Miracle-dz/UniFAR-FTUs huggingface dataset:
Prevalence of Methicillin-Resistant Staphylococcus Aureus in Ambulances in Southern Maine

Abstract Objective. To determine whether methicillin-resistant Staphylococcus aureus (MRSA) could be found in ambulances in a predominantly rural state. Methods. Samples were obtained from specified areas in 51 ambulances in southern Maine. These samples were tested on mannitol salt agar containing 4 μg/mL oxacillin. Resulting colonies were gram-stained and tested for the presence of catalase and coagulase. Results. Of the 51 ambulances tested, 25 (49%%) had at least one area positive for MRSA contamination. Conclusions. A significant number of ambulances operating in southern Maine have MRSA contamination, and ambulances may represent an important reservoir for the transmission of potentially serious infections to patients and EMS personnel. There was no statistical difference between the service types (fire-based vs. non–fire-based) or annual call volume. There was, however, a statistically significant lower rate of contamination in services that provided paid, 24-hour coverage versus those that did not.
Klinische Symptome und Diagnose von BSE

Bovine spongiform encephalopathy (BSE) in cattle is characterised by typical signs and an insidious course. There is gradual weight loss and decreased milk production, and the disease is distinguished by disturbances in behaviour, sensitivity and locomotion. The most common behavioural changes are apprehension and abnormal temperament. The most common changes in sensitivity are hypersensitivity to tactile, auditory and optical stimuli, kicking during milking and excessive licking of the muzzle. The most important disturbances in locomotion include ataxia, falling down and inability to get up. Diagnostic procedures include a thorough clinical and neurological examination followed by a more detailed examination to assess behaviour, locomotion and sensitivity to touch, sound and light stimuli. Other causes of central nervous system disease may be ruled out by a complete blood count, biochemical profile, urinalysis and examination of cerebrospinal fluid. Disturbances in behaviour, locomotion and sensitivity that occur singly, rather than in combination with each other, should be interpreted with caution. However, in cattle with disturbances in two or more of these categories, a tentative diagnosis of BSE can be made, and the veterinary authorities must be notified.
Usefulness of rapid tests for diagnosis of BSE

Experience from the application of rapid tests for BSE diagnosis in comparison to reference methods is described. Sensitivity and specificity of all three rapid tests was evaluated. Detection of the first three cases of BSE in Poland was based on rapid tests which gave positive results. Opposite to that histopathology was negative/positive/positive while immunohistochemistry was positive/weak positive/positive in the first, the second and third case of BSE, respectively.
A Comparison of Proximal Tibia, Distal Femur, and Proximal Humerus Infusion Rates Using the EZ-IO Intraosseous Device on the Adult Swine (Sus scrofa) Model

Abstract Objective. We sought to compare the flow rates of the proximal tibia, the distal femur, and the proximal humerus using high pressure (greater than 300 mmHg) through an intraosseous (IO) infusion needle in an adult swine model. Methods. We performed a prospective interventional study in 11 swine. After placement of central vein and arterial lines, blood was removed via the central line until the animal's mean arterial pressure decreased 25% from the recorded baseline. We inserted a 25-mm IO needle into the proximal tibia and 45-mm needles into the distal femur and proximal humerus. All extremities were utilized in each study animal. We infused normal saline at each site for 10 minutes with a pressure bag inflated to the highest achievable pressure (greater than 300 mmHg) as measured at the infusion site with a calibrated portable inline pressure gauge. We measured the volume of normal saline remaining and we calculated infusion rates for each site. We then compared infusion flow rates between the three locations. Statistical analysis and comparison of the infusion rates of all three study arms were as performed using analysis of variance (ANOVA). Results. The average weight of the swine was 71 kg (range 64–84 kg). Successful placement of the IO needle was confirmed at all three sites. The mean infusion flow rate was 213 mL/min (standard deviation [SD] 53.2 mL/min) for the proximal humerus, 138 mL/min (SD 65.3 mL/min) for the distal femur, and 103 mL/min (SD 48.1 mL/min) for the proximal tibia (p < 0.001). The flow rate through the proximal humerus was statistically greater than that for the proximal tibia and the distal femur (p < 0.001). The flow rates through the proximal tibia and distal femur were similar. Conclusion. The humerus is a suitable alternative site for IO placement, with a potential for higher flow rates than the proximal tibia and distal femur when resuscitating a patient. Key words: intraosseous; prehospital; resuscitation; tactical combat casualty care; emergency medical services
EMS Provider Compliance with Infection Control Recommendations Is Suboptimal

