Miracle-dz/UniFAR-FTUs huggingface dataset:
Expression of ghrelin is correlated to a favorable outcome in invasive breast cancer

Abstract Background. Expression of the peptide hormones ghrelin and obestatin has previously been demonstrated in human mammary glands. However, the clinical implications of the expression of these peptides in breast cancer are unclear. The aim of this study was to investigate the potential clinical value of ghrelin and obestatin as breast cancer biomarkers. Methods. A tissue microarray containing breast cancer specimens from 144 patients was immunostained with antibodies directed towards ghrelin and obestatin. Using varying cut-offs, the expression of the two peptides was evaluated and correlated to previously known prognostic factors in breast cancer and to the outcome. Cox regression analysis was used to assess whether these markers may predict survival of breast cancer patients. Results. Moderate to strong immunoreactivity for ghrelin and obestatin was observed in 71.5% and 77.1% of the cases, respectively. Ghrelin and obestatin expression was significantly but weakly correlated to low histological grade, estrogen receptor positivity, small tumor size and low proliferation. Only ghrelin expression was significantly correlated to better recurrence-free and breast cancer-specific survival (HR = 0.3–0.4, p = 0.02–0.05) in both uni- and multivariate analyses. The optimal cut-off was any ghrelin expression versus none. Reproducibility between the two readers was very good for both stainings with kappa values of 0.94–1.00. Conclusions. Patients with tumors expressing ghrelin had 2.5–3 times lower risk for recurrence or breast cancer death than those lacking ghrelin expression. Ghrelin expression is easily assessable with high reproducibility using immunohistochemistry. Further investigations are needed to establish the clinical significance of ghrelin as a biomarker in breast cancer.
Prevalence of health behaviors and their associated factors among a sample of university students in India

Abstract Objective: With advances in knowledge about health promotion, public health professionals are in search for the determinants of personal health behaviors. The purpose of this study was to assess the prevalence of health behaviors and its associated factors in a sample of Indian university students. Materials and methods: Using a cross-sectional survey, we assessed health behavior among a sample of randomly selected university students. The sample included 800 university students from non-health (mainly engineering and sciences) undergraduate courses of Gitam University, Visakhapatnam in India. The students were 541 (67.6%) males and 259 (32.4%) females in the age range of 17–20 years (Median age=18.2 years, SD=1.0). Results: On average, students engaged in 15.8 out of 25 health behavior practices. There was a high rate of overweight and obesity (26.8% and 10.7%, respectively), low rate of brushing teeth at least twice a day (28.6%), annual dental check-up (25.8%), habitual seatbelt use (23%), and poor dietary patterns (79% ate less than the recommended fruit and vegetable consumption of five servings a day, and 68.5% did not avoid eating fat and cholesterol). In multivariate analysis among men, personal constraints (Odds Ratio=OR 1.75, Confidence Interval=CI 1.09–2.82), health benefits (OR=2.01, CI=1.27–3.17), and not suffering from depression (OR=0.60, CI=0.22–0.94) were associated with the health behavior index. Among women, those who were living away from their parents or guardians (OR=1.94, CI=1.06–3.55), economically better off (OR=2.16, CI=1.00–4.63), and had higher social support (OR=3.65, CI=1.75–7.63), were associated with the health behavior index. Discussion: Students had a high proportion of health behavior practices. Several high health risk practices were identified, including overweight, poor dental practices, poor dietary and sleeping habits. It is hoped that the gender-specific predictors identified, including sociodemographics as well as social and mental health variables, can also be utilized in designing health promotion programs.
Short and long-term relationship between physician density on infant mortality: a longitudinal econometric analysis

While countries with higher levels of human resources for health typically have better population health, the evidence that increases in the level of human resources for health leads to improvements in population health is limited. We provide estimates of short-run and long-term effects of physician density on infant mortality. We use a dynamic regression model that allows an estimation of both short- and long-run effects of physician density on infant mortality. We also used instrumental variables analysis to identify the causal effect of physician density on health. We estimate that increasing the number of physicians by one per 1,000 population decreases the infant mortality rate by 15% within five years and by 45% in the long-run. We find all countries are moving towards their own steady state at around 3% a year and are only half way there after 15 years. We conclude that the long-run effects of human resources for health are substantially larger than previously estimated. Our results suggest that health sector inputs can play a role in reducing infant mortality. However, meeting the Millennium Development Goal of reducing child mortality rate by two thirds from 1990 to 2015 would have required much earlier action.
Incidence of thromboembolic events in patients with locally advanced rectal cancer receiving neoadjuvant chemoradiotherapy

