Miracle-dz/UniFAR-FTUs huggingface dataset:
Atypical ductal hyperplasia diagnosed at sonographically guided core needle biopsy: frequency, final surgical outcome, and factors associated with underestimation.

OBJECTIVE The purposes of this article were to review the mammographic and sonographic features of breast masses yielding atypical ductal hyperplasia (ADH) at sonographically guided biopsy, evaluate the surgical pathology outcome of these lesions, and determine whether clinical or imaging features can be used to predict upgrade to malignancy. MATERIALS AND METHODS Among 6325 sonographically guided biopsies (2003- 2010) (14-gauge cores), 56 yielded the diagnosis of ADH (0.9%). Six patients were excluded (lost to follow-up). Fifty lesions were surgically excised in 45 patients. Mammographic and sonographic features were analyzed in consensus by two radiologists using the BI-RADS lexicon. RESULTS Forty-five patients (mean age, 56 years; 12 < 50 years; six with synchronous breast carcinoma) had 50 ADH lesions (median size, 0.6 cm). Surgical excision yielded malignancy in 28 cases (56% underestimation rate). Among 42 mammograms (47 lesions), 30 lesions were identified (30/47, 64%) as masses (12/30, 40%), asymmetric densities (10/30, 33%), microcalcifications (4/30, 13%), and architectural distortions (4/30, 13%). Sonographically, most lesions appeared as hypoechoic masses (64%, 30/47) with irregular shape (51%, 24/47), microlobulated margins (49%, 23/47), no posterior acoustic feature (25/47, 53%), abrupt interface (70%, 33/47), and parallel orientation (57%, 27/47). No mammographic and sonographic features were associated with malignant outcome, whereas age less than 50 years (p = 0.03) and synchronous malignancy (p = 0.03) were associated with malignant outcome. CONCLUSION ADH diagnosed at sonographically guided 14-gauge core needle biopsy shows a high underestimation rate. Synchronous carcinoma or age less than 50 years is associated with malignant outcome.
The effect of manual therapy on lumbar disc protrusion.

Introduction: A herniated disc is among the most common diagnoses among the degenerative changes of the lumbar spine. Occurs by a displacement of the nucleus pulposus through the annulus fibrosus and generally postero-lateral lying, may cause compression and irritation of the lumbar roots and dural sac, represented by clinically known as sciatica. Objective: To evaluate the effects of manual therapy on lumbar disc protrusion. Method: The study treated a longitudinal experimental research with quantitative approach. The sample was not random type, consisting of six participants. Pompage, neural mobilization, stabilization, segmental and global postural reeducation: 12 sessions, twice a week, which consisted of the following techniques were performed. Results: The data analyzed in the Graph Pad Prism 5.0 statistical program and the level of significance was p<0,05. In the assessment of the results of the pain Visual Analog Scale, the participants presented a significant decrease. In relation to the neural damage, there was a significant improvement of the test of elevating the leg with the extended knee, but there was not a significant improvement in the Slump Test. In the assessment of the amplitude of the flexion movement of upper body, there was a numerical gain in relation to the flexibility of the patients; however, it was not statistically significant. In the assessment of the variable paravertebral muscular strength, there was a significant improvement. In the abdominal muscular strength, there was a numerical increase; however, this value was not statistically significant. Conclusion: the treatment program with manual techniques used in this present research provided significant effects about the damages caused by lumbar disc protrusion.
Technical aids in hemiparetic patients: prescription, costs and usage

Objective: The purpose of the study was to document the amount and sorts of technical aids prescribed for hemiparetic stroke patients treated within a one-year period in a German rehabilitation centre. Design: A retrospective study checking the medical records, and sending a questionnaire asking for level of satisfaction with the use of technical aids, frequency of use, punctuality of delivery, and cost coverage to patients after discharge. Setting: A department of a neurological rehabilitation clinic (Klinik Berlin) in Germany. Subjects: All stroke patients treated in one year. Results: The medical records of 466 patients were checked: 194 (42%) of them received at least one technical aid with a mean of 2.1 items per person, totalling ECU 690 per person. These 194 patients were sent questionnaires at home six to ten months after discharge: 121 (62.3%) questionnaires were returned. Ninety-four patients used their technical aids regularly, 19 occasionally and eight had abandoned usage of wheelchairs and orthoses due to improvement in gait ability and/or poor fit. Eighty-five per cent of patients had a satisfaction level of over 50%. Except for lightweight wheelchairs, technical aids were delivered in time according to patients' estimations, and in most cases costs were fully covered by the regular health insurance (some private insurance schemes do not cover the (full) costs of certain technical aids). Compared with other countries, fewer technical aids were prescribed and fewer home visits (n = 23) were conducted. Conclusion: The data provide useful information for health care planning and support the need for future prescription of technical aids to consider not only the ability of the user, but also the living environment and, where relevant, the ability of carers. In this regard more home visits could probably increase the efficient provision of technical aids and subsequently produce a higher level of satisfaction from the users.
Indian Students' Choice of Study Destination: Reasons for Choosing Singapore