Abstract Introduction. Standard precautions are disease transmission prevention strategies recommended by both the World Health Organization (WHO) and by the Centers for Disease Control and Prevention (CDC). Emergency medical services (EMS) personnel are expected to utilize standard precautions. Methods. This was a prospective observational study of the use of standard precautions by EMS providers arriving at a large urban emergency department (ED). Research assistants (RAs) observed EMS crews throughout their arrival and delivery of patients and recorded data related to the use of gloves, hand hygiene, and equipment disinfection. Results. A total of 423 EMS deliveries were observed, allowing for observation of 899 EMS providers. Only 512 (56.9%) EMS providers arrived wearing gloves. Hand washing was observed in 250 (27.8%) of providers. Reusable equipment disinfection was noted in only 31.6% of opportunities. The most commonly disinfected item was the stretcher (55%). Conclusion. EMS provider compliance with standard precautions and equipment disinfection recommendations is suboptimal. Strategies must be developed to improve EMS provider compliance with internationally recognized infection control guidelines. Key words: Emergency medical services, hand washing, hygiene, disinfection, disease prevention
Spinal Motion Restriction: An Educational and Implementation Program to Redefine Prehospital Spinal Assessment and Care

Abstract Introduction. Prehospital spine immobilization has long been applied to victims of trauma in the United States and up to 5 million patients per year are immobilized mostly with a cervical collar and a backboard. Objective. The training of paramedics and emergency medical technicians on the principals of spine motion restriction (SMR) will decrease the use of backboards. Methods. The training for SMR emphasized the need to immobilize those patients with a significant potential for an unstable cervical spine fracture and to use alternative methods of maintaining spine precautions for those with lower risk. The training addressed the potential complications of the use of the unpadded backboard and education was provided about the mechanics of spine injuries. Emergency medical services (EMS} personnel were taught to differentiate between the critical multisystem trauma patients from the more common moderate, low kinetic energy trauma patients. A comprehensive education and outreach program that included all of the EMS providers (fire and private), hospitals, and EMS educational institutions was developed. Results. Within 4 months of the policy implementation, prehospital care practitioners reduced the use of the backboard by 58%. This was accomplished by a decrease in the number of patients considered for SMR with low kinetic energy and the use of other methods, such as the cervical collar only. Conclusion. The implementation of a SMR training program significantly decreases the use of backboards and allows alternative methods of maintaining spine precautions. Keywords: Emergency Medical Services; humans; spinal injuries/therapy; transportation of patients; cervical vertebrae/injuries; emergency medical services/ methods; emergency medical technicians; immobilization/ methods; spinal motion restriction
EMS Intubation Improves with King Vision Video Laryngoscopy

