Miracle-dz/UniFAR-FTUs huggingface dataset:
Krusen's Handbook of Physical Medicine and Rehabilitation

This third edition of Krusen is a considerable departure from the second edition of 1971. It is a most comprehensive, multiauthored work. Three editors, all with Mayo Clinic experience, write eight of 52 chapters—the remainder are written by 22 other contributors from various parts of this country, and two from abroad. The scope of the book is large, including sections on arthritis, amputation, stroke, brain damage in children, spinal cord injury, auditory disorders, pulmonary and cardiac disease, burns, and cancer. Its scholarly nature is underlined throughout by references to basic physiology and with chapters specially devoted to motor function, gait analysis, electromyography, and nerve conduction, including one on the effects of immobilization. The physiological effect of various forms of physical therapy is well documented with extensive citations to the literature. The psychological reaction to injury seems to be the newest theme in rehabilitation. While the psychology of the injured person
Adrenal incidentalomas: Risk of adrenocortical carcinoma and clinical outcomes

The number of incidentally discovered adrenal lesions is increasing due to the widespread use of abdominal imaging. Although most incidentalomas are benign, larger suspicious lesions will require adrenalectomy. The aim of this study is to determine the risk of malignancy in patients undergoing surgery for adrenal incidentaloma; and to compare clinical outcomes in those with adrenocortical carcinoma (ACC) based on the mode of presentation.
Robot-assisted laparoscopic prostatectomy versus open: comparison of the learning curve of a single surgeon.

BACKGROUND AND PURPOSE Because of the increased use of robot-assisted laparoscopic prostatectomy (RALP) for the management of localized prostate cancer, surgeons in training face the issues of developing skills in both open surgery and the robotic console. This study compares prospectively the safety and efficacy of the first 50 open radical retropubic prostatectomy (RRP) procedures and the first 50 RALP procedures, performed by the same surgeon in the same institution. PATIENTS AND METHODS The patients' baseline demographic, clinical, and oncologic parameters were prospectively recorded. The study end points included oncologic outcome, functional outcomes (at 3 months), and perioperative parameters. Complications were classified according to the modified Clavien system. RESULTS No statistically significant differences were noted between the two groups in terms of preoperative patient characteristics and oncologic parameters. The operative time and mean estimated blood loss were lower in the RALP group (P<0.001), but no statistically significant difference was noted in regard to transfusion rates (P=0.362). Mean hospital stay was lower in the RALP group (P<0.001). The minor (Clavien I+II) and major (Clavien III+IV) complication rates were comparable between the two groups. The overall positive margin (PSM) rates were 20% and 18% for RRP and RALP, respectively (P=0.799), while for pT(3) disease, the PSM rates were 26.1% and 22.2%% for RRP and RALP, respectively (P=0.53). The 3-month continence rates were 88% and 90% for RRP and RALP, respectively (P=0.749). For preoperatively potent patients, 3-month potency rates were comparable between the two groups (60.6% and 62.1% in the RRP and the RALP group, respectively, P=0.893). CONCLUSION The early learning curve for RALP appears safe and results in equivalent functional and oncologic outcome, when compared with the results of open surgery.
Extending limits of resection for metastatic colorectal cancer: Risk benefit ratio

Improvements in treatment strategies and a better knowledge of tumor biology have contributed to an increase in the number of patients with colorectal liver metastases (CLM) who are candidate for surgery. These progresses are on going and the introduction of effective systemic therapy agents contributes further to the increase in the resectability of patients with advanced CLM. J. Surg. Oncol. 2010;102:996–1001. © 2010 Wiley‐Liss, Inc.
Hepatitis C screening beyond CDC guidelines in an Egyptian immigrant community

Many Egyptian‐born persons in the U.S. are at high risk of chronic hepatitis C virus (HCV) infection, yet are not aware of their infection and lack healthcare coverage or linkage to care. In this study, we target Egyptian‐born persons living in the New York City area for screening and link to care.
Risk factors for perioperative complications of laparoscopic adrenalectomy including single-site surgery.

