Miracle-dz/UniFAR-FTUs huggingface dataset:
Simultaneous bilateral total knee arthroplasty

Total knee arthroplasty is a treatment procedure which reliefs pain, corrects deformity, improves functions for the patients whose have gonarthrosis which are unresponsive to conservative therapy. Many patients with arthritic knees have symmetrical involvement. For the adequate functional improvement, both knees must be operated. Three procedure can be used for this purpose; simultaneous bilateral total knee arthroplasty, staged bilateral total knee arthroplasty with same hospitalization, staged bilateral total knee arthroplasty with separate hospitalization. Simultaneous bilateral total knee arthroplasty remain populer because of proven good to excellent functional results, opportunity for only one anesthetic risk, symmetric knee rehabilitation, cost savings, morbidity and mortality incidence is no greather than the other procedures. Because of these determinations, simultaneous bilateral total knee arthroplasty is preferable in whom requires replacement for severley arthritic knees. Purpose of this paper to evaluate twenty-one patients whose have simultaneous bilateral total knee arthroplasty with regard to literature.
Pain: A Textbook for Therapists

Foreword. Preface. Section 1 Understanding pain. Introduction to pain. Neuroanatomy of the nociceptive system. Neurophysiology of pain and pain modulation. Psychosocial, environmental and behavioural dimensions of the pain experience. Placebo analgesia - friend not foe. Pain across the lifespan. Section 2 Assessing pain. Pain assessment and measurement. Section 3 Managing pain. Generic principles of practice. Psychologically based pain management. Physical treatments. Electrophysical agents in pain management. Alternative and complementary therapies. Exercise and pain. Re-integration into work. Lifestyle management. Pharmacology of pain management. Section 4 Different pain problems. Musculoskeletal pain. Neuropathic pain. Pain in the acute care setting. Chronic pain problems. Cancer pain. Chronic pain and psychiatric problems. Index.
Tobacco Taxes, Smoking Restrictions, and Tobacco Use

Tobacco researchers have focused considerable attention on the evaluation of various mechanisms to control cigarette use, including regulation of economic availability through increases in cigarette excise taxes. In contrast, the effects of mechanisms to control the availability of ST product on ST use have not been as extensively studied. This paper presents estimates of the effects of tobacco excise taxes and laws restricting public smoking on the likelihood of current use of different forms of tobacco (moist snuff and cigarettes) obtained from tobacco use data in the Current Population Surveys (CPS) for September 1992, January 1993, and May 1993. The full sample is restricted to males age 16 or older who self identify as either white or black (i.e., other' is excluded), which yields a usable sample of 165,653 individuals. This large sample is particularly useful given the relative rarity of self-reported snuff use (about 18% of those in the sample report current use but only 1.2% report current snuff use). The results indicate that individuals living in areas with higher snuff tax rates are to be less likely to use snuff. A 1% increase in the snuff tax rate is estimated to reduce the probability of snuff use by -0.10%. Consistent with numerous prior studies, individuals in areas with higher cigarette ta rates are less likely to smoke cigarettes. In terms of cross-tax effects, higher cigarette tax rates are associated with a higher probability of snuff use. This is consistent with substitution of snuff for cigarettes when the price of cigarettes increases relative to the price of snuff. However, higher snuff tax rates are not associated with greater cigarette use. Finally, laws restricting smoking in workplaces or other public places appear to discourage both cigarette and snuff use, though less consistently so for snuff.
Clinical psychopathology in youth at familial high risk for psychosis

While the course of psychopathology has been explored from an index mental health diagnosis onwards, there are few detailed, prospective studies of the occurrence of clinical psychopathology in youth with familial risk for severe mental illnesses such as psychosis. We sought to describe the appearance of Axis I psychopathology in a unique sample of adolescents with a family history of schizophrenia (FHR).
Phase 1 Trials of rVSV Ebola Vaccine in Africa and Europe.

