Miracle-dz/UniFAR-FTUs huggingface dataset:
Reversed halo sign in invasive fungal infections: criteria for differentiation from organizing pneumonia.

BACKGROUND The purpose of this study was to identify CT scan findings that differentiate the reversed halo sign (RHS) caused by invasive fungal infection (IFI) from the RHS caused by organizing pneumonia (OP). METHODS We retrospectively reviewed CT scans of patients with RHS caused by IFI or OP. The study included 15 patients with proven or probable IFI (eight men and seven women) and 25 patients with biopsy-proven OP (13 women and 12 men). The CT images were reviewed individually by two chest radiologists who were blinded to the final diagnosis. RESULTS Reticulation inside the RHS was observed in 14 of the 15 patients with IFI (93%) and in no patient with OP. The maximal thickness of the consolidation rim was 2.04 ± 0.85 cm for IFI and 0.50 ± 0.22 cm for OP. Pleural effusion was noted in 11 of the 15 patients with IFI (73%) and in no patient with OP. Other parenchymal abnormalities, such as consolidation and ground-glass and linear opacities, were observed in both groups. The number of lesions showing the RHS did not differentiate IFI and OP. CONCLUSION The presence of reticulation inside the RHS, outer rim thickness > 1 cm, and associated pleural effusion strongly suggest the diagnosis of IFI rather than OP.
Mental Health Services in Nursing Homes: Psychopharmacologic Interventions in Nursing Homes: What Do We Know and Where Should We Go?

Psychiatric symptoms are common among individuals who live in nursing homes, with prevalence rates ranging from 51 percent to 94 percent. Accordingly, psychotropic medications are widely prescribed in this setting and are the subject of considerable debate and regulation. Current regulations arose from public and governmental concerns that psychiatric medications were being prescribed inappropriately to frail patients. Concern has also been raised about the absence of evidence on which to base prescribing decisions. Nursing homes are slowly being recognized as complex health care settings that warrant considerable research attention. This article explores the origins of the regulation of the use of psychotropic drugs in nursing homes, reviews controlled trials of these drugs in nursing homes, examines the role of these agents in adverse drug events experienced by nursing home residents, and proposes policy and research areas that merit consideration.
A produção de conhecimento sobre HIV/AIDS no campo da teoria de representações sociais em 25 anos da epidemia

This is a exploratory, descriptive and quantitative research. Its objective is to identify and to analyze the scientific production about social representations related to the HIV/AIDS, in dissertations, thesis and articles. The virtual databases searched were: CAPES, BIREME, USP and UFRJ, with the criteria: to present the terms HIV and/or AIDS and the expression social representation or social representations in the abstracts; to be published between 1980 and 2006; in the languages portuguese, spanish and english. The majority of the studies analyzed were published between 2001 and 2006, with the largest quantitative of productions in the nursing field. The largest of the group studied were patients with HIV or AIDS and adolescents. The locations for data collection most used were the school and the hospital. The predominant themes were “social representation about HIV/AIDS”, “prevention of HIV/AIDS” and “living with the HIV/AIDS”. Its concluded that there is a growing interest of researchers in the psychosocial approach of the social representations and HIV/AIDS, defining a scientific response to the HIV/AIDS epidemic. Key words : Nursing; Nursing Research; HIV; Acquired Immunodeficiency Syndrome.
Evaluation of vaccination with a commercial subunit vaccine on shedding of Salmonella enterica in subclinically infected dairy cows.

OBJECTIVE To estimate the efficacy of a commercially available Salmonella enterica subunit vaccine on the subclinical shedding of S enterica in dairy cattle. DESIGN Randomized, controlled trial. ANIMALS 175 mature cows on 2 dairy farms with a history of S enterica infection. PROCEDURES 25% of the mature cows from each herd were systematically randomized to receive an S enterica subunit vaccine following label guidelines. The remaining 75% of cows in each herd served as nonvaccinated controls. Fecal samples were collected from all cows at the time of initial vaccination (day 0), booster vaccination (day 14), 2 weeks following the booster vaccination (day 28), and 10 weeks following the start of the trial (day 70). All samples were processed on the day of collection and cultured for S enterica. RESULTS 651 fecal samples were obtained over the entire study period. Salmonella enterica was recovered from 46 (7.1%) of the samples. Shedding of S enterica was similar for vaccinated and nonvaccinated control cows on each of the collection dates. CONCLUSIONS AND CLINICAL RELEVANCE The study revealed no evidence that extralabel vaccination with a commercial subunit S enterica vaccine reduced shedding of S enterica in subclinically infected dairy cows in these herds.
The Contribution of Traditional Herbal Medicine Practitioners to Kenyan Health Care Delivery Results from Community Health-Seeking Behavior Vignettes and a Traditional Herbal Medicine Practitioner Survey

