Miracle-dz/UniFAR-FTUs huggingface dataset:
Interim Guidelines for Management of Abnormal Cervical Cytology

THE INCIDENCE of and mortality from cervical cancer in the United States have decreased dramatically over the past 40 years, in part because of early diagnosis and treatment of cervical cancer precursor lesions. The success of cervical cytological screening has served as a model for early diagnosis of other types of cancer. Although numerous studies have shown that lack of cytological screening is a major risk factor for the development of invasive cervical cancer, 1-3 it is important to emphasize that none of the screening, diagnostic, or therapeutic techniques used in medicine are perfect. Accordingly, a few women will develop cervical cancer despite adherence to accepted screening protocols . In addition, problems inherent with sampling, interpretation, and effective clinical follow-up preclude total prevention of cervical cancer. In recent years it has become evident that the cost and morbidity associated with the detection and treatment of low-grade cervical lesions have escalated, probably
Recommendations for the Description of Genetic and Audiological Data for Families with Nonsyndromic Hereditary Hearing Impairment

1 UOA Otochirurgia Az, Ospedaliera di Padova, Italy 2 Department. of Medical Genetics, University of Antwerp, Belgium 3 Victoria University of Manchester, Department of Education Studies – Centre for Human Communication and Deafness, UK 4 Department of Audiology, Bispebjerg Hospital, Copenhagen, Denmark. 5 Department of ENT, Head & Neck Surgery and Communication disorders, University Hospital Antwerp, Belgium 6 Department of Audiology, University of Ferrara, Italy
Workforce Matters: Exploring a New Flexible Role in Health Care

This thesis describes an action research study that took place in the context of increasing intervention by UK central government in the shaping and delivery of health services, and broadening expectations about who could deliver services. The study was aimed at exploring the issues arising from the development of the interprofessional care co-ordinator (IPCC) role in an acute in-patient setting. The role was new, introduced with an inherent flexibility that enabled IPCCs to speed patients through their in-patient stays as fast as clinically possible. None of the four IPCCs appointed held a registrable qualification in health or social care. A review of the literature identified that very little is known about care co-ordinator roles in practice, particularly those held by non-registered workers. The study reported in this thesis began two years after the IPCCs took up post. The study’s objectives were to describe the characteristics, impact, issues and influences on the role. A wide range of qualitative and quantitative data were gathered and analysed between October 1998 and July 2000 within the framework of an action research approach. The findings identified that the IPCC role had informally shifted over time to take up the complex discharge planning work previously carried out by nurses. This shift was not reflected in Trust policy and had not been accompanied by a review of training, regulation or supervision. This had led to situations of risk for some patients. The findings threw light on contextual factors that enabled the role shift and disrupted the reflective leadership and long-term overview needed to monitor and respond to the shift. These factors included nursing staff shortages and a turbulent environment for managers characterised by multiple pressures, top-down targets particularly for acute efficiency, and high managerial turnover. In addition, nurses did not perceive that they had an influence on the ongoing development of the IPCC role. The findings support Abbott’s (1988) theory that an occupational group can take up the discarded work of a higher status occupational group, but challenge the theory that the work discarded is always more routine than the work retained. They support theories of a growing challenge to the primacy of professional knowledge and the existence of an organisational culture in the NHS in which there are broader expectations of who can deliver which health services. They also indicate that role substitution can lead to the routinisation and marginalisation of aspects of patient care. The findings also illustrate how an innovation can continue to be re-invented following its establishment into routine practice, and how the journey of an innovation can be influenced by its context. The findings throw light on a role in practice that is a cameo of current policy on new roles and have a number of implications for practice, policy, education and research.
Myopic macular hole: response

