Miracle-dz/UniFAR-FTUs huggingface dataset:
Is Closed Reduction and Percutaneous Fixation of Unstable Posterior Ring Injuries as Accurate as Open Reduction and Internal Fixation?

Objectives: The objective of this retrospective review was to determine whether a closed reduction technique for unstable pelvic ring injuries is as accurate as an open technique. Design: Retrospective review. Setting: Two academic Level 1 trauma centers. Patients/Participants: We reviewed the records of 113 patients who had unilateral unstable pelvic ring injuries (Bucholz type 3, OTA type 61-C1) treated with closed reduction and percutaneous fixation (CRPF) or open reduction with internal fixation (ORIF). Intervention: Sixty patients were treated at one institution with open reduction and percutaneous iliosacral screw fixation. This involved prone positioning and a gluteus maximus sparing approach for direct visualization and reduction of the fracture. A second cohort of 53 patients was treated at a separate institution with closed reduction and percutaneous iliosacral screw fixation. This involved supine positioning and skeletal traction. Main Outcome Measures: Preoperative and postoperative plain radiographs of the pelvis were reviewed and standardized measurements were made to compare quality of reduction. Results: We were able to measure displacement within 0.1 mm. Overall reduction quality was slightly better for the CRPF group. The largest average difference in postoperative displacement was seen at the iliac wing height on anteroposterior pelvis radiographs with 6.3 mm (range 0–19.6) in the ORIF group versus 1.9 mm (range 0–4.7) in the CRPF group. Conclusions: The closed reduction technique described here is as effective as the ORIF technique in obtaining reduction of unstable pelvic ring injuries (Bucholz type 3, OTA type 61-C1). Level of Evidence: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Current Status of Schistosoma mansoni Infections and Associated Risk Factors among Students in Gorgora Town, Northwest Ethiopia

Background and Objective. Schistosomiasis is highly prevalent in tropics and causes morbidity and mortality in developing countries including Ethiopia. This study is aimed to assess the current status of S. mansoni infections and associated risk factors among students in Gorgora town, Northwest Ethiopia. Method. A cross-sectional study was conducted from October 2010 to November 2010 at Gorgora, Northwest Ethiopia. All students (579) present during the study period were enrolled. Pretested questionnaires were used to collect sociodemographic data and predisposing factors. Stool examination was performed using wet mount and Kato-Katz techniques. Data were entered and analysed using SPSS version 20.0 statistical software. Result. Among 579 students enrolled, 291 (50.3%) were positive for one or more intestinal parasites. Prevalence of S. mansoni was found to be 20.6% with mean intensity of infection (125 eggs per gram of feces). Lack of awareness and water contact habits such as frequent swimming in the open water source, agricultural activities on bare foot, and washing clothes were also associated with high risk of S. mansoni infection. Conclusion. Even though there seems to be a decline in the prevalence of S. mansoni infections in the study area, the problem still persists and affects students significantly. Therefore, therapeutic intervention and health education are needed.
Prevalência de sobrepeso e obesidade em crianças e adolescentes de diferentes condições socioeconômicas

OBJECTIVES: to compare overweight and obesity in preschool children, school children and adolescents belonging to different socioeconomic conditions. METHODS: cross-sectional and based on a 1616 children and adolescents sample. Nutritional indicators were defined according to the National Center of Health Statistics 2000 recommendations, overweight being BMI equal to or above 85 percentile and below percentile 95; obesity indicator being defined with BMI equal to or above the 95 percentile. RESULTS: overweight was detected in 234 (14.5%) individuals and obesity in 134 (8.3%). Overweight prevalence was higher among preschool children (22.2%), though prevalence reduction was noted in younger school children (12.9%) and adolescents (10.8%). A similar pattern was found for obesity in 13.8% of preschool children, 8.2% of school children, and 4.9% of adolescents. Overweight and obesity were mostly observed among children and adolescents of high income families. CONCLUSIONS: as age increases overweight and obesity diminish. Similar overweight prevalence was detected among preschool children irrespective of socioeconomic conditions. Overweight prevalence was highest among school children with high socioeconomic conditions and adolescents with low socioeconomic conditions.
Posterior Malleolar Fractures Associated With Tibial Shaft Fractures and Sequence of Fixation

