Miracle-dz/UniFAR-FTUs huggingface dataset:
Is the obesity epidemic worsening the cardiovascular risk factor profile of children? Evidence from two Québec samples measured 10 years apart

Background: The impact of the obesity epidemic on cardiovascular health in young people is of increasing concern. However, data on secular trends in CVD indicators are outdated and mixed. Methods: This study compared lipid profiles and insulin of 9–10 year olds in 2008 (n = 605) and 1999 (n = 779). Data were drawn from two population-based samples of youth: the 1999 Québec Child and Adolescent Health and Social Survey and the 2008 Québec Longitudinal Study of Child Development. Results: Mean body mass index (BMI) Z-scores were higher in 2008 than in 1999 in both boys (0.37 vs 0.12, p = 0.004) and girls (0.32 vs 0.05, p = 0.0004). After adjusting for maturity stage, height, BMI Z-score, age and household income, high-density lipoprotein cholesterol was 0.12 mmol/L (p < 0.05) and 0.10 mmol/L (p < 0.05) higher in 2008 than 1999 in boys and girls, respectively. Total cholesterol, low density lipoprotein cholesterol and insulin were not significantly different between 2008 and 1999. Conclusions: Despite higher BMI Z-scores in 2008, differences in cardiometabolic indicators between 1999 and 2008 were small and may not be clinically meaningful. Surveillance to closely monitor trends in cardiometabolic indicators in Canadian youth is needed.
Role of very short-term intravenous hydrocortisone in reducing postdural puncture headache

Objective: Headache is not an uncommon complication of spinal anesthesia. The efficacy of intravenous (IV) hydrocortisone in treating the patients with postdural puncture headache was observed in this study. Materials and Methods: Sixty patients with headache following spinal anesthesia were randomly allocated into two groups. Thirty patients received only conventional therapy (recumbent positioning, IV or oral hydration, analgesics with caffeine, stool softeners, and soft diet) plus 2 ml of normal saline IV (placebo) 8 hourly for 48 h. Thirty other patients received conventional therapy plus hydrocortisone IV (100 mg in 2 ml 8 hourly for 48 h). Headache intensity was measured using visual analogue scale. Results: No significant difference was observed in baseline headache intensity between the two groups (P = 0.6642) before beginning of treatment. After 6 h, the mean headache intensity in patients treated conventionally was 6.02 ± 2.46, while it was 2.06 ± 1.98 in other patients who received additional hydrocortisone IV (P < 0.0001). After 24 h, headache intensity was 3.77 ± 1.85 in conventionally treated group versus 0.94 ± 2.67 in hydrocortisone group (P < 0.0001), while it was 1.95 ± 1.12 in conventionally treated group versus 0.69 ± 1.64 in hydrocortisone group (P = 0.001) after 48 h. Conclusions: Very short-term use of IV hydrocortisone was found effective in reducing headache following spinal anesthesia. However, its clear mechanism of action is yet to be determined. Large-scale studies are recommended to consider the steroid therapy as a standard treatment for postdural puncture headache.
Pubertal development profile in patients with Turner syndrome

Abstract Introduction: Puberty can be divided into two independent events: adrenarche and gonadarche. In healthy children, adrenarche is followed by gonadarche, but in patients with gonadal dysgenesis there is partial or complete dissociation between these two events. Objective: To evaluate the age and chronology of the development of secondary sexual characteristics and occurrence of these events and their relationship to the induction of puberty in patients with Turner syndrome (TS). Materials and methods: A descriptive analysis with historical records of the patients with clinical and cytogenetic TS was conducted. The following variables were recorded: karyotype; age of thelarche, pubarche, and menarche; occurrence of spontaneous puberty; maintenance of puberty or secondary failure; and the onset of hormone replacement therapy (HRT) with estrogen. Results: We evaluated 123 medical charts. Seven (5.7%) patients were prepubertal, 10 (8.1%) had only pubarche, and 5 (4%) had only thelarche. Forty-seven (38.2%) patients entered puberty spontaneously. Among these, 35 (28.5%) remained in puberty, and 12 (9.8%) required subsequent HRT; 54 (44%) had puberty induced. Sixty-six (56.9%) patients had pubarche started before thelarche. Menarche occurred in 67 patients, spontaneously in 19. Pubarche spontaneously presented in 91 (78.4%) patients, and in 25 (21.5%) after HRT introduction. Conclusions: Spontaneous puberty occurred in approximately one-third of the patients. Pubarche was the first feature in most patients and about 20% showed pubarche only after estrogen therapy.
Effect of mitochondrial, APOE. ACE and NOS3 gene polymorphisms on cardiovascular risk factors among the Vaqueiros de Alzada, a Northern Spain human isolate

