Miracle-dz/UniFAR-FTUs huggingface dataset:
Familia, amigos y otras fuentes de información asociadas al inicio de las relaciones sexuales en adolescentes de El Salvador

OBJETIVO: El objetivo de este estudio es comprobar como influyen en el inicio de la actividad sexual de los jovenes salvadorenos los mensajes que reciben sobre cuestiones de sexualidad, afectividad y ocio a traves de la familia, los amigos y los medios de comunicacion. METODOS: Estudio transversal a partir de una muestra representativa de 2 615 estudiantes (de 13 a 19 anos) de El Salvador. Se utilizo un muestreo sistematico aleatorio para seleccionar 30 colegios. Se recogieron aspectos sociodemograficos, estilos de vida y fuentes de informacion sobre sexualidad y amor utilizadas por los jovenes. RESULTADOS: La edad media de los jovenes fue de 15 anos (DE = 1,8). En total 638 (24,4%) jovenes afirmaron haber tenido relaciones sexuales. Los siguientes factores se asociaron con una mayor probabilidad de haber tenido relaciones sexuales: percibir que los hermanos (OR = 1,8, IC 95%: 1,2-2,7) o los amigos (OR = 1,7, IC 95%: 1,3-2,2) apoyan que se tengan relaciones sexuales. Como factores protectores se encontraron la supervision de los padres (OR = 0,5, IC 95%: 0,4-0,7); recibir mensajes que apoyan la abstinencia por parte de amigos (OR = 0,7, IC 95%: 0,6-1,0) o hermanos (OR = 0,7, IC 95%: 0,5-0,8) y recibir mensajes favorables al matrimonio por parte de los padres (OR = 0,4, IC 95%: 0,3-0,6). CONCLUSIONES: Los mensajes de la familia y amigos son factores que parecen influir en el inicio de las relaciones sexuales de los jovenes. Los programas de promocion de la salud sexual en El Salvador deberian tener en cuenta estos factores.
NEW PERSPECTIVES ON THE DIFFERENTIATION OF APLASTIC ANEMIA AND MDS IN CHILDREN

Due to recent advances in immunosuppressive therapy, the prognosis for aplastic anemia (AA) has improved dramatically. As more patients with this disease have been surviving longer, the number of AA patients who develop myelodysplastic syndrome (MDS) or leukemia has increased. However, it is unclear whether the development of this type of late clonal disorder is related to a particular therapy, and whether hypoplastic MDS can be differentiated from AA at diagnosis. Although there are no definitive answers to these questions, some forms of AA and MDS are likely within the same spectrum of disease. Thus, when treating AA, it is essential to evaluate various clinical and laboratory information, including cell morphology and chromosomal aberration. This paper discusses acute myelocytic leukemia (AML) and MDS in children diagnosed as having AA, and it presents problems associated with the diagnosis of this disease.
Seasonal Patterns in Acute Gastroenteritis in a Hospital at Maharashtra, India -

Acute gastrointestinal illnesses are amongst the most common diseases worldwide: ranging from mild annoyances to devastating, dehydrating illnesses that can kill within hours. Although acute gastroenteritis is a common illness in all seasons, it definitely shows change in the number of cases at different times of the year. A descriptive cross-sectional study was conducted in a Government Medical College and Hospital in Maharashtra, India. The gastroenteritis patients who were admitted to this hospital during the study period of 1 calendar year from April 2006 to March 2007 were studied. The hospital records of the previous 2 calendar years from April 2004 to March 2006 were also studied to know the changing patterns in the acute gastroenteritis cases. During April 2004 to March 2007, the average monthly admissions due to gastroenteritis were 48. Gastroenteritis resulted in 1.92% (i.e. 685 out of 35644) of the total hospital admissions. Contrary to the regular belief that gastroenteritis is more common during rainy season and early parts of summer, in present study as well as in various other studies it was found that, the number of cases was more during winter.
Redução nos níveis de ansiedade e depressão de pacientes com doença pulmonar obstrutiva crônica (DPOC) participantes de um programa de reabilitação pulmonar