BACKGROUND The replication-competent recombinant vesicular stomatitis virus (rVSV)-based vaccine expressing a Zaire ebolavirus (ZEBOV) glycoprotein was selected for rapid safety and immunogenicity testing before its use in West Africa. METHODS We performed three open-label, dose-escalation phase 1 trials and one randomized, double-blind, controlled phase 1 trial to assess the safety, side-effect profile, and immunogenicity of rVSV-ZEBOV at various doses in 158 healthy adults in Europe and Africa. All participants were injected with doses of vaccine ranging from 300,000 to 50 million plaque-forming units (PFU) or placebo. RESULTS No serious vaccine-related adverse events were reported. Mild-to-moderate early-onset reactogenicity was frequent but transient (median, 1 day). Fever was observed in up to 30% of vaccinees. Vaccine viremia was detected within 3 days in 123 of the 130 participants (95%) receiving 3 million PFU or more; rVSV was not detected in saliva or urine. In the second week after injection, arthritis affecting one to four joints developed in 11 of 51 participants (22%) in Geneva, with pain lasting a median of 8 days (interquartile range, 4 to 87); 2 self-limited cases occurred in 60 participants (3%) in Hamburg, Germany, and Kilifi, Kenya. The virus was identified in one synovial-fluid aspirate and in skin vesicles of 2 other vaccinees, showing peripheral viral replication in the second week after immunization. ZEBOV-glycoprotein-specific antibody responses were detected in all the participants, with similar glycoprotein-binding antibody titers but significantly higher neutralizing antibody titers at higher doses. Glycoprotein-binding antibody titers were sustained through 180 days in all participants. CONCLUSIONS In these studies, rVSV-ZEBOV was reactogenic but immunogenic after a single dose and warrants further evaluation for safety and efficacy. (Funded by the Wellcome Trust and others; ClinicalTrials.gov numbers, NCT02283099, NCT02287480, and NCT02296983; Pan African Clinical Trials Registry number, PACTR201411000919191.).
An audit of unplanned postoperative intensive care unit admissions in Enugu, Nigeria: Causes and outcome

Objective. To carry out an audit of unplanned postoperative (anaesthetic and surgical) intensive care unit (ICU) admissions in our hospital. It was hoped that this would serve as a tool to assess the peri-operative management of surgical patients in our centre. Materials and methods. The hospital records of unbooked or unplanned post-surgical/anaesthetic admissions to our ICU from March 2003 to February 2007 were reviewed. Patient demographics, surgical and anaesthetic records, duration of stay in the unit, interventions and patient outcome were noted. Obstetric patients were not included. Results. There were a total of 497 ICU post-surgical/anaesthetic admissions to our ICU during the 4-year study period, of which 26 were unplanned. There were 6 581 anaesthetics/operations in the general operating theatre during the study period, giving an unplanned postoperative ICU admission rate of 3.9/1 000 anaesthetics or 0.39%. Six admissions were related to anaesthetic complications and 20 to surgical complications. The average duration of stay was 3.2 days. There were 8 deaths, giving a mortality rate of 1.2/1 000 anaesthetics/operations. Of the deaths 2 were associated with anaesthetic complications and 6 with surgical complications (there were 3 deaths after thyroidectomy, 2 after rigid bronchoscopy and 1 due to massive haemorrhage). Conclusion. The majority of the admissions to the ICU followed head and neck surgery. These findings will modify practice in that more senior surgeons and anaesthetists will be involved in procedures involving the head and neck, and the necessary modern equipment will be acquired. Meticulous pre-operative assessment may detect potentially difficult cases, which should be managed by the most experienced hands.
Polymer-free Drug-Coated Coronary Stents.

本研究では欧州、アジア、豪州、カナダの 20 ヶ国 68 施設より、登録した待機的 PCI の計画されている、 出血ハイリスク患者 2,466 人を DCS 群もしくは類似デバイス Gazelle BMS 群に 1:1 に無作為に割り付 けた。 本試験では DAPT を 1 ヶ月継続し、その後はアスピリン単剤に切り替えるとした。 1 ヶ月までは 94.9%が DAPT を継続したが、1 ヶ月以降には 9.5%にまで低下した。 主要有効性評価項目に設定した臨床由来の TLR の割合は,DCS 群が 5.1%、BMS 群が 9.8%(p<0.001)、 主要安全性評価項目(390 日の心臓死,MI,definite/probable のステント血栓症)の割合は DCS 群が 9.4%、BMS 群が 12.9%を記録した(p=0.005、p<0.0001). Definite/probable のステント血栓症の発症 率は DCS 群で 2.0%BMS 群で 2.2%と差はなく(p=0.70),出血合併症でも両群間に有意差はなかった。
Extended-Release Naltrexone to Prevent Opioid Relapse in Criminal Justice Offenders.