This study examines the role that Traditional Herbal Medicine Practitioners (THMPs) play in Kenya in the context of its human resources for health crisis. Two surveys were carried out to obtain evidence. The first documented the choices and perceptions of households in 36 communities on seeking medical assistance for eight common illnesses. The second survey asked 258 THMPs in five provinces to identify their knowledge sources, training, common illnesses treated, forms of payment, challenges, and concerns. Community-derived data show that households make reasonable decisions when faced with difficult circumstances: they prefer hospitals when these are affordable and seek care at clinics and health centers when hospitals are too far away. There is significant self-care and use of pharmacies, although THMPs are preferred for worms and lower respiratory problems. In general, THMPs provide an important though diminishing role in the provision of health care; they are not sought out in situations when inadequate care is dangerous, specifically infant diarrhoea and potential TB. Whilst Human Resources for Health (HRH) policies are urgently required to strengthen the conventional health workforce and increase their accessibility for the poor, policies should not ignore the findings from this study: many of the rural poor currently receive services from a traditional health workforce not linked to, or regulated by, the national government. This paper argues that formal recognition of their role by the government and by the conventional medical associations, and a targeted strategy to strengthen and build on the positive qualities evident in many traditional medicine practices may be beneficial to safeguarding the well-being of the poor.
KAP study on the assessment of needlestick injuries and occupational safety among health-care workers

Results: It was found that 64% participants experienced NSI at least once during the past 3 months. Of participants, 55% were vaccinated for hepatitis B whereas the rest were not vaccinated or did not complete the entire schedule. An NSI was experienced by 60.9% of participants during recapping of needle; 56.2% of HCW reported the incident to the infection control staff Conclusion: In addition to very high rates of NSIs, low safety practices including inadequate vaccination coverage, unavailability of infection control guidelines, and other preventive facilities were reported in this study. Formal training by health authorities in the local area about safe practices and availability of preventive facilities should be ensured regarding NSIs among HCWs
Prevalence and factors associated with depressive symptoms among Yoruba adults in a semi-urban community in South-Western Nigeria -

Background: Previous cross-cultural and mono-cultural studies have reported the prevalence of depressive symptoms to vary across different populations and ethnic groups. Research on prevalence and factors associated with depressive symptoms among adults in the different geopolitical regions of Nigeria is sparse, despite the differences in sociocultural attribute. Aim: The aim was to assess the prevalence and factors associated with depressive symptoms among Yoruba adults in South-Western Nigeria. Methods: Data on 200 Yoruba adults residing in Ile-Ife, Nigeria were collected using a questionnaire composed of socio-demographic data, quality of life (QoL), overall health, perceived stress, and depressive symptoms. Results: The prevalence of depressive symptoms among the respondents was 17.0% (male = 15.9%, female = 18.3%). The depressed respondents reported higher mean scores on all items of the Zung’s self-rating depression scale compared to the non-depressed except in suicidal rumination. Smoking of tobacco was significantly associated depression (P < 0.025). The non-depressed respondents reported significant higher mean scores on overall QoL and overall health compared to the depressed respondents (P < 0.001). However, depressed respondents reported significant higher perceived stress when compared to the non-depressed (P < 0.001). The predictors of depressive symptoms were perceived stress (odds ratio [OR] = 1.409, 95% confidence interval [CI] = 1.167-1.702) and overall health (OR = 0.288, 95% CI = 0.130-0.638). Conclusion: Prevalence of depressive symptoms is high among our sample and factors that significantly predicted it includes high perceived stress and poor self-rated overall health. The findings in this study support the development of interventional strategies targeted specifically at ameliorating stress levels and improving general health at the level of the community.
Reduction of peripherally inserted central catheter-associated DVT.