Objectives: The purpose of this study was to evaluate posterior malleolar injuries associated with nailed tibial fractures and to determine the quality of reduction based on the sequence of fixation in associated fracture patterns. Design: Retrospective cohort study. Patients: 1113 tibia fractures treated with an intramedullary nail at 3 level I trauma centers. Intervention: Tibial shaft fractures with posterior malleolar injury were analyzed regarding type of fracture, mechanism of injury, energy of injury, fracture characteristic, surgical characteristics including sequence of fixation, obvious intraoperative displacement of the posterior malleolar fragment, and the quality of reduction. One group (“malleolus-first”) consisted of patients in whom the posterior malleolus was fixed before tibial nailing and the other group (“tibia-first”) included patients in whom tibial nailing was done before posterior malleolus fixation. Outcomes Measured: Intraoperative displacement, quality of reduction. Results: Ninety-six of 1113 (9%) nailed tibial shaft fracture patients had a concomitant posterior malleolus fracture (9%). Of the 96 posterior malleolar fracture patients, 70 patients were operatively treated (73%). In the malleolus-first group (54 patients), intraoperative displacement of the posterior malleolar fragment was observed in 1 patient, and 1 case of poor reduction of the posterior malleolar fragment was observed (2%). In the tibia-first group (16 patients), obvious intraoperative displacement of the posterior malleolar fragment was observed in 5 patients (31%), and poor reduction of the posterior malleolar fragment was observed in 7 patients (44%). These percentages of patients with poor quality of reduction were statistically significantly different (p ⩽ 0.01). Conclusion: Many low-energy tibia fractures with a spiral configuration do have an associated posterior malleolus fracture. In order to avoid intraoperative displacement and poor reduction, we recommend fixation of the posterior malleolar fragment before nailing of the tibia in associated fracture pattern. Level of Evidence: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
A study on the relevance among Self efficacy, Major satisfaction, Nursing ethics values in Nursing Students before Clinical Practice

Abstract The purpose of this study was to explore relationship among self efficacy, major satisfaction, nursing ethics values in nursing department students so nursing students' ethical values, so that the correct opening for the establishment of training courses was to try to provide the basic data. Data were collected from 275 nursing department students and analyzed using descriptive statistics, t-test, ANOVA, Bonferroni's test and Pearson's correlation coefficients with the SPSS/WIN 18.0 program. The results of this study self-efficacy, major satisfaction was more than the middle, the subjects were taking positions of responsibility. Nursing ethics values and self-efficacy, major satisfaction and subject areas showed a very low correlation, self-efficacy and major satisfaction is a significant positive correlation. Therefore, to enhance self-efficacy and nursing students that can be sustained by developing a variety of educational programs for nursing professionals to meet and establish a firm that values nursing ethics is urgently required.
CYANIDE POISONING IN SAN FRANCISCO

A few minutes before 3 o'clock on the afternoon of July 26, 1932, three men were brought by ambulance to the Central Emergency Hospital, all in coma and showing signs of cyanosis. They had collapsed, less than fifteen minutes previously, immediately after taking a drink of liquor in the office of one of the three (L. J.). Treatment, consisting of gastric lavage, artificial respiration and cardiorespiratory stimulants, was begun immediately. Death occurred in all three instances, the result of cyanide poisoning. Case 1. —J. L. , a traffic officer, was comatose when he arrived at the hospital. There was cyanosis of the face, neck and hands; dilated pupils, white froth about the lips, and incontinence of urine. There were no convulsions. The pulse was imperceptible; the respiration, shallow and slow. Artificial respiration and oxygen inhalation (tubal) and gastric lavage (sodium bicarbonate solution) were administered, and caffeine sodiobenzoate (0.5 Gm. subcutaneously) and
Population screening for prostate cancer: An overview of available studies and meta‐analysis

The objective of the present review was to evaluate the effect of population‐based screening on the incidence of prostate cancer, prostate cancer tumor stage and grade, prostate cancer mortality, and overall mortality. A systematic review was carried out in April 2011, searching the Medline and Web of Science databases. The records were reviewed to identify comparative and randomized controlled trials evaluating the effect of screening on prostate cancer. Eight trials were identified containing personalized data on a screened versus a non‐screened cohort. Prostate‐specific antigen and digital rectal examination were the main screening tools. Prostate‐specific antigen threshold and screening interval was not uniform among the different trials. Screening was associated with a significant increase in prostate cancer detection (relative risk 1.55; P = 0.002), and a significant shift towards more localized (relative risk 1.81; P = 0.01) and more low‐grade tumors (relative risk 2.32; P = 0.001). In overall analysis, no significant effect on prostate cancer mortality (relative risk 0.88; P = 0.18) and overall mortality (relative risk 0.90; P = 0.27) in favor of screening was observed. An adjusted analysis excluding papers with short follow up, high prostate‐specific antigen contamination in the non‐screening group and low participation in the screening group was able to show a significant reduction in prostate cancer mortality of 24%. The ideal screening strategy is unclear. Screening is associated with better PC detection and this in a more localized stage and of less aggressive tumors. Excluding the main shortcomings in screening studies (short follow up, high prostate‐specific antigen contamination in non‐screening group and low participation in screening group), screening is able to reduce prostate cancer mortality.
Self-Stigma Experiences Among Older Adults with Mental Health Problems Residing in Long-Term Care Facilities: A Qualitative Study

