Miracle-dz/UniFAR-FTUs huggingface dataset:
Dealing with liver trauma

Bleeding from a traumatic liver injury often ceases spontaneously, which is the basis for non-operative management, currently used in about 80% of patients with blunt hepatic trauma. The selection of patients for non-operative management is based on the assessment of haemodynamic stability and the presence of associated organ injuries requiring surgical repair. In patients requiring surgery, definitive repair is preferred in stable patients with normal tissue perfusion and temperature, and ranges from the use of local haemostats and sutures to non-anatomic hepatic resection and direct repair of juxtahepatic venous injuries. In the most seriously injured patients with major bleeding causing severe physiological derangement, a damage control strategy including perihepatic packing is the treatment method of choice. Adjunctive procedures including hepatic angiography and embolisation are often needed in high-grade liver injuries whether undergoing surgical or non-operative management. The multidisciplinary approach also includes procedures performed for biliary complications, such as percutaneous or endoscopic drainage of bile leaks.
Community pharmacist and technician communication with Spanish-speaking patients: needs assessment.

OBJECTIVES To estimate the prevalence of community pharmacists and technicians who are capable of communicating with patients in Spanish and to estimate the need for Spanish language education initiatives for student pharmacists and pharmacists. DESIGN U.S. census data (2006) were used to stratify states and counties based on Hispanic population densities. Protocols were used for telephone interviews with pharmacists in randomly selected national community pharmacies. RESULTS Of 2,109 pharmacies contacted, 923 participated (43.8%) and 165 (17.9%) reported having at least one full- or part-time Spanish-speaking pharmacist employed. Slightly more than one-third (n = 328; 35.6%) of pharmacies reported having one or more full-time Spanish-speaking technicians on staff. Of respondents, 70% indicated that they would be interested in attending a live (57.8%) or Web-based (62.9%) course to learn basic Spanish terms related to health care. When asked about the need for Spanish language education in pharmacy schools, 22.0% believed that a Spanish for health professionals course should be required, while 77.0% believed the course should be offered as an elective. CONCLUSION Currently, a low proportion of community Spanish-speaking pharmacists and technicians are available to meet the needs of the Spanish-speaking limited English proficiency population in the United States. Pharmacy schools should offer resources to support Spanish language education initiatives. Community pharmacy administrators should provide resources to promote effective communication between pharmacists and their clientele.
Pharmacokinetics and Pharmacodynamics of the New Quinolones

In this review, the authors describe the pharmacokinetic (PK) and pharmacodynamic (PD) characteristics of the new quinolones (levofloxacin, gatifloxacin, moxifloxacin, gemifloxacin, and garenoxacin) and discuss their implications on adequate therapy of patients with respiratory infections. The newer quinolones display excellent bioavailability and have longer serum half-lives than ciprofloxacin. In addition, they have the ability to concentrate in respiratory tract tissues and fluids at levels that exceed serum-drug concentrations. Also, the newer quinolones exhibit broad-spectrum activity against both susceptible and resistant organisms. Those favorable PK/PD properties make the new quinolones an attractive therapeutic alternative to traditional agents for common respiratory infections. Understanding the PK/PD of quinolone antibiotics can facilitate selection of optimal regimens to hasten response, prevent treatment failures, and minimize the development of resistance.
Potential additive effects of garcinia cambogia on atorvastatin treated hyperlipidemic patients: randomized crossover clinical study

