95% CI, 1.08-2.26) in individuals with OSA compared with those without OSA, after adjusting for all confounding factors including body mass index. A combination of short sleep duration (< 5 h) and OSA substantially increased the OR for visceral obesity (OR, 4.40, 95% CI, 1.80-10.77) compared with those who slept longer (≥ 7 h) without OSA. CONCLUSION Short sleep duration and OSA are independently associated with visceral obesity in adults. The association is particularly strong in short sleepers with OSA.
Electroencephalographic power spectral density profile of the orexin receptor antagonist suvorexant in patients with primary insomnia and healthy subjects.

STUDY OBJECTIVES Suvorexant, an orexin receptor antagonist, improves sleep in healthy subjects (HS) and patients with insomnia. We compared the electroencephalographic (EEG) power spectral density (PSD) profile of suvorexant with placebo using data from a phase 2 trial in patients with insomnia. We also compared suvorexant's PSD profile with the profiles of other insomnia treatments using data from 3 HS studies. DESIGN Phase 2 trial--randomized, double-blind, two-period (4 w per period) crossover. HS studies--randomized, double-blind, crossover. SETTING Sleep laboratories. PARTICIPANTS Insomnia patients (n = 229) or HS (n = 124). INTERVENTIONS Phase 2 trial--suvorexant 10 mg, 20 mg, 40 mg, 80 mg, placebo; HS study 1--suvorexant 10 mg, 50 mg, placebo; HS study 2--gaboxadol 15 mg, zolpidem 10 mg, placebo; HS study 3--trazodone 150 mg, placebo. MEASUREMENTS AND RESULTS The PSD of the EEG signal at 1-32 Hz of each PSG recording during nonrapid eye movement (NREM) and rapid eye movement (REM) sleep were calculated. The day 1 and day 28 PSD profiles of suvorexant at all four doses during NREM and REM sleep in patients with insomnia were generally flat and close to 1.0 (placebo) at all frequencies. The day 1 PSD profile of suvorexant in HS was similar to that in insomnia patients. In contrast, the other three drugs had distinct PSD profiles in HS that differed from each other. CONCLUSIONS Suvorexant at clinically effective doses had limited effects on power spectral density compared with placebo in healthy subjects and in patients with insomnia, in contrast to the three comparison insomnia treatments. These findings suggest the possibility that antagonism of the orexin pathway might lead to improvements in sleep without major changes in the patient's neurophysiology as assessed by electroencephalographic.