Miracle-dz/UniFAR-FTUs huggingface dataset:
Le risque cardiovasculaire au cours des traitements antirétroviraux

Depuis l’avenement des inhibiteurs de protease dans l’arsenal des anti‐retroviraux, le pronostic de l’infection par le VIH a ete transforme et la morbi‐mortalite s’est effondree. Des lors, l’augmentation de l’esperance de vie a ete contemporaine de l’apparition d’effets indesirables, en particulier metaboliques. Parallelement, des cas de complications cardiovasculaires precoces ont ete decrits. Malgre des etudes epidemiologiques discordantes, des donnees prospectives recentes indiquent que l’incidence des infarctus du myocarde est en progression et suggerent l’existence d’une atherosclerose acceleree. De fait, ces patients presentent des troubles metaboliques potentiellement atherogenes, une prevalence accrue du tabagisme, un etat inflammatoire chronique et un allongement du temps d’exposition a ces differents facteurs de risque cardiovasculaire. Si le risque coronarien absolu de cette population reste faible par rapport aux benefices des traitements antiretroviraux, il est justifie de sensibiliser patients et soignants afin de depister et traiter preventivement les sujets les plus a risque des a present.
Interventions for preventing infectious complications in haemodialysis patients with central venous catheters.

BACKGROUND Central venous catheters (CVC) continue to play a prominent role in haemodialysis vascular access with 46% to 70% of patients commencing haemodialysis via a CVC. CVC access is associated with catheter-related infections, increased patient hospitalisations and death due to infection. A variety of interventions are used to prevent CVC infection. OBJECTIVES To evaluate the benefits and harms of prophylactic topical antimicrobials, topical antiseptics, medicated and non-medicated dressings on infectious complications among haemodialysis patients with CVC. SEARCH STRATEGY We searched the Cochrane Renal Group's specialised register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE and reference lists of articles without language restriction. SELECTION CRITERIA We included randomised controlled trials (RCTs) and quasi-RCTs investigating any intervention that prevented infectious complications among haemodialysis patients with CVC. We excluded antimicrobial impregnated CVC or CVC using locking solutions with antimicrobial properties. DATA COLLECTION AND ANALYSIS Two authors assessed study quality and extracted data. Dichotomous outcomes were expressed as risk ratios (RR) with 95% confidence intervals (CI) and continuous outcomes as mean differences (MD). MAIN RESULTS Ten studies (786 patients) were included. Mupirocin ointment reduced the risk of catheter-related bacteraemia (RR 0.17, 95%CI 0.07 to 0.43) and had a significant effect on catheter-related infections caused by S. aureus. The risk of catheter-related bacteraemia was reduced by polysporin (RR 0.40, 95%CI 0.19 to 0.86) and povidone-iodine ointment (RR 0.10, 95%CI 0.01 to 0.72). Subgroup analysis suggested mupirocin (RR 0.12, 95%CI 0.01 to 2.13) and povidone-iodine ointment (RR 0.84, 95%CI 0.24 to 2.98) had no effect on all-cause mortality while polysporin ointment showed a significant reduction (RR 0.22, 95%CI 0.07 to 0.74). Mortality related to infection was not reduced by mupirocin, polysporin or povidone-iodine ointment. Topical honey did not reduce the risk of exit site infection (RR 0.45, 95%CI 0.10 to 2.11) or catheter-related bacteraemia (RR 0.80, 95%CI 0.37 to 1.73). Transparent polyurethane dressing compared to dry gauze dressing did not reduce the risk of CVC or exit site infection, or catheter-related bacteraemia. AUTHORS' CONCLUSIONS Mupirocin ointment appears effective in reducing the risk of catheter-related bacteraemia. Insufficient reporting on mupirocin resistance was noted and needs to be considered in future studies. A lack of high quality data on the routine use of povidone-iodine ointment, polysporin ointment and topical honey warrant larger RCTs. Insufficient data were available to determine which dressing type (transparent polyurethane or dry gauze dressing) has the lowest risk of catheter-related infections.
Music during caesarean section under regional anaesthesia for improving maternal and infant outcomes.

