Miracle-dz/UniFAR-FTUs huggingface dataset:
Relationship Between Fuchs Endothelial Corneal Dystrophy Severity and Glaucoma and/or Ocular Hypertension.

OBJECTIVE To investigate whether Fuchs endothelial corneal dystrophy (FECD) severity is associated with glaucoma and/or ocular hypertension (G/OHTN). METHODS A subset of eyes (n = 1610) from the FECD Genetics Multi-Center Study were examined to estimate the association between FECD severity (grades 0-6 based on guttae confluence) and G/OHTN. Logistic regression models that accounted for the correlation between eyes and adjusted for age, sex, central corneal thickness, intraocular pressure, presence of diabetes, and time of day of the initial evaluation were fit. RESULTS A total of 107 eyes (6.6%) had G/OHTN based on the study definition. The prevalence of G/OHTN in the control group was 6.0%. The prevalence was lower in index cases with an FECD grade of 1 through 3 and family members with a grade of 0 or 1 through 3 (0.0% and 2.1%, respectively) but higher in index cases and family members with a grade of 4 through 6 (11.2% and 8.5%, respectively). Adjusting for covariates, eyes with a grade of 4 through 6 were more likely to have concurrent G/OHTN than eyes with no FECD (index cases vs controls: odds ratio [OR] = 2.10, P = .04; affected vs unaffected family members: OR = 7.06, P = .07). Age (OR = 1.06 per 1-year increase, P < .001) and intraocular pressure (OR = 1.15 per 1-mm Hg increase, P < .001) were also associated with an increased prevalence of G/OHTN. Sex, diabetes, time of day of evaluation, and central corneal thickness were not associated with the prevalence of G/OHTN (P ≥ .15). CONCLUSIONS Glaucoma and/or ocular hypertension occurs more often in eyes with severe FECD compared with unaffected eyes. Therefore, it may be beneficial to monitor for the development of glaucoma in these patients.
Kinematic analysis in oculoplastic reconstructive surgery: measuring manual control and fluidity of movement.

OBJECTIVE To evaluate higher-order kinematic analysis, a technique not previously applied to surgical skills assessment, as a tool for elucidating patterns of movement. METHODS An observational cohort study of 27 subjects, divided into 3 equal groups based on surgical experience consisting of novice (performed <5 prior procedures), intermediate (performed 5-100 prior procedures), and expert (performed >100 prior procedures) subjects. The subjects placed a deep 3-1-1 suture onto a shielded hook on a standardized surgical skills practice board. Detailed 3-dimensional motion data were obtained using a motion capture system. Two novel parameters were used to analyze movement patterns: the frequency distribution (cumulative histogram), describing the distribution of movement sizes used, and the probability density function (normalization of frequency distribution data), evaluating the distribution of motion against the magnitude of movement. The α risk for statistical significance was set at . 05. RESULTS We found significant differences among the 3 groups for frequency distribution (P = .02; Kruskal-Wallis test) and probability density function (P = .03). CONCLUSIONS These 2 indices, derived from kinematic analysis, appear to distinguish between groups of test subjects with known differences in surgical experience. The evaluation of higher-order motion patterns appears to be of value in the objective evaluation of surgical skills. This method for assessment of manual skills is likely to provide a better guide as to which patterns of movement have the greatest efficiency for specific tasks.
RETARD DIAGNOSTIQUE ET IMPLICATION PRONOSTIQUE EN MILIEU AFRICAIN. CAS DES URGENCES EN CHIRURGIE DIGESTIVE À L’HÔPITAL NATIONAL DE ZINDER, NIGER

