Miracle-dz/UniFAR-FTUs huggingface dataset:
Suitability and calibration of a rebound tonometer to measure IOP in rabbit and pig eyes.

OBJECTIVE To utilize the Icare tonometer TAO1 for intraocular pressure (IOP) determination in experimental animals. To calculate true IOP calibration functions for rabbit and porcine eyes. ANIMALS Enucleated eyes of 3-year-old healthy experimental rabbits (New Zealand white), and healthy 1 year old experimental pigs (Deutsche Landrasse) were used for the determination of IOP. PROCEDURES Manometric (Geuder GmbH, Heidelberg/Germany) and rebound tonometry (Icare tonometer TAO1, Icare, Helsinki/Finland) were used to record IOP in enucleated animal eyes (rabbit n=2, pig n=3). RESULTS The Icare tonometer TAO1 measurements underestimated true IOP by 37-60% in rabbit eyes and 17-63% in porcine eyes. IOP values obtained by both rebound and manometric tonometry for rabbit and porcine eyes followed a linear regression curve. Linear functions were calculated to correct the Icare tonometer TAO1 measurements to true IOP for both rabbit (p=1.4244p(ic) + 4.2421) and porcine eyes (p=1.0799p(ic) + 5.8557). CONCLUSIONS The Icare tonometer TAO1 can be utilized for IOP determination in rabbit and porcine eyes when measured values are corrected with the appropriate linear function.
Procalcitonin as a prognostic and diagnostic tool for septic complications after major trauma*

Objective:The primary aim of this study was to investigate the diagnostic value of procalcitonin (PCT) and C-reactive protein (CRP) in septic complications after major trauma. A secondary aim was to determine whether there was a prognostic value of PCT for severity of injury, organ dysfunction, and sepsis. Design:Prospective study. Setting:Medical/surgical intensive care unit (ICU). Patients:Ninety-four patients with consecutive trauma ≥16 years who were admitted to the ICU for an expected stay of >24 hours. Interventions:None. Measurements:PCT and CRP were collected at admission and every day thereafter. The American College of Chest Physicians/Society of Critical Care Medicine Consensus Conference definition was used to identify sepsis criteria. The Sequential Organ Failure Assessment score was used to describe the severity of organ dysfunction. We retrospectively analyzed the occurrence of systemic inflammatory response syndrome and sepsis using the collected variables (criteria fulfilled at least during three continuous days). Main Results:Patients with trauma presented an early and significant increase in PCT at the moment of septic complications compared with concentrations measured 1 day before the diagnosis of sepsis: 0.85 vs. 3.32 ng/mL for PCT (p < 0.001) and 135 vs. 175 mg/L for CRP (p = not significant). The areas under the respective curve at admission in the diagnosis of sepsis were 0.787 (p < 0.001) and 0.489 for PCT and CRP, respectively. Conclusion:PCT plasma reinduction marks possible septic complication during systemic inflammatory response syndrome after major trauma. In addition, high PCT concentration at admission after trauma in ICU patients indicates an increased risk of septic complications.
The microanatomy of spinal cord injury: A review

Spinal cord injury is a highly prevalent condition associated with significant morbidity and mortality. The pathophysiology underlying it is extraordinarily complex and still not completely understood. We performed a comprehensive literature review of the pathophysiologic processes underlying spinal cord injury. The mechanisms underlying primary and secondary spinal cord injury are distinguished based on a number of factors and include the initial mechanical injury force, the vascular supply of the spinal cord which is associated with spinal cord perfusion, spinal cord autoregulation, and post‐traumatic ischemia, and a complex inflammatory cascade involving local and infiltrating immunomodulating cells. This review illustrates the current literature regarding the pathophysiology behind spinal cord injury and outlines potential therapeutic options for reversing these mechanisms. Clin. Anat. 28:27–36, 2015. © 2014 Wiley Periodicals, Inc.
Tear production in normal juvenile dogs.