BACKGROUND Evidence on the benefits of music during caesarean section under regional anaesthesia to improve clinical and psychological outcomes for mothers and infants has not been established. OBJECTIVES To evaluate the effectiveness of music during caesarean section under regional anaesthesia for improving clinical and psychological outcomes for mothers and infants. SEARCH STRATEGY We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (30 September 2008). SELECTION CRITERIA We included randomised controlled trials comparing music added to standard care during caesarean section under regional anaesthesia to standard care alone. DATA COLLECTION AND ANALYSIS Two review authors, Malinee Laopaiboon and Ruth Martis, independently assessed eligibility, risk of bias in included trials and extracted data. We analysed continuous outcomes using a mean difference (MD) with a 95% confidence interval (CI). MAIN RESULTS One trial involving 76 women who planned to have their babies delivered by caesarean section met the inclusion criteria, but data were available for only 64 women. This trial was of low quality with unclear allocation concealment and only a few main clinical outcomes reported for the women. The trial did not report any infant outcomes. It appears that music added to standard care during caesarean section under regional anaesthesia had some impact on pulse rate at the end of maternal contact with the neonate in the intra-operative period (MD -7.50 fewer beats per minute, 95% CI -14.08 to -0.92) and after completion of skin suture for the caesarean section (MD -7.37 fewer beats per minute, 95% CI -13.37 to -1.37). There was also an improvement in the birth satisfaction score (maximum possible score of 35) (MD of 3.38, 95%CI 1.59 to 5.17). Effects on other outcomes were either not significant or not reported in the one included trial. AUTHORS' CONCLUSIONS The findings indicate that music during planned caesarean section under regional anaesthesia may improve pulse rate and birth satisfaction score. However, the magnitude of these benefits is small and the methodological quality of the one included trial is questionable. Therefore, the clinical significance of music is unclear. More research is needed to investigate the effects of music during caesarean section under regional anaesthesia on both maternal and infant outcomes, in various ethnic pregnant women, and with adequate sample sizes.
Acupuncture and assisted reproductive technology.

BACKGROUND Acupuncture is commonly undertaken during an assisted reproductive technology (ART) cycle although its role in improving live birth and pregnancy rates is unclear. OBJECTIVES To determine the effectiveness and safety of acupuncture as an adjunct to ART cycles for male and female subfertility. SEARCH METHODS All reports which described randomised controlled trials of acupuncture in assisted conception were obtained through searches of the Menstrual Disorders and Subfertility Group Specialised Register, CENTRAL, Ovid MEDLINE, EMBASE, CINAHL (Cumulative Index to Nursing & Allied Health Literature), AMED , www.clinicaltrials. gov (all from inception to July 2013), National Research Register, and the Chinese clinical trial database (all to November 2012). SELECTION CRITERIA Randomised controlled trials of acupuncture for couples who were undergoing ART, comparing acupuncture treatment alone or acupuncture with concurrent ART versus no treatment, placebo or sham acupuncture plus ART for the treatment of primary and secondary infertility. Women with medical illness that was deemed to contraindicate ART or acupuncture were excluded. DATA COLLECTION AND ANALYSIS Twenty randomised controlled trials were included in the review and nine were excluded. Study selection, quality assessment and data extraction were performed independently by two review authors. Meta-analysis was performed using odds ratio (OR) and 95% confidence intervals (CI). The outcome measures were live birth rate, clinical ongoing pregnancy rate, miscarriage rate, and any reported side effects of treatment. The quality of the evidence for the primary outcome (live birth) was rated using GRADE methods. MAIN RESULTS This updated meta-analysis showed no evidence of overall benefit of acupuncture for improving live birth rate (LBR) regardless of whether acupuncture was performed around the time of oocyte retrieval (OR 0.87, 95% CI 0.59 to 1.29, 2 studies, n = 464, I(2) = 0%, low quality evidence) or around the day of embryo transfer (ET) (OR 1.22, 95% CI 0.87 to 1.70, 8 studies, n = 2505, I(2) = 69%, low quality evidence). There was no evidence that acupuncture had any effect on pregnancy or miscarriage rates, or had significant side effects. AUTHORS' CONCLUSIONS There is no evidence that acupuncture improves live birth or pregnancy rates in assisted conception.
Workplace interventions for preventing work disability