Purpose: this study aimed to analyze the epidemiological aspects and evaluate the impact of late diagnosis on prognosis of gastrointestinal surgical emergencies at the National Hospital of Zinder (Niger). Patients and method: this is a prospective study from 1 January to 31 December 2013. All patients underwent surgery for digestive emergency were included. Results: We collected 302 patients. Emergencies digestive surgery accounted for 22% of 1358 cases of surgical emergencies recorded over the period of the study period. The sex ratio is 3/1 in favor of men. The average age of patients was 23 years. Digestive surgical emergencies affect more children (45%) and young adults (43%). The majority (70%) of our patients did not attend school and 49% were from rural areas. The diagnosis delay rule, 171 patients (57%) arrived to emergency department more than 48 hours after onset of symptoms. Abdominal pain with or without other signs was the main reason for consultation (92% of patients). 182 patients had a poor general status. The etiologies were dominated by peritonitis (52%) followed by intestinal obstruction (28%), and abdominal trauma with 10% of cases. The parietal suppuration isolated or associated with other morbidities was the main postoperative (28%). The average length of hospital stay was 9 days. 36 patients (12%) had died. Almost half of the deaths (47%) occurred within the first 48 hours of admission. The delay of admission and the surgical management was statistically significant effect on the prognosis (P<0.006, p< 0.0001). Conclusion: The prognosis of gastrointestinal surgical emergencies is highly correlated with the speed of diagnosis leading to appropriate treatment as soon as possible. This promptness is the only guarantee of a decline in the high morbidity and mortality which is often linked to dysfunction of our hospitals and/or accessibility problems faced by patients.
Addressing risk factors, screening, and preventative treatment for diabetic retinopathy in developing countries: a review

The number of people with diabetic retinopathy (DR) has increased with the increasing prevalence of diabetes mellitus worldwide, especially in developing countries. In recent years, the successful implementation of public health programs in developed countries has been thought to contribute to decreases in blindness from DR. Developing countries, however, have not seen the same improvements, and their public health interventions still face significant challenges. In this review we describe the current state of public health approaches including risk factor control, screening and treatment techniques for DR in developing countries, and suggest recommendations. While the awareness of DR is variable, specific knowledge about DR is low, such that many patients have already experienced vision loss by the time they are screened. Attempts to improve rates of screening, in particular through non‐mydriatic cameras and tele‐screening, are ongoing and promising, although challenges include collaboration with healthcare systems and technology failures. Laser treatment is the most readily available, with anti‐VEGF therapy and vitreo‐retinal surgery increasingly sought after and provided. Recommendations include the use of ‘targeted mydriasis’ for fundus imaging to address high rates of ungradable images, increased communication with diabetes management services to improve patient retention and mobilization of access to DR treatments.
Review of the ophthalmic manifestations of gout and uric acid crystal deposition

Gout is a clinical disorder that is characterized by the deposition of monosodium urate crystals (MSU) in joints and tendons, usually in the presence of prolonged hyperuricaemia. Following an asymptomatic phase of hyperuricaemia, gout usually presents as acute monoarthritis followed by periods of remission and exacerbation. Conjunctival hyperaemia and subconjunctival haemorrhage exacerbated by purine intake are two of the more common manifestations that may go unrecognized. Other ocular and adnexal structures can be affected by urate crystal deposition and associated inflammation, with potentially vision-threatening consequences; however, ocular manifestations of gout are rare and may have been over-reported in the older literature, but our understanding of the clinic-pathological features of ocular urate deposits remains limited.
Nasal growth and maturation age in adolescents: a systematic review.

