Miracle-dz/UniFAR-FTUs huggingface dataset:
Physician's practices and perspectives regarding tobacco cessation in a teaching hospital in Mysore City, Karnataka

Context: Tobacco is a leading cause of disease and premature death. Most of the smokers visit a doctor for various health related ailments and thus such clinic visits provide many opportunities for interventions and professional tobacco cessation advice. Aims: The primary aim of the following study is to assess the physician practices, perspectives, resources, barriers and education relating to tobacco cessation and their perceived need for training for the same. The secondary aim is to compare the physician's cessation practices from patient's perspective. Settings and Design: A descriptive study was conducted in a hospital attached to Medical College in Mysore city, Karnataka. Materials and Methods: Information about doctor's practices, perspectives and their perceived need for training in tobacco cessation were collected using pre-structured self-administered Questionnaire, which were distributed in person. Patient's practices and perspectives were assessed using a pre-structured Oral Questionnaire. Results: Almost 95% of physicians said that they ask patients about their smoking status and 94% advise them to quit smoking, but only 50% assist the patient to quit smoking and only 28% arrange follow-up visits. Thus, they do not regularly provide assistance to help patients quit, even though 98% of the physicians believed that helping patients to quit was a part of their role. Only 18% and 35% of the physicians said that Undergraduate Medical Education and Post Graduate Medical Education respectively prepared them very well to participate in smoking cessation activities. Conclusions: Tobacco cessation requires repeated and regular assistance. Such assistance is not being provided to patients by attending doctors. Our medical education system is failing to impart the necessary skills to doctors, needed to help patients quit smoking. Reforms in education are needed so as to prepare the physician to effectively address this problem.
Inhibin A and pro‐αC inhibin in Down syndrome and normal pregnancies

Using two enzyme‐linked immunosorbent assays specific for inhibin A and pro‐αC inhibin, levels of the two proteins were assessed in maternal serum from 43 Down syndrome and 300 chromosomally normal pregnancies at 15–17 weeks' gestation. Compared to the control pregnancies, both inhibin A and pro‐αC inhibin were significantly elevated in the Down syndrome pregnancies with median levels, expressed as multiples of the normal median, of 1·53MoM and 1·34MoM, respectively (P<0·001 and P=0·046 compared to controls). Levels of inhibin A and pro‐αC inhibin were weakly but significantly correlated in both the control and the Down syndrome sera (r=0·25, P<0·0001; r=0·4, P=0·008, respectively). These data suggest that the mechanism(s) underlying the elevated inhibin levels observed in Down syndrome may affect the regulation of both the inhibin α‐ and βA‐subunits. Copyright © 1998 John Wiley & Sons, Ltd.
EFFECT OF PLACENTAL REMOVAL METHOD ON THE DURATION OF SURGERY AND PUERPERAL INFECTION AFTER CESAREAN DELIVERY

We aimed to determine the effect of manual removal and spontaneous delivery of placenta on operative time and post cesarean infection . It was a prospective study on 2 62 women with normal and term pregnancy . Those were selected for electiv e cesarean section in Razi and I mam khomeini hospitals in Ahvaz Jundishapur University of medical sciences . The subjects were select by simple random sampling in two groups based on th e method of pla cental removal: study group (manual p lacental removal were 131) and control group ( spontaneous placental removal were 131) . Post cesarean endometritis was determined by at l e a st two temperature > 38/50 6 h apart after the first 24 h . Till 10 days offer cesarean section and uterin e tenderness or foul - smelling lochia . Operative time was recorded from the initial skin incision to the completion of skin closure. There was no significant difference in incidence of post cesarean infe ction between two groups. ( Study group % 11/4 and control group % 9/9 p > 0.05 ). The mean time of interval between newborn birth and placental removal in spontaneous delivery was 4 1/2 min ute as compare with manual removal group that was 1 1/1 min ute (p < 0.001) . However this span was more in study group there were no significant difference in total operating time between the two groups. The finding of our study s uggest s that, there is not an association between the method of pl a centa l d elivery and post cesarean infection in elective cesarean section.
Influence of Prognostic Factors on Survival in Locally Advanced Non-Small Cell Lung Cancer Patients Treated with Combination of Chemoradiotherapy