Abstract Background: The Vaqueiros de Alzada are a human isolate from Asturias, a Northern Spain region. Several hypotheses have been proposed to explain the origin of Vaqueiros. Methods and results: To determine whether the Vaqueiros and non-Vaqueiros from the same region have different genetic backgrounds, this study analysed nine mtDNA polymorphisms that define the common European mitochondrial haplogroups in a cohort of Vaqueiros (n = 60) and non-Vaqueiros (n = 110). Haplogroup H was the most frequent in Vaqueiros (42%) and non-Vaqueiros (46%). A total of 37% Vaqueiros were H1, compared to 31% of the non-Vaqueiros. This study also genotyped the two groups for three polymorphisms at the NOS3. APOE and ACE genes, that have previously been linked to risk of cardiovascular diseases. Allele and genotype frequencies did not differ between Vaqueiros and non-Vaqueiros. In addition, none of these polymorphisms were related to risk of hypertension, diabetes or hypercholesterolaemia in the two groups. Conclusion: The data suggested that Vaqueiros share the main haplogroup distribution as their non-Vaqueiros neighbours and other Cantabrian populations. In addition, no effect of the mitochondrial, NOS3. APOE and ACE polymorphisms on cardiovascular risk factors was observed.
SEMINARS IN HEARING—VOLUME 18, NUMBER 2 MAY 1997 COMMUNICATION STRATEGIES TRAINING

Much research has emerged concerning communication strategies and theoretical models of communication interactions when one of the participants has a hearing loss. The results, as well as clinical experience, have led many speech and hearing professionals to recognize that effective use of communication strategies may minimize the communication difficulties experienced by hearing-impaired clients and their family members (i.e., their frequent communication partners). Consequently, many professionals are becoming interested in the "nuts and bolts" of communication strategies training. They are asking questions such as, "How can I encourage both clients and their partners to use strategies more effectively? "; "What are specific activities to incorporate into communication strategies training? "; and "How can I fit training into a busy clinical practice? " The primary goals of this article are to describe a training model for a communication strategies training program and specific activities for each stage of the model, and also, to describe activities that may be useful when clinicians and/or clients are unable to commit much time or financial resources to the program. To provide a context for this discussion, a cursory overview of possible program content and research about communication strategies is first presented. More in-depth considerations of these two topics may be found in Erber (1988), Erber and Lind (1994), Tye-Murray (1992a, 1994), and Tye-Murray and Schum (1994).
Renal replacement therapy in ICU

Diagnosing and managing critically ill patients with renal dysfunction is a part of the daily routine of an intensivist. Acute kidney insufficiency substantially contributes to the morbidity and mortality of critically ill patients. Renal replacement therapy (RRT) not only does play a significant role in the treatment of patients with renal failure, acute as well as chronic, but also has spread its domains to the treatment of many other disease conditions such as myaesthenia gravis, septic shock and acute on chronic liver failure. This article briefly outlines the role of renal replacement therapy in ICU.
Association of LXRα polymorphisms with obesity and obesity-related phenotypes in an Iranian population

Abstract Background: Obesity is a multifactorial disorder due to the complex interaction between genetic and environmental factors. Liver X receptor alpha (LXRα), encoded by the gene NR1H3, is involved in lipoprotein metabolism and its genetic variations may also play a role in the aetiology of obesity. Aim: To assess the association of two NR1H3 polymorphisms (rs11039155 and rs2279238) and their haplotypes with obesity in an Iranian population. Subjects and methods: A total of 447 unrelated subjects (including 206 overweight, 162 obese and 79 controls) were enrolled in the study and were genotyped by TaqMan assay using DNA from peripheral blood. The association of these two LXRα polymorphisms with the presence of obesity and overweight was assessed. Results: There was no significant association between the two SNPs and obesity, even after adjustment for age and sex. By logistic regression using a dominant model, the odds ratios for obesity were: 1.32 (0.85–2.74) for rs11039155 and 0.77 (0.30--1.99) for rs2279238. Haplotype analyses identified three common haplotypes GC, GT and AC with frequency greater than 1%, but none of the haplotypes was associated with the risk of obesity. Conclusions: This study revealed that there was no significant association between LXRα polymorphisms and the presence of obesity in an Iranian population and suggests that these two SNPs are not major contributors to obesity risk in this population.
Gender differences in the relationship between serum zinc concentration and metabolic syndrome