ABSTRACT Self-stigma is linked with a variety of deleterious consequences for the stigmatised individual. Much of the past research on self-stigma focuses on younger adults; however, little is known about the self-stigma experience among institutionalised older adults with mental health problems. This study aims to explore experiences of self-stigma among older adults with mental health problems in long-term care facilities. Ten semi-structured interviews were conducted. Insight into mental illness was identified as having a key influence upon the self-stigma experiences among this group. Participants shared common understandings, views, and behavioural reactions towards mental health problems. Lacking control, public stigma, sympathy, disinterest, avoidance, and fear were key themes among them. Re-conceptualising self-stigma theories and implementing interventions that aim at reducing stigmatising attitudes among this group are essential.
Time From Injury to Surgical Fixation of Diaphyseal Humerus Fractures Is Not Associated With an Increased Risk of Iatrogenic Radial Nerve Palsy

Objectives: To determine whether time from injury to fixation of diaphyseal humeral fractures and nonunions is associated with the risk of iatrogenic radial nerve palsy. Design: Retrospective review. Setting: Two Level 1 trauma centers. Patients/Participants: Between 2001 and 2015, 325 patients who had documented intact radial nerve function preoperatively were treated with fixation of a humerus fracture or humerus nonunion. Intervention: Open reduction and internal fixation. Main Outcome Measurements: Development of an iatrogenic radial nerve injury. Those with an injury were followed to either resolution of the nerve palsy or definitive treatment. Results: The risk of iatrogenic radial nerve palsy was 7.7% (25/325). Time to surgery was not significantly associated with iatrogenic radial nerve palsy. In a multiple variable analysis, when comparing patients treated within 4 weeks to those treated 4–8 weeks (P = 0.41), 8–12 weeks (P = 0.94), and over 12 weeks (0.20), there were no significant associations. Independent risk factors for iatrogenic radial nerve palsy included distal location of fracture (P = 0.04, odds ratio 3.71) and previous fixation (P = 0.03, odds ratio 3.80). Of the 25 iatrogenic nerve injuries, 22 recovered fully with expectant management, 1 was lost to follow-up, and 2 required either nerve graft or tendon transfers. Conclusions: Time from injury to surgery does not seem to be a risk factor for developing an iatrogenic radial nerve palsy when treating diaphyseal humerus fractures. Patients with distal fractures, and those with previous fracture implants, are at increased risk of iatrogenic radial nerve palsy. Level of Evidence: Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Considerations for the orthodontic treatment during pregnancy

Pregnant women are advised against doing many things during their pregnancy, from taking certain types of medication, to eating some foods. However, there is no real reason why pregnant women should not have orthodontic treatment. For pregnant women orthodontic treatment is typically considered to be a safe, but with some precaution. Some local and systemic conditions limit the treatment modalities. There are some considerations for pregnant women to take into account. Sensitivity is often heightened during pregnancy and this may mean that braces seem a little more uncomfortable than usual; it is also worth bearing in mind that most painkillers are off-limits during pregnancy and hence patient will have to battle through any pain without taking medication. Hormonal changes in the body during pregnancy can increase the risk of swollen, sore gums and braces may irritate the gums. Hormonal changes and drugs can affect the orthodontic tooth movement. If patient have braces are pregnant and have concerns about their braces, it is important for patients to see their orthodontist on a regular basis during pregnancy.
Self-Reports of Recovery-Oriented Practices of Mental Health Nurses in State Mental Health Institutes: Development of a Measure

The focus of this study was to modify a measure of recovery practice for mental health nurses and explore nurses' self reports of recovery practices. Findings support the soundness of the Recovery Self Assessment-Registered Nurse Version (RSA-RN) as a self-assessment instrument designed to evaluate recovery-oriented nursing practice. More favorable perceptions of recovery practices were noted amongst older and more experienced nurses, those who had previous formal training or education in mental health recovery or psychiatric rehabilitation, and those who considered their facilities to be recovery-oriented. The RSA-RN can be use to identify nurses' and nursing departments' strengths in the provision of recovery-oriented interventions and lead to focused performance improvement.
Prediction Model of In-Hospital Mortality After Hip Fracture Surgery