OBJECTIVE To define the end of the nasofacial growth spurt in order to schedule rhinoseptoplasty in patients with cleft without disturbing nasofacial growth. DATA SOURCES We searched the PubMed and Cochrane bibliographic databases from inception through December 31, 2007, using the primary indexing term facial growth with the confining search terms growth AND (face OR nose) AND (cephalometry OR anthropometry). The reference lists of the retrieved articles were searched for missed relevant studies. Articles written in English, German, or Dutch were included in the review. STUDY SELECTION Studies of white adolescents without genetic disorders or malformations whose growth patterns had been followed up from at least 12 years of age until 18 years of age, with intervals between relevant measurements not longer than 2 years, were selected for this review. DATA EXTRACTION A reviewer performed data extraction by obtaining raw study data from the selected studies or by requesting them from the authors. DATA SYNTHESIS Growth velocity curves were fit to different relevant measures for nasofacial growth. The end of the nasofacial growth spurt was defined as the age at which these growth velocity curves have their steepest descending slope. This definition yielded an average age of 13.1 years for adolescent girls and 14.7 years for adolescent boys. Because no information could be found for the spread in age of nasal growth spurt of individuals, 2 SDs of the age distribution for body height growth velocity were added. This resulted in 98% of white adolescent girls being nasally mature at the age of 15.8 years and 98% of white adolescent boys being nasally mature at the age of 16.9 years. CONCLUSION Rhinoseptoplasty can safely be performed after the age of 16 years in girls and 17 years in boys.
HUBUNGAN ANTARA ASUPAN PROTEIN, BESI, DAN SENG DENGAN STATUS GIZI PADA ANAK BALITA GIZI BURUK DI WILAYAH KERJA DINAS KESEHATAN KOTA SEMARANG

Background : Severe malnutrition was threatening children under five years growth. Protein deficiency in long time caused severe malnutrition. Children with severe malnutrition had micronutrients deficiency, like iron and zinc. Iron and zinc deficiency caused nutritional status decreasing. Objective : This research conduct to analyze the association dietary protein, iron, and zinc intake with nutritional status in severe malnutrition children under five years of age. Method : Study cross sectional in 21 severe malnutrition children under five years of age at work region Semarang City Health Department.The data nutritional status were searched using indicator of weight by height (W/H). The data dietary protein, iron, zinc, and fiber intake were searched by semi quantitative food frequency questionnaire (SQFFQ). The data analyzed by SPSS 12.0 for windows. Bivariate analysis used pearson product moment and multivariate analysis used multiple regression linier. Result : Nutritional status subjects which using W/H indicator were -5.72 until -3.02. At 13 until 36 month of age, subjects had 6.8 gr/d until 31.5 gr/d dietary protein intake, 1.3 mg/d until 6 mg/d dietary iron intake, and 1 mg/d until 3.3 mg/d dietary zinc intake. At 37 until 59 month of age, subjects had 11.3 gr/d until 48.5 gr/d dietary protein intake, 2.6 mg/d until 10.2 mg/d dietary iron intake, and 1.5 mg/d until 5.6 mg/d dietary zinc intake. Most of dietary protein (61.9%), iron (90.5%), and zinc (100%) intake were deficit category according to Recommended Dietary Allowances. But, most of dietary protein (61.9%) and zinc (57.1%) were good category, and all of dietary iron was deficit category according to each dietary requirements. There were no association between dietary protein (r=0.143;p=0.27), iron (r=0.089;p=0.35), and zinc intake (r=0.122;p=0.3) with nutritional status in severe malnutrition children under five years of age. Conclusion : There were not evidenced of association between dietary protein, iron, and zinc intake with nutritional status in severe malnutrition children under five years of age. Keywords : Nutritional status, severe malnutrition children under five years of age, protein intake, iron intake, and zinc intake
Appropriateness of use criteria for transthoracic echocardiography: are they relevant outside the USA?