According to the literature, performance status, stage-tumor dimension and nodal status, weight loss, were the most important prognostic factors for survival in patients with locally advanced non-small cell lung cancer. To evaluate the treatment results and prognostic variables in our patients, study of 85 patients was randomly assigned to one of the two treatment arms. In the sequential arm, 45 patients had previously received sequential chemotherapy with 4 cycles of and etoposide followed by conformal radiotherapy (RT). In the second concurrent group, 40 patients received concomitant chemotherapy of cisplatine and etoposide and conformal RT, followed by two cycles of consolidation chemotherapy of carboplatine and etoposide. We described all phases of the conformal three dimensional (3-D) RT. From October 2005 to April 2008, 85 patients were enrolled. Eight patients were not eligible, seven had stage IV and one patient had pleural effusion. They were all initially considered to have stage IIIB disease. The median survival was 13 months for the patients in the sequential arm and 19 months for those in the concurrent treatment arm. The differences were statistically significant (log-rank test p=0.0039). The disease-free survival was 9 months in the sequential arm and 16 months in the concurrent treatment group. The differences were statistically significant (log-rank test p=0.0023). We found that the following prognostic factors significantly influenced the survival in lung cancer patients treated with conservative method: (1) age: p<0.05; (2) Performance status: p<0.001; (3) Weight loss: p<0.001; (4) Tumor dimension: p<0.05; (5) Nodal involvement: p<0.05 Conclusions: Given the higher toxicity in the concurrent-consolidation schedule, it should be reserved for patients younger than 70 years, having good performance status and minimal weight loss. Also we highly recommend precisely define the stage of disease and the prognostic factors in lung cancer patients for giving better treatment.
Hacia la cobertura universal en salud: protección social para todos en México

Mexico alcanzara la cobertura universal en salud en 2012. El seguro nacional de salud denominado Seguro Popular, introducido en 2003, garantiza el acceso a un paquete de servicios de salud integrales con proteccion financiera a mas de 50 millones de mexicanos previamente excluidos de la seguridad social. La cobertura universal en Mexico es sinonimo de proteccion social en salud. Este informe analiza el camino hacia la cobertura universal en sus tres dimensiones de proteccion: a) contra riesgos para la salud, b) de los pacientes a traves de la garantia de calidad de la atencion a la salud y c) contra las consecuencias financieras de la enfermedad y las lesiones. Se presenta una discusion conceptual sobre la transicion de una seguridad social basada en la condicion laboral a la proteccion social en salud, que implica el acceso a una atencion integral de la salud como derecho universal basado en la ciudadania, plataforma etica de la reforma mexicana. Se describen asimismo las condiciones que llevaron a la reforma, asi como su diseno y puesta en marcha, y se discute el proceso de implantacion a nueve anos de iniciado y las evidencias que dieron origen a actualizaciones y mejoras del programa original. El nucleo del informe se centra en los efectos e impactos de la reforma que se desprenden de la literatura sobre el tema, que incluye articulos cientificos y otras publicaciones disponibles. La evidencia indica que el Seguro Popular esta mejorando el acceso a los servicios de salud y reduciendo la prevalencia de los gastos en salud catastroficos y empobrecedores, especialmente entre los pobres. Estudios recientes muestran asimismo una mejora en la cobertura efectiva. Tambien se discuten los desafios prevalentes, incluyendo la necesidad de traducir los recursos financieros en servicios de salud mas efectivos, equitativos y sensibles a las expectativas de los usuarios. Se requiere una nueva generacion de reformas que incluya medidas sistemicas para consolidar la reorganizacion del sistema de salud por funciones. El articulo concluye con una discusion sobre las implicaciones de la busqueda de la cobertura universal de salud en Mexico y su importancia para otros paises de ingresos bajos y medios.
Assessment of different concentrations of ketofol in procedural operations