1Department of Radiology, Oncology and Human Pathology, Division of Oncology B, “Sapienza” University of Rome, Rome, Italy, 2Department of Radiology, Oncology and Human Pathology, Division of Radiotherapy “Sapienza” University of Rome, Rome, Italy, 3Department of Surgical Science, Division of DEA, “Sapienza” University of Rome, Rome, Italy, 4Carnegie Mellon University, Pittsburg, USA, and 5Department of Statistical Science, “Sapienza” University of Rome, Rome, Italy
Long-term Health Outcomes and Medical Effects of Torture Among US Navy Prisoners of War in Vietnam

Objective. —To characterize incidence of illnesses and injuries from 1979 to 1993 in former naval aviator prisoners of war (POWs) from the Vietnam War and a comparison group of naval aviators from the same war. Design. —Cohort analytic study. Setting. —A US Navy primary care clinic. Participants. —Volunteer sample consisting of 70 former naval aviator POWs (white men, aged 47 to 69 years in 1993) and a comparison group of 55 naval aviators who served in Vietnam but were not POWs, matched on race, age, marital status, education, rank, year of entry into the navy, and pilot status. Subjects participated in an annual health screening program. This study reports data sampled on a biennial basis from subjects screened both in 1979 and 1993. Main Outcome Measure. —Medically diagnosed incidence of illness and injury based on a standard protocol. Results. —POWs had higher incidence rates than the comparison group did of disorders of the peripheral nervous system (relative risk [RR], 8.4; 95% confidence interval [CI], 2.7-25.9; P P P P Conclusions. —During captivity, ropes, ratchet handcuffs, leg irons, or stocks were used to put tightly constrictive pressure around the extremities of POWs as a means of torture, resulting in painful ischemia and subsequent neuropathies. Being a former POW was associated with increased cumulative incidence rates of chronic disorders of the peripheral nervous system, joints, and back and an increased hazard rate of peptic ulcer.
Achados ultra-sonográficos abdominais em pacientes com dengue

OBJECTIVE: To review the abdominal ultrasound findings in patients with serologically proven dengue fever and to compare the results with data from the literature. MATERIALS AND METHODS: Thirty-eight patients with serologically proven dengue fever, 25 female and 13 male, mean age of 35 years, were submitted to abdominal ultrasound. The ultrasound findings were compared with data from the literature. RESULTS: The most relevant ultrasound findings were diffuse gallbladder wall thickening in 18 cases (47.4%), abdominal and/or pelvic free fluid in 12 (31.6%), splenomegaly in 11 (28.9%), hepatomegaly in 10 (26.3%) and perivesicular fluid in 10 (26.3%). Twenty-six percent of the patients had normal abdominal ultrasound. CONCLUSION: Abdominal sonography is a useful additional diagnostic tool for the confirmation of suspected cases of dengue hemorrhagic fever and for the evaluation of severity and progression of the disease. The knowledge of the ultrasound possible findings in patients with dengue fever is of extreme importance for the radiologist.
Long-term clinical outcome of patients with soft tissue sarcomas treated with limb-sparing surgery and postoperative radiotherapy