Objetivos: A abordagem multidisciplinar oferecida por programas de reabilitacao pulmonar (PRP) tem sido a melhor alternativa terapeutica para o tratamento de portadores de doenca pulmonar obstrutiva cronica. Este ensaio clinico avaliou a prevalencia de ansiedade e depressao e o efeito de um PRP sobre os niveis de ansiedade e depressao de 46 portadores de DPOC (idade: 62 ± 11 anos; 34 homens e 12 mulheres). Pacientes e metodos: Os pacientes participaram de um PRP com 12 semanas de duracao: 24 sessoes de exercicios fisicos, 24 sessoes de fisioterapia, 12 sessoes de acompanhamento psicologico e tres sessoes educacionais. Todos os pacientes foram avaliados na linha de base e ao termino do PRP atraves de tres instrumentos: inventario de Beck para ansiedade (BAI); inventario de Beck para depressao (BDI), teste da caminhada de seis minutos (Tcam6'). Resultados: Os pacientes estudados demonstraram reducao significativa nos niveis de ansiedade e depressao e melhora significativa no Tcam6': BAI 16,4 ± 6,9 vs. 6,8 ± 5,3 (p < 0,001); BDI: 16,9 ± 8,7 vs. 7,5 ± 6,6 (p < 0,001); Tcam6': 335,7 ± 83,4 vs. 441,6 ± 100,8 (p < 0,05). Conclusoes: Pacientes com DPOC estudados apresentaram alta prevalencia de ansiedade e depressao. O PRP foi capaz de reduzir de forma significativa os niveis de ansiedade e depressao, bem como de aumentar o desempenho do Tcam6'.
RETROSPECTIVE EPIDEMIOLOGIC STUDY OF DISEASES IN RUMINANTS IN KHAGRACHARI HILL TRACT DISTRICT OF BANGLADESH

A retrospective epidemiologic study of animal diseases was undertaken at Khagrachari Sadar Veterinary Hospital during January, 2006 to December, 2010 to determine prevalence and distribution of animal diseases. According to the diseases register, a total of 3988 sick animals were examined and 53 types of diseases were identified during this period. The commonly found various diseases were worm infestation (51.5%), pneumonia and pneumonitis (7.9%), ephemeral fever (3.7%), enteritis (3.4%), mastitis(3.2%), mange (3.2%), indigestion (2.8%), anestrous(2.6%). Rest of the diseases had lower percentage than 2%. Out of 3988 sick animals, 74.7% were female and 25.3 % were male animals. Animals aged between 2-5 (A1) years had high prevalence (54.0%) and it was low in age group 8-10 years (A4), 2.4%. Prevalence of diseases was high (42.3%) in rainy season (June-October) followed by (32.5%) in winter (November-February) and lowest (25.2%) in summer season (March-May). Gastrointestinal diseases 61.6 % (2458 cases) was seen highly prevalent among all groups of animals which was followed by infectious diseases 10.4% (416 cases), skin diseases 9.4 % (377 cases), respiratory diseases 8.27% (330 cases) and reproductive diseases 7.93% (cases). This study suggests that for a period of 15 years or more will help to identify the risk factors of diseases in this area. DOI: http://dx.doi. org/10.3329/bjvm.v9i2. 13457
Oral mucosal involvement as the sole or main manifestation of linear IgA disease: case report and review of the literature

Background: Linear IgA disease is a rare autoimmune subepithelial blistering condition that predominantly affects the skin. Lesions also commonly occur on mucosal surfaces, including the oral mucosa. Demonstration by direct immunofluorescence of IgA deposits in a linear pattern along the basement membrane zone is required for diagnosis. Case report: A case of linear IgA disease in which oral mucosal involvement remained the sole manifestation of the disease for twenty-three years is presented. Literature review: A review of the literature revealed seventeen cases in which the disease manifested itself principally in the oral mucosa. Desquamative gingivitis or gingival erythema appears to be the most common manifestation of the disease. Vesicles and bullae, shallow ulcers, erosions, white striae and white patches are also commonly seen. There may be considerable clinical and histological overlap with other diseases, principally mucous membrane pemphigoid and lichen planus. Conclusion: Although a number of case reports have been published describing instances in which oral mucosal involvement was the only or main manifestation of the disease, the fact that linear IgA disease can manifest itself as a predominantly oral mucosal condition is not widely appreciated by clinicians. This may lead to potentially serious delays in arriving at the correct diagnosis in these cases.
Influence of retirement on nonadherence to medication for hypertension and diabetes