We would like to thank Essex for his interest in our recent paper regarding double peel for myopic macular hole related detachments. In our case series, the double peel has a higher success rate (70% vs. 44%) compared with the control group. We accept the authors’ comment that our results did not reach a statistical significance, and it is mainly because of its small sample size and its non-randomized nature. Nevertheless, we strongly believe a more complete removal of tangential and anterior-posterior traction on the macular hole, using the double peel technique, can lead to a higher surgical successful rate. Concerning the visual acuity results, the author has correctly pointed out that the preoperative and postoperative visual acuity was quoted as ‘Snellen’, as this was the clinical method we used when measuring the visual acuity in the subjects. However, the difference between lines in Snellen visual acuity was not linear, and this cannot be presented by simple subtraction as we do in logMAR. Hence, we converted the visual acuity to logMAR units when comparing the difference for easier calculations and better understanding. Finally, the statistical significant results of the visual acuity changes were generated using the SPSS program Version 11.5 (SPSS Inc., Chicago, IL, USA) and doublechecked with the statistician in our department. The variances were small in the study group and suffice to reject the null.
Insidious Renal Damage in Patients with Thalassemia Major: Is it More Serious than Appreciated?

Aim: To investigate early renal injury in thalassemia major patients by using novel serum markers and demonstrate the factors leading to renal injury. Material and Methods: Seventy-one thalassemia major patients (37 males) who were on regular transfusion and chelation programme with deferasirox have been enrolled in this study. Thirty-five healthy children of the same age served as a control group. Serum urea-creatinine, electrolytes, cystatin C and glomerular filtration rate were all noted in our cohort and compared with the control group. Proteinuria was also investigated by calculating UPr/UCr ratio. Results: The median serum creatinine level was 0.4 mg/dL (range; 0.2-0.76 mg/dL ) and the median glomerular filtration rate level was 192 mL/min/1.73 m2 (range; 106-308 mL/min/1.73 m2 ) in patients. More than half of the patients had glomerular hyperfiltration (n=48, 67.6%). Hyperfiltration was prominent in thalassemia group (66.2% vs. 19.4%) (p=0.0001). Mean serum cystatin C levels were found to be statistically elevated in patient group comparing with controls (p=0.0001). Serum cystatin C level was above >1 mg/L in 46 patients (64.7%) whereas only three in controls (p=0.0001). Sex, age, hemoglobin level and cardiac T2* MRI results were not related to the elevated cystatin C levels. On the other hand, liver iron burden and serum ferritin levels were noted to be statistically correlated to elevated cystatin C level (p=0.024 and p=0.04). Deferasirox dose below 25 mg/kg/day was also found in relation with elevated cystatin C levels. Conclusion: Renal injury is multifactorial, insidious but progressive in thalassemia patients. High index of suspicion and routine use of novel markers are required for detection of renal injury during the follow up of thalassemia patients.
A retrospective study of post-operative gall bladder pathology with special reference to incidental carcinoma of the gall bladder

Background: Surgical removal of gall bladder for its diseases is common. However, not much is known about the incidence of incidental carcinoma in such patients in our population. Objective of current study was to analyze the different pathological entities of post-operative gall bladder specimen with particular emphasis on incidental carcinoma. Methods: This retrospective study was carried out at a multi-specialty hospital in eastern India from the pathology records for the period from August 2005 to July 2008. The records were analyzed for gender, age group distribution, and pathological types with different histology. Results: Out of 863 records, chronic cholecystitis 51.2% was the most common histology and malignancy was seen in 2.7% (23/863) both pre-operative and post-operative diagnosis. In the neoplastic group incidental carcinoma was diagnosed in 1.9% (17/23) of cases Conclusion: Histopathological examination of gallbladder specimen helps to identify non-neoplastic conditions with its complications and also, for the detection of incidental carcinoma. Thorough sampling of all gallbladder specimens is a must to detect focal neoplastic changes.
Effects of atorvastatin on expression of ICAM-1 in atherosclerotic rabbits