BACKGROUND Extended-release naltrexone, a sustained-release monthly injectable formulation of the full mu-opioid receptor antagonist, is effective for the prevention of relapse to opioid dependence. Data supporting its effectiveness in U.S. criminal justice populations are limited. METHODS In this five-site, open-label, randomized trial, we compared a 24-week course of extended-release naltrexone (Vivitrol) with usual treatment, consisting of brief counseling and referrals for community treatment programs, for the prevention of opioid relapse among adult criminal justice offenders (i.e., persons involved in the U.S. criminal justice system) who had a history of opioid dependence and a preference for opioid-free rather than opioid maintenance treatments and who were abstinent from opioids at the time of randomization. The primary outcome was the time to an opioid-relapse event, which was defined as 10 or more days of opioid use in a 28-day period as assessed by self-report or by testing of urine samples obtained every 2 weeks; a positive or missing sample was computed as 5 days of opioid use. Post-treatment follow-up occurred at weeks 27, 52, and 78. RESULTS A total of 153 participants were assigned to extended-release naltrexone and 155 to usual treatment. During the 24-week treatment phase, participants assigned to extended-release naltrexone had a longer median time to relapse than did those assigned to usual treatment (10.5 vs. 5.0 weeks, P<0.001; hazard ratio, 0.49; 95% confidence interval [CI], 0.36 to 0.68), a lower rate of relapse (43% vs. 64% of participants, P<0.001; odds ratio, 0.43; 95% CI, 0.28 to 0.65), and a higher rate of opioid-negative urine samples (74% vs. 56%, P<0.001; odds ratio, 2.30; 95% CI, 1.48 to 3.54). At week 78 (approximately 1 year after the end of the treatment phase), rates of opioid-negative urine samples were equal (46% in each group, P=0.91). The rates of other prespecified secondary outcome measures--self-reported cocaine, alcohol, and intravenous drug use, unsafe sex, and reincarceration--were not significantly lower with extended-release naltrexone than with usual treatment. Over the total 78 weeks observed, there were no overdose events in the extended-release naltrexone group and seven in the usual-treatment group (P=0.02). CONCLUSIONS In this trial involving criminal justice offenders, extended-release naltrexone was associated with a rate of opioid relapse that was lower than that with usual treatment. Opioid-use prevention effects waned after treatment discontinuation. (Funded by the National Institute on Drug Abuse; ClinicalTrials.gov number, NCT00781898.).
Randomized Trial of Longer-Term Therapy for Symptoms Attributed to Lyme Disease.

BACKGROUND The treatment of persistent symptoms attributed to Lyme disease remains controversial. We assessed whether longer-term antibiotic treatment of persistent symptoms attributed to Lyme disease leads to better outcomes than does shorter-term treatment. METHODS In a randomized, double-blind, placebo-controlled trial conducted in Europe, we assigned patients with persistent symptoms attributed to Lyme disease--either related temporally to proven Lyme disease or accompanied by a positive IgG or IgM immunoblot assay for Borrelia burgdorferi--to receive a 12-week oral course of doxycycline, clarithromycin plus hydroxychloroquine, or placebo. All study groups received open-label intravenous ceftriaxone for 2 weeks before initiating the randomized regimen. The primary outcome measure was health-related quality of life, as assessed by the physical-component summary score of the RAND-36 Health Status Inventory (RAND SF-36) (range, 15 to 61, with higher scores indicating better quality of life), at the end of the treatment period at week 14, after the 2-week course of ceftriaxone and the 12-week course of the randomized study drug or placebo had been completed. RESULTS Of the 281 patients who underwent randomization, 280 were included in the modified intention-to-treat analysis (86 patients in the doxycycline group, 96 in the clarithromycin-hydroxychloroquine group, and 98 in the placebo group). The SF-36 physical-component summary score did not differ significantly among the three study groups at the end of the treatment period, with mean scores of 35.0 (95% confidence interval [CI], 33.5 to 36.5) in the doxycycline group, 35.6 (95% CI, 34.2 to 37.1) in the clarithromycin-hydroxychloroquine group, and 34.8 (95% CI, 33.4 to 36.2) in the placebo group (P=0.69; a difference of 0.2 [95% CI, -2.4 to 2.8] in the doxycycline group vs. the placebo group and a difference of 0.9 [95% CI, -1.6 to 3.3] in the clarithromycin-hydroxychloroquine group vs. the placebo group); the score also did not differ significantly among the groups at subsequent study visits (P=0.35). In all study groups, the SF-36 physical-component summary score increased significantly from baseline to the end of the treatment period (P<0.001). The rates of adverse events were similar among the study groups. Four serious adverse events thought to be related to drug use occurred during the 2-week open-label ceftriaxone phase, and no serious drug-related adverse event occurred during the 12-week randomized phase. CONCLUSIONS In patients with persistent symptoms attributed to Lyme disease, longer-term antibiotic treatment did not have additional beneficial effects on health-related quality of life beyond those with shorter-term treatment. (Funded by the Netherlands Organization for Health Research and Development ZonMw; PLEASE ClinicalTrials.gov number, NCT01207739.).
Cyclosporine before PCI in Patients with Acute Myocardial Infarction.