BACKGROUND Appropriateness of use criteria (AUC) for transthoracic echocardiography (TTE) have been developed by American cardiology associations to help avoid unnecessary scans by formalizing indications for imaging. There are 98 indications classified as either appropriate (A), inappropriate (I), or uncertain (U). AUC may allow better targeting of limited resources, but they have not been tested systematically outside the USA. AIM OF THE STUDY To test AUC in Wales, one of the four countries of the UK. METHODS We collected requests for TTE and the corresponding TTE reports from all Welsh hospitals during 1 week in June 2012 and analysed them according to appropriateness, specialty, and location (secondary vs. tertiary services) of the referring physician. RESULTS We analysed 1070 pairs of echocardiography requests and TTE reports from 14 hospitals [mean age 66.5 (16.1) years; 579 (51%) M]: A-922 (86%); I-115 (11%), and U-33 (3%); 287 (25%) studies were from two tertiary centres and 338 (29.5%) were of inpatients. Main indications were the evaluation of: cardiac structure and function (489, 45.7%), valvular function (267, 25%), and hypertension, heart failure, or cardiomyopathy (149, 13.9%). In-patient requests (main indication--'initial evaluation of left ventricle ejection fraction post acute coronary syndrome'--44 studies, 13.7%) were more often appropriate than outpatients (main indication--'symptoms/conditions potentially related to suspected cardiac aetiology'--142 studies, 19.8%): 94.4 vs. 83.5%, P < 0.05. The most common inappropriate indication was 'initial evaluation for a murmur/click without symptoms/signs of structural heart disease' (29 studies, 2.7%). The proportion of appropriate requests by specialty was 89% for medical, 87% for GPs, 85.3% for cardiologists, 80.8% for surgical, and 60% for cardiac surgeons (P < 0.05 for cardiac surgeons); 47.8% of requests were generated by cardiologists, and abnormalities were detected in 82% of all scans (37% minor findings and 45% major findings), least often in those requested by general practitioners. CONCLUSION Application of AUC yields results similar to those reported from the USA; ∼1 in 10 scans could be avoided.
Adesão à higienização das mãos e ao uso de equipamentos de proteção pessoal por profissionais de enfermagem na atenção básica em saúde - doi: 10.4025/cienccuidsaude.v11i2.15204

This study aimed to evaluate the adhesion to the Personal Protective Equipment (PPE) and Hand Hygiene (HH) by health professionals who work in Primary Health Care in a District of Goiânia - GO. Data were collected from January to May 2010 through direct and no participant observation, reported in a check list and a questionnaire for the characterization of the professional. An evaluation of 149 procedures performed by 28 professionals in 280 hours of observation was carried out. Data analysis was performed through descriptive statistics, using simple frequency. The data was presented in tables. There was poor adhesion to HH and PPE. The low rates of HH, in addition to non-adhesion to proper technique form a risk behavior that endangers health professionals and users. Failures related to the availability of PPE in the studies services can influence the low adhesion to them. Educational and management actions aimed to consolidate a professional practice, awareness of the potential biological risk and importance of the availability of resources, are necessary for a greater adhesion to this Standard Precautions (SP).
Systematic reviews: the good, the not so good and the good again

Systematic reviews provide a rigorous approach to combining research findings across several studies. They follow a structured protocol and are specifically designed to control for the various types of bias that can threaten the review process. Systematic reviews provide a more scientific approach to a review of existing research where included studies are also rated for quality of included studies. They are a useful resource for student essays and dissertations as a way of gaining knowledge about a topic area because they strive to cover as much of the relevant published and unpublished literature as possible. For busy practitioners they offer a useful way of keeping up to date with the evidence-base. Systematic reviews are considered to be at the top of the evidence hierarchy, as such they provide midwives and student midwives with a sound basis on which to base their practice.
Prevalence of domestic violence and its related factors in women referred to health centers in Khuzestan Province

Background: Domestic violence is a risk factor for a wide range of health problems. This study investigated the prevalence of domestic violence and its related factors among women who attending health centers in four cities of Khuzestan provinces. Methods: In a descriptive-analytical study, 1820 women aged between 14-56 years who referred to health centers of Ahwaz, Abadan, Dezful and Andymeshk were studied. An interview-administered questionnaire was used for data collection. Logistic regression model for the calculating the odds ratio was applied. Results: Overall prevalence of physical violence at any time of life was 20.2%. The prevalence of psychological, sexual and any type of violence were 41%, 10.9% and 47.3%, respectively. Logistic regression showed that experience of any type of violence has a significant relationship with literacy, employment, ethnicity, city of residence, age of women and history of psychiatric disorders in husbands. Conclusion: The prevalence of violence in Khuzestan was high. Health centers need to consider routine screening and referring victims of violence.
Reproducibility of clinical grading of tonsillar size.