Abstract Introduction. Intubation success by paramedics has historically been variable. The lack of first-pass success (FPS) has been associated with increased adverse events. Various video laryngoscope (VL) devices have been investigated to improve success among paramedics. Conflicting research exists on VL vs. direct laryngoscopy (DL) by paramedics and on the effects of the specific King Vision device on FPS and overall success (OS) in an emergency medical services (EMS) system with low intubation frequency and historically low success rates. Objectives. To evaluate the effect of an ongoing training program using the King Vision VL on FPS, OS, and success per attempt when compared with DL in one suburban EMS system with low historical intubation success rates. Methods. We performed a retrospective analysis of electronic patient care reports in a suburban EMS system. We analyzed three metrics of intubation success before DL and after implementation of ongoing training with VL in both cardiac arrest and in all other indications: success per attempt, overall success, and first-pass success. We also performed an intention to treat analysis of these rates to account for protocol violations. Results. During the study period, intubation was attempted on 514 patients. There was no difference between the DL and VL groups in age, weight, gender, or percentage receiving paralytic medications. There was improvement over DL with VL in each of the outcome measures: overall success (64.9 vs. 91.5%, p < 0.01), first-pass success (43.8% vs. 74.2%, p < 0.01), and success per attempt (44.4 vs. 71.2%, p < 0.01). A subgroup analysis by indication for intubation also showed improvement in all metrics for all indications. There were several protocol violations: 11 of 376 attempts that should have used VL (2.9%) but were done with DL. An intention to treat analysis was therefore done. Again, we saw an improvement in all metrics for all indications. Conclusion. In this suburban EMS system with historically low intubation success rates and low frequency of intubation, paramedics were able to improve all measures of intubation success using the King Vision video laryngoscope and an ongoing training program when compared with direct laryngoscopy. Key words: intubation; airway management; emergency medical services; prehospital emergency care
Epidemiology of Sepsis and Its Recognition by Emergency Medical Services Personnel in the Netherlands

Abstract Little is known about the epidemiology of sepsis in the Netherlands. In addition, information regarding the ability of emergency medical services (EMS) personnel to recognize sepsis is lacking. The aim of this study is to determine epidemiological characteristics of sepsis and the recognition of sepsis by EMS personnel in an urban area in the Netherlands. We conducted a retrospective cohort study using transport information from EMS Amsterdam and admission diagnoses at the emergency department gathered through discharge data from two academic hospitals in Amsterdam for the year 2012. A total of 253 patients with sepsis were evaluated, of which 131 were transported by ambulance. The in-hospital mortality rate of the total population was 21% and a mean length of hospital stay was of 13.5 days. Sixty-seven patients (26.5%) were admitted to the intensive care unit. Almost half of the patients were assigned to the internal medicine ward (117; 46.2%). The most common site of infection was the urinary tract (30%). E. coli was the most frequent cause of infections. EMS staff recognized 18/131 (13.7%) transported patients with (severe) sepsis or septic shock. In 52 cases (39.7%) sepsis went unrecognized, probably due to an incomplete primary survey. In 60 cases (45.8%) sepsis went unrecognized, although enough systemic inflammatory response syndrome criteria were present at initial presentation. Recognition of sepsis by EMS staff in the Netherlands is low, probably due to a lack of awareness of the syndrome and infrequent measurement of temperature and respiratory rate. As early initiation of treatment is crucial, the EMS staff, general practitioners, and other specialties could benefit from more education on this critical illness.
Navigated non-image-based registration of the position of the pelvis during THR. An accuracy and reproducibility study

The precise recording of the position of the pelvis is a prerequisite for total hip replacement (THR). The anterior pelvic plane is an accepted reference for determining the 3D pelvic orientation. We hypothesized that cutaneous palpation of this plane was accurate and reproducible. Ten consecutive navigated implantations of THR prostheses were studied. In each case, four palpations of both anterior iliac spines and the pubic symphysis were performed with a navigated stylus. The first palpation was made on actual bone contours through a skin puncture and was considered as the reference. The other three palpations were made over the intact skin as a normal intra-operative procedure. There was no significant difference between the pelvic orientations measured by the three cutaneous palpations, or between the orientations measured by transcutaneous palpation and the mean result with cutaneous palpation. Cutaneous palpation can be considered as a reliable technique for the definition of pelvic orientation during THR with the non-image-based system employed.
Histopathological evaluation of supportive effect of vitamin C on testes following long-term administration of copper sulfate in mice -

