Miracle-dz/UniFAR-FTUs huggingface dataset:
Anesthetic management of a dog with severe subaortic stenosis and mitral valve disease complicated with atrial fibrillation undergoing ovariohysterectomy

The anesthetic management in patients with subaortic stenosis and mitral valve disease should involve intensive monitoring and the anesthesiologist’s main concern is to ensure oxygen delivery and tissue perfusion. Since anesthetic procedures in such patients are rare, there is no previous report about the anesthetic management. A 5.5-year old, 32-kg Boxer, suffering a severe heart disease due to a final stage subaortic stenosis and mitral insufficiency, was anesthetized for an ovariohysterectomy to remove an ovarian tumor that was producing high-volume ascites. Methadone (0.3 mg kg−1) was administered intramuscularly (IM) for pre-anesthetic medication, etomidate (1.3 mg kg−1) and midazolam (0.2 mg kg−1) were used for the induction of anesthesia and after endotracheal intubation, anesthesia was maintained with sevoflurane vaporized in oxygen and air. Fentanyl (5–10 μg kg−1 h−1) and paracetamol (15 mg kg−1) were administered to improve analgesia. Previous persistent atrial fibrillation was refractory to medication (digoxin, diltiazem, and pimobendan) and continued during the anesthetic procedure. Dobutamine (1.5–5 μg kg−1 minute−1) helped to maintain mean arterial blood pressure above 60 mmHg. Epidural morphine (0.1 mg kg−1) and incisional bupivacaine (2 mg kg−1) were administered at the end of surgery to provide postoperative analgesia. Anesthesia was otherwise uneventful, and recovery was considered excellent.
An Introduction To Discourse Analysis Theory And Method

an introduction to discourse analysis theory and method is available in our digital library an online access to it is set as public so you can download it instantly. Our digital library hosts in multiple locations, allowing you to get the most less latency time to download any of our books like this one. Merely said, the an introduction to discourse analysis theory and method is universally compatible with any devices to read.
Prevalence of Low Back Pain and its Associated Factors in Reproductive Age Group Female Patients Attending Gynaecology OPD

Background: Low back pain related disability and work absence accounts for high economical costs in modern society. A prevalence of 28-80% has been found with increase of prevalence with age and female preponderance. Methods: The present study was conducted on 125 non pregnant women complaining of low back pain attending OPD Department of Obstetrics and Gynaecology, Era’s Lucknow Medical College and Hospital during the period of 6 months. A brief questionnaire was used to screen, among the respondents, the occurrence of low back pain in the past year. Results: Low back pain was associated with high BMI, high waist circumference, more number of children, irregular and prolonged duration of menstruation, young maternal age at first birth and with history of abortion. Conclusions: Hormonal and reproductive factors are associated with low back pain. Keywords: Hormonal factors, Reproductive factors, Reproductive female
Reliability of a Test for Assessment of Isometric Trunk Muscle Strength in Elderly Women

Objective The aim of this study was to analyze the reproducibility of a protocol using the maximal isometric strength test of the trunk in elderly women aged above 60 years, without low back pain. Methods Twenty-one physically inactive elderly women, who had not engaged in any activity or exercise program in the past three months, participated in the cross-sectional study that consisted of two days of evaluations for the maximal isometric strength of the extensor and flexor muscles of the trunk, with a 48 h interval between the sessions. A platform with fixed seating was used, which allowed the fixation of the hip and lower limbs, with a load cell connected to a linear encoder. To verify the reliability of the test, the interclass correlation coefficient, variation coefficient, minimum detectable difference (MDD), standard error of measurement, and Bland–Altman graphs were calculated. Results No statistical difference was observed between the first and second evaluation, which indicates that there was no learning effect. Interclass correlation coefficient values were classified as very high and high for extensor (0.98) and flexor (0.86) muscles, respectively, besides low variation (9% for both muscle groups) and acceptable values for minimum detectable difference (extensors = 51.1 N, flexors = 48.9 N). In addition, the Bland–Altman analysis revealed low bias and values within the limits of agreement. Conclusion It is concluded that the test of maximum isometric strength of the trunk in healthy and trained elderly people presents high reliability. These values proved to be reliable if performed in at least two evaluation sessions, which confirms the hypothesis of the authors by the consistency of the measurement test.
Neuregulin-1 effects in metabolic changes induced by pulmonary arterial hypertension