PURPOSE To determine predictive factors for perioperative complications of laparoscopic adrenalectomy (LA) including single-site surgery performed or supervised by experienced laparoscopic surgeons. PATIENTS AND METHODS We retrospectively reviewed 265 consecutive unilateral LAs performed at a single institution from 2001 to 2011. All surgical procedures were performed or supervised by one of two experienced laparoscopic surgeons. The transabdominal approach was used in 248 patients, while a retroperitoneal approach was used in 17 patients. Laparoendoscopic single-site adrenalectomy was performed in 58 patients. Predictive factors for postoperative complications were analyzed. RESULTS There were no postoperative deaths. At least one postoperative complication occurred in 12 (4.6%) patients. No patient underwent reoperation for a complication. Only one (0.4%) patient's procedure was converted to open surgery, and only this patient needed a blood transfusion during the operation. One patient who underwent laparoendoscopic single-site adrenalectomy had the procedure converted to conventional laparoscopic adrenalectomy. Multivariable logistic regression analysis showed that an American Society of Anesthesiologists-physical status grade 3 or above was the only predictive factor for perioperative complications. CONCLUSION American Society of Anesthesiologists-physical status grade 3 or above was a statistically significant factor for perioperative complications associated with laparoscopic adrenalectomy that involved laparoendoscopic single-site adrenalectomy, which was performed or supervised by an experienced laparoscopic surgeon. According to the findings of this retrospective study, single-site operation, obesity, adrenal tumor size, and tumor type may not be considered as risk factors for perioperative complications after LA performed or supervised by an experienced laparoscopic surgeon.
Health Aspects of Resistance Exercise and Training

RESISTANCE TRAINING, WHICH includes the regular use of free weights, weight machines, body weight, elastic bands, and other forms of equipment to improve muscular strength, muscular power, and muscular endurance, has become an increasingly popular form of physical activity. Recent recommendations have been made regarding the use of resistance training in healthy populations (2, 43). Resistance training is currently being advocated for use with special populations such as cardiac rehabilitation patients (158) and the elderly (3). It is generally accepted that resistance training increases muscular size, strength, and power and is useful for enhancing athletic performance. Benefits resulting from resistance training are strongly influenced by the large number of training variables that can be manipulated in a program. Variations in load, volume, intensity, active muscle mass, muscle contraction type, rest interval, equipment, technique, initial level of fitness, training status, and program type can all influence the magnitude and duration of the response to resistance exercise and ultimately the adaptations associated with resistance training. Taking all of these factors into consideration, there is an accumulating base of scientific evidence suggesting that a number of health-related benefits may be derived from participation in a well-designed resistance training program. Having reviewed the available scientific literature on resistance training and health, it is the position of the NSCA that:
Report of 19 cases of photoallergic contact dermatitis to sunscreens seen at the Skin and Cancer Foundation

We report on our experience with sunscreen allergy between 1992 and 1999 and also review the international literature on sunscreen allergy. There were a total of 21 allergic reactions to sunscreen chemicals observed in 19 patients over the 8 years. There were nine positive photopatch reactions to oxybenzone, eight to butyl methoxy dibenzoylmethane, three to methoxycinnamate and one to benzophenone. No positive reactions were observed to para aminobenzoic acid. Six patients also had positive patch tests to components of the sunscreen base. In our experience, sunscreen chemicals are the most common cause of photoallergic contact dermatitis.
HCV direct‐acting antiviral agents: the best interferon‐free combinations