Abstract Background: Zinc, a co-factor of antioxidant enzymes, may be involved in the pathophysiology of metabolic syndrome (MetS). Aim: To determine the association between serum zinc concentration and MetS in a population-based study. Subjects and methods: In the Tehran Lipid and Glucose Study, serum zinc concentration was measured by flame atomic absorption spectrometry in 2626 adult participants. After removal of outliers, usable data was available for 2401 participants. Dietary zinc was assessed by a validated semi-quantitative food frequency questionnaire. Results: Compared to those without the MetS, serum zinc concentration was significantly higher in men with syndrome (17.1 ± 4.9 vs 16.5 ± 4.6 μmol/L, p = 0.035); however, values were comparable in females (16.1 ± 4.8 vs 15.8 ± 4.4, p = 0.460). Men in tertile 3 of serum zinc had significantly higher chances of having MetS, even after multivariate adjustment (OR = 1.48, 95% confidence interval (CI) = 1.07–2.06, p = 0.020). Women in tertile 2 of serum zinc had significantly lower chances of having MetS, which remained significant after multivariate adjustment (OR = 0.68, 95% CI = 0.47–0.99, p = 0.046). Conclusion: This study observed a gender difference between serum zinc and MetS, with higher levels being positively associated with MetS in men and having a protective effect in women. Further studies are needed to elucidate the role of zinc status in the development of MetS.
How does autoimmune thyroiditis in children with type 1 diabetes mellitus influence glycemic control, lipid profile and thyroid volume?

Abstract Aim: To investigate whether autoimmune thyroiditis (AIT) in children with type 1 diabetes mellitus (DM1) has any influence on glycemic control, lipid profile or thyroid volume. Methods: A total of 330 patients with DM1 and AIT (DM1+AIT group) were compared with 309 children with DM1 without AIT (control group). Patients were treated in four Polish academic pediatric diabetes centers from 2008 to 2012: Warsaw, Lodz, Katowice and Gdansk. All patients underwent measurements of thyroid-stimulating hormone (TSH), free thyroxine, anti-thyroid peroxidase (anti-TPO) antibody, anti-thyroglobulin (anti-TG) antibody and HbA1c levels, and thyroid ultrasound examination. Results: Among AIT+DM1 patients, 62% (n=205) were female, whereas in the control group 60.8% (n=188) were male (p<0.0001). Children with AIT+DM1 had lower a BMI-SDS (mean difference of –0.5, 95% CI –0.68 to –0.33; p<0.0001), had a higher SDS thyroid volume (0.27, 95% CI 0.03–0.51; p=0.014) and needed less insulin (–0.15, 95% CI –0.20 to –0.11 U/kg body weight per day; p<0.0001) in comparison with the control group. AIT patients had higher HbA1c levels (0.66, 95% CI 0.36%–0.96%, p<0.0001), lower HDL-cholesterol levels (–3.68, 95% CI –1.41 to –5.94 mg/dL, p=0.002) and higher triglyceride levels (7.16, 95% CI 1.22–13.10 mg/dL, p=0.02). Patients with positive anti-TPO and anti-TG antibodies were older (by 1.95 years, 95% CI 0.98–2.92 years, p=0.006) and had longer DM1 duration (by 1.64 years, 95% CI 0.76–2.52 years, p=0.006). Presence of anti-TPO antibodies was associated with higher TSH levels (odds ratio 2.34, 95% CI 1.36–4.04; p=0.007). Conclusion: AIT accompanying DM1 is associated with worse glycemic control and lipid profile as well as a lower daily insulin requirement. The female gender is more likely to develop AIT and hypothyroidism.
Differences in motor performance between children and adolescents in Mozambique and Portugal: impact of allometric scaling