Background. Propofol is an intravenous anesthetic that is often used as an adjuvant during monitored anesthesia care, the addition of ketamine to propofol may counteract the cardiorespiratory depression seen with propofol used alone. Ketofol (ketamine/propofol combination) was used for procedural sedation and analgesia. However, evaluation of the effectiveness of different concentrations of Ketofol in procedural operation regarding changes in haemodynamics, emergence phenomena, recovery time, the doses, and adverse effects was not yet studied, so this randomized, double blinded study was designed to compare the quality of analgesia and side effects of intravenous different concentrations of ketofol Patient and Methods. One hundred children of both sex undergoing procedural operation, e.g. esophgoscopy, rectoscopy, bone marrow aspiration and liver biopsy participated in this. Patients received an infusion of a solution containing either combination of propofol: ketamine (1:1) (Group I) or propofol: ketamine (4:1) (Group II). Subsequent infusion rates to a predetermined sedation level using Ramsay Sedation Scale. Heart rate, noninvasive arterial blood pressure (NIBP), oxygen saturation (SpO2), end tidal carbon dioxide (Etco 2 ) and incidence of any side effects were recorded. Results. There were no significant hemodynamic changes in both groups after induction. However, there was an increase in postoperative nausea, psychomimetic side effects, and delay in discharge times in group I compared to group II. Conclusion. The adjunctive use of smaller dose of ketamine in ketofol combination minimizes the psychomimetic side effects and shortens the time of hospital discharge.
KNK437, a benzylidene lactam compound, sensitises prostate cancer cells to the apoptotic effect of hyperthermia

Hyperthermia is known to serve as a powerful tool in the treatment of prostate cancer which is commonly diagnosed in men. Quercetin and KNK437, Hsp70 inhibitors, play an important role in blocking thermotolerance in some cancer cells. In the present study we investigated the effects of KNK437 and quercetin on the acquisition of thermotolerance and heat-induced apoptosis. Also, it was examined whether the possible mechanism triggering apoptotic pathway included caspase-3 activation in prostate cancer cells. For this purpose, PC-3 and LNCaP cells were treated with hyperthermia following pretreatment with or without KNK437 or quercetin. Thermotolerance was investigated by colony formation assay in these cells, while Hsp70 mRNA levels were measured by real time RT-PCR. Sandwich ELISA was used for detection of Hsp70 protein levels. Apoptosis was detected by flow cytometric annexin V binding assay and by western blot analysis of procaspase-3 and cleaved poly (ADP-ribose) polymerase levels. In our study, KNK437 and quercetin inhibited thermotolerance in a dose-dependent manner in PC-3 cells. KNK437 and quercetin decreased heat-induced accumulation of Hsp70 mRNA and protein in PC-3 and LNCaP cells. KNK437 and quercetin pretreatment enhanced the apoptotic effect of hyperthermia in both cells. We found that KNK437 was more effective than quercetin in inducing apoptotic cell death, activation of caspase-3, and cleavage of PARP in prostate cancer cells. We suggest that KNK437 is a useful agent for enhancing the efficiency of hyperthermic therapy which has less toxic side-effects in prostate cancer.
Adaptação do questionário internacional de atividade física para idosos

The International Physical Activity Questionnaire (IPAQ) estimates the weekly energy expenditure for physical activities (PA). This instrument was validated for use with Brazilian older adults. The need to adapt the structure and application of the IPAQ arose from the difficulties of older adults to correctly measure the number of days, time and intensity of PA (domains) during a normal week and the difficulties encountered by the interviewers in field research. The adapted IPAQ consists of five domains and 15 questions and is applied by interview because of the low educational level of Brazilian older adults. The instrument is applied in its long form to permit better discrimination of PA in each domain and refers to a normal week to help recall morning, afternoon and evening activities. In addition, it includes details about mild, moderate and vigorous intensity. The training of the interviewers is fundamental. The report of the IPAQ adapted for older adults should be delivered in minutes per week and should use the classification active (< 150 min/week). The IPAQ adapted for older adults is an international instrument that is valid for the Brazilian elderly population. The instrument is a noninvasive easily applied method of low cost that reaches large population groups, among other advantages.
Bacillus anthracis lethal toxin induces TNF-α–independent hypoxia-mediated toxicity in mice