Abstract Background. To evaluate long-term local control, survival, radiation side effects and functional outcome after limb-sparing surgery followed by postoperative radiotherapy (RT) for soft tissue sarcoma (STS). Material and methods. Between 1995 and 2010, 118 patients with STS of an extremity were treated with limb-sparing surgery and postoperative RT. Follow-up was complete for all patients. Acute and late radiation related toxicities were scored using CTCAE v4.0. Results. Median follow-up was 93 months. RT dose was 60 Gy in 92.4% of the patients; 5.1% received 66 Gy; 2.5% 50–56 Gy. Actuarial local recurrence rates at five and 10 years were 9% and 12%. Five- and 10-year overall survival rates were 69% and 51%. Acute radiation toxicities occurred in 91% of the patients; 19% were grade 3, 2% grade 4. Late radiation toxicities were reported in 71% of the patients: 50% grade 1, 18% grade 2, and 3% grade 3. Limb and joint function after treatment were good, 19% having mild limitation of motion, 1.5% moderate, and 2.5% severe limitations. Conclusion. Limb-sparing surgery with 60 Gy postoperative radiotherapy for patients with STS provides excellent local control and high survival rates with acceptable toxicity and functional outcomes.
Drug Therapy Problems in Patients with Type-2 Diabetes in a Tertiary Hospital in Nigeria

Background: Patients with Type-2 diabetes mellitus (T2DM) are known to be at risk of drug therapy problems since they often receive multiple medications due to co-morbidities associated with the condition. This study assessed the prevalence of drug therapy problems and related factors in a population of diabetic patients in a tertiary hospital. Methods: A retrospective analysis of randomly selected medical records of Type 2 diabetic patients was conducted from February to September, 2013. Data was collected and analyzed for demographics, clinical conditions (co-morbidity), types of medications used and medication complications. Results: 399 patients with a total of 792 drug therapy problems were identified, averaging 2.1(± 1.4) problems per patient. There were more males (52.1%) than females (47.9%) diabetics. Mean age of the patients was 65(± 12.4) years, ranging from 35 to 91 years. 49(12.4%) of the patients experienced at least one episode of hypoglycemia. Non-adherence was the most common DTP at 26.7% while polypharmacy was identified as a major factor that contributed to DTP among the patients. Conclusion: Findings suggest significant incidence of DTPs in the health facility indicating the need for comprehensive medication management approach which requires the use of pharmacists to play more active roles in managing patients with diabetes.
Staphylococcus aureus on computer mice and keyboards in intensive care units of the Universitas Academic Hospital, Bloemfontein, and ICU staff's knowledge of its hazards and cleaning practices

Nosocomial infections result in severe health and financial difficulties for patients and healthcare facilities. The objective of the study was to determine the presence of Staphylococcus aureus on computer mice and keyboards in the intensive care units (ICUs) of Universitas Academic Hospital, Bloemfontein, and ICU staff's knowledge regarding cleaning of computer mice and keyboards and their potential hazard as reservoirs for pathogens. Swab specimens from computer mice and keyboards (14 each) were investigated for S. aureus. Swabbing was repeated six months later. Standard microbiology laboratory methods were used to culture and identify organisms. An anonymous questionnaire completed by the ICU staff determined their awareness of computer mice and keyboards as potential sources of nosocomial infections. In addition to various environmental microorganisms and normal human flora, S. aureus was initially isolated from one computer mouse, and from two keyboards and five mice six months later. The questionnaire response rate was 85.6%. Seventy-one percent of respondents stated that they regarded keyboards and mice as an important source of nosocomial infections. Nevertheless, 62% of doctors and 40.3% of nurses indicated that they never washed their hands before or after using the computer. Ninety-seven percent of respondents were not aware of an official cleaning policy for computer equipment. In order to prevent nosocomial infections resulting from microbial transmission between equipment, staff and patients, proper cleaning policies should be implemented.
Retrospective study of spectrum of cutaneous lymphoma presenting to dermatology.

512 Approximately 40% of women in some geographical areas use hair-coloring agents. The prevalence of PPD sensitivity in various population based epidemiological studies has been estimated to be between 0.1% and 1%. [2] Penchalaiah et al.[3] studied the sensitizers commonly causing contact dermatitis from cosmetics in India. [3] Of 436 patients, 31 (7.1%) were suspected of having cosmetic dermatitis due to hair dye and only 8 (1.8%) showed positivity to 1% PPD.
Socio-demographic association of non communicable diseases’ risk factors in a representative population of school children: a cross-sectional study in Sousse (Tunisia)