This study was set to investigate whether the adverse effects of long-term copper (Cu) consumption on testicular tissue could be prevented by vitamin C administration. Thirty-six sexually mature male NMRI mice were randomly divided into three groups of 12 animals. The first group (group Cu) which is treated by gavage with copper sulfate at a dose of 200 mg/kg/day (0.2 ml) and 0.1 ml of distilled water via intraperitoneal (i.p.) injection daily for 6 weeks, the treatment group (group Cu + Vit.C) which is treated by gavage with copper sulfate at a dose of 200 mg/kg/day (0.2 ml) and received 10 mg/kg/day (0.1 ml) vitamin C by i.p. injection, and the control group which received the same volume of distilled water by gavage and i.p. injection during the experimental period. Shrinkage and collapse of tubules, decreased number of germinal cells and decrease in epithelial height were histopathologial lesions of testes of Cu group, while, treatment group showed normal morphology with presence of spermatozoa in their lumen. In conclusion, vitamin C can be one of the suitable choices for preventive therapeutic effects and/or improvement in testicular tissue after Cu toxicosis.
Antibiotics susceptibility patterns and characterization of clinical Salmonella serotypes in Katsina State, Nigeria

Serotyping characterization and antimicrobial susceptibility of Salmonella clinical isolates were examined for a period of 10-months to study the most frequently encountered serovars in salmonellosis and their antimicrobial susceptibility patterns. Seven hundred and twenty (720) samples of both stool and blood specimens were collected from out patients attending three hospitals in Katsina State, Nigeria. The samples were collected from patients diagnosed by clinicians with either pyrexia, gastroenteritis or both. Samples were cultured; isolates were identified and antibiotic susceptibility test was performed using standard procedures. The total number of 108 (15%) of the 720 samples collected yielded positive for Salmonella strains. Out of the 108 isolates, 61 (56.5%) were responsible for typhoidal salmonellosis, while 47(43.5%) were responsible for non-typhoidal salmonellosis. Of the 108 cases of salmonellosis, 91(84.3%) were from children and 17(15.7%) from adults. S. Typhi (40.7%) was the most frequently encountered, followed by S. Enteritidis (26.9%) and least encountered was S. Arizonae (2.8%). There was no significant difference in the serotypes isolated from each of the hospitals with respect to the type of salmonellosis caused with their p values > 0.05. Of the total isolates, 94.2% were found to be resistant to ampicillin, 22.2% resistant to cefotaxime, 72.8% resistant to chloramphenicol, 31.8% resistant to co-trimoxazole and 4.9% resistant to nalidixic acid. However, resistance to ofloxacin and ciprofloxacin by the isolates were not found. Therefore, ofloxacin and ciprofloxacin remains the drug of choice for severe cases of salmonellosis, although caution should be exercised by clinicians in their prescriptions such that fluoroquinolones antibiotic therapy is used only in laboratory-proven cases of typhoid fever and Salmonella-associated bacteraemia to preserve its efficacy. Key words: Antimicrobial, fluoroquinolones, Salmonella, salmonellosis, susceptibility, resistance.
Experiences of participation in occupations of women on long-term sick leave

Abstract The majority of individuals on long-term sick leave experience negative effects in their lives associated with limitations on their participation, decreased income, and feelings of guilt. The aim was to describe the experiences that women on long-term sick leave have of participation in occupation. Unstructured interviews were used for the data collection, which involved eight women; a grounded theory approach was used. The results showed that the women's long-term sick leave changed their roles, daily habits, and routines, and their participation in occupations was negatively influenced. Their occupational performance also diminished, thereby having a negative influence on their social relationships. However, over time they came to find different strategies that contributed to a feeling of occupational competence and thence they started to rebuild their occupational identity. Through this began the process of occupational adaptation, which resulted in an increased experience of participating in occupation. As a conclusion, it should be noted that occupational therapy interventions should be directed at women on long-term sick leave at an early stage in the rehabilitation process to address the adaptation of their roles, habits, routines, and social environment.
Heart complications in familial transthyretin amyloidosis: impact of age and gender