Aims Lipid accumulation and inflammatory response are major events in the progression of atherosclerosis. This research was performed to determine if atorvastatin could prevent atherosclerosis and its underlying mechanisms. Methods An atherosclerotic model was established in rabbits. Atorvastatin was administrated by gavage. Blood samples were collected to measure plasma total cholesterol, total triglyceride and low-density lipoprotein (LDL)-cholesterol. After the high-cholesterol diet with or without atorvastatin treatment, the morphological changes of the rabbits were examined with hematoxylin and eosin staining of tissues, and the expression of intercellular adhesion molecule 1 (ICAM-1) was determined by immuno-staining and reverse transcriptase-PCR (RT-PCR). Results Atorvastatin significantly reduced plasma levels of total cholesterol (41.7%) and LDL-cholesterol (34.6%). Neither the hypercholesterol diet nor atorvastatin treatment had any significant impact on body weight and plasma triglycerides. Treatment with atorvastatin significantly restored 40.9% of the widened intima and even down-regulated the ratio of intima/media by 55.5%. The inhibitory effects of atorvastatin on the expression of ICAM-1 showed a decrease of up to 37.6% (P < 0.01). The diseased rabbits showed a 167.3% increase in ICAM-1 mRNA expression (P < 0.01), which was reversed by nearly 46.4% by treatment with atorvastatin. Conclusion Atorvastatin significantly prevents atherosclerotic changes in rabbits with a high-cholesterol diet, possibly by lowering plasma lipids and decreasing over-expressed ICAM-1.
Four polymorphisms of cholesteryl ester transfer protein gene and coronary stenosis in a Tunisian population

Aims The role of cholesteryl ester transfer protein (CETP) in the development of atherosclerosis is under debate. We studied the association of four polymorphisms (Taq1B, I405V, R451Q and A373P) in the CETP gene with lipid profile and coronary artery disease. Methods Four CETP polymorphisms were studied in 316 Tunisian patients undergoing coronary angiography. Patients were clinically examined and their lipid profiles were estimated. Genotyping was performed using polymerase chain reaction-restriction fragment length polymorphism analysis. Results The 451Q allele, associated with lower high-density lipoprotein-cholesterol (HDL-C) and higher total cholesterol and apolipoprotein B (ApoB) concentrations, was also significantly associated with an increased risk of significant stenosis [odds ratio (OR) = 1.74, 95% confidence interval (CI) 1.15–2.61, P = 0.007]. The B2 allele of Taq1B polymorphism had an increase in HDL-C concentration and was associated with a decreased risk of coronary stenosis, as described earlier. It was also associated with low risk of hypoHDLaemia [OR = 0.615, 95% CI 0.377–1.002, P = 0.035]. No significant effect of different A373P and I405V alleles was found on the lipid profile and on coronary stenosis. When CETP polymorphisms were combined in haplotypes possessing R451Q, A373P, I405V, Taq1B polymorphisms, the 1112 haplotype (where 1 is the wild genotype and 2 represents carriers of the variant allele) seems to be the most protective against significant stenosis (OR = 0.71, 95% CI 0.188–0.983; P = 0.014), whereas 2111 was probably the most atherogenic, with an OR = 2.17, 95% CI 1.06–5.88; P = 0.039. Conclusion The Q allele of the R451Q polymorphism was associated with decreased HDL-C, increased ApoB concentrations and increased risk of coronary stenosis. In haplotype analysis, we found that 1112 seems to be a protective haplotype, whereas 2111 has an atherogenic effect in a coronary Tunisian population.
Prevalence of anemia in the school children of Kattankulathur, Tamil Nadu, India

Anemia is the most widespread nutrition problem in the world and has predominance in developing countries like India, particularly in children and women. The magnitude of the anemia has been well-documented in pregnant women and infants, however, there is no data on the prevailing occurrence of anemia in school children. The main objective of this study was to estimate the prevalence of anemia and its correlation to variables such as age, gender and body mass index in school children of Kattangulathur, Tamil Nadu, India. A total of 900 children in the age group of 8-16 years were included in this study. Parental consent was obtained in the written format. Blood was collected by finger prick and the hemoglobin was determined by cyanmethemoglobin method. A preplanned questionnaire was used to collect the health details of the children. The children were grouped according to the age. Prevalence of anemia as per the World Health Organization (WHO) recommended cutoff value of hemoglobin, among these children was 52.88%. The frequency of the prevalence of anemia was significantly higher amongst girls as compared to the boys. Results of the study population reveal that 52.88% were anemic, girls (67.77%) were 32.2% higher than the boys (35.55%) and anemic children were underweight. Therefore our study results suggest that all the school children should be screened periodically and appropriate measures should be taken.
Drug use in gestational diabetes