Abstract Introduction: A better understanding of socio-demographic characteristics of subgroups, which have a high risk to develop chronic diseases, is essential to develop more efficient interventional programs especially for youth. This study aimed to determine the association between clusters of non communicable diseases (NCDs’) risk factors and the socio-demographic characteristics among a sample of Tunisian school children. Materials and methods: We conducted, in 2013/2014, a cross-sectional study among a proportional and stratified school children sample, selected in 17 elementary public schools in Sousse (Tunisia). A cluster analysis was used to identify different NCDs risk factors clusters, based on tobacco use, physical inactivity, unhealthy diet, and excess weight. Subsequent χ2-tests were used to identify differences between the NCDs risk factors clusters in regards to socio-demographic characteristics. Results: Four clusters of NCDs risk factors were found: 1) Cluster 1: physical inactivity behavior with normal weight, 2) Cluster 2: physical inactivity behavior associated to excess weight, 3) Cluster 3: unhealthy diet associated to excess weight and low practice of physical activity, and 4) Cluster 4: smoking behavior with physical activity behavior. The pattern of cluster membership differed across sex (<10–3), school level, and socioeconomic level (<10–3) but there was no significant difference between clusters for mother’s education levels and household tenure. Conclusion: This study can have important implications for health policy and practice. Indeed, it found that many subjects have simultaneous multiple NCDs risk factors which leads to identify groups at risk and implement integrated intervention program.
Changes in body mass index and alcohol and tobacco consumption among breast cancer survivors and cancer-free women: A prospective study in the Danish Diet, Cancer and Health Cohort

Abstract Background. A breast cancer diagnosis has been suggested as a teachable moment when a woman is more open to making healthier lifestyle changes. Little is known about the health behaviour changes women with breast cancer initiate compared to those made by other women. Material and methods. We examined changes in body mass index (BMI) and tobacco and alcohol consumption among women with a diagnosis of breast cancer and among cancer-free women. We used data from 23 420 women aged 50–64 years who participated in the Diet, Cancer and Health cohort, of whom 449 were diagnosed with breast cancer between baseline (1993–1997) and follow-up (2000–2002), and 22 971 remained cancer-free. We used multiple linear regression analysis to examine differences in BMI and alcohol and tobacco consumption between the two groups and to examine whether demographic and prognostic factors were associated with behavioural changes in women with breast cancer. Results. There were no significant differences in changes in BMI, alcohol and tobacco consumption between the two groups. Only in sub-analyses among women who lost weight between baseline and follow-up, women with breast cancer lost more weight than cancer-free women (β = 0.2; CI 0.1; 0.4), but residual confounding from stage cannot be excluded. Among the women with breast cancer we found no significant changes in BMI, alcohol and tobacco consumption by level of education, marital status, chemotherapy, hormone therapy or radiation. Conclusion. Women with breast cancer did not reduce their BMI, or modify their alcohol use or tobacco consumption compared with cancer-free women. This study indicates that guidelines and interventions to change health behaviour are needed after a cancer diagnosis.
The Physical and Psychological Symptoms of the Menopause

THE recent success of certain endocrine preparations in the treatment of menopausal symptoms has focussed attention on this syndrome. It may, therefore, be of interest to review the physical and psycfiological complaints which may occur before and after the cessation of the menstrual flow. Such a tabulation of symptoms, especially of the psychological disturbances, is not to be found readily in a textbook and may be useful for any worker who is attempting to assess the therapeutic value of some particular therapy. The case-histories on which the present findings are based were obtained from working-class patients. The women were all married and between the ages of 40 and 55, and had shown some of the classical menopausal symptoms. One hundred and eleven women were thus subjected to a thorough physical and psychological examination.
The Attending Round Observation System

Two separate reliability studies were conducted on an observational instrument derivedfrom previous qualitative research and designedfor collecting data on teaching behaviors demonstrated by attending physicians during attending rounds. The first study involved five observers coding 17 20-minute, videotaped segments of attending rounds. The second study involved two observers coding27 two-hour attending round sessions as they occurred live on hospital wards. The reliability estimates from both studies were quite high, indicating that the instrument shows promise for use in both research and evaluation studies.
Accuracy of indirect immunofluorescence on sodium chloride-split skin in the differential diagnosis of bullous pemphigoid and epidermolysis bullosa acquisita.