n recent years, there has been a marked increase in the number of Indian international students studying at Australian universities in Singapore while during the same period; there has been a corresponding decrease in the number of this group of students studying in Australia. The study aimed to understand why one current group of Indian students studying in Singapore chose to study in Singapore at an Australian tertiary institution rather than study in Australia or elsewhere in the world. While recent assaults on Indian students in Australia may have influenced Indian students' decisions to study in locations other than Australia, there may have been other influences as well. These include the increasing strength of the Australian dollar as well as a tightening of the student visa applications. The research design employed a mixed methods approach using focus group interviews and descriptive statistics from two surveys. The study found that for most international Indian students studying in Singapore, safety, proximity to India, lower cost of living and the perception at there were better job prospects in Singapore on the completion of their degrees compared to other locations were the prime reasons they chose to study in Singapore. The study highlights future recommendations for universities in attracting and catering for students from overseas countries.
The effect of a self-bonding polymer on plaque and gingivitis over six months: A pilot study

The purpose of this study was to evaluate the effect of self-bonding polymer (SBP) (KISSCARE® Concentrated Gel, KISS-COTE Inc., Tampa, FL, USA) in relation to plaque attachment and subsequent gingival inflammation. This randomized blinded clinical study followed a split-mouth design and examined prospectively 15 participants over a 6-month period. The average plaque index (PI) and average gingival index (GI) were measured for the control and SBP groups at baseline (week 0) and again after 2, 4, 12, and 24 weeks. Within the SBP groups, mean PI and GI at baseline, respectively, were compared to the same measures at the follow-up visits. Additionally, the control and SBP groups were compared in terms of the change in PI and GI from baseline to each of the follow-up points. For most part, the average PI and the average GI improved in both the control and SBP groups. The improvement in GI was statistically significant in both groups at weeks 2 and 4, while the improvement in PI was statistically significant at all follow-up visits. Among the areas to which polymer was applied, the average PI was statistically significantly lower than baseline at all follow-up visits. The SBP group showed significantly greater decrease in GI values when compared with the control group at week 2 (P<0.005). The overall potential benefit of SBP was too small to be clinically substantial as it may be compounded by an increase in subjects’ attention to their oral hygiene during the clinical study.
Echogenic foci in thyroid nodules: significance of posterior acoustic artifacts.

OBJECTIVE This study was undertaken to define and evaluate echogenic foci and their posterior acoustic artifacts in thyroid nodules. Whether these findings were indicative of benignity or malignancy was assessed. MATERIALS AND METHODS Echogenic foci were classified into five types: no posterior artifact, large comet-tail artifact, small comet-tail artifact (≤1.0 mm), and posterior shadowing (subdivided into internal versus peripheral). Nodules were also classified into four parenchymal patterns: hypoechoic, hyperechoic, >50% solid, and cystic. Results were compared with the cytologic or surgical findings. RESULTS A total of 704 nodules had echogenic foci; 246 did not. The prevalence of malignancy ranged between 15.4% and 19.5% for all types of foci except large comet-tail artifacts (3.9%). Foci without posterior artifacts had a 21.9% rate of cancer in hypoechoic lesions and 15.8% in hyperechoic lesions. Foci with small comet-tail artifacts had a 27.6% rate of malignancy in hypoechoic nodules. For internal calcifications, no malignant nodules were found in either partially cystic group. Nodules with peripheral calcifications had prevalence rates of 20.0% in cystic nodules and 11.1% in predominately solid nodules. Identification of one additional type of high-risk focus increased the chance of malignancy 1.48 times. CONCLUSION All categories of echogenic foci except those with large comet-tail artifacts are associated with high cancer risk. Identification of large comet-tail artifacts suggests benignity. Nodules with small comet-tail artifacts have a high incidence of malignancy in hypoechoic nodules. With the exception of nodules that have peripheral calcifications, the risk of malignancy is low when echogenic foci are present in partially cystic lesions.
A PREALBUMIN ACTIVATOR OF PREKALLIKREIN