There has been a traditional reluctance to recommend oral antidiabetic drugs for the management of hyperglycaemia in gestational diabetes mellitus. Recent publications suggest that both sulphonylureas and metformin may have a contribution to therapy in this condition and in particular the Metformin in Gestational Diabetes (MiG) trial provides good quality evidence that this drug might be particularly suitable when obesity is a factor in gestational diabetes. This article gives an overview of the rationale for use of oral antidiabetic agents in the treatment of gestational diabetes. Br J Diabetes Vasc Dis 2009;9:33–35
Deterministic?: Newspaper Representations of Obesity and Genetics

Media coverage of the role of genetics in obesity causation may influence health behaviours as well as public support for obesity prevention policies. This study examined the five highest circulating daily newspapers for articles addressing genetics and obesity between January 1, 1990 and June 14, 2007. Of 776 articles found, 109 were reviewed. Results indicate a shift away from a deterministic view of obesity towards a personal responsibility perspective over time. These findings may have implications for public policy.
Correlation of histologic grading of canine mast cell tumors with Ki67/PCNA/AgNOR/c‐Kit scores: 38 cases (2002–2003)

Introduction: The Patnaik grading system for canine cutaneous MCT is currently one of the best determinants of prognosis; however, clinical outcome does not always correlate with histologic grade. The development of molecular markers offers a potential advantage and may complement subjective grading. The primary purpose of this study was to correlate histologic grading to Ki67/PCNA/AgNOR/c-Kit scores. Methods: Thirty-eight dogs with cutaneous MCT underwent surgical resection. Tumors were graded, with expansion of grade II MCT to low, medium (or II only) and high. For statistical purposes, MCT grade I, II (low, medium, high) and III were assigned a score of 1, 2, 3, 4, or 5, respectively. Sections were processed for AgNOR staining and expression of PCNA, Ki67 and c-Kit as previously described (modified biotin-strepavidin with DAB substrate). Paraffin-embedded canine tissue arrays were used as positive and negative controls (primary antibody replaced with pre-immune sera). Parametric statistical testing was performed using Statview statistical software with P ≤ . 05 as significant. Results: There were 12, 20, 5 and 1 grade II low, grade II medium, grade II high and grade III MCT, respectively. The mean Ki67 score was 9.114 (median 8.0, range 1–28), mean PCNA score was 26.25 (median 24.0, range 5–65), mean AgNOR score was 1.499 (median 1.35, range 1.02–2.76) and c-Kit scores were +1 (9/37), +2 (19/37) and +3 (9/37). With parametric statistical testing, significantly positive correlations were found for Ki67/Grade, PCNA/Grade, AgNOR/Grade, Ki67/PCNA, Ki67/AgNOR and PCNA/AgNOR (all P < .0001). No significant correlation was found for c-Kit and grade; however, +3 c-Kit scores had statistically significantly higher grades than +2 c-Kit scores (P = .0458). Conclusions: Ki67/PCNA/AgNOR scores are positively correlated to grade in dogs with MCT. Further studies to correlate Ki67/PCNA/AgNOR/c-Kit scores with clinical variables are ongoing.
Effect of coinfection with genogroup 1 porcine torque teno virus on porcine circovirus type 2-associated postweaning multisystemic wasting syndrome in gnotobiotic pigs.