Bacillus anthracis lethal toxin (LT) is the major virulence factor of anthrax and reproduces most of the laboratory manifestations of the disease in animals. We studied LT toxicity in BALB/cJ and C57BL/6J mice. BALB/cJ mice became terminally ill earlier and with higher frequency than C57BL/6J mice. Timed histopathological analysis identified bone marrow, spleen, and liver as major affected organs in both mouse strains. LT induced extensive hypoxia. Crisis was due to extensive liver necrosis accom- panied by pleural edema. There was no evidence of disseminated intravascular coagulation or renal dysfunction. Instead, analyses revealed hepatic dysfunction, hypoalbuminemia, and vascular/oxy- genation insufficiency. Of 50 cytokines analyzed, BALB/cJ mice showed rapid but transitory increas- es in specific factors including KC, MCP-1/JE, IL-6, MIP-2, G-CSF, GM-CSF, eotaxin, FasL, and IL-1β. No changes in TNF-α occurred. The C57BL/6J mice did not mount a similar cytokine response. These factors were not induced in vitro by LT treatment of toxin-sensitive macrophages. The evidence pre- sented shows that LT kills mice through a TNF-α-independent, FasL-independent, noninflammato- ry mechanism that involves hypoxic tissue injury but does not require macrophage sensitivity to toxin. J. Clin. Invest. 112:670-682 (2003). doi:10.1172/JCI200317991.
Contralateral approaches to bilateral cerebral aneurysms: a microsurgical anatomical study

✓ In patients with bilateral supratentorial aneurysms, surgical clipping of all aneurysms via a unilateral approach would obviate the need for a second operation. The authors conducted a microsurgical study in human cadaver heads to examine the contralateral exposure for four common aneurysm sites in the anterior circulation: the ophthalmic artery (OA) origin, the posterior communicating artery (PCoA) origin, the internal carotid artery (ICA) termination, and the middle cerebral artery (MCA) bifurcation. Frontotemporal craniotomies were performed in 16 cadavers to evaluate the corridor for exposure of these sites from the contralateral side. Morphometric data, including lengths and diameters of major arterial segments and optic nerves, were documented for anatomical correlation. In this study, the contralateral OA origin was successfully exposed in 62% of specimens, the PCoA origin in 50%, the ICA bifurcation in 100%, and the MCA bifurcation in 62%. Exposure of the OA origin and, in some cases, the PCoA, .
Taboos and opportunities in sonothrombolysis for stroke

Systemic thrombolysis with tissue plasminogen activator (tPA) is the only approved treatment for acute ischaemic stroke that improves functional outcome if given up to 4.5 h from symptom onset. At least half of treated patients have unfavourable outcomes long-term though, emphasising the need to amplify the only approved acute stroke therapy. Ultrasound targeting of an intra-arterial occlusive clot and delivering mechanical pressure to its surrounding fluids (referred to as sonothrombolysis) accelerates the thrombolytic effect of tPA. Higher recanalisation rates produce a trend towards better functional outcomes that could be safely achieved with the combination of 2 MHz frequency ultrasound and systemic tPA. To further accelerate the clot-dissolving effect of ultrasound, a variety of frequencies and intensities as well as other adjuvant treatment elements are being studied. However, literature reports argue efficacy and safety of these novel approaches doubting promptly translation into the clinical practice. This review will summarise our current knowledge about potentially harmful (taboos) directions and what we think are promising avenues for these future stroke therapies. We also give a prospect for novel technologies such as operator-independent devices that aim to further spread the use of sonothrombolysis for stroke.
Pathological complete response and sphincter-sparing surgery after neoadjuvant radiochemotherapy with regional hyperthermia for locally advanced rectal cancer compared with radiochemotherapy alone