BACKGROUND Previous reports have shown that indirect immunofluorescence (IIF) performed on sodium chloride-split skin (SSS) is helpful to differentiate epidermolysis bullosa acquisita (EBA) from bullous pemphigoid (BP). Antibodies of BP may bind to the epidermal side of SSS, while antibodies of EBA bind to the dermal side. AIMS To determine the accuracy of IIF-SSS in the differential diagnosis of EBA and BP utilizing immunoblotting (IB) analysis. METHODS Sera from 78 patients, diagnosed with BP by clinical features, histopathology, and direct immunofluorescence (DIF), were assayed using IIF-SSS and IB. RESULTS Of the 43 serum samples with an epidermal reaction to IIF-SSS assay, 42 were recognized with BP antigens (180 kDa or 230 kDa). Of the 11 serum samples with a dermal reaction pattern, 7 were recognized with the 290 kDa antigen of EBA and 3 with sera bound BP antigens. Seven serum samples with epidermal and dermal combined staining, of which 5 of them reacted with BP antigens, 1 reacted with both BP and EBA antigens. One serum sample from each group showed a negative result by IB. Approximately 9.0% (7/78) of patients diagnosed with BP using regular methods were actually EBA. CONCLUSIONS Epidermal reaction using the IIF-SSS assay highly correlated with the diagnosis of BP. However, dermal reactions correlated poorly with EBA, with some serum samples from BP patients binding to dermal-side antigens. In both epidermal and dermal stained sera using IIF-SSS, there was a possibility of BP and EBA. Differential diagnosis should be confirmed using IB, especially in cases of dermal and double staining patterns assayed using IIF-SSS.
The Effect of Peer Group Education on Anxiety of Patients with Multiple Sclerosis

Introduction: Multiple Sclerosis (MS) is one of the most common chronic diseases of the central nervous system which causes mental disorders including anxiety in patients. Since the peer group can better communicate with their counterparts and encourage them to choose appropriate healthy behaviors, this study was designed to examine the impact of peer educational program on anxiety of multiple sclerosis patients. Methods: This was a quasi-experimental study conducted in year 2011 in MS Society of Iran (Tehran). A convenient sample of 110 patients with MS was divided randomly into two equal groups (experimental and control). After preparing peer teachers, they held six training sessions for experimental group during six weeks. DASS-21 questionnaire was used to measure anxiety which was completed by both groups before and 4 months after the test. Data was analyzed using chi 2 , paired t, and independent t tests. Results: The findings of independent t test did not show any significant difference between anxiety scores of experimental and control group before intervention while a statistically significant difference was observed after intervention between the scores of two groups (p=.032). Paired t test showed a statistically significant difference in anxiety level in experimental group after intervention (p=.002), whereas the same test showed no statistically significant difference in control groups (p =.659). Conclusion : Peer group educational program reduced anxiety in patients suffering from MS. Hence the conduction of this program is recommended as an effective, affordable, and effective teaching method which did not require any special equipment.
Comparative study of genotoxic effects in workers exposed to inorganic lead and low dose irradiation using micronucleus test

This paper presents a case-control study of micronuclei score evaluation as cytogenetic test in male workers exposed to inorganic lead from a non-ferrous metallurgical plant, Romania. Literature data on genotoxic effects of this heavy metal are still matter of discussions. We have compared micronuclei frequency measured from the lymphocytes of both inorganic lead-exposed and radiation-exposed workers as well as their respective matched controls. The study consisted of 60 subjects divided into three groups: lead exposed workers, workers exposed to ionizing radiation and controls. Exposure to inorganic lead was assessed either by determination of lead concentration in the workplace air or by biotoxicological analyses (blood lead level, urine lead level, urine δ-aminolevulinic acid). The results of our investigation showed an increased micronuclei mean score in lead-exposed workers compared to control group (6.0±2.328‰ vs. 2.7±0.978‰, p<0.001). We found that lead produces chromosomal damage comparable to that induced by ionizing radiation (micronuclei mean score 5.55±1.877‰ in subjects exposed to X rays). In conclusion, we propose the use of the micronucleus assay as a screening test for occupationally lead-exposed workers displaying repeated occupational poisoning and pathological outcome.