Background: The extent to which common life transitions influence medication adherence among patients remains unknown. We examined whether retirement is associated with a change in adherence to medication in patients with hypertension or type 2 diabetes. Methods: Participants in the Finnish Public Sector study were linked to national registers. We included data for the years 1994–2011. We identified and followed 3468 adult patients with hypertension and 412 adult patients with type 2 diabetes for medication adherence for the 3 years before their retirement and the 4 years after their retirement (mean follow-up 6.8 yr). Our primary outcome was proportion of patients with poor adherence to medication, which we defined as less than 40% of days covered by treatment. We determined these proportions before and after retirement using data from filled prescriptions. Results: The preretirement prevalence of poor adherence to medication was 6% in men and women with hypertension, 2% in men with diabetes and 4% in women with diabetes. Among men, retirement was associated with an increased risk of poor adherence to both antihypertensive agents (odds ratio [OR] 1.32, 95% confidence interval [CI] 1.03–1.68) and antidiabetic drugs (OR 2.40, 95% CI 1.37–4.20). Among women, an increased risk of poor adherence was seen only for antihypertensive agents (OR 1.25, 95% CI 1.07–1.46). Similar results were apparent for alternative definitions of poor adherence. Our results did not differ across strata of age, socioeconomic status or comorbidity. Interpretation: We found a decline in adherence to medication after retirement among men and women with hypertension and men with type 2 diabetes. If these findings can be confirmed, we need randomized controlled trials to determine whether interventions to reduce poor adherence after retirement could improve clinical outcomes of treatments for hypertension and diabetes.
Clustering Practitioners Within Service Organizations May Improve Implementation Outcomes for Evidence-Based Programs

Data for the present study were collected from Parent Management Training Oregon model (PMTO) therapists (n = 83) employed in Norwegian social service organizations. Survey data were analyzed using partial correlation, MANCOVA, and contrast tests. There were statistically significant positive relationships between the number of PMTO therapists working in an agency and respondents reports of: (1) how many families they had treated with PMTO in the past 6 months, (2) PMTO being well integrated in their organization, and (3) how much time they have to practice PMTO in their current position. In addition, practitioners in organizations with more PMTO colleagues were significantly less likely to report that they would stop using the program. Finally, there was a marginally significant positive relationship between the number of PMTO therapists in an agency and practitioners’ reports that they received a sufficient number of PMTO cases. The size of the organization, the number of years therapists had worked wit.
Impact of risperidone long-acting injectable on hospitalisation and medication use in Canadian patients with schizophrenia

Summary A retrospective chart review was used to assess hospitalisation and medication switching in patients with schizophrenia initiated on either intramuscular risperidone long-acting injectable (RLAI) (n=69) or oral atypical antipsychotics (n=93) in Canada. In the RLAI-treated patients, compared with an identical period prior to RLAI use (40.8 months), there were significant decreases in hospitalisation (50.7 vs. 4.3%; p<0.0001) and duration of hospitalisation (23.5 vs. 0.3 days per patient; p<0.0001) when patients were switched to RLAI (mean treatment period 41.5 months). Compared with patients receiving oral atypicals for 57.2 months, RLAI patients had a reduced risk of hospitalisation (95% confidence interval 1.8–16.5% vs. 54.7–76.4%) and medication switching (95% confidence interval 34.6–58.4% vs. 55.7–76.4%). By virtue of its periodic intramuscular administration, RLAI offers the efficacy and tolerability of an atypical medication without the compliance issues associated with oral drugs, and leads to significant decreases in hospitalisation.
Treating Clostridium difficile infection

A randomized controlled trial (RCT) showed that metronidazole was as effective as vancomycin taken orally for the treatment of mild Clostridium difficile infection. However, in cases of severe infection, 97% of patients given vancomycin had clinical resolution compared with only 76% of those given
Expression of Survivin in Gastric Carcinoma and its Relation to Tumor Cell Proliferation and Apoptosis