Pulmonary arterial hypertension (PAH) is a chronic rare disease, characterized by increased pulmonary vascular resistance (PVR) with progressive overload and remodelling of the right ventricle (RV), that eventually leads to right ventricular heart failure (RVHF). These derangements arise from a metabolic switch from glucose oxidation towards glycolysis, the Warburg effect, affecting glucose metabolism at the systemic level. The neuregulin-1 (NRG1), a protein that has been shown to play beneficial effects on PAH and RV hypertrophy, has also been associated with the regulation of glucose metabolism given its role in modulating the expression of glucose transporters (GLUTs). In this study we aimed to evaluate the effect of rhNRG1 chronic treatment on glycolysis pathway genes expression in the RV and skeletal muscle in a monocrotaline (MCT)-induced PAH animal model and in chronic hypoxia/Sugen5416 model that also reproduces key pathophysiological features from human PAH. We have found that RV GLUT1 and GLUT4 mRNA expression is altered in PAH and was similar between the MCT and hypoxia/Sugen5416 animal models, being this related with the development of RV hypertrophy (RVH). However, the treatment with rhNRG1 only attenuated GLUTs expression toward normal values in MCT-induced PAH model. The expression of GLUT1 and GLUT4 is correlated with cardiac markers of disease, while the glycolytic pathway genes are correlated with the morphophysiological changes resulting from the development of PAH in MCT model. From the analysis of some glycolytic pathway genes, we conclude that beyond GLUTs, several genes are related, not only with the Warburg effect, but also with the disease progression. We also found that the treatment with rhNRG1 attenuated the changes in some glycolytic pathway genes, resulting in an improvement of glucose metabolism. The glucose tolerance evaluation revealed that the animals with PAH from both models are insulin resistant and that the treatment with rhNRG1 regulated systemic glucose concentration in both animal models. In conclusion, the therapeutic effects of NRG1 in experimental PAH may be due, in part, to the regulation of metabolic changes associated with PAH progression and RV dysfunction, which were reflected in the reversion of the ventricular phenotype of the disease.
Chinese guidelines for the diagnosis and treatment of hospital-acquired pneumonia and ventilator-associated pneumonia in adults (2018 Edition).

Hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP) are the most common hospital-acquired infections in China. The difficulty in diagnosis and treatment of HAP/VAP leads to high mortality. In China, it has been nearly two decades since the initial “ Guideline for the Diagnosis and Treatment of Hospital-acquired Pneumonia ( draft )” was published in 1999 (1). Afterwards, a number of guidelines for HAP/VAP have been published or updated at home and abroad (2-10). The definitions of HAP/VAP have been changing as more and more relevant researches available highlighting greater details. Moreover, there are growing evidence in the epidemiology, etiology, clinical diagnosis and treatment of HAP/VAP, especially the accumulating evidence from the researches in China, which shows that the distribution and antibiotic resistance rate of HAP/VAP pathogens in China are largely different from the data reported in other countries. Therefore, it is necessary to amend the initial guideline in 1999 accordingly in order to better guide clinical practice.
Mitral valve Z value in Iranian patients with tetralogy of Fallot