Background: Dyslipidemia is a major risk factor linking in the direction of the progression of ischemic heart diseases, which is measured to be the chief principal reason of international morbidity and mortality. Numerous lessons seeming for substitute treatments include attempted herbal medicine for reducing the expansion of ischemic heart and vascular diseases. Along with herbs with hypolipidemic actions were garlic, garcinia cambogia, gum guggul and others plants. Garcinia cambogia is an herbal agent found in different fruit plants inhibit lipid synthesis via its active materials hydroxycitric acid that inhibit cytoplasmic adenosine triphosphate-dependent citrate lyase, which responsible for hepatic lipogenesis in dose dependent manner. Thus, the objective of this experimental research was for elucidation the potential combined effects of atorvastatin and garcinia cambogia resting on lipid profile in hyperlipidemic patients. Methods: A total of 25 hyperlipidemic patients enrolled in this clinical trial under scientific approval committee and spoken consent taken from all patients. Five patients were withdrawn from this study due to incompliance so, only 20 patients (12 males + 8 females) continue this clinical trial. All patients not took any medications through 2 weeks and all non-diabetic or hypertensive with age ranged 45-65 years. The patients divided into two groups: Group A: 10 patients (4 females + 6 males) take atorvastatin 40/day. Group B: 10 patients (6 males + 4 females) take atorvastatin 40/day + garcinia cambogia 500/day. The duration of treatment was 8 weeks, and baseline lipid profile measurements were done and regarded as control. Results: The atorvastatin effects during 8 weeks treatment at dose of 40 mg/day produced significant effects on all lipid profile p 0.05. The combined effects of garcinia cambogia 500 mg/day and atorvastatin 40 mg/day showed significant effects on all lipid profiles and AI p < 0.05. Conclusion: This study scrutinizes the value of garcinia cambogia in treatment of hyperlipidemia alone or in combination with atorvastatin. It produced significant additive effect with atorvastatin and hence atorvastatine doses can be reduced and substituted with garcinia cambogia for reduction serious atorvastatin associated adverse effects.
Folliculotropic mycosis fungoides with extreme pilosebaceous involvement and hematological abnormalities

Folliculotropic mycosis fungoides (fMF) has been defined as a variant of MF with follicular infiltration of atypical lymphoid cells, sparing the interfollicular epidermis [1-4]. We report two patients with fMF who presented with a variety of pilosebaceous manifestations and elevated CD4/CD8 ratios and showed distinct clinical courses.A 65-year-old woman presented with a 6-month history of multiple, discrete, reddish papules and comedones on the face. On examination, numerous reddish, follicular papules [. ]
Effect of pharmacist intervention on herpes zoster vaccination in community pharmacies.

OBJECTIVE To evaluate the effectiveness of community pharmacy-based interventions in increasing vaccination rates for the herpes zoster vaccine. DESIGN Prospective intervention study with a pre-post design. SETTING Three independent community pharmacies in Tennessee, from December 2007 to June 2008. PATIENTS Patients whose pharmacy profiles indicated that they were eligible for the vaccine and patients presenting to receive the vaccine at study sites. INTERVENTION Pharmacists promoted the herpes zoster vaccine through a press release published in local newspapers, a flyer accompanying each prescription dispensed at participating pharmacies, and a personalized letter mailed to patients whose pharmacy profiles indicated that they were eligible for the vaccine. MAIN OUTCOME MEASURES Comparison of vaccination rates for the herpes zoster vaccine during the control and intervention periods and patients' indication for their sources of education and influence in receiving the vaccine. RESULTS Vaccination rates increased from 0.37% (n = 59 of 16,121) during the control period to 1.20% (n = 193 of 16,062) during the intervention period ( P < 0.0001). Cochran-Armitage trend analyses, including the months before and after the interventions, confirmed a significantly higher vaccination rate during the intervention month than other months analyzed. More patients indicated that they were educated about the herpes zoster vaccine by one of the pharmacist-driven interventions than by a physician, family/friend, or other source during the intervention period ( P < 0.0001 for all comparisons). Also, more patients were influenced to receive the vaccination as a result of one of the pharmacist-driven interventions than influenced by a physician ( P = 0.0260) or other source ( P < 0.0001). No difference in the effectiveness of patient influence was found when the pharmacy interventions were compared with family/friends ( P = 0.1025). CONCLUSION Three pharmacist-driven interventions were effective in increasing vaccination rates for the herpes zoster vaccine.
Cutaneous angiosarcoma at an interval of thirty-six years from radiation for a testicular germ cell tumor