BACKGROUND As peripherally inserted central catheter (PICC) use has increased, so has the upper extremity DVT rate. PICC diameter may pose the most modifiable risk for PICC-associated DVT. METHODS A 3-year, prospective, observational study of all PICC insertions by a specially trained and certified team using a consistent and replicable approach was conducted at a 456-bed, level I trauma and tertiary referral hospital during January 1, 2008, through December 31, 2010. An intensified effort by the PICC team in 2010 was introduced to discuss and reach interdisciplinary consensus on the need for each lumen of the PICC and a change to smaller diameter 5F triple-lumen PICC. RESULTS Significantly more 4F single-lumen PICCs were used during 2010 (n = 470) compared with 2008 and 2009 (n = 338, 382; P < .0001). DVT rates were similar with the use of 5F triple-lumen PICCs in 2010 as 5F double-lumen PICCs and lower rates than 6F triple-lumen catheters used in 2008 and 2009. The PICC-associated DVT rate was significantly lower (1.9% vs 3.0%, P < .04) in 2010 compared with 2008 and 2009. The cost and length of stay attributable to PICC-associated DVT were $15,973 and 4.6 days. CONCLUSIONS A significant increase in the use of single-lumen PICCs in addition to the institutional adoption of smaller 5F triple-lumen PICCs was associated with a significant decrease in the rate of PICC-associated DVT.
Composition, disintegrative properties, and labeling compliance of commercially available taurine and carnitine dietary products.

OBJECTIVE To test the quality, disintegration properties, and compliance with labeling regulations for representative commercially available taurine and carnitine dietary products. DESIGN Evaluation study. SAMPLE POPULATION 11 commercially available taurine and 10 commercially available carnitine products. PROCEDURES For each product, the amount of taurine or carnitine was determined and compared with the label claim. All products were evaluated for concentrations of mercury, arsenic, and selenium. Disintegration properties of 5 taurine and 8 carnitine products were determined in vitro. Labels were evaluated for compliance with FDA guidelines. RESULTS 10 of 11 taurine and 10 of 10 carnitine products were within 10% of the stated label claim. Three of 11 taurine and 6 of 10 carnitine products were within 5% of the stated label claim. The median percentage difference between laboratory analysis and label claim was -5.7% (range, -26.3% to 2.5%) for taurine and 3.6% (range, -2.6% to 8.8%) for carnitine. No substantial amount of contamination with mercury, arsenic, or selenium was found in any of the products. During disintegration testing, 1 of 5 taurine products and 5 of 8 carnitine products did not disintegrate within 45 minutes during at least 1 test. Disintegration time for those that did disintegrate ranged from 1.7 to 37.0 minutes. All product labels conformed with FDA regulations. CONCLUSIONS AND CLINICAL RELEVANCE Taurine and carnitine products evaluated in this study closely adhered to manufacturer claims and labeling guidelines. However, disintegration testing suggested high variability in some products, possibly limiting uptake and use by animals that receive them.
The association between smoking quantity and lung cancer in men and women.

BACKGROUND Studies have shown that for the same quantity of cigarettes smoked, women are more likely to develop heart disease than men, but studies in lung cancer have produced conflicting results. We studied the association between smoking quantity and lung cancer in men and women. METHODS Using data from The Health Improvement Network (a UK medical research database), we generated a data set comprising 12,121 incident cases of lung cancer and 48,216 age-, sex-, and general practice-matched control subjects. We used conditional logistic regression to calculate ORs for lung cancer according to highest-ever-quantity smoked in men and women separately. RESULTS The odds of lung cancer in women who had ever smoked heavily compared with those who had never smoked were increased 19-fold (OR, 19.10; 95% CI, 16.98-21.49), which was more than for men smoking the same quantity (OR, 12.81; 95% CI, 11.52-14.24). There was strong evidence of a difference in effect of quantity smoked on lung cancer between men and women (interaction P < .0001), which remained after adjusting for height (a proxy marker for lung volume). CONCLUSIONS Moderate and heavy smoking carry a higher risk of lung cancer in women than in men, and this difference does not seem to be explained by lung volume. The findings suggest that extrapolating risk estimates for lung cancer in men to women will underestimate the adverse impact of smoking in women.
IgE-mediated immune responses and airway detection of Aspergillus and Candida in adult cystic fibrosis.