Abstract Background: Children from developed and developing countries have different anthropometric characteristics which may affect their motor performance (MP). Aim: To use the allometric approach to model the relationship between body size and MP in youth from two countries differing in socio-economic status—Portugal and Mozambique. Subjects and methods: A total of 2946 subjects, 1280 Mozambicans (688 girls) and 1666 Portuguese (826 girls), aged 10–15 years were sampled. Height and weight were measured and the reciprocal ponderal index (RPI) was computed. MP included handgrip strength, 1-mile run/walk, curl-ups and standing long jump tests. A multiplicative allometric model was adopted to adjust for body size differences across countries. Results: Differences in MP between Mozambican and Portuguese children exist, invariably favouring the latter. The allometric models used to adjust MP for differences in body size identified the optimal body shape to be either the RPI or even more linear, i.e. approximately (height/mass0.25). Having adjusted the MP variables for differences in body size, the differences between Mozambican and Portuguese children were invariably reduced and, in the case of grip strength, reversed. Conclusion: These results reinforce the notion that significant differences exist in MP across countries, even after adjusting for differences in body size.
Correlation between cytological and histopathological examination of the endometrium in abnormal uterine bleeding

Background: Abnormal uterine bleeding (AUB) is a common problem for which women seek gynecological consultation. Endometrial aspiration cytology (EAC) is an acceptable and valuable diagnostic procedure for screening the endometrial status. Materials and Methods: Endometrial aspiration using a menstrual regulation (MR) syringe and a 4 mm Karman's cannula was performed just prior to D and C in 100 women presenting with AUB. Smears were reviewed for cytomorphological findings and were correlated with the histopathological findings. These findings were categorized as benign endometrium, endometrial hyperplasia, malignancy and inadequate smears. Results: Age of the patients ranged from 19 to 70 years. In our study, the accuracy in diagnosing benign conditions of endometrium, hyperplasia, and malignancy on aspiration cytology were 93.88%, 96.94% and 96.84%, respectively. Conclusions: Endometrial aspiration is an effective, useful and a minimally invasive procedure. With an experienced cytologist, it can be used routinely for the primary investigation of women with AUB, provided all the points of discrepancies are taken care of.
Malignant small round cell tumors

Malignant small round cell tumors are characterised by small, round, relatively undifferentiated cells. They generally include Ewing's sarcoma, peripheral neuroectodermal tumor, rhabdomyosarcoma, synovial sarcoma, non-Hodgkin's lymphoma, retinoblastoma, neuroblastoma, hepatoblastoma, and nephroblastoma or Wilms’ tumor. Other differential diagnoses of small round cell tumors include small cell osteogenic sarcoma, undifferentiated hepatoblastoma, granulocytic sarcoma, and intraabdominal desmoplastic small round cell tumor. Differential diagnosis of small round cell tumors is particularly difficult due to their undifferentiated or primitive character. Tumors that show good differentiation are generally easy to diagnose, but when a tumor is poorly differentiated, identification of the diagnostic, morphological features is difficult and therefore, no definitive diagnosis may be possible. As seen in several study reports, fine needle aspiration cytology (FNAC) has become an important modality of diagnosis for these tumors. The technique yields adequate numbers of dissociated, viable cells, making it ideally suitable for ancillary techniques. Typically, a multimodal approach is employed and the principal ancillary techniques that have been found to be useful in classification are immunohistochemistry and immunophenotyping by flow cytometry, reverse transcriptase polymerase chain reaction (RT-PCR), fluorescence in situ hybridization (FISH), and electron microscopy. However, the recent characterization of chromosomal breakpoints and the corresponding genes involved in malignant small round cell tumors means that it is possible to use molecular genetic approaches for detection.
Critical analysis of cell block versus smear examination in effusions

Objectives: To assess the utility of the cell block preparation method in increasing the sensitivity of cytodiagnosis of serous fluids and to know the primary site of malignant effusions. Materials and Methods: A total of 190 cases were subjected to routine smear examination as well as cell block preparation. After the cytological diagnosis, each case was objectively analysed for cellularity, arrangement (acini, papillae, cell balls, and proliferation spheres), cytoplasmic, and nuclear details. Results: Out of 190 cases, 70 cases were found to be malignant and had been examined in smears and paraffin-embedded cell blocks. Using a combination of the cell block and smear techniques yielded 13% more malignant cases than what were detected using smears by themselves. The combined technique helped to ascertain the primary site of malignancy in 83.3% of the cases, whereas the primary site could not be ascertained in 17.7% of the cases. Conclusions: The cell block technique not only increased the positive results, but also helped to demonstrate better architectural patterns, which could be of great help in making correct diagnosis of the primary site. The cell block technique was also useful for special stains and immunohistochemistry and can give morphological details by preserving the architectural patterns.
Thyroid disease in Chinese girls with Turner syndrome