Purpose: To evaluate the influence of regional hyperthermia on rates of complete pathological response (pCR) and sphincter-sparing surgery in the context of an up-to-date radiochemotherapy protocol for locally advanced rectal cancer. Methods: Between 2007 and 2010, 106 patients with locally advanced cancer of the middle and lower rectum were admitted to neoadjuvant radiochemotherapy either with (n = 61) or without (n = 45) regional hyperthermia. A retrospective comparison was performed between two groups: 45 patients received standard treatment consisting of 5040 cGy in 28 fractions to the pelvis and 5-fluorouracil (RCT group) and 61 patients received the same treatment in combination with regional hyperthermia (HRCT group). Target temperature was 40.5°C for at least 60 min. Total mesorectal excision was performed routinely. Results: pCR was seen in 6.7% of patients in the RCT group and 16.4% in the HRCT group. Patients who received at least four hyperthermia treatments (n = 40) achieved a significantly higher pCR rate (22.5%) than the remaining 66 patients (p = 0.043). Rates of sphincter-sparing surgery were similar in both groups with 64% in the RCT group and 66% in HRCT. When considering only low-lying tumours located within 8 cm of the anal verge prior to treatment, the rate of sphincter-sparing surgery was 57% in the HRCT group compared with 35% in the RCT group (p = 0.077). Conclusion: The combination of regional hyperthermia and neoadjuvant radiochemotherapy may lead to an increased pCR rate in locally advanced rectal cancer. Patients with low-lying tumours especially may benefit when additional downsizing allows sphincter-preserving surgery.
Euthanasia: An Indian perspective

In our society, the palliative care and quality of life issues in patients with terminal illnesses like advanced cancer and AIDS have become an important concern for clinicians. Parallel to this concern has arisen another controversial issue-euthanasia or “mercy –killing” of terminally ill patients. Proponents of physician-assisted suicide (PAS) feel that an individual's right to autonomy automatically entitles him to choose a painless death. The opponents feel that a physician's role in the death of an individual violates the central tenet of the medical profession. Moreover, undiagnosed depression and possibility of social ‘coercion’ in people asking for euthanasia put a further question mark on the ethical principles underlying such an act. These concerns have led to strict guidelines for implementing PAS. Assessment of the mental state of the person consenting to PAS becomes mandatory and here, the role of the psychiatrist becomes pivotal. Although considered illegal in our country, PAS has several advocates in the form of voluntary organizations like “death with dignity” foundation. This has got a fillip in the recent Honourable Supreme Court Judgment in the Aruna Shaunbag case. What remains to be seen is how long it takes before this sensitive issue rattles the Indian legislature.
Efecto de la publicidad de alimentos anunciados en la televisión sobre la preferencia y el consumo de alimentos: revisión sistemática

Objective: The aim of this study was to perform a systematic review of papers that assess the effect of television food advertisings (TFA) in the food preferences and consumption in different age groups. Methods: Randomized clinical trials published up to November 2010 were searched in Pubmed, Ebsco, Cochrane and Scielo. Studies were included if they assessed the effect of direct exposition to TFA over the food preferences, demand, and consumption. Results: Ten studies fulfilled the inclusion criteria. In the three studies conducted on preschooler children an increase in selection and demand of advertized foods was reported. All the fives studies conducted on scholar children reported negative outcomes in those children exposed to unhealthy food. An increase on food consumption was observed in two of the three studies conducted on adults. Conclusion: The assess studies show that in pre-school and school children the effect of advertising on food consumption was consistent, while in adults there is a trend toward an strong association of exposure food advertising and preference, consumption and demand of the food advertised.