OBJECTIVE To establish a baseline range or average for tear production in normal juvenile dogs and evaluate the effects of age, weight, and gender on Schirmer tear test (STT) in juvenile dogs. MATERIALS AND METHODS Healthy puppies of various breeds <6 months of age. STT1 and STT2 were performed in both eyes of each subject. Statistical analysis was performed using a backwards stepwise regression model with repeated measures. Using continuous variables of STT1 and STT2 as the dependent variables separately, the independent variables were age (days), eye (left or right), gender (male or female), ocular disease processes in eyes or not, and weight (kg). RESULTS Eighty-six eyes from 27 males and 16 females were included in this study. Ages ranged from 25 to 133 (mean ± SEM: 61.74 ± 24.15) days and weights ranged from 0.88 to 8.86 (3.27 ± 2.22) kg. STT1 results ranged from 0 to 26 (15.76 ± 5.79) mm/min. STT2 results ranged from 0 to 24 (8.79 ± 5.01) mm/min. Age, weight, and gender significantly affected STT1 results. Weight and gender significantly affected STT2 results. STT1 values increased by 0.15 mm/min for each 1 day increase in age and by 0.84 mm/min for each 1 kg increase in body weight. STT2 values increased by 0.57 mm/min for each 1 kg increase in body weight. CONCLUSIONS Age, weight, and gender significantly affect tear production in normal juvenile dogs. STT1 increases to adult values at approximately 9-10 weeks of age.
Spectrum of practice in the diagnosis of nosocomial pneumonia in patients requiring mechanical ventilation in European intensive care units

Objectives:Information on clinical practice regarding the diagnosis of pneumonia in European intensive care units is limited. The aim of this study was to describe the spectrum of actual diagnostic practices in a large sample of European intensive care units. Design:Prospective, observational, multicenter study. Setting:Twenty-seven intensive care units of nine European countries. Patients:Consecutive patients requiring invasive mechanical ventilation for an admission diagnosis of pneumonia or receiving mechanical ventilation for >48 hrs irrespective of admission diagnosis. Interventions:None. Measurements and Main Results:A total of 2,436 patients were evaluated; 827 were admitted with or developed nosocomial pneumonia (hospital-acquired pneumonia [HAP], 27.1%; ventilator-associated pneumonia [VAP], 56.2%; very early onset VAP, 16.7%). Mean age was 59.4 ± 18.1 yrs, 65.0% were men, and mean admission Simplified Acute Physiology Score II was 46.7 ± 17.1. Worsening oxygenation (76.8%), purulent/changing respiratory secretions (72.1%), and new temperature elevation (69.2%) were the most frequent clinical signs of nosocomial pneumonia. Etiological diagnosis was based on noninvasive respiratory specimens in 74.8% of episodes. Bronchoscopy was performed in 23.3% of episodes. Bronchoscopy performance, after adjustment by severity of illness, age, and type of hospital, were predicted by worsening oxygenation (odds ratio 2.03; 95% confidence interval, 1.27–3.24) and male sex (odds ratio 1.77; 95% confidence interval, 1.19–2.65). Definite cause was documented in 69.5% of nosocomial pneumonia cases. The most common isolates were Staphylococcus aureus (16.3% methicillin-sensitive S. aureus and 16.0% methicillin-resistant S. aureus), Pseudomonas aeruginosa (23.1%), and Acinetobacter baumannii (19.1%). Presence of nosocomial pneumonia significantly prolonged mean length of mechanical ventilation (10.3 days, p < .05) and mean intensive care unit length of stay (12.2 days, p < .05) in intensive care unit survivors. Mortality rate was 37.7% for nosocomial pneumonia vs. 31.6% for patients without pneumonia (p < .05). Conclusions:Etiological diagnosis of nosocomial pneumonia in a large sample of European intensive care units was based mainly on noninvasive techniques. However, there was high variability in bronchoscopy use between the participating intensive care units.
The role of alcohol in women's lives: a review of issues and responses