BACKGROUND The recovery of Aspergillus and Candida from the respiratory secretions of patients with cystic fibrosis (CF) is common. Their relationship to the development of allergic sensitization and effect on lung function has not been established. Improved techniques to detect these organisms are needed to increase knowledge of these effects. METHODS A 2-year prospective observational cohort study was performed. Fifty-five adult patients with CF had sputum monitored for Aspergillus by culture and real-time polymerase chain reaction and Candida by CHROMagar and carbon assimilation profile (API/ID 32C). Skin prick tests and ImmunoCAP IgEs to a panel of common and fungal allergens were performed. Lung function and pulmonary exacerbation rates were monitored over 2 years. RESULTS Sixty-nine percent of patient sputum samples showed chronic colonization with Candida and 60% showed colonization with Aspergillus. There was no association between the recovery of either organism and the presence of specific IgE responses. There was no difference in lung function decline for patients with Aspergillus or Candida colonization compared with those without (FEV₁ percent predicted, P = .41 and P = .90, respectively; FVC % predicted, P = .87 and P = .37, respectively). However, there was a significantly greater decline in FEV1 and increase in IV antibiotic days for those sensitized to Aspergillus (FEV₁ decline, P = .03; IV antibiotics days, P = .03). CONCLUSIONS Allergic sensitization is not associated with recovery of Candida or Aspergillus from the sputum of patients with CF. Aspergillus but not Candida sensitization is associated with greater lung function decline and pulmonary exacerbations.
Comparison of ultrasonography versus radiography for the diagnosis of dorsal fragmentation of the metacarpophalangeal or metatarsophalangeal joint in horses.

OBJECTIVE To compare clinical usefulness of ultrasonography versus radiography for detection of fragmentation of the dorsal aspect of the metacarpophalangeal (MCP) and metatarsophalangeal (MTP) joints in horses. DESIGN Cross-sectional study. ANIMALS 36 horses with fragmentation of the MCP (n = 19) and MTP (29) joints. PROCEDURES In all joints, radiography (4 standard projections) and ultrasonography were performed prior to arthroscopic examination and fragment removal. Number and location of fragments identified radiographically and ultrasonographically were compared with arthroscopic findings. RESULTS Radiographic and arthroscopic findings were in agreement with respect to both number and location of fragments in 21 of the 48 (44%) joints. Ultrasonographic and arthroscopic findings were in agreement with respect to number and location of fragments for 46 of the 48 (96%) joints. In the remaining 2 joints, arthroscopy revealed additional fragments that were not identified ultrasonographically. When ultrasonographic findings were compared with radiographic findings, more fragments were seen ultrasonographically in 3 joints and fewer fragments were seen ultrasonographically in 1 joint. Ultrasonographic findings also confirmed the absence (4 joints) or presence (3 joints) of fragmentation at the dorsoproximal aspect of the joint that had been suspected on the basis of radiographic findings. Ultrasonography was also able to determine the location of the fragments in the joints where this was not possible radiographically. CONCLUSIONS AND CLINICAL RELEVANCE Results of the present study suggested that ultrasonography was a useful method for determining the number and location of fragments in horses with dorsal fragmentation of the MCP or MTP joint.
Water-flow variation and pharmacoepidemiology of tetracycline hydrochloride administration via drinking water in swine finishing farms.