For HCV infection, there have been major advancements during last several years with large numbers of ongoing trials with various direct‐acting antivirals (DAA) showing high potency, favourable tolerability profile, higher barrier to resistance, shortened treatment duration, all oral regimen, pan‐genotypic, fewer drug interactions and reduced pill burden. By 2014, several DAAs are anticipated to complete successful phase III trials and will be commercially available. Initially, a wave of IFN‐based regimen (sofosbuvir, faldaprevir and simeprevir) will be available for treatment of HCV genotype 1. In the near future, combination of antiviral agents with additive potency that lack cross‐resistance with good safety profile will likely be the new recommended regimens, making HCV, the first chronic viral infection to be eradicated worldwide with a finite duration of combination DAA therapy without IFN or ribavirin. The aim of this review was to summarize the results obtained from recent DAA combination studies without IFN.
Esophageal body length, lower esophageal sphincter length, position and pressure in health and disease.

We compared esophageal dimensions in control subjects and patients with differing motility disorders and severities of reflux disease. Patients (1108) and healthy controls (36) underwent manometry and 24-h pH monitoring. Subjects were grouped according to pH and manometry data into seven groups. Mean (s.e.m.) esophageal body length is greatest in achalasia [22.41 (0.27) cm] and least in reflux disease [20.06 (0.13) cm, p < 0.05]. Lower esophageal sphincter (LES) pressure is greatest in achalasia [17.46 (1.06) mmHg] and least in reflux disease [6.57 (0.24) mmHg, p < 0.05]. LES length is least in achalasia patients and control subjects. The ratio of intra-abdominal to intrathoracic LES is greatest in achalasia (1.29), no reflux and normal motility group, and controls and least in reflux disease (1.04, p < 0.05). In conclusion, esophageal body length is greatest in achalasia and least in reflux disease. This is associated with caudal movement of the LES in achalasia and cranial movement of the LES in reflux disease, relative to the diaphragm.
Rising incidence and prevalence of primary biliary cirrhosis: a large population‐based study

Large population‐based studies are much needed to accurately establish the epidemiology of primary biliary cirrhosis (PBC). We aimed to collect all PBC patients in a geographically defined area to evaluate the epidemiology of PBC and examine the possible association of PBC with smoking, age at menarche, age at first pregnancy and number of pregnancies.
Health-related Quality of Life in Retired Older People in Tehran City

Population aging has become an important social issue worldwide and the biggest challenge is improving older people’s quality of life. We aimed to determine the quality of life (QOL) of retired older adults in Tehran using the SF-36. About 321 men and 146 women, aged 60 to 69 (62%) and 70 or older (38%), participated. In the older group, the total QOL score was lower than in the younger group, but the older group scored higher in the mental domain. Education had a significant relationship with the mental domain of QOL, as did gender with the physical and mental domains. The income sufficiency state was significantly related to both domains of QOL. The findings can be useful in designing intervention studies that could eventually lead to application of strategies to promote QOL in retired older adults in Iran and other countries with similar sociocultural and economic backgrounds.
Exclusive breastfeeding practice in Indonesia

This grounded theory study aimed to explore the cultural practices and behaviours, which lead to unsuccessful exclusive breastfeeding in Indonesian mothers. Data were obtained through semi-structured interviews carried out with 8 key participants (breastfeeding mothers) and 10 general participants (family members and health cadre). Four categories: the initial breastfeeding practice following delivery, the decision making surrounding the efforts to maintain breastfeeding, when to wean the baby onto other types of milk or food, and the consequences of weaning the baby, and two corresponding subcategories: external and internal factors that influence the decision making to wean the baby emerged from comparative analysis. Results from this study confirmed that women believed that they produced insufficient breast milk, which led them to wean their babies before the reccomended age of 6 months. This belief arose from a complex process and was strongly affected by various biopsychosocial factors. The results o.
Endoscopic combined intrarenal surgery for large calculi: simultaneous use of flexible ureteroscopy and mini-percutaneous nephrolithotomy overcomes the disadvantageous of percutaneous nephrolithotomy monotherapy.