This review addresses some of the issues related to women's drinking at a time when this is extremely topical. Evidence suggests that there has been a marked increase in alcohol consumption amongst young women in the United Kingdom (UK). Teenage girls have even been shown to be engaging in ‘binge’ or ‘heavy episodic’ drinking more than their male counterparts. Levels of adverse effects, such as liver disease and psychiatric hospital admissions amongst young women have been increasing. Some of the factors associated with these changes are considered. These include changing social roles, feminism, gender stereotypes, occupation and advertising. Some of the powerful positive effects associated with the consumption of beverage alcohol are considered, together with the adverse consequences. The latter include both acute consequences, such as intoxication, injuries and accidents, as well as long‐term or chronic consequences, such as liver disease, cancer and alcohol dependence. This review also describes some of the available evidence related to treatment for alcohol problems amongst women including special populations, relapse and the issue of professional training. Finally, the implications for both alcohol control policy and research into alcohol‐related issues are considered. It is concluded that existing UK alcohol policies are not fully evidence based. Moreover, research into beverage alcohol in the UK is severely under‐funded.
Ethnic differences in do‐not‐resuscitate orders after intracerebral hemorrhage

Objective: To explore ethnic differences in do‐not‐resuscitate orders after intracerebral hemorrhage. Design: Population‐based surveillance. Setting: Corpus Christi, Texas. Patients: All cases of intracerebral hemorrhage in the community of Corpus Christi, TX were ascertained as part of the Brain Attack Surveillance in Corpus Christi (BASIC) project. Interventions: None. Measurements and Main Results: Medical records were reviewed for do‐not‐resuscitate orders. Unadjusted and multivariable logistic regression were used to test for associations between ethnicity and do‐not‐resuscitate orders, both overall (“any do‐not‐resuscitate”) and within 24 hrs of presentation (“early do‐not‐resuscitate”), adjusted for age, gender, Glasgow Coma Scale, intracerebral hemorrhage volume, intraventricular hemorrhage, infratentorial hemorrhage, modified Charlson Index, and admission from a nursing home. A total of 270 cases of intracerebral hemorrhage from 2000–2003 were analyzed. Mexican‐Americans were younger and had a higher Glasgow Coma Scale than non‐Hispanic whites. Mexican‐Americans were half as likely as non‐Hispanic whites to have early do‐not‐resuscitate orders in unadjusted analysis (odds ratio 0.45, 95% confidence interval 0.27, 0.75), although this association was not significant when adjusted for age (odds ratio 0.61, 95% confidence interval 0.35, 1.06) and in the fully adjusted model (odds ratio 0.75, 95% confidence interval 0.39, 1.46). Mexican‐Americans were less likely than non‐Hispanic whites to have do‐not‐resuscitate orders written at any time point (odds ratio 0.37, 95% confidence interval 0.23, 0.61). Adjustment for age alone attenuated this relationship although it retained significance (odds ratio 0.49, 95% confidence interval 0.29, 0.82). In the fully adjusted model, Mexican‐Americans were less likely than non‐Hispanic whites to use do‐not‐resuscitate orders at any time point, although the 95% confidence interval included one (odds ratio 0.52, 95% confidence interval 0.27, 1.00). Conclusions: Mexican‐Americans were less likely than non‐Hispanic whites to have do‐not‐resuscitate orders after intracerebral hemorrhage although the association was attenuated after adjustment for age and other confounders. The persistent trend toward less frequent use of do‐not‐resuscitate orders in Mexican‐Americans suggests that further study is warranted.
Effects of non-ionic contrast media on the blood flow through the femoral artery of the dog