Background: Tetralogy of Fallot (TOF) refers to a condition in which left ventricular volume is normal or slightly less than normal. Given the differences observed in some Asian patients with TOF, the present study was conducted to investigate left heart by determining Z-scores for the mitral valve in Iranian patients with TOF. Methods: Eligible subjects in this prospective descriptive study comprised all patients with TOF presenting to Shahid Modarres Hospital in Tehran from March 2012 to March 2015 and diagnosed as the candidates for surgery. After determining the need for surgery and the therapeutic method required, the mitral valve size and Z-scores were calculated. We analyzed sex, age, body surface area (BSA), mitral size (in 2-chamber and 4-chamber view), mitral Z-score, other cardiac anomalies, number of surgery and previous surgery. Results: Of a total of 80 patients included in the study over 3 years, 29 (36.3%) were male and 51 (63.8%) were female. The mean age of the patients was 7.15±3.37 years and their mitral size was found to be 10-27 mm (16.2±5.99 mm) using echocardiography. Z-scores of the mitral valve were also obtained as -3.09±2.11, ranging between -7.1 SD and +1.3 SD. 58 (72.5%) patients have only TOF and 22 (27.5%) with other cardiac anomalies. 45 patients were for first time underwent surgery and 22 patients for second time, 12 patients for three time and 1 for forth. Of a total of 35 patients had previous surgery, the most common were shunt 15 (42.9%) and then tetralogy of Fallot total correction (TFTC) in 12 (34.3%). Of a total of 80 patients, 59 (73.8%) underwent TFTC, 17 (21.3%) under pulmonary valve replacement and 4 (5%) shunt. Conclusion: Z-scores of the mitral valve were found to be significantly below the normal value, (i.e. 0±2 SD), in the study patients, suggesting the risk of hypoplastic left heart syndrome in Iranian patients with TOF, nevertheless, the type of TOF examined in these patients might have been different from those observed in other races and re-gions. Abstract
Effects of geomorphometric variables variability due to different computing algorithms in environmental modeling

Various environmental modeling models use geomorphometric variables in their structure, for estimating environmental variables. These geomorphometric variables have several computing algorithms implementations, which give different values of output for every algorithm. Although there are several papers concerning the ranking of the algorithm accuracy compared with reference data, not always the best ranked algorithm will be used for computing that geomorfometric variable, because of several reasons, including algorithm availability in GIS software. We use gridded mathematical surfaces as source of geomorphometric variables and different algorithms to compute them, in order to test the effects of their value variability in several types of environmental models. Error propagation equations are used as estimators of error due to variables variability, and the variance of obtained value with reference to the average value of the total obtained values using all the algorithms, is used to assess the variability. Because not always a single algorithm can be considered the best estimator, we consider the use of the all possible algorithms and the averaging of the results, which can be a general and a spatial good performance operation for minimizing the errors. © 2010 Published by Elsevier Ltd. Selection and/or peer-review under responsibility of (name organizer)
Interleukin-6 Expression in Colorectal Tumors in Iraqi Patients

Background: Colorectal cancer ranks as the 7th most common cancer among Iraqis. This task intended to check out the tissue level of Interleukin-6 (IL-6) in colorectal tumors using IL-6 specific antibodies and Immunohistochemistry (IHC). Methods: IHC staining was performed using Interleukin-6 (IL6) specific antibodies. Tissue samples included 50 cases of colorectal cancer, 8 cases of colon adenomas in addition to 20 samples of normal colon tissues as a control. Results: Total 39 out of 50 colorectal cancer cases (78%) demonstrated positive expression of IL-6 specific antibody. While only 2 out of 8 adenomas (25%) exhibited positive outcome when stained with this marker, comparing to 20 normal colon tissue samples which revealed a negative expression of IL-6. Results disclosed significant association between IL-6 expression and clinicopathological traits including age, sex as well as tumor stage and grade. Conclusion: Our findings revealed that IL-6 might be a valuable indicator for predicting the prognosis for patients with colorectal cancer and might act as a future therapeutic approach in colorectal cancer.
The effect of iron on vitamin D level in children with combined iron and vitamin D deficiency