BACKGROUND AND PURPOSE Percutaneous nephrolithotomy (PCNL) is considered the standard procedure for the removal of large renal calculi. The development of the "minimally invasive PCNL" (mini-PCNL) has reduced the complications of the surgery; it also appears to be associated with less morbidity than the conventional PCNL (con-PCNL). This study aimed at evaluating the efficacy of endoscopic intrarenal surgery, using the prone-split leg position, using flexible ureteroscopy and mini-PCNL (mini- endoscopic combined intrarenal surgery [ECIRS]) by retrospectively comparing this technique with mini-PCNL and con-PCNL. PATIENTS AND METHODS In total, 161 consecutive patients who were observed for the follow-up of large renal calculi between February 2004 and January 2013 were selected for mini-ECIRS (60), mini-PCNL (19), or con-PCNL (82). Mini-ECIRS was performed with patients in the prone split-leg position via 18F minipercutaneous tract and 14F ureteral access sheath. The mini-PCNL was performed via 18F percutaneous tract and con-PCNL performed via the 30F tract. Mean size of the renal calculi removed via mini-ECIRS, mini-PCNL, and con-PCNL were 39.2, 38.4, and 34.6 mm, respectively. RESULTS Average surgical time for mini-ECIRS was shorter than that for mini-PCNL and con-PCNL (120.5 vs. 181.9 vs 134.1 min, respectively; P<0.001). The stone-free rate for mini-ECIRS was significantly higher than that of the other procedures (initial rates 81.7% vs. 38.9% vs. 45.1%, respectively; P<0.001; rates after further treatment 86.7% vs. 61.1% vs. 61.0%, respectively; P=0.002). Only one patient in the mini-ECIRS group needed blood transfusions. The decrease in hemoglobin during mini-ECIRS and mini-PCNL was significantly lower than that during con-PCNL (P=0.011). CONCLUSION Mini-ECIRS is better than monotherapy with mini-PCNL or con-PCNL. The study results show that mini-ECIRS is a safe, efficient, and versatile procedure that can be effective for the management of renal calculi.
Retrograde, antegrade, and laparoscopic approaches to the management of large upper ureteral stones after shockwave lithotripsy failure: a four-year retrospective study.

PURPOSE We compare the success rate and complications of retrograde ureteroscopy, laparoscopic ureterolithotomy, and percutaneous nephrolithotomy for the management of large upper ureteral stones. PATIENTS AND METHODS We retrospectively analyzed data from 73 patients with large (≥1 cm) upper ureteral stones at two institutions from January 2010 to May 2013. Twenty-two patients underwent retrograde ureteroscopy (group ULS), 30 patients underwent percutaneous nephrolithotripsy (group PCNL), and 21 patients underwent laparoscopic ureterolithotomy (group LS) for removal of upper ureteral stones. CT, intravenous urography, and ultrasound were performed 1 week and 1 month after surgical removal. RESULTS There were no significant differences in age, sex, or stone size among the three groups. Mean estimated blood loss and mean hospital stay showed a statistically significant difference among the three groups. Success rates in the PCNL, LS, and ULS groups were 100%, 90.5%, and 77.3%, respectively. The procedures of two patients in group LS were converted to open surgery because of the inability to find the ureteral stone in one patient and an adhesion too difficult to dissect in the other. The procedures of two patients in the ULS group were converted to LS, and those of three patients were converted to PCNL because of severe edema impaction at the site of the stone, a sharply angulated ureter obstruction, upward migration of the stone (seven patients), and intraoperative complications (two patients). CONCLUSIONS Percutaneous antegrade nephrolithotomy is a safe and effective minimally invasive treatment for patients with large upper ureteral stones that has several advantages over retrograde ureteroscopy and laparoscopic ureterolithotomy. Thus, percutaneous antegrade nephrolithotomy is recommended as a safe and good treatment option for large upper ureteral stones. A combined procedure (e.g., ureteral push-back and percutaneous removal) can be considered in some patients.
Comparison of micronutrients in patients having had panproctocolectomy and either ileal pouch anal anastomosis or Brooke ileostomy for chronic ulcerative colitis (UC)