Heart arrhythmia is common in Swedish patients with familial amyloidotic polyneuropathy (FAP), as well as cardiomyopathy. We investigated the relationship between Holter ECG and echocardiographic findings in 108 FAP patients, with particular focus on age and gender differences. Female patients were younger than male patients at symptom onset (p < 0.01). Only 4 of 39 patients with septal hypertrophy were females. Regression analysis showed that age of onset, gender and duration of disease were significantly related with intraventricular septum (IVS) thickness. Sixty-five patients (25 females) presented with abnormal 24-h ECG recordings. IVS thickness was not significantly related to conduction disturbances or the presence of ventricular arrhythmia (VA). However, IVS thickness and atrial dimension were both related to increased rate of supraventricular arrhythmia (SVA). Male gender was clearly associated with more pronounced septal thickness of the heart. Conduction disturbances were not related to IVS thickness, indicating that the distribution and extent of infiltration of the heart by amyloid are heterogeneous and related to gender and age of onset. These findings highlight the necessity of 24-h ECGs to detect conduction disturbances, due to their occurrence in the absence of echocardiographic evidence of amyloid deposition in the myocardium.
A°land Island Eye Disease (Forsius-Eriksson Syndrome) Associated With Contiguous Deletion Syndrome at Xp21: Similarity to Incomplete Congenital Stationary Night Blindness

• We report the ophthalmological findings of a 6-year-old boy who has features of both Aland Island eye disease (also called Forsius-Eriksson ocular albinism) and incomplete congenital stationary night blindness, as defined by Miyake, leading us to supsect that they are the same entity. This child has a deletion of part of band 21 of the short arm of the X chromosome (Xp21) and three other X-linked disorders: congenital adrenal hypoplasia, glycerol kinase deficiency, and Duchenne type muscular dystrophy. The electroretinogram showed negative scotopic and abnormal photopic waveforms that were similar, if not identical, to the electroretinographic findings in both Aland Island eye disease and X-linked incomplete congenital stationary night blindness. Because of this similarity and the defective dark adaptometry that has been reported in patients with this disorder, we believe that Aland Island eye disease is more appropriately classified as a form of congenital night blindness than as a form of ocular albinism. From our case and review of the literature, Aland Island eye disease and incomplete congenital stationary night blindness appear indistinguishable. If further studies confirm that the disorders are the same, we recommend use of the term Aland Island eye disease or Forsius-Eriksson-Miyake syndrome . We also recommend that the gene symbols CSNB1 and CSNB2 be used for complete congenital stationary night blindness and Aland disease, respectively.
Noninvasive detection of cardiac involvement in patients with hereditary transthyretin associated amyloidosis using cardiac magnetic resonance imaging: a prospective study

Abstract Background: Most of the studies that described cardiac amyloidosis using cardiac magnetic resonance (CMR) imaging refer to patients with primary light chain (AL) amyloidosis. The goal of this study was to evaluate cardiac involvement in patients with hereditary transthyretin associated (ATTR) amyloidosis and asymptomatic carriers and its relationships with clinical symptoms and genotype, using CMR imaging. Methods and results: Fifty-three patients with hereditary ATTR amyloidosis and 14 asymptomatic carriers were included in this study. Morphological, functional and late gadolinium enhancement (LGE) findings were noted on CMR images. A positive LGE suggesting cardiac amyloidosis was detected in 60% of patients. The pattern of LGE was diffuse, focal and circumferential in 32, 26 and 2% of patients, respectively. The inferior basal segment was the most frequently involved (93%) in case of focal involvement. Diffuse pattern was exclusively encountered in patients with cardiac symptoms. Nineteen percent of patients with isolated neurological symptoms and 20% of subjects without left ventricular wall thickening exhibited cardiac abnormalities on CMR. Conclusion: Cardiac involvement can be detected in patients with hereditary ATTR amyloidosis with isolated neurological symptoms and without left ventricular wall thickening, suggesting that CMR could be useful in detecting preclinical cardiac amyloidosis.