Human plasma kallikrein has been shown to directly and selectively attract human neutrophils from a mixed leukocyte population. The capacity of plasma kallikrein to be chemotactic and to generate the nonapeptide bradykinin was maintained during progressive purification. While neither highly purified prekallikrein nor the prealbumin Hageman factor fragments were chemotactic alone, their interaction so as to convert prekallikrein to kallikrein yielded both chemotactic and kinin-generating activity. Both functions of kallikrein were inhibited by treatment with diisopropyl fluorophosphate, indicating an essential role for the active site of the enzyme in the expression of its chemotactic activity.
Effectiveness Of Intensive Case Management For Homeless Adolescents

This article describes the Seattle Homeless Adolescent Research Project (SHARP), a research demonstration program with a goal of implementing and evaluating an intensive mental health case management program for homeless adolescents. This new program, Project Passage, is based on nine primary components: (a) assessment, (b) planning, (c) linkage, (d) monitoring or tracking, (e) advocacy, (f) counseling or the therapeutic relationship, (g) treatment teams, (h) crisis service, and (i) flexible funds. Case load was limited to no more than 12 cases, so that adolescent-centered, individualized services could be delivered. Youths were randomly assigned to Project Passage or a “regular” case management program. A 3-month follow-up found that both groups demonstrated significant improvements in mental health outcomes and social adjustment; however, youths in Project Passage evidenced lower levels of aggression and greater satisfaction with their quality of life.
Prevalence, Comorbid Associations and Prognostic Value of the Hyperdense Middle Cerebral Artery Sign

Background. The significance of the Hyperdense Middle Cerebral Artery Sign (HMCAS) is uncertain. Aims. This prospective study investigated the sensitivity, specificity, prevalence, prognosis, interobserver variability, and associated clinical features of HMCAS in acute ischemic stroke. Methods. Initial CT scans of 117 patients with acute ischemic stroke or transient ischemic attack (TIA) and 65 age-matched controls were reported independently by two neuroradiologists blinded to diagnosis. Details of initial stroke severity and comorbidities were collected, and outcome on the modified Rankin scale (mRS) was assessed at 3–6 months. Results. HMCAS was seen in 15% of all ischemic strokes and 25% of all middle cerebral artery (MCA) strokes; specificity was 100%. HMCAS was associated with more severe initial deficit and atrial fibrillation. Only 21% of patients with a first-ever MCA stroke and HMCAS had a good outcome () compared to 55% of those without the sign (). Interobserver agreement was only 0.747 (Kappa statistic). Conclusion. The prevalence, specificity, sensitivity, and clinical associations of HMCAS were similar to previous reports. This study confirmed prospectively that HMCAS was associated with a poorer outcome at 3 to 6 months and demonstrated interobserver variability in detection of the sign.
Successful Dose Reduction Using Reduced Tube Voltage With Hybrid Iterative Reconstruction in Pediatric Abdominal CT.

OBJECTIVE The purpose of this article is to assess radiation dose reduction, image quality, and diagnostic confidence using low tube voltage in combination with hybrid iterative reconstruction in contrast-enhanced pediatric abdominal CT. MATERIALS AND METHODS CT examinations of 133 patients (median age, 10 years) were performed at sequentially reduced doses. The first group (group 1) was scanned using dimension-based protocols at 120 kV for all patient sizes. The optimized group (group 5) was scanned at 80 kV for less than 18 cm in the lateral dimension and 100 kV in the 19-30 cm lateral dimension. CT examinations reconstructed with filtered back projection (FBP) and four levels of hybrid iterative reconstruction were reviewed by four blinded readers for subjective image quality and diagnostic confidence. Objective noise, volume CT dose index (CTDIvol), and size-specific dose estimate (SSDE) were recorded. Data were analyzed using t tests, one and two-way ANOVA, and the intraclass correlation coefficient. RESULTS Compared with group 1, the radiation dose was reduced for group 5 by 63% measured by SSDE (4.69 vs 10.00 mGy; p < 0.001). Subjective image noise was increased for FBP images (p < 0.001) but not was statistically significantly different for all levels of hybrid iterative reconstruction; artifacts were reduced and visibility of small structures was improved (both p < 0.001). Diagnostic confidence was improved for solid organ injury and metastatic disease (both p < 0.001) and was not statistically significantly different for appendicitis (p = 0.306). CONCLUSION Use of hybrid iterative reconstruction with low-tube-voltage protocols enables substantial radiation dose reduction for pediatric abdominal CT with equivalent to improved subjective image quality and diagnostic confidence.
The cardiovascular safety of rosiglitazone