OBJECTIVE To determine whether genogroup 1 porcine torque teno virus (g1-TTV) can potentiate clinical disease associated with porcine circovirus type 2 (PCV2). SAMPLE POPULATION 33 gnotobiotic baby pigs. PROCEDURES Pigs were allocated into 7 groups: group A, 5 uninoculated control pigs from 3 litters; group B, 4 pigs oronasally inoculated with PCV2 alone; group C, 4 pigs inoculated IP with first-passage g1-TTV alone; group D, 4 pigs inoculated IP with fourth-passage g1-TTV alone; group E, 6 pigs inoculated IP with first-passage g1-TTV and then oronasally inoculated with PCV2 7 days later; group F, 6 pigs inoculated IP with fourth-passage g1-TTV and then inoculated oronasally with PCV2 7 days later; and group G, 4 pigs inoculated oro-nasally with PCV2 and then inoculated IP with fourth-passage g1-TTV 7 days later. RESULTS 6 of 12 pigs inoculated with g1-TTV prior to PCV2 developed acute onset of postweaning multisystemic wasting syndrome (PMWS). None of the pigs inoculated with g1-TTV alone or PCV2 alone or that were challenge exposed to g1-TTV after establishment of infection with PCV2 developed clinical illness. Uninoculated control pigs remained healthy. CONCLUSIONS AND CLINICAL RELEVANCE These data implicated g1-TTV as another viral infection that facilitates PCV2-induced PMWS. This raises the possibility that torque teno viruses in swine may contribute to disease expression currently associated with only a single infectious agent.
Predictors of Women's Choices in Breastfeeding Initiation and Exclusivity at Six Months

The purpose of this study was to analyze the Canadian Maternal Experiences Survey to determine the predictors of breastfeeding initiation and exclusive breastfeeding at six months. Logistic regression analyses were used to assess potential predictors. Independent predictors for breastfeeding initiation included: adequate information about feeding, assistance with breastfeeding initiation, postpartum maternal skin contact, baby’s location in the first hour after birth, province of birth, maternal immigration, maternal smoking, maternal dissatisfaction with support from her husband/partner during labour, length of time the baby spent in a different room in the first twenty four hours, mother’s level of education, and population size. Independent predictors for exclusive breastfeeding at six months were: adequate information received about formula feeding, pacifier use, contact made by a healthcare provider after the birth, marital status, province of birth, mother’s return to work, maternal smoking, timing until first breastfeeding, maternal breast pain, maternal age, and prepregnancy BMI.
Sedative and cardiopulmonary effects of medetomidine hydrochloride and xylazine hydrochloride and their reversal with atipamezole hydrochloride in calves.

OBJECTIVE To assess the sedative and cardiopulmonary effects of medetomidine and xylazine and their reversal with atipamezole in calves. ANIMALS 25 calves. PROCEDURES A 2-phase (7-day interval) study was performed. Sedative characteristics (phase I) and cardiopulmonary effects (phase II) of medetomidine hydrochloride and xylazine hydrochloride administration followed by atipamezole hydrochloride administration were evaluated. In both phases, calves were randomly allocated to receive 1 of 4 treatments IV: medetomidine (0.03 mg/kg) followed by atipamezole (0.1 mg/kg; n = 6), xylazine (0.3 mg/kg) followed by atipamezole (0.04 mg/kg; 7), medetomidine (0.03 mg/kg) followed by saline (0.9% NaCl; 6) solution (10 mL), and xylazine (0.3 mg/kg) followed by saline solution (10 mL; 6). Atipamezole or saline solution was administered 20 minutes after the first injection. Cardiopulmonary variables were recorded at intervals for 35 minutes after medetomidine or xylazine administration. RESULTS At the doses evaluated, xylazine and medetomidine induced a similar degree of sedation in calves; however, the duration of medetomidine-associated sedation was longer. Compared with pretreatment values, heart rate, cardiac index, and PaO(2) decreased, whereas central venous pressure, PaCO(2), and pulmonary artery pressures increased with medetomidine or xylazine. Systemic arterial blood pressures and vascular resistance increased with medetomidine and decreased with xylazine. Atipamezole reversed the sedative and most of the cardiopulmonary effects of both drugs. CONCLUSIONS AND CLINICAL RELEVANCE At these doses, xylazine and medetomidine induced similar degrees of sedation and cardiopulmonary depression in calves, although medetomidine administration resulted in increases in systemic arterial blood pressures. Atipamezole effectively reversed medetomidine- and xylazine-associated sedative and cardiopulmonary effects in calves.