The injection of angiographic contrast media into the femoral artery is followed by an increased blood flow through the artery ascribed to vasodilatation. From results gained in experiments on dogs (HILAL 1966) and cats (LINDGREN et coll. 1967, 1968) it has been concluded that this vasodilatation is to some extent caused by the hypertonicity, relative to plasma, of the angiographic contrast medium. In the research laboratories of Nyegaard & Co. a group of non-ionic, water-soluble contrast media has been synthetized. These new compounds are, among others, characterized by their low osmolality when compared in iodine equivalent concentrations to the angiographic media of today. The present investigation was performed to find out whether the reduced osmolality of the non-ionic contrast media was accompanied by a reduced vasodilatory effect following injection into the femoral artery.
Refractive state of the Spanish Thoroughbred horse: a comparison with the Crossbred horse.

OBJECTIVE To assess the refractive state of the equine eye utilizing retinoscopy. To compare the refractive state of Spanish Thoroughbred horses with the refractive state of Crossbred horses. PROCEDURES The refractive state of 135 horses (264 eyes) was assessed utilizing streak retinoscopy. Two perpendicular meridians were examined in order to assess astigmatism at a working distance of approximately 67 cm. A group of 81 Spanish Thoroughbred horses was compared with a group of 54 Crossbred horses. Cyclopentolate ophthalmic solution was instilled in the eyes of a group of 18 horses to determine if accommodation has any influence on the assessment of the refractive state. RESULTS Mean ± SE refractive state of all horses examined was -0.17 ± 0.04 D. The mean refractive state of the Spanish Thoroughbred was -0.28 ± 0.06 D while that of the Crossbred was -0.01 ± 0.05 D. The refractive state of the Spanish Thoroughbred was found to be statistically different to that of the Crossbred. The most prevalent refractive state was emmetropia in all cases, followed by hyperopia for the Crossbred, and myopia for the Spanish Thoroughbred. Astigmatism ≥0.50 D present in both eyes from the same individual was found in 21.7% of all horses examined. Anisometropia ≥1.00 D was diagnosed in 4 out of 129 horses with both visual eyes. Cycloplegia did not statistically affect the refractive state of the evaluated eyes. CONCLUSIONS The equine eye has a refractive state close to emmetropia. Myopia is higher among Spanish Thoroughbred horses than among Crossbred horses.
Therapeutic hypothermia for acute liver failure

Cerebral edema is a potentially life-threatening complication of acute liver failure, the syndrome of abrupt loss of liver function in a patient with a previously healthy liver. Although the prevalence of cerebral edema appears to be decreasing, patients with rapidly progressive (hyperacute) liver failure, such as after acetaminophen overdose, remain at highest risk. In severe cases of cerebral edema, intracranial hypertension develops and leads to brain death after brainstem herniation or to anoxic brain injury and permanent neurologic impairment. Intracranial hypertension in patients with acute liver failure often can be temporarily controlled by manipulating body position, increasing the degree of sedation, and increasing blood osmolarity through pharmacologic means. However, these maneuvers often postpone, but do not eliminate, the risk of brainstem herniation unless orthotopic liver transplantation or spontaneous liver regeneration follows in short order. To buy time, the induction of therapeutic hypothermia (core temperature 32°C-35°C) has been shown to effectively bridge patients to transplant. Similar to the experience in patients with cerebral edema after other neurologic insults, hypothermia reduces cerebral edema and intracranial hypertension in patients with acute liver failure by decreasing splanchnic ammonia production, restoring normal regulation of cerebral hemodynamics, and lowering oxidative metabolism within the brain. Hypothermia may also ameliorate the degree of liver injury. Hypothermia has not been adequately studied for its safety and theoretically may increase the risk of infection, cardiac dysrhythmias, and bleeding, all complications independently associated with acute liver failure. Therefore, although an ample body of experimental and human data provides a rationale for the use of therapeutic hypothermia in patients with acute liver failure, multicenter, randomized, controlled clinical trials are needed to confirm that hypothermia secures brain viability and improves survival without causing harm.
Integrated fluorine-18 fluorodeoxyglucose (18f-fdg) pet/ct compared to standard contrast-enhanced CT for characterization and staging of pulmonary tumors eligible for surgical resection