Background: Thiazolidinediones (rosiglitazone, pioglitazone) influence insulin sensitivity and are used for the treatment of Type 2 diabetes. Rosiglitazone achieves sustained improvements in glycaemic control, whilst having pleiotropic effects on cardiovascular risk factors. However, analysis of cardiovascular outcomes has been controversial. Objectives: Review the cardiovascular safety of rosiglitazone by conducting a literature search. Methods: We conducted a PubMed search and critically reviewed published work on cardiovascular outcome of rosiglitazone, including clinical studies and meta-analyses. Results/conclusion: The meta-analysis by Nissen and Wolski suggested increased cardiovascular risk in users of rosiglitazone, but this was not supported by an interim analysis of the RECORD trial designed to evaluate this, and several other reports failed to shed conclusive light on this issue. The cardiovascular benefits of pioglitazone have also been in doubt due to the failure of the PROactive trial to reach the primary cardiovascular end points, although this study reported a significant reduction in secondary end points. All of this has left diabetes care in some disarray, with weak evidence for adverse cardiovascular effects driving the reduced use of rosiglitazone, an agent that has important sustained effects on glycaemic control.
Slowing heart rate with ivabradine: new treatment options

The burden of coronary artery disease (CAD) remains high and is the main cause of death and a major cause of morbidity. The treatment of patients with symptomatic CAD is aimed at preventing myocardial infarction and death, and reducing the symptoms of angina and occurrence of myocardial ischaemia. Significant evidence shows that elevated heart rate plays an important role in triggering ischaemic events in patients with CAD and is an important predictor of cardiovascular morbidity and mortality. Ivabradine is a potent anti-anginal agent which works by specifically lowering heart rate. Its antianginal and anti-ischaemic efficacy has been established in a number of randomized placebo-controlled trials, ivabradine being non-inferior to beta-blockers and to calcium antagonists. These trials have also shown that ivabradine is well tolerated and can be safely combined with other cardiovascular agents. The ASSOCIATE study showed that ivabradine provides significant heart rate reduction and improvement in all exercise test criteria in patients with stable angina receiving the beta-blocker atenolol. In addition to its effects on myocardial ischemia and anginal symptoms, ivabradine has the potential to improve clinical outcomes in patients with limiting angina or in patients with a heart rate above 70 b.p.m. as suggested in the BEAUTIFUL trial. In summary, ivabradine is a potent anti-anginal agent, which can be used alone (when beta-blockers are contraindicated or not tolerated) or in combination with beta-blockers, with excellent tolerability.
Seroprevalence and Risk Factors of Varicella-Zoster Among Children of Kashan- Center of Iran

Background: Varicella, the primary infection of varicella-zoster virus(VZV), is a highly contagious and vaccine preventable infectious disease. It can cause severe complications in neonates and adults. Herpes zoster results from VZV reactivation later in life. Objectives: This study was performed to determine the seroprevalence of VZV by evaluating the specific IgG antibody in 1-15 year-old children in Kashan. Patients and Methods: This cross-sectional study was carried out on 558, one through fifteen year-old children among health-care centers in Kashan city during 2011. IgG antibodies against VZV were measured in sera by enzyme-linked immunosorbent assay (ELISA). Results: In total, 27.6% of children were seropositive. The seroprevalence of varicella zoster antibodies increased by age (12.7% in 1-5 year-old, 34.4% in 6-10 year-old and 39.6% in 11-15 year-old children). There was no difference in seroprevalence of VZV according to sex and habitation zone. By using multivariate analysis, independent factors associated with seropositivity were the family size being greater than 4 (OR = 2.01, 95% CI 1.35 - 3.29 P = 0.001) and history of varicella (OR = 39.31, 95% CI 22.79-67.79 P < 0.001). The Negative predictive value of varicella history was 91.1% and slightly decreased by age. Conclusions: In this region, a significant proportion of children are susceptible to VZV, severe varicella and its complications at older ages. It is recommended for varicella vaccine to be added to routine childhood vaccination programs and also to be injected to susceptible adolescents. Negative history of varicella would be a predictor of varicella antibody status in children and young adults.
Quantitative Versus Qualitative Methods in Evaluation of T2 Signal Intensity to Improve Accuracy in Diagnosis of Pheochromocytoma.