OBJECTIVE To evaluate variation of drinking-water flow rates in swine finishing barns and the relationship between drinker flow rate and plasma tetracycline concentrations in pigs housed in different pens. DESIGN Cross-sectional (phase 1) and cohort (phase 2) studies. SAMPLE POPULATION 13 swine finishing farms (100 barns with 7,122 drinkers) in phase 1 and 100 finishing-stage pigs on 2 finishing farms (1 barn/farm) in phase 2. PROCEDURES In phase 1, farms were evaluated for water-flow variation, taking into account the following variables: position of drinkers within the barn, type of drinker (swing or mounted), pig medication status, existence of designated sick pen, and existence of leakage from the waterline. In phase 2, blood samples were collected from 50 pigs/barn (40 healthy and 10 sick pigs) in 2 farms at 0, 4, 8, 24, 48, and 72 hours after initiation of water-administered tetracycline HCl (estimated dosage, 22 mg/kg [10 mg/lb]). Plasma tetracycline concentrations were measured via ultraperformance liquid chromatography. RESULTS Mean farm drinker flow rates ranged from 1.44 to 2.77 L/min. Significant differences in flow rates existed according to drinker type and whether tetracycline was included in the water. Mean drinker flow rates and plasma tetracycline concentrations were significantly different between the 2 farms but were not different between healthy and sick pigs. The plasma tetracycline concentrations were typically < 0.3 microg/mL. CONCLUSIONS AND CLINICAL RELEVANCE Many factors affected drinker flow rates and therefore the amount of medication pigs might have received. Medication of pigs with tetracycline through water as performed in this study had questionable therapeutic value.
Interobserver variability in grading transbronchial lung biopsy specimens after lung transplantation.

BACKGROUND Acute rejection remains a major source of morbidity after lung transplantation. Given the importance of this diagnosis, an international grading system was developed to standardize the diagnosis of acute lung-allograft rejection. The reliability of this grading system has not been adequately assessed by previous studies. METHODS We examined the level of agreement in grading transbronchial biopsy specimens obtained from a large multicenter study (AIRSAC [Comparison of a Tacrolimus/Sirolimus/Prednisone Regimen vs Tacrolimus/Azathioprine/Prednisone Immunosuppressive Regimen in Lung Transplantation] trial). Biopsy specimens were initially graded for acute rejection and lymphocytic bronchiolitis by the site pathologist and subsequently graded by a central pathologist. Reliability of interobserver grading was evaluated using Cohen κ coefficients. RESULTS A total of 481 transbronchial biopsy specimens were graded by both the site and central pathologists. The overall concordance rates were 74% and 89% for grade A and grade B biopsy specimens, respectively. When samples from biopsies performed at different time points after transplantation were assessed, there was a higher level of agreement early (≤ 6 weeks) after transplant compared with later time points for acute rejection. However, there was still only moderate agreement for both grade A (κ score 0.479; 95% CI, 0.29-0.67) and grade B (κ score 0.465; 95% CI, 0.08-0.85) rejection. CONCLUSIONS These results expand upon previous reports of interobserver variability in grading transbronchial biopsy specimens after lung transplantation. Given the variability in grading these specimens, we advocate further education of the histopathologic findings in lung transplant biopsy specimens, as well as revisiting the current criteria for grading transbronchial biopsy specimens to improve concordance among lung transplant pathologists. TRIAL REGISTRY ClinicalTrials.gov; No. NCT00321906; URL: www.clinicaltrials. gov.
Effect of lameness on sow longevity.

OBJECTIVE To analyze the association of lameness and performance variables on sow longevity by use of time-to-event analysis. DESIGN Cohort study. ANIMALS 674 sows from a commercial breeding herd. PROCEDURES A lameness assessment was performed on each sow. Data on farrowing performance and longevity were collected for the sows during 3 or fewer parities from the database of the herd during 2005 and 2006. The association of risk factors with sow longevity within 350 days after lameness assessment was analyzed via Cox regression analysis. Pigs per day, total production days, and survival at 350 days after lameness evaluation were compared between lame and nonlame sows. RESULTS Numbers of preweaning baby pig deaths, stillborn pigs, and mummified pigs were negatively associated with sow longevity within 350 days after lameness assessment. A higher number of pigs born alive and younger parity of sows were protective. Lame sows had a higher risk (1.710 times as high) of removal from the herd within 350 days after lameness assessment. The number of pigs born alive per day, survival of sows at 350 days, and total number of days in the herd were lower in lame sows. CONCLUSIONS AND CLINICAL RELEVANCE Results of this study indicated significant differences in the survivability of lame and nonlame sows in a commercial herd. Parity and farrowing performance variables were factors influencing sow longevity in this herd. Producers need to minimize sow lameness and remove lame sows from a herd early (when treatment is not an option) to minimize economic loss.