Background: Accurate staging is necessary to determine the appropriate therapy in patients with lung cancer. Few studies have compared integrated fluorine-18 fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) and contrast-enhanced CT in the characterization and staging of pulmonary tumors considered eligible for surgical resection. Purpose: To compare 18F-FDG PET/CT with standard contrast-enhanced CT for the diagnosis and staging of lung neoplasms eligible for surgical resection. Material and Methods: Seventy-six consecutive patients (56 male, 20 female; mean age±SD, 63.4±20 years) with 84 pulmonary tumors suspected for malignancy and considered eligible for surgical resection were prospectively enrolled. Seventy-three malignant (65 non-small-cell lung carcinomas, one small-cell lung cancer, two carcinoids, and five metastases) and 11 benign lung tumors (three hamartomas, two sarcoidosis, one amyloidosis, one Wegener granulomatosis, one tuberculosis, and three areas of scarring) were finally diagnosed by histology. Tumor staging was based on the revised American Joint Committee on Cancer. Results: In lesion characterization, the sensitivity and specificity of 18F-FDG PET/CT versus contrast-enhanced CT were 90% vs. 83% and 18% vs. 63% (P<0.05, McNemar test), respectively. In nodal staging, the sensitivity and specificity of 18F-FDG PET/CT versus contrast-enhanced CT were 78% vs. 46% and 80% vs. 93% (P<0.05), respectively. Conclusion: In patients with lung neoplasms considered eligible for surgical resection, 18F-FDG PET/CT versus contrast-enhanced CT revealed higher sensitivity in nodal staging, but lower specificity both in lesion characterization and nodal staging.
Could insulin sensitization be used as an alternative to intensive insulin therapy to improve the survival of intensive care unit patients with stress-induced hyperglycemia?

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The screening for diabetic nephropathy in diabetes clinic in Khartoum- Sudan

Background: diabetes mellitus and its complications is one of the major health problems. This study is about the screening for one of these complications -diabetic nephropathy- in our clinical practice in Khartoum Sudan. Objectives: The main objective is to determine whether the clinical practice in the diabetes clinics in Khartoum- Sudan is following the recommended guidelines for the screening for diabetic nephropathy. Study Design: Prospective cross- sectional study. Populations: during the period from Jan-March 2008, 98 diabetic patients with type 1 or type 2 were randomly selected from patients attending the outpatient diabetes clinic in Omdurman Teaching Hospital. Methodology: ninety eight adult type1 and 2 diabetic patients were studied using simple, direct, standardized questionnaire, previous records were seen and a urine sample for each patient was examined for proteinuria. Results: 6.1% of the total number of patients had urine examination on regular bases, 75.5% rarely had urine examination, while 18.4% had their urine never been examined before in the diabetes clinics. None of patients was diagnosed as having diabetic nephropathy or seen by a nephrologist. Only 7.1% of the total patients were using ACE inhibitors or ARB agents and these were prescribed for indications other than diabetic nephropathy. Testing urine of our patients we found that 18.4% had macroalbuminuria, 40.8% microalbuminuria, while40.8% had negative results. The majority of the patients with either type of albuminuria were in the age group 51-65 years and most of them had type 2 diabetes. Conclusion: A large number of our patients had evidence of diabetic nephropathy. However, none of them had been screened before for that. Despite the small number of patients, this study raises a serious alarm regarding the clinical practice in our diabetes clinics in Khartoum Sudan and it strongly recommends urgent intervention by the authorities to implement the international guidelines of screening and management of these patients. Keywords : macroalbuminuria, microalbuminuria, proteinuria, chronic kidney disease Sudan Journal of Medical Science Vol. 3 (4) 2008: pp. 285-290