Background : Survivin, a novel antiapoptotic gene has been linked with tumor development and progression in various human carcinomas including gastric carcinomas. The aim of this study was to evaluate the expression of survivin in gastric carcinoma and its correlation with tumor cell proliferation and apoptosis. Methods : Expression of survivin was evaluated immunohistochemically in 84 surgically resected gastric carcinomas. Tumor cell apoptosis was evaluated with terminal deoxynucleotidyl transferase (TdT) mediated deoxyuridine triphosphate (dUTP) nick-end labeling (TUNEL), and Ki-67 immunostaining was used for evaluation of tumor cell proliferation. Results : Expression of survivin was noted in 53.6% of the gastric carcinomas, and was significantly associated with depth of invasion, status of lymph node metastasis or tumor stage (p=0.022, 0.034, 0.040, respectively). There was an inverse correlation between survivin expression and apoptotic index (p=0.015). But there was no significant correlation between survivin expression and Ki-67 labeling index (p=0.430). Conclusions : These results suggest that survivin expression may contribute to tumor development and progression by inhibiting apoptosis in human gastric carcinoma.
Median and ulnar neuropathies in university guitarists.

STUDY DESIGN Descriptive study. OBJECTIVES To determine the presence of median and ulnar neuropathies in both upper extremities of university guitarists. BACKGROUND Peripheral nerve entrapment syndromes of the upper extremities are well documented in musicians. Guitarists and plucked-string musicians are at risk for entrapment neuropathies in the upper extremities and are prone to mild neurologic deficits. METHODS AND MEASURES Twenty-four volunteer male and female guitarists (age range, 18-26 years) were recruited from the Belmont University School of Music and the Vanderbilt University Blair School of Music. Individuals were excluded if they were pregnant or had a history of recent upper extremity or neck injury. Subjects completed a history form, were interviewed, and underwent a physical examination. Nerve conduction status of the median and ulnar nerves of both upper extremities was obtained by performing motor, sensory, and F-wave (central) nerve conduction studies. Descriptive statistics of the nerve conduction study variables were computed using Microsoft Excel. RESULTS Six subjects had positive findings on provocative testing of the median and ulnar nerves. Otherwise, these guitarists had normal upper extremity neural and musculoskeletal function based on the history and physical examinations. When comparing the subjects' nerve conduction study values with a chart of normal nerve conduction studies values, 2 subjects had prolonged distal motor latencies (DMLs) of the left median nerve of 4.3 and 4.7 milliseconds (normal, < 4.2 milliseconds). Prolonged DMLs are compatible with median neuropathy at or distal to the wrist. Otherwise, all electrophysiological variables were within normal limits for motor, sensory, and F-wave (central) values. However, comparison studies of median and ulnar motor latencies in the same hand demonstrated prolonged differences of greater than 1.0 milliseconds that affected the median nerve in 2 additional subjects, and identified contralateral limb involvement in a subject with a prolonged distal latency. The other 20 subjects demonstrated normal comparison studies of the median and ulnar nerves in both upper extremities. CONCLUSIONS In this descriptive study of a population of 24 university guitarists, 4 musicians (17%) were found to have electrophysiologic evidence of median neuropathy at or distal to the wrist or carpal tunnel syndrome. Ulnar nerve electrophysiological function was within normal limits for all subjects examined.
Instrument-assisted cross-fiber massage accelerates knee ligament healing.