Abstract Aim: The aim of this study was to determine the prevalence of autoimmune thyroid disease in Turner syndrome (TS) and the association between thyroid autoantibodies (TAA), thyroid dysfunction, age, and karyotype. Methods: Sixty-nine girls with TS were divided into two groups according to being TAA-positive or TAA-negative. TAA and thyroid hormone concentrations were determined by immunochemiluminescence. Results: One third (23/69) of the girls were TAA positive, with antibody prevalence increasing with age. Of the TAA-positive girls, seven were hypothyroid and three hyperthyroid. Compared with the TAA-negative group, the girls in the TAA-positive group were significantly older (p<0.05). For those who were TAA positive, 26.3% of patients were 5–10 years old, 37.1% 10–15 years old, and 62.5% above the age of 15 years. Conclusion: Chinese girls with TS are prone to Hashimoto’s thyroiditis, especially those older than 5 years, and routine thyroid testing is advocated thereafter on a yearly basis. There was no specific association between the incidence of autoimmune thyroid disease and TS karyotypes.
Relationship between indices of adiposity obtained by peripheral quantitative computed tomography and dual-energy X-ray absorptiometry in pre-pubertal children

Background/Aim: The study investigated the relationship between indices of adiposity measured by peripheral quantitative computed tomography (pQCT) and dual-energy X-ray absorptiometry (DXA) in pre-pubertal children. Subjects and methods: DXA-derived per cent body fat (%BF) was measured in 284 boys and 288 girls, aged 7–10 years. Cross-sections of the forearm (n=427) and lower leg (n=560) were obtained by pQCT to measure total cross-sectional area of the limb (Total CSA), Muscle CSA, Fat CSA, %Fat CSA (Fat CSA/Total CSA×100) and muscle density. Results: Peripheral QCT-derived %Fat CSA in the forearm and lower leg correlated strongly with DXA-derived %BF (r=0.83–0.89, p<0.01) in both boys and girls. However, forearm and lower leg %Fat CSA were higher than whole body %BF by 5% and 10%, respectively. A better prediction of whole-body %BF was achieved by including %Fat CSA, muscle density and height into a hierarchical regression model. Using sex-specific regression equations, 87.7% of the boys and 83.7% of the girls had a predicted %BF within 3% units of the %BF obtained by DXA. Conclusion: In pre-pubertal children, pQCT measures of adiposity are strongly associated with whole-body per cent body fat. This reproducible method could be an alternative technique to estimate body composition in this population.
The effect of socio-economic status and area of residence on household food variety in Morocco

Background: In Morocco, few studies have specifically addressed the association between food variety and household socio-economic status and area of residence. Aim: The study's objective was to obtain a qualitative description of food consumption in samples of Moroccan households and to examine the influence of socio-economic factors and area of residence on their food variety. Subjects and methods: A qualitative food frequency questionnaire was administered by adolescent school pupils in their own households between March 2005 and March 2006 in 526 households in the regions of Marrakesh north of the High Atlas range and Ouarzazate to the south. We calculated the Food Variety Index (FVI) based on 183 food items and compared scores for advantaged/disadvantaged and urban/rural households. Results: Mean FVI scores for all individuals and total food groups differ significantly between the area of residence, urban and peri-urban Marrakesh and urban Ouarzazate having the highest scores. The mean total FVI scores, presented according to the household's socio-economic status from highest to lowest, are 123.8 ± 17.1 for urban Marrakesh, 107.6 ± 21.6 for urban Ouarzazate, 92.0 ± 22.4 for rural Skoura, 110.5 ± 21.5 for peri-urban Marrakesh and 89.9 ± 10.8 for rural Iguerferouane (F-test = 26.7, p < 0.001). Advantaged households have significantly greater variety than disadvantaged households for all variables only in the two urban samples. In peri-urban Marrakesh and rural Skoura, there are no significant differences between advantaged and disadvantaged households. Conclusion: In our Moroccan sample, food variety is distributed according to two patterns: One based on area of residence, urban areas having greater variety than rural areas, and the other on socio-economic factors, with advantaged households having higher FVI values but only in urban areas. The limited availability of certain foods and food preferences by the populations mean that not all households are able to diversify their diets.