Introduction: Iron deficiency (ID) and vitamin D deficiency (VDD) are two common nutritional problems. Recently, an association between these two disorders has been suggested that remains to be definitely confirmed.Objectives: Our aim was to compare treatment with iron, vitamin D, and their combination on serum levels of vitamin D in children with ID and vitamin D insufficiency (VDI). Patients and Methods: A total of 90 patients with low levels of ferritin and vitamin D were assigned to three groups of 30 each: treatment with iron for ID, treatment with vitamin D, and co-treatment with vitamin D and iron. Levels of vitamin D and ferritin were measured before and 3 months after treatment. Data analysis was entirely conducted by paired t-test, one-way ANOVA using SPSS 19. Results: Serum vitamin D levels significantly changed 3 months after treatment in the vitamin D and iron+ vitamin D groups (P < 0.01), but not in the iron group (P = 0.68). Comparison of mean changes in serum vitamin D levels was not significantly different between the iron+ vitamin D and vitamin D groups (P = 0.774). Conclusion: Iron supplementation alone could not significantly increase vitamin D levels in studied children. Vitamin D supplementation and vitamin D+ iron supplementation caused similar effects on serum vitamin D levels, and management of ID did not have any incremental effect on vitamin D levels in children. It is necessary to use vitamin D supplementation to control and treat VDD.
Acute Exacerbations of COPD; A One Year Hospital-Based Study, Egypt

Background: acute exacerbations are frequent during the course of chronic obstructive pulmonary disease (COPD). They are associated with increased morbidity and mortality. The aim of the study: is to characterize the patients who are hospitalized for acute exacerbation of COPD and the factors related to frequent hospitalization. Patients and Methods: observational cohort study. One hundred and one patients admitted to our hospital for acute exacerbation of COPD over one year (group I) and equal number of patients with mild COPD exacerbation not requiring hospital admission (groupII) were studied. Results: We found that 101 patients admitted with acute exacerbation of COPD accounted for 10% of all admissions to medical departments and 2% of all admissions to our hospital. Group I patients had more advanced disease, high frequency of current smoking and comorbidities, frequent use of systemic steroids and home oxygen therapy. They had significant leukocytosis with neutrophilia, and higher partial pressure of carbon dioxide in arterial blood (paCO2). Significantly lower partial pressure of oxygen in arterial blood (PaO2), low 6-minute walking distance (6MWD) and more advanced COPD assessment test (CAT) score and BODE index. Severity of acute exacerbation of COPD, hypercapnia, previous ICU admission, low body mass index (BMI), low (6MWD), low PaO2, and the presence of comorbidities are the factors associated with increased frequency of hospital admission. Conclusion: COPD patients who had severe acute exacerbation, comorbidities, hypoxemia, hypercapnia, history of previous admission to ICU, low BMI, and impaired physical activity are more likely to be admitted to hospital during acute exacerbation of COPD.
The Prevalence and Risk Factors for Potential Oral Malignant Disorders in a Middle Aged North Indian Population

INTRODUCTION: The menace of oral cancer has become a public health concern and its prevalence is increasing with every passing day, making it the sixth most common cancer across the globe. OBJECTIVE: To evaluate the prevalence and risk factors for potential oral malignant disorders in a middle aged north Indian population. MATERIALS AND METHODS: This Cross-sectional study was carried out on 1260 individuals in Delhi and NCR. A questionnaire was created to record information about socio demographic traits, oral hygiene routines, threat associated to oral probable malignant disorders . The Oral Mucosal lesions were examined by professionals. Results. The Overall Prevalence of Potential oral malignant disorders was found to be with oral submucous fibrosis (6.09%) found in a greater extent and erythroplakia (0.15%)found to be lesser. RESULTS: It was documented that 11.48% of the Northern Indian Population which suffered from oral malignant lesions, with the prevalence rates of leukoplakia in 3.01%, Lichen Planus in 1.42% and lowest being erythroplakia in 0.15% of the subjects. The prevalence of oral malignant lesions among males was found to be higher(12.8%) as compared to females p value <0.0001. No significant difference was found between categories of socio-economic status, tooth brushing methods ,brushing frequency with prevalence of oral malignant disorders CONCLUSION: The Study augments an interrelation between tobacco and areca nut consumption with oral probable malignant disorders. An interrelation of oral probable malignant disorders with diabetes and BMI was confirmed by this study.
Influence of erythrocyte shape on platelet scattering towards vessel wall