OBJECTIVE The purpose of this study was to assess T2 signal intensity (SI) of adrenal pheochromocytoma at 1.5 T using the rapid acquisitions with relaxation enhancement (RARE) sequence. We also sought to determine whether quantitative parameters can distinguish pheochromocytoma from other adrenal lesions with better accuracy than conventional qualitative methods. MATERIALS AND METHODS MRI examinations of 74 patients (26 with pheochromocytoma, 25 with lipid-poor adenomas, 18 with malignant adrenal lesions, and five with adrenal cysts) were retrospectively reviewed. MRI sequences included single-shot fast spin-echo (n = 38) and fast-recovery fast spin-echo (n = 36) acquisitions. T2 SI of lesions was qualitatively compared with CSF. Quantitative evaluation included applying ROI measurements and calculating SI ratio of each mass to liver, spleen, paraspinal muscle, and CSF. Twoway ANOVA compared SI ratios between different adrenal lesions and between two pulse sequences. ROC analysis determined the optimal threshold SI ratio for distinguishing pheochromocytomas from other adrenal lesions. RESULTS Sixty-nine percent of pheochromocytomas displayed isointensity to CSF (p < 0.005), resulting in 81% specificity and 69% sensitivity for differentiation of pheochromocytomas from lipid-poor adenomas and malignant lesions. Adrenal-to-muscle SI ratio was the strongest discriminator for differentiation of pheochromocytomas from other lesions. A threshold of at least 3.95 yielded 88% specificity and 81% sensitivity for distinguishing pheochromocytomas from lipid-poor adenomas and malignant adrenal lesions. CONCLUSION Quantitative normalization of T2 SI with reference to muscle improves the sensitivity and specificity profile for differentiation of pheochromocytoma compared with qualitative assessment alone. At 1.5 T field strength, an adrenal-to-muscle SI ratio of at least 3.95 is recommended.
EFFECTS OF A NEW TESTOSTERONE TRANSDERMAL DELIVERY SYSTEM, BIOLIPID B2®-TESTOSTERONE IN HEALTHY MIDDLE AGED MEN: A CONFOCAL RAMAN SPECTROSCOPY STUDY

The Transdermal Delivery System (BIOLIPID B2®) is a nanoemulsion that can be a pplied directly to the skin by a metered pump to deliver hormones into the systemic circulation. The ai ms of this study were to assess the efficacy of BIOLIPID B2 ® to deliver testosterone systemically and evaluate the short - term effects on Thyroid - Stimulating Hormone (TSH), C - reactive protein (CRP) serum levels and blood pressure in middle aged men with tes tosterone deficiency . An open label randomized prospective study enrolled 14 Brazilian middle aged men with testosterone deficiency . The volunteers received in the forearm 50mg of transdermal BIOLIPID B2® - testosterone nanostructured formulation daily for 3 months. Confocal Raman Spectroscopy (CRS) was used to determine depth and concentration of testosterone on skin layers. Clinical parameters and serum concentrations were compared between the base line and 3 months after treatment. Serum concentrations of t estosterone, CPR and TSH changed significantly (p 0.05) and no changes were observed in the blood pressure . N o adverse events were attribu ted to this transdermal hormone replacement therapy protocol. The BIOLIPID B2 ® nanoemulsion formulation is safe and effective in reestabli shing testosterone and Thyroid - Stimulating Hormone (T SH) serum levels. This transdermal protocol may serve as a strate gy for hormone replacement therapy in middle aged men.