BACKGROUND Experimental and clinical evidence suggests that cyclosporine may attenuate reperfusion injury and reduce myocardial infarct size. We aimed to test whether cyclosporine would improve clinical outcomes and prevent adverse left ventricular remodeling. METHODS In a multicenter, double-blind, randomized trial, we assigned 970 patients with an acute anterior ST-segment elevation myocardial infarction (STEMI) who were undergoing percutaneous coronary intervention (PCI) within 12 hours after symptom onset and who had complete occlusion of the culprit coronary artery to receive a bolus injection of cyclosporine (administered intravenously at a dose of 2.5 mg per kilogram of body weight) or matching placebo before coronary recanalization. The primary outcome was a composite of death from any cause, worsening of heart failure during the initial hospitalization, rehospitalization for heart failure, or adverse left ventricular remodeling at 1 year. Adverse left ventricular remodeling was defined as an increase of 15% or more in the left ventricular end-diastolic volume. RESULTS A total of 395 patients in the cyclosporine group and 396 in the placebo group received the assigned study drug and had data that could be evaluated for the primary outcome at 1 year. The rate of the primary outcome was 59.0% in the cyclosporine group and 58.1% in the control group (odds ratio, 1.04; 95% confidence interval [CI], 0.78 to 1.39; P=0.77). Cyclosporine did not reduce the incidence of the separate clinical components of the primary outcome or other events, including recurrent infarction, unstable angina, and stroke. No significant difference in the safety profile was observed between the two treatment groups. CONCLUSIONS In patients with anterior STEMI who had been referred for primary PCI, intravenous cyclosporine did not result in better clinical outcomes than those with placebo and did not prevent adverse left ventricular remodeling at 1 year. (Funded by the French Ministry of Health and NeuroVive Pharmaceutical; CIRCUS ClinicalTrials.gov number, NCT01502774; EudraCT number, 2009-013713-99.).
Malignant trophoblastic disease in paraguay.

The incidence of malignant trophoblastic diseases in the population of Paraguay was low in the 1960-1969 and 1970-1974 periods as shown by the analysis of unselected hospital admissions as compared to the total population. The Institute of Pathologic Anatomy and the National Tumor Registry in Asuncion Paraguay receive material from the entire republic. Cases are reported from all the affiliated centers. During the 10 years from 1960-1970 227 cases of hydatidiform mole 21 of choriocarcinoma and 13 of chorioadenoma destruens were registered. In the 1970-1974 period 121 hydatiform moles 10 choriocarcinomas and 3 chorioadenomas destruens were registered. To determine the incidence of choriocarcinoma and chorioadenoma destruens for Paraguay the number of cases was divided by the number of total pregnancies calculated from an analysis of 1965 estimates and related to the fertility rate in each age group. Using the estimated number of total pregnancies per year in Paraguay there is 1 choriocarcinoma per 43489 pregnancies and 1 chorioadenoma destruens per 70252 pregnancies if all the probable pregnancies in the period of fertility are considered. Thus the incidence of choriocarcinoma and chorioadenoma destruens is 0.229 and 0.142/1000 pregnancies respectively. This means that 25.22 hydatidiform moles occur for 1 carcinoma or 17.46 hydatidiform moles for 1 chorioadenoma destruens. There were no differences in the calculations for the 1970-1974 period. Vaginal metastases were found in 28.57% of the patients with choriocarcinoma.
Using Critical Incident Technique (CIT) to Capture the Voice of the Student