Cutaneous angiosarcoma is an aggressive, malignant, vascular tumor [1]. It is commonly subdivided into three forms; classic angiosarcoma of the scalp, face and neck of the elderly; angiosarcoma arising secondary to chronic lymphoedema (Stewart-Treves syndrome); and radiation-induced angiosarcoma. Individuals receiving radiation therapies are required to have periodical examination because angiosarcomas may occur in the applied area. For instance, angiosarcomas are the most frequently found malignant [. ]
Changes in serum desnutrin levels in patients with acne vulgaris

BackgroundAndrogens and insulin may contribute to increased sebum production in the pathogenesis of acne vulgaris.ObjectiveWe investigated the association between serum desnutrin levels and acne vulgaris in the pathogenesis of insulin resistance.Material and methods25 patients presenting with acne vulgaris and 25 control subjects participated in this study. Fasting blood glucose, triglycerides, LDL, VLDL, HDL, total cholesterol, insulin, C-peptide and thyroid function tests were measured. The homeostasis model assessment of insulin resistance (HOMA-IR) was used to calculate insulin resistance. Desnutrin levels were determined by enzyme-linked immunosorbent assay (ELISA) according to the manufacturer’s protocol.ResultsPatients with acne vulgaris had a mean serum desnutrin level of (8.83 ± 1.13 μIU/mL), which was statistically significantly lower in the control group (10:58 ± 3.43 μIU/mL). In patients with acne vulgaris the serum glucose levels, insulin levels and HOMA-IR values (87.92 ± 7:46 mg/dL, 11.33 ± 5.93 μIU/mL, 2.49 ± 1.40, respectively) were significantly higher than the control group (77.36 ± 9.83 mg/dL, 5.82 ± 2.68 μIU/mL, 1.11 ± 0.51, respectively) (p = 0.01, p<0.001, p<0.001, p<0.001, respectively). ConclusionFull cohort (patients and controls) evaluation revealed a negative correlation between the serum glucose and desnutrin levels (r = −0.31, p<0.05). Apositive correlationwas found between insulin and desnutrin levels (r = 0.42, p<0.001). In patients with acne vulgaris, as a result of increased levels of serum glucose and insulin, the function of desnutrin was suppressed, perhaps contributing to insulin resistance.
LOW SERUM ZINC LEVEL IN DPRESSION

BACKGROUND: Major Depressive Disorder (MDD) is a common disorder, with a lifetime prevalence of about 15 percent, perhaps as high as 25 percent for women. The etiology of MDD is too complex to be explained totally by a single social, developmental, or biological theory. A variety of factors appear to work together to cause or precipitate depressive disorders. Various functions have been reported for trace elements such as zink in recovery or exacerbation of depression. METHODS: In this experimental study, we studied 46 patients with MDD based on DSM IV criteria, among the patients referred to mental disorders clininc of Noor Hospital. Twenty Patients were men and 26 were women. Thirty two volunteers of general population were evaluated for depression with Beck depression test who did not show any depressive symptoms with this test. A blood sample of 5cc was obtained from each person and the serum zinc concentration was measured. Data gathered and analyzed with SPSS, logistic regression and chi-squar tests. RESULTS: Serum zinc concentrations were 74 to 130 mg/dl in men and 60 to 128 mg/dl in women of control group. Serum zinc concentration was 30 to 60 mg/dl in depressive patients that it was lower in women than men. The difference between serum zinc concentrations of normal and depressive persons was meaningful (P = 0.02). CONCLUSION: In our study, the serum concentration of zinc was about half of normal value. This study replicates previous findings that major depressed subjects show significantly lowered serum zinc concentration. KEYWORDS: Depression, zinc.
Effect of Yoga Exercise on Metabolic and Homeostatic Parameters of Insulin Resistance