Work disability has serious consequences for all stakeholders and society. Workplace interventions are considered appropriate to facilitate return to work by reducing barriers to return to work, involving the collaboration of key stakeholders. The aim of this review is to determine the effectiveness of workplace interventions compared to usual care or clinical interventions on work-related outcomes and health outcomes; and to evaluate whether the effects differ when applied to musculoskeletal disorders, mental health problems, or other health conditions.
The Study of Harmful and Beneficial Drug Interactions in Intensive Care, Kerman, Iran

Since multidrug therapy is common in the intensive care unit (ICU), the risk of drug interactions is high. This study aimed to examine the prevalence of drug interactions and risk factors in patients who were admitted to ICUs. In a cross-sectional study, the medication flow sheet of 101 patients was investigated in terms of the number and the type of drug interactions. The Drug Interaction Facts reference text book (2010 edition) was used to determine the type and the number of drug interactions. In total, 609 potential drug interactions were found. The mean number of drug interactions per patient was 6.1 (SD=5.6). Of all observed drug interactions, 66.9% were classified as harmful and 33.1% beneficial. In terms of the nature of interactions, delayed, moderate, and possible were the most common types. The most frequent harmful interaction was between phenytoin and omeprazole (63 occasions). Critically ill patients are at a higher risk of drug interactions. Although 33.1% of the drug interactions were considered beneficial, medical teams should be aware that even beneficial interactions can have undesirable side-effects in the critically ill.
Generalization of practical stability for delay differential equations with respect to initial time difference

A new definition of a stability nonlinear delay differential equations is introduced and studied. This type of stability generalizes the known in the literature practical stability and it is a generalization in two directions – the behavior of two nonzero solutions are compared; – the solutions are with different initial data – different initial time intervals as well as different initial functions. The introduced concept of stability is an extension of the studied up today types of stability and it gives a new tool for more adequate investigating of real world problems in science, engineering, technologies. Several sufficient conditions are obtained. Lyapunov functions as well as comparison results for scalar ordinary differential equations have been employed.
Relevance of Spatial Heterogeneity of Immune Infiltration for Predicting Risk of Recurrence After Endocrine Therapy of ER+ Breast Cancer

Background Despite increasing evidence supporting the clinical utility of immune infiltration in the estrogen receptor-negative (ER-) subtype, the prognostic value of immune infiltration for ER+ disease is not well defined. Methods Quantitative immune scores of cell abundance and spatial heterogeneity were computed using a fully automated hematoxylin and eosin-stained image analysis algorithm and spatial statistics for 1178 postmenopausal patients with ER+ breast cancer treated with five years' tamoxifen or anastrozole. The prognostic significance of immune scores was compared with Oncotype DX 21-gene recurrence score (RS), PAM50 risk of recurrence (ROR) score, IHC4, and clinical treatment score, available for 963 patients. Statistical tests were two-sided. Results Scores of immune cell abundance were not associated with recurrence-free survival. In contrast, high immune spatial scores indicating increased cell spatial clustering were associated with poor 10-year, early (0-5 years), and late (5-10 years) recurrence-free survival (Immune Hotspot: LR-χ2 = 14.06, P < .001, for 0-10 years; LR-χ2 = 6.24, P = .01, for 0-5 years; LR-χ2 = 7.89, P = .005, for 5-10 years). The prognostic value of spatial scores for late recurrence was similar to that of IHC4 and RS in both populations, but was not as strong as other tests in comparison for recurrence across 10 years. Conclusions These results provide a missing link between tumor immunity and disease outcome in ER+ disease by examining tumor spatial architecture. The association between spatial scores and late recurrence suggests a lasting memory of protumor immunity that may impact disease progression and evolution of endocrine treatment resistance, which may be exploited for therapeutic advances.
Personalizing Survival Predictions in Advanced Colorectal Cancer: The ARCAD Nomogram Project