Objectives: Mortality in elderly patients after the surgical treatment of hip fractures remains high. Although individual clinical risk factors have been widely studied, there has been limited research on prediction models in this population. The purpose of this study was to develop a prediction model for in-hospital mortality after hip fracture surgery and to evaluate the performance of this model. Methods: Using the National Inpatient Sample database from 2012 to 2013, we collected data on 535,475 patients older than 50 years who had hip fracture surgery. Patient characteristics, surgery-specific factors, and Elixhauser comorbidities were used as candidate variables. The patients were randomly divided into training and testing cohorts. The Lasso (least absolute shrinkage and selection operator) method was used to select predictor variables, and points were assigned to each variable based on its coefficient. Results: We identified 8 essential predictors (age, timing of surgery, male sex, congestive heart failure, pulmonary circulation disease, renal failure, weight loss, and fluid and electrolyte disorders) for mortality, with a maximum prediction score of 20. The model's area under the curve was 0.74, and the Hosmer–Lemeshow test P value was 0.59 on the testing set. With the application of cutoff values (scores 0–5, 6–9, and 10–20), the observed in-hospital postoperative mortality was 0.6%, 2.5%, and 7.5%, respectively. Conclusions: We built a simple prediction model with 8 essential clinical factors that predict in-hospital mortality after hip fracture surgery. This model may assist in counseling patients and families and measuring hospital quality of care. Level of Evidence: Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Perceptions of the Relationship Between Mental Health Professionals and Family Caregivers: Has There Been Any Change?

A number of international studies have highlighted family caregivers' (FCGs') dissatisfaction with their relationship with mental health professionals (MHPs) when providing care for mentally ill family members. However, few studies have explored the mental health professionals' perspective of this relationship. This study explored both FCGs' and MHPs' perspectives. Semi-structured interviews were conducted with seven FCGs and seven MHPs from two different geographical areas of New Zealand. Thematic analysis of these interviews revealed four distinct MHP themes and five FCG themes. The themes illuminate incongruence between MHPs' intentions to form a positive working relationship with families and the FCGs' mainly negative experiences of this relationship.
Integrated meta-analysis on 6402 patients with early breast cancer receiving neoadjuvant anthracycline-taxane +/- trastuzumab containing chemotherapy.

Abstract #79 Background: An integrated meta-analysis on individual data has been performed on 7 prospective neoadjuvant trials containing doxorubicin (A) or epirubicin (E), docetaxel (D) or paclitaxel (P) (with or without trastuzumab (H)) conducted by the German Breast Group and the AGO Breast Group. Methods : Patients (Pts) with operable or locally advanced, non-metastatic breast cancer were included in trials between 1998 and 2002: GeparDo (dose-dense (dd) AD +/- tamoxifen (Tam), N=248), GeparDuo (ddAD+Tam vs AC-D+Tam;N=904), AGO 1 (EP vs ddE-ddP;N=666), Gepartrio-Pilot (DAC+/-vinorelbine/capecitabine(NX);N=284), and between 2003 and 2007: GeparTrio (DACx6 vs DACx8; DACx6 vs DAC-NX;N=2072); Prepare (EC-P vs ddE-ddP-CMF;N=733) and GeparQuattro (EC-D vs EC-DX vs EC-D-X;+H if HER2+),N=1495). Pathological complete response (pCR) is defined as no invasive residuals in the breast and lymphnodes (ypT0/is,ypN0). Results: Overall 1200 (18.7%) out of 6402 pts (13.7% before and 21.2% after 2003) had a pCR at surgery. pCR-rates according to treatment groups were: conventional dosed (N=5007): 20.1% vs dose-dense (N=1395): 13.9% (p = 50 yrs (N=3248): 15.9% (p 5cm (N=1358): 14.1% (p Conclusions: Findings of this meta-analysis might be used to better select patients and treatment for the neoadjuvant approach and development of new strategies to further improve pCR and breast conservation rate. Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 79.
The Use of Intramedullary Helix Wire for the Treatment of Proximal Humerus Fractures

Objective: To present the functional and radiographic outcome 1 and 6 years after application of a new intramedullary fixation device for proximal humerus fractures. Design: Retrospective case series. Setting: Level II orthopaedic surgery hospital. Patients: Twenty-six consecutive patients (average age 68.9 years) with 2-, 3- and 4-part fractures of the proximal humerus were operated at a single institution. Follow-up was performed after 1 year (26 patients) and 6 years (16 patients). Intervention: All patients were treated with closed reduction and intramedullary helix wires. Main Outcome Measurements: The Constant-Murley score and the University of California Los Angeles (UCLA) score. Clinical complications and radiological posttraumatic arthritis were recorded. Results: The average Constant-Murley score was 70.3 (points) and 70.7 after 1 and 6 years, respectively; the average UCLA score was 27.2 and 31.5 after 1 and 6 years, respectively. Major complications were 4 revisions for 3 secondary fragment displacements and 1 nonunion with partial avascular osteonecrosis in the first postoperative year. Complications were found predominantly in 4-part fractures (3/5, 60%). There were no further complications or progressive posttraumatic arthritis up to 6 years following surgery. Conclusion: The helix wire is well suited for displaced or unstable 2- and 3-part proximal humerus fractures. Adequate functional outcome, a low number of implant displacements, a low number of application morbidity, and infrequent implant removals were recorded. The use of this device is not recommended for 4-part fractures.