Effect of Yoga Exercise on Metabolic and Homeostatic Parameters of Insulin Resistance The aim of this study is to assess the effect of yoga exercise on the anthropometric parameters and metabolic parameters in individuals regularly exercising yoga as well as to assess the possible impact on cardiovascular risk prevention. The study sample composed of two groups: A (57 healthy control) and B (61 subjects exercised yoga). For each group were measured: blood pressure, body mass index (BMI) and laboratory values of total cholesterol, triglycerides, high density lipoproteins (HDL) and low density lipoproteins (LDL) cholesterol, glycaemia and insulinemia, homeostasis model assessment of insulin resistance (HOMA-IR) and quantitative insulin-sensitivity check index (QUICKI). BMI was significantly lower (p= 0.005923) in the group B (yoga). We found an impact of yoga on the homeostatic indices HOMA-IR and QUICKI and it mens significantly lower value of systolic blood pressure (p= 0.043543) and LDL cholesterol levels (p=0.008714). Based on these outcomes, we consider yoga to be a suitable physical activity to prevent cardiovascular diseases.
Chlamydia trachomatis detection in HIV infected patients using polymerase chain reaction

Introduction: Chlamydia trachomatis is a sexually transmitted organism and causes important public health problem in the sexually active age group. Limited studies are found regarding the prevalence of C. trachomatis in Nepal. Moreover, currently there are no any study in Nepal reporting the association of chlamydia and HIV infection. This study attempts to determine the burden of chlamydia on HIV positive patients. Materials and Methods: A total of 117 HIV positive patients visiting a HIV clinic in Kathmandu, were screened for chlamydia infection. For this, urine samples were collected and analyzed using the Polymerase Chain Reaction Technique (PCR). Results: C. trachomatis was detected in 4.2% of the total 117 HIV patients. Out of positive cases 60% were males and 40% were females. However, chlamydia was found more prevalent among females (6.8%) than males (3.4%). Eighty percent of positive cases were asymptomatic. Conclusions: Although, the prevalence of chlamydia infection was found less HIV patients, most of those cases were asymptomatic. Therefore, routine checkup is recommended for all suspected cases for timely management of the disease. DOI: http://doi.dx. org/10.3126/ijim.v2i1. 8003 Int J Infect Microbiol 2013;2(1):12-16
Separate and Combined Effects of Local and Continuous Intravenous Administration of β-Cyclodextrin Tetradecasulfate on Intimal Hyperplasia after Angioplasty in Porcine Coronary Arteries

Background: Beta-Cyclodextrin tetradecasulfate binds fibroblast growth factors and possesses anticoagulant properties. This study was designed to assess the separate and combined effects of local intramural delivery and intravenous administration of β-cyclodextrin tetradecasulfate on neointimal formation and arterial damage following angioplasty. Methods and Results: Fifty-two pigs randomized into four groups underwent coronary artery angioplasty: 1) control, 2) continuous intravenous infusion of 100 mg/kg/d of β-cyclodextrin tetradecasulfate, 3) intramural delivery of 1250 mg β-cyclodextrin tetradecasulfate, 4) intramural delivery of 1250 mg β-cyclodextrin tetradecasulfate followed by continuous intravenous infusion of 100 mg/kg/d. Fourteen days after injury, morphometric analysis revealed that arteries randomized to the intravenous β-cyclodextrin tetradecasulfate groups had a decreased normalized neointima area: control, 3.03 ± 0.75 mm2; intravenous, 1.67 ± 0.73 mm2 (40% decrease; P < 10-7); intravenous plus local, 1.95 ± 0.76 mm2 (30% decrease; P < 10-5). There was no difference in neointimal response following local β-cyclodextrin tetradecasulfate delivery only (2.82 ± 1.14 mm2). Coronary arterial damage, defined as aneurysm, dissection, adventitial rupture, and retromedial hematoma was similar in all groups (12% in control and local groups, 10% in the intravenous group, 14% in the intravenous plus local; NS). Bleeding complications were more frequent in the intravenous and intravenous plus local groups compared to the local and control groups (23%vs 7.6% and 0%, respectively; P < 0.05). Conclusions: Continuous intravenous administration of β-cyclodextrin tetradecasulfate substantially reduced intimal hyperplasia, while intramural delivery had no effect, indicating that a single bolus of β-cyclodextrin tetradecasulfate did not reduce intimal hyperplasia. There was no additive effect of local intramural delivery of β-cyclodextrin tetradecasulfate. However, local delivery of β-cyclodextrin tetradecasulfate induced less bleeding complications and did not lead to additional arterial injury, indicating that local delivery of an anticoagulant does not cause additional arterial injury.
Counselling in primary care: A 2-year follow-up of outcome and client perceptions