Patients having panproctocolectomy undergo major metabolic changes. A recent study suggested that patients who have had a panproctocolectomy and ileal pouch‐anal anastomosis (IPAA) may be trace element‐deficient, while other recent evidence has suggested a gradual decrease in vitamin B12. This study was undertaken to compare patients who had a panproctocolectomy for UC in combination with either an IPAA or a Brooke ileostomy (BI), and to determine whether the type of surgery post‐proctocolectomy influences the absorption of trace elements, as well as comparing the levels after both operations with the normal population values.
The effect of postoperative pelvic irradiation after complete resection of metastatic rectal cancer

The 2010 NCCN clinical practice guidelines recommend radiation as a part of the standard adjuvant or neoadjuvant treatment for stage IV rectal cancer patients. This study evaluated the oncologic efficacy of postoperative radiotherapy (RTx) in loco‐regional control after complete removal of primary and metastatic lesions in stage IV rectal cancer.
Latvian community nurses practising in a time of turmoil: a thin line of defence for children at risk.

Recent World Health Organization (WHO) statistics rank Latvia below average on a number of health indicators, compared to other European Union (EU) candidate countries. Nurses who visit children in the home see a close-up view of the decline in health. This exploratory study was designed to understand the day-to-day experience of a representative sample of 17 Latvian nurses visiting infants and children in 1999, almost 10 years after the collapse of the Soviet Union. Analysis of practice reports from group and individual interviews, using interpretive phenomenologic methods, revealed three consistently emerging themes: the negative impact of societal change and dislocation on clients and nurses; clinical reasoning concerning degree of risk to children and priorities for intervention; and the physical and emotional burden of caring for increasingly vulnerable children. Risk assessment was expressed in the classification of families as 'good little family, a family that was 'simply poor, or a family that was a 'social risk. ' With the first two types of families, concern about children was balanced with concern about the family as a whole. With 'social risk' families, the primary concern of the nurses was safeguarding the child. The findings cannot be generalized, but may imbue family health and welfare statistics with a human face, and suggest directions for education, practice and further research.
Anti‐kelch‐like 12 and anti‐hexokinase 1: novel autoantibodies in primary biliary cirrhosis

Using high‐density human recombinant protein microarrays, we identified two potential biomarkers, kelch‐like 12 (KLHL12) and hexokinase‐1 (HK1), in primary biliary cirrhosis (PBC). The objective of this study was to determine the diagnostic value of anti‐KLHL12/HK1 autoantibodies in PBC. Initial discovery used sera from 22 patients with PBC and 62 non‐PBC controls. KLHL12 and HK1 proteins were then analysed for immunoglobulin reactivity by immunoblot and enzyme‐linked immunosorbent assay (ELISA) in two independent cohorts of PBC and disease/healthy control patients.
Heterogeneity of Human Platelets: IV. IDENTIFICATION OF A YOUNG PLATELET POPULATION WITH [75Se]SELENOMETHIONINE

Summary. Heavy‐large platelets have previously been shown to be more active metabolically and functionally compared to light‐small platelets and to be present in increased per cent during conditions of enhanced thrombopoiesis. In the present report, the kinetics of platelet synthesis has been followed by in vivo labelling of megakaryocytes with the amino acid analogue, [75Se]selenomethionine. Kinetic measurements in three volunteer subjects indicated that heavy‐large platelets were young platelets and suggested a progression with age of heavy‐large platelets to light‐small platelets.
Pancreatic cancer: Management

Pancreatic cancer still represents a serious medical concern for which no adequate solution has thus far been found. Surgery is the only appropriate therapy, but has a survival rate of around 30-35% at three years, with an operative mortality below 3% and an operative morbidity approaching 10% of radically resected patients, all of which applies to surgery performed by expert teams in highly experienced sites.