Background Estimating prognosis on the basis of clinicopathologic factors can inform clinical practice and improve risk stratification for clinical trials. We constructed prognostic nomograms for one-year overall survival and six-month progression-free survival in metastatic colorectal carcinoma by using the ARCAD database. Methods Data from 22 674 patients in 26 randomized phase III clinical trials since 1997 were used to construct and validate Cox models, stratified by treatment arm within each study. Candidate variables included baseline age, sex, body mass index, performance status, colon vs rectal cancer, prior chemotherapy, number and location of metastatic sites, tumor mutation status (BRAF, KRAS), bilirubin, albumin, white blood cell count, hemoglobin, platelets, absolute neutrophil count, and derived neutrophil-to-lymphocyte ratio. Missing data (<11%) were imputed, continuous variables modeled with splines, and clinically relevant pairwise interactions tested if P values were less than . 001. Final models were internally validated via bootstrapping to obtain optimism-corrected calibration and discrimination C-indices, and externally validated on a 10% holdout sample from each trial (n = 2257). Results In final models, all included variables were associated with overall survival except for lung metastases, and all but total white cell count associated with progression-free survival. No clinically relevant pairwise interactions were identified. Final nomogram calibration was good (C = 0.68 for overall and C = 0.62 for progression-free survival), as was external validity (concordance between predicted >50% vs < 50% probability) and actual (yes/no) survival (72.8% and 68.2% concordance, respectively, for one-year overall and six-month progression-free survival, between predicted [>50% vs < 50% probability] and actual [yes/no] overall and progression-free survival). Median survival predictions fell within the actual 95% Kaplan-Meier confidence intervals. Conclusions The nomograms are well calibrated and internally and externally valid. They have the potential to aid prognostication and patient-physician communication and balance risk in colorectal cancer trials.
Is Maternal and Child Health Handbook effective? : Meta-Analysis of the Effects of MCH Handbook

Abstract Background: Maternal and child health handbook (MCHH) consists of records of pregnancy, delivery, child development and immunization, as well as child growth charts. MCHH has been utilized in Japan since 1947 and it is now introduced in more than 20 countries in the world. Objectives: The objectives of this study were to collect research documents and reports in the past studies of MCHH and to analysis the effect of MCHH on maternal and child health through systematic review. Methods: The systematic searches were conducted for the studies published between 1980 and October 2011. After the initial screening of titles and abstracts of the studies, we reviewed 57 documents which were studied for MCHH in maternal and child health (MCH) programs or activities. After the final selection, we identified only 5 documents with 43 question items in Indonesia (1999 and 2001), Bangladesh (2003), the Philippines (2009) and Cambodia (2010). Results: The relationship between MCHH and pregnancy care revealed that mothers who used MCHH during pregnancy had higher level of knowledge (OR 1.44, 95% CI: 1.22-1.70) than whose did not use MCHH during pregnancy. The strong significant effects of MCHH were observed in knowledge of antenatal care visit (OR 1.86, 95% CI: 1.59-2.18), and mother should consume more food during pregnancy (OR 1.97, 95% CI: 1.37-2.83). Mothers who got MCHH during pregnancy had safer practice by skilled birth attendants (OR 1.12, 95% CI: 0.95-1.32) and delivered in health facilities (OR 1.31, 95% CI: 1.12-1.53). MCHH showed the effect of knowledge of child health care (OR 1.22, 95% CI; 1.05-1.41). Discussion: This study utilizing meta-analyses showed MCHH had higher association with knowledge of mothers than practice in pregnancy and child health care, although the study has its limitation. The illumination of the relationship between knowledge and practice by the effect of MCHH needs more quantitative analysis in both community and hospital settings in many countries.
Epidemiological correlates of nutritional anemia in adolescent girls of rural Wardha.