Seventy clients were contacted by post, approximately 2 years after receiving brief counselling in a general practice setting for mental health problems. Among the 41 who replied, clinically significant reductions in anxiety and depression achieved during the six sessions of counselling had been maintained at follow-up. Frequency of visits to the GP had reduced. Counselling was seen as a helpful intervention by 87.8% of respondents. Although some found the process was distressing, and a small proportion felt that six sessions was insufficient, the majority felt that counselling had enduring benefits which had generalised to other problem situations.
Special Care Aides' Attitudes Toward Therapeutic Recreation for the Elderly in Long-Term Care

Abstract There is great interest in enhancing the quality of life for residents in long-term care facilities and, in that regard, therapeutic recreation is receiving substantial attention. In order for residents to benefit from therapeutic recreation, it is important for all professionals in long-term care homes to have positive attitudes and behaviors toward therapeutic recreation. Special Care Aides have the most contact with elderly patients and are the largest segment of staff that works with the aged. Without the cooperation of Special Care Aides, therapeutic recreation activities will not be successful. The purpose of the present study was to examine Special Care Aides and Care Aides attitudes toward therapeutic recreation for the elderly in long-term care homes using Ajzen's (1991) Theory of Planned Behavior. Participants were 78 Special Care Aides and Care Aides from four long-term care homes. The Therapeutic Recreation Attitude Measurement(TRAM), a revised version of the Leisure Attitude Measure, was used to assess attitudes and behaviors toward therapeutic recreation for the elderly. Participants' intention to perform positive behaviors toward therapeutic recreation predicted their behavior. Participants' cognitive attitudes toward therapeutic recreation influenced participants' behavioral intentions. The implications of these findings for advancing the acceptance of therapeutic recreation activities were discussed.
Ten cases of severe oral lichen planus showing granular C3 deposition in oral mucosal basement membrane zone

BackgroundOral lichen planus (OLP) may show depositions of immunoglobulins and complement components in oral mucosal basement membrane zone (BMZ) in direct immunofluorescence, although these finding are not frequently seen.ObjectiveWe collected and examined ten cases of severe OLP showing granular C3 deposition in BMZ.Materials and MethodsIn addition to clinical, histopathological and direct immunofluorescence assessments, we performed various immuneserological tests, including indirect immunofluorescence of normal human skin and 1M NaCl-split skin, immunoblotting of normal human epidermal and dermal extracts, recombinant proteins of BP180 NC16a and C-terminal domains, concentrated culture supernatant of HaCaT cells and purified human laminin-332, and enzyme-linked immunosorbent assays for BP230 and BP180.ResultsDirect immunofluorescence showed C3 deposition in BMZ exclusively of granular pattern in 7 cases and of both granular and linear patterns in 3 cases. The 10 cases showed no positive reactivity for either IgG or IgA antibodies in any immunoserological tests. Detailed analyses of clinical, histopathological and immunological findings revealed striking female prevalence, although other parameters were in general characteristic of OLP.ConclusionsGranular C3 deposition in oral BMZ may be one of the characteristic features of severe OLP, although mechanisms for C3 deposition and its pathogenic role in OLP are currently unknown.
Injection therapy for stress urinary incontinence in adult women.

Stress urinary incontinence (SUI) is prevalent in adult women and has a considerable impact on quality of life. However, it often remains undiagnosed and therefore untreated. Noninvasive treatment is likely to be offered in mild cases and may entail pelvic floor muscle re-education, minimally invasive devices or pharmacotherapy. Surgical intervention is widely considered as the only effective option for more severe SUI, although it is not suitable for all patients. Injection therapy with urethral bulking agents represents an alternative minimally invasive procedure and can be used for all types of SUI. Many bulking agents have been developed, although the ideal remains to be discovered. The safety and durability of agents remain a concern. No differences in agents from an efficacy point of view have been found. For many years urethral injection could only be administered endoscopically. The recent development of devices for blind injection has increased the speed and convenience of urethral injection, rem.