OBJECTIVE To determine the reproducibility of the Brodsky grading scale and the modified 3-grade and 5-grade scales in reporting the size of the tonsils. DESIGN Retrospective review of 60 video recordings of tonsil examination by 12 independent observers with different clinical backgrounds and various levels of training. The sizes of the tonsils were graded using different grading scales. SETTING Tertiary care university hospital. PARTICIPANTS The video recordings were chosen from an ongoing epidemiologic study of sleep-related breathing disorder in children in Hong Kong. Main Outcomes Measures The intraobserver and interobserver reproducibility of each grading scale was determined using intraclass correlation. An intraclass correlation coefficient (ICC) exceeding 0.75 was set a priori to indicate an acceptable level of reliability. RESULTS The mean intraobserver ICCs for the Brodsky grading scale and the modified 3-grade and 5-grade scales were 0.858, 0.830, and 0.865, respectively. The mean interobserver ICCs for the Brodsky grading scale and the modified 3-grade and 5-grade scales were 0.763, 0.739, and 0.783, respectively. CONCLUSION The Brodsky grading scale and the modified 5-grade scale achieved acceptable intraobserver and interobserver reproducibility.
Economic evaluation of sunitinib, sorafenib, bevacizumab/interferon-alfa or temsirolimus in 1st-line treatment of metastatic renal cell carcinoma (mRCC): An indirect comparison

5048 Background: Several new drugs are available as 1st-line therapies in mRCC. Sunitinib malate (SU) showed superior clinical efficacy vs. interferon-α (IFN-α) in a randomized phase III study (Motzer RJ et al. NEJM 2007). Sorafenib (SFN), temsirolimus (TMS) and bevacizumab+IFN-α (BEV/I) have also been compared with IFN-α in phase II/III studies, but no head-to-head trial has assessed SU vs. the new agents. To assist treatment choice in mRCC, we compared the economic value of SU vs. the new drugs from a US third-party payer perspective. Methods: A Markov model with a 10-year time horizon was developed to assess the cost-efficacy of SU vs. SFN, TMS and BEV/I as 1st-line therapy. The model projected survival and costs in 6-week cycles based on extrapolation of survival data with IFN-α, and hazard ratios (HRs) from clinical trials against IFN-α. Endpoints were PFS, overall survival (OS), quality of life, adverse events (AEs), and change in dose intensity. The model incorporated second-line treatment and best.
Association of IL1A, IL1B, and TNF gene polymorphisms with chronic rhinosinusitis with and without nasal polyposis: A replication study.

OBJECTIVE To replicate and extend recent findings in a Turkish population of associations between chronic rhinosinusitis (CRS) with nasal polyposis and single-nucleotide polymorphisms (SNPs) in the IL1A (rs17561 and Ser114Ala), IL1B (rs16944), and TNF (rs361525 and rs1800629) genes. DESIGN In a case-control replication study, DNA samples were obtained from 206 patients with severe CRS (cases) and from 196 postal code-matched controls. For IL1A and TNF, the 3 reported SNPs were complemented with tagging SNPs using an International HapMap genotyping data set to ensure complete genetic coverage. For IL1B, only the single reported SNP was assessed. A total of 24 SNPs (7 in IL1A, 1 in IL1B, and 16 in TNF) were individually genotyped. The PLINK software package was used to perform genetic association tests. SETTING Academic research. PATIENTS Canadian population of individuals with severe CRS. MAIN OUTCOME MEASURES Allelic differences between cases and controls. RESULTS Significant allelic differences between cases and controls were obtained for IL1A rs17561 (odds ratio [OR], 1.48; P = .02). The following 3 additional SNPs in this gene were associated with CRS: rs2856838 (OR, 0.63; P = .003), rs2048874 (OR, 0.57; P = .01), and rs1800587 (OR, 1.49; P = .02). These 3 SNPs remained significant after correction for multiple testing. No association was found with IL1B or TNF. CONCLUSIONS We replicated the previously reported association between the IL1A polymorphism and severe CRS and identified 3 potential new associations in the same gene. This further supports the potential contribution of IL1A to the development of CRS. We were unable to replicate previous reports of associations with IL1B or TNF.