Purpose – The aim of this paper is to compare the use of critical incident technique (CIT) for gathering student feedback in higher education (HE) with the more traditional and commonly used questionnaire survey method.Design/methodology/approach – The investigation involved a critical evaluation of the standard self-completion, multi-question "tick-box" quantitative survey questionnaire traditionally employed to collect student feedback in HE, against the more qualitative critical incident technique that was tested within the HE context. This evaluation was supported by a review of the extant literature to determine the advantages and disadvantages of both feedback methods and a comparison of the data gathered from university students using both survey instruments. Conclusions were then drawn regarding the value of both methods. The criteria used for the comparison were the design and administration of the survey instruments, analysis and quality of the data collected, and finally, the potential usefulness of the data to HE managers.Findings – The main issue regarding suitability of approach is resource utilization. The CIT questionnaire is much quicker and easier to design than the traditional questionnaire, asking only a small number of questions. However, completion, input and analysis of the CIT questionnaire take longer than the standard tick-box questionnaire. The richness of the data more than compensates for these drawbacks. In principle, the qualitative critical incident technique should be used to complement the existing methods of gathering student feedback in order to find out what is significant to students. However, in practice, it is more likely that managers within HE will continue to use the more traditional survey questionnaire, because of the limited resources available to them.Research limitations/implications – Not only is CIT a method that can be used by researchers in the education sector nationally and internationally, to gather rich and useful data about the student experience but it may also be useful for gathering information from other stakeholders.Originality/value – The paper is the first to use CIT to gather feedback from students on their university experience. It proposes that, in order to obtain valid and reliable data on which to base service provision decisions, university management should consider using this qualitative technique in combination with more traditional quantitative methods of gathering student feedback.
Clinical Significance of Symptoms in Smokers with Preserved Pulmonary Function.

BACKGROUND Currently, the diagnosis of chronic obstructive pulmonary disease (COPD) requires a ratio of forced expiratory volume in 1 second (FEV1) to forced vital capacity (FVC) of less than 0.70 as assessed by spirometry after bronchodilator use. However, many smokers who do not meet this definition have respiratory symptoms. METHODS We conducted an observational study involving 2736 current or former smokers and controls who had never smoked and measured their respiratory symptoms using the COPD Assessment Test (CAT; scores range from 0 to 40, with higher scores indicating greater severity of symptoms). We examined whether current or former smokers who had preserved pulmonary function as assessed by spirometry (FEV1:FVC ≥0.70 and an FVC above the lower limit of the normal range after bronchodilator use) and had symptoms (CAT score, ≥10) had a higher risk of respiratory exacerbations than current or former smokers with preserved pulmonary function who were asymptomatic (CAT score, <10) and whether those with symptoms had different findings from the asymptomatic group with respect to the 6-minute walk distance, lung function, or high-resolution computed tomographic (HRCT) scan of the chest. RESULTS Respiratory symptoms were present in 50% of current or former smokers with preserved pulmonary function. The mean (±SD) rate of respiratory exacerbations among symptomatic current or former smokers was significantly higher than the rates among asymptomatic current or former smokers and among controls who never smoked (0.27±0.67 vs. 0.08±0.31 and 0.03±0.21 events, respectively, per year; P<0.001 for both comparisons). Symptomatic current or former smokers, regardless of history of asthma, also had greater limitation of activity, slightly lower FEV1, FVC, and inspiratory capacity, and greater airway-wall thickening without emphysema according to HRCT than did asymptomatic current or former smokers. Among symptomatic current or former smokers, 42% used bronchodilators and 23% used inhaled glucocorticoids. CONCLUSIONS Although they do not meet the current criteria for COPD, symptomatic current or former smokers with preserved pulmonary function have exacerbations, activity limitation, and evidence of airway disease. They currently use a range of respiratory medications without any evidence base. (Funded by the National Heart, Lung, and Blood Institute and the Foundation for the National Institutes of Health; SPIROMICS ClinicalTrials.gov number, NCT01969344.).
Forebyggelse af overvægt blandt børn og unge - oplæg til strategi

The Danish Fitness and Nutrition Council has evaluated the basis for recommending strategies to prevent obesity among children and adolescents. There is limited evidence of a preventive effect from large population based interventions. It is possible, though, to change to a healthier lifestyle. Currently, many different Administrations conduct interventions against obesity, and it is suggested that an independent authority should be established whose primary aim is to reduce the prevalence of obesity and which will be responsible for the effort against obesity.