STUDY DESIGN Controlled laboratory study. OBJECTIVES To investigate the effects of instrument-assisted cross-fiber massage (IACFM) on tissue-level healing of knee medial collateral ligament (MCL) injuries. BACKGROUND Ligament injuries are common and significant clinical problems for which there are few established interventions. IACFM represents an intervention that may mediate tissue-level healing following ligament injury. METHODS Bilateral knee MCL injuries were created in 51 rodents, while 7 rodents were maintained as ligament-intact, control animals. IACFM was commenced 1 week following injury and introduced 3 sessions per week for 1 minute per session. IACFM was introduced unilaterally (IACFM-treated), with the contralateral, injured MCL serving as an internal control (nontreated). Thirty-one injured animals received 9 ACFM treatments, while the remaining 20 injured animals received 30 treatments. Ligament biomechanical properties and morphology were assessed at either 4 or 12 weeks postinjury. RESULTS IACFM-treated ligaments were 43.1% stronger (P<.05), 39.7% stiffer (P<.01), and could absorb 57.1% more energy before failure (P<.05) than contralateral, injured, nontreated ligaments at 4 weeks postinjury. On histological and scanning electron microscopy assessment, IACFM-treated ligaments appeared to have improved collagen fiber bundle formation and orientation within the scar region than nontreated ligaments. There were minimal differences between IACFM-treated and contralateral, nontreated ligaments at 12 weeks postinjury, although IACFM-treated ligaments were 15.4% stiffer (P<.05). CONCLUSION IACFM-accelerated ligament healing, possibly via favorable effects on collagen formation and organization, but had minimal effect on the final outcome of healing. These findings are clinically interesting, as there are few established interventions for ligament injuries, and IACFM is a simple and practical therapy technique. J Orthop Sports Phys Ther 2009;39(7):506-514, Epub 24 February 2009. doi:10.2519/jospt.2009. 2997.
Clinical interpretation of computerized adaptive test outcome measures in patients with foot/ankle impairments.

STUDY DESIGN Prospective cohort study of 10 287 patients with foot/ankle impairments receiving outpatient physical therapy. OBJECTIVES To describe meaningful interpretations of functional status (FS) outcomes measures, estimated using a body-part-specific computerized adaptive test (CAT). BACKGROUND Increased use of CATs to generate outcome measures in rehabilitation has stimulated questions concerning score interpretation. Identifying meaningful intra-individual change and reporting clinical interpretation of those generated outcomes are essential to advance the quality of rehabilitation practice. METHODS We performed 4 approaches to clinically interpret outcomes data. First, we used the standard error of the estimate to construct a 90% confidence interval for each CAT estimated score. Second, we presented the percentile rank of FS scores. Third, we used 2 threshold approaches to define individual-patient-level change: statistically reliable change and clinically important change. Last, we illustrated a functional staging method. RESULTS Precision of a single score was estimated by an FS score of +/-4. Based on score distribution, percentile ranks at 25th, 50th, and 75th percentiles corresponded to intake FS scores of 38, 47, and 57, and discharge FS scores of 52, 64, and 77, respectively. Minimal detectable change supported 7 or more FS change units out of 100 represented statistically reliable change, and ROC analyses supported 8 or more FS change units represented minimal clinically important improvement. Using a functional staging system, we established 5 hierarchical functional status levels. CONCLUSION CAT-generated outcome measures can be interpreted to improve clinical interpretation and to assist clinicians in using patient-reported outcomes during therapy practice.
Hamstring strain injuries: recommendations for diagnosis, rehabilitation, and injury prevention.

UNLABELLED Hamstring strain injuries remain a challenge for both athletes and clinicians, given their high incidence rate, slow healing, and persistent symptoms. Moreover, nearly one third of these injuries recur within the first year following a return to sport, with subsequent injuries often being more severe than the original. This high reinjury rate suggests that commonly utilized rehabilitation programs may be inadequate at resolving possible muscular weakness, reduced tissue extensibility, and/or altered movement patterns associated with the injury. Further, the traditional criteria used to determine the readiness of the athlete to return to sport may be insensitive to these persistent deficits, resulting in a premature return. There is mounting evidence that the risk of reinjury can be minimized by utilizing rehabilitation strategies that incorporate neuromuscular control exercises and eccentric strength training, combined with objective measures to assess musculotendon recovery and readiness to return to sport. In this paper, we first describe the diagnostic examination of an acute hamstring strain injury, including discussion of the value of determining injury location in estimating the duration of the convalescent period. Based on the current available evidence, we then propose a clinical guide for the rehabilitation of acute hamstring injuries, including specific criteria for treatment progression and return to sport. Finally, we describe directions for future research, including injury-specific rehabilitation programs, objective measures to assess reinjury risk, and strategies to prevent injury occurrence. LEVEL OF EVIDENCE Diagnosis/therapy/prevention, level 5.