Red Blood Cell (RBC) geometry forms unique distinguished shape. This shape is thought to have a major influence on both the function and the dynamics of the moving erythrocyte. The shape of the RBC is hypothesised to cause platelet scattering and diffusion towards vessel wall. The current study is built to provide a detailed review of the previous theories that discuss the influence of RBC shape on its functionality and dynamics, a detailed focus on the influence of RBC dynamics on platelet migration towards the vessel wall is presented. Afterwards, computational results representing the influence of RBC shape on platelet migration to the vessel wall are listed. The results involve comparison between circular and elliptical RBCs using low Reynolds number channel flow regime. It is shown that this migration process is primarily affected by the diameter of the RBC and not by its shape.
Prevalência de leptospirose em fêmeas bovinas abatidas em frigoríficos no município de São Luís, MA

ABSTRACT. Coelho E.L. M. , Chaves N.P., SA J.C. de, Melo S. de A. & Silva A.L. A. [Prevalence of leptospirosis in bovine females slaughtered in slaughterhouse in the municipality of Sao Luis, MA. ] Prevalencia de leptospirose em femeas bovinas abatidas em frigorificos no municipio de Sao Luis, MA. Revista Brasileira de Medicina Veterinaria, 36(2):111-115, 2014. Departamento de Patologia, Universidade Estadual do Maranhao, Cidade Universitaria Paulo VI, Cx. Postal 9, Tirirical, Sao Luis, MA 65055-970, Brazil. E-mail: abreusilva.ana@gmail.com The aim of this study was to determine the prevalence of leptospirosis in bovine females slaughtered in slaughterhouse in the city of Sao Luis, MA. Sera samples from 100 cows not been vaccinated against leptospirosis were analyzed using the microscopic agglutination test (SAM). The study was conducted in 03 stores under the Municipal Inspection. Blood samples were collected from females without clinical signs of leptospirosis over the age of 24 months. Among 100 serum samples analyzed for 64% (n = 64) were positive with titres equal to or greater than 1:200, and 36% (n = 36) negative for all serovars tested. Of the 24 strains was tested the most frequent in descending order were: hadjo, grippotyphosaand wolffi. The prevalence of leptospirosis in cows slaughtered in abattoirs in Sao Luis, MA was high. These findings indicate the need to carry out systematic diagnosis and monitoring of herds, besides the implementation of control measures and prophylaxis, as the gradual removal of infected animals, performing quarantine to the entry of new properties in animals, serological tests, vaccinations and implementation of good hygiene practices in slaughterhouses.
Is N-terminal pro-brain natriuretic peptide a reliable marker for body fluid status in children with chronic kidney disease?

Introduction Brain natriuretic peptides, released in response to left ventricular stress, have a strong prognostic value in dialysis patients. However, their role in detecting abnormalities of fluid status is under debate; the relationship between volume status and brain natriuretic peptides (BNPs) differs among various studies. The aim of our study was to evaluate the clinical utility of N-terminal proBNP in the assessment of fluid status and cardiovascular risk in this setting. Material and methods The study included 65 children: 10 pre-dialysis, 13 hemodialysis, 12 peritoneal dialysis patients and 30 healthy controls. Volume status was determined by multifrequency bioimpedance and NT-pro-BNP, as well as echocardiography to estimate the left ventricle structure and function. Results The median log NT-proBNP values of hemodialysis and peritoneal dialysis patients were 3.66 (2.05–4.90) and 3.57 (2.51–4.13) pg/ml, respectively, and significantly higher compared with the control group (p < 0.001, p < 0.001). On simple correlation, NT-proBNP was correlated with markers of volume overload and cardiac dysfunction. On multivariate regression analysis, only left ventricle mass index (β = 0.402, p = 0.003) and left atrium diameter (β = 0.263, p = 0.018) were independently associated with NT-proBNP (adjusted R2 of the model: 0.707, p < 0.001). Conclusions Our research suggested that NT-proBNP, which was correlated with LV systolic and diastolic dysfunction and fluid overload as assessed by bioimpedance, can be used to evaluate cardiovascular states in a chronic kidney disease (CKD) population. From the early stages of CKD, periodic monitoring of NT-proBNP levels may be essential for early detection of patients with high risk of cardiovascular events, and for taking preventive intervention as soon as possible.