The objectives were to study the epidemiological correlates of nutritional anemia among adolescent girls in rural Wardha. A cross-sectional study was carried out in adolescent girls of four villages of Kasturba Rural Health Training Centre Anji. The relevant information was collected with anthropometric measurements and hemoglobin estimation. Univariate and Multivariate Logistic Regression analysis was done using SPSS 10. The prevalence of anemia was found to be 59.8%. In univariate analysis low socioeconomic status low iron intake vegetarian diet history of worm infestation and history of excessive menstrual bleeding showed significant association with anemia. While Multivariate logistic regression analysis suggested that strongest predictor of anemia was vegetarian diet (OR=5.83 CI=3.73-9.13) followed by history of excessive menstrual bleeding (OR=5.65 CI=1.26-25.38) iron intake <14mg (OR=4.16 CI=2.08-8.31) followed by 14-20mg (OR=2.07 CI=1.06-4.05) and history of worm infestation (OR=4.11 CI=1.70-9.93). However age education socioeconomic status BMI and status of menarche did not contribute significantly. (authors)
Is there a relation between clinical disease activity and acute phase response in Behcet's disease?

The aim of this study was to evaluate a possible relation between clinical disease activity determined by a scale validated and most widely used acute phase response parameters in patients with Behcet's Disease (BD). One hundred patients with BD were included in this study. The demographic properties including age, sex, and disease durations were recorded. BD Current Activity Form (BDCAF), which scores the history of clinical features that have been present during the four weeks prior to the day of assessment, was used for the evaluation of disease activity. Erythrocyte sedimentation rate (ESR) and C‐reactive protein (CRP) levels were evaluated as acute phase response. The independent samples t test and Pearson's correlation test were performed for the statistical analysis. There were 60 male and 40 female patients with an age range of 19–51 years. The disease durations of the patients were between 12 and 240 months. In the comparison of the laboratory parameters of the patients with or without the components of BDCAF, we found significantly higher levels of ESR and CRP in patients with erythema and arthralgia‐arthritis versus without these involvements. There were significant positive correlations between ESR‐CRP levels and patient's perception of disease activity (P = 0.012 and P < 0.05, respectively), clinician's overall perception of disease activity (P < 0.005), and total BDCAF score (P = 0.008 and P < 0.000, respectively). In conclusion, the presence of a newly‐developed erythema nodosum, superficial thrombophlebitis, or joint involvement may be associated with higher levels of ESR and CRP. Also, correlations between these indices and general disease activity scores may contribute the overall disease activity perception in BD.
Interventions for preventing excessive weight gain during pregnancy.

BACKGROUND Excessive weight gain during pregnancy is associated with multiple maternal and neonatal complications. However, interventions to prevent excessive weight gain during pregnancy have not been adequately evaluated. OBJECTIVES To evaluate the effectiveness of interventions for preventing excessive weight gain during pregnancy and associated pregnancy complications. SEARCH METHODS We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (20 October 2011) and MEDLINE (1966 to 20 October 2011). SELECTION CRITERIA All randomised controlled trials and quasi-randomised trials of interventions for preventing excessive weight gain during pregnancy. DATA COLLECTION AND ANALYSIS We assessed for inclusion all potential studies we identified as a result of the search strategy. At least two review authors independently assessed trial quality and extracted data. We resolved discrepancies through discussion. We have presented results using risk ratio (RR) for categorical data and mean difference for continuous data. We analysed data using a fixed-effect model. MAIN RESULTS We included 28 studies involving 3976 women; 27 of these studies with 3964 women contributed data to the analyses. Interventions focused on a broad range of interventions. However, for most outcomes we could not combine data in a meta-analysis, and where we did pool data, no more than two or three studies could be combined for a particular intervention and outcome. Overall, results from this review were mainly not statistically significant, and where there did appear to be differences between intervention and control groups, results were not consistent. For women in general clinic populations one (behavioural counselling versus standard care) of three interventions examined was associated with a reduction in the rate of excessive weight gain (RR 0.72, 95% confidence interval 0.54 to 0.95); for women in high-risk groups no intervention appeared to reduce excess weight gain. There were inconsistent results for mean weight gain (reported in all but one of the included studies). We found a statistically significant effect on mean weight gain for five interventions in the general population and for two interventions in high-risk groups.Most studies did not show statistically significant effects on maternal complications, and none reported significant effects on adverse neonatal outcomes. AUTHORS' CONCLUSIONS There is not enough evidence to recommend any intervention for preventing excessive weight gain during pregnancy, due to the significant methodological limitations of included studies and the small observed effect sizes. More high-quality randomised controlled trials with adequate sample sizes are required to evaluate the effectiveness of potential interventions.