Miracle-dz/UniFAR-FTUs huggingface dataset:
Transurethral incision of the bladder neck to treat bladder neck dysfunction and voiding dysfunction in patients with high‐level spinal cord injuries

Detrusor–sphincter dyssynergia (DSD) and bladder neck dysfunction (BND) may cause voiding dysfunction in patients with spinal cord injury (SCI). We report the surgical outcomes in patients with high‐level SCI who underwent transurethral incision of the bladder neck (TUI‐BN).
Future Directions for Vascular Access for Hemodialysis

Hemodialysis vascular access is at the same time both the “Lifeline” and the “Achilles Heel” of hemodialysis. This review will initially summarize the vascular biology of dialysis vascular access dysfunction and then use this information to describe some novel and innovative ways (including advances in the process of care for vascular access) to prevent this problem.
Differentiating illiteracy from Alzheimer's disease by using neuropsychological assessments

ABSTRACT Background: In Asia, where illiteracy rates are high, determining the degree to which neuropsychological measures can be used to identify cognitive impairment in illiterate elders is important. The aim of this study was to evaluate the effectiveness of using formal neuropsychological assessments to distinguish healthy illiterate elders from dementia patients. Methods: We compared the cognitive performance of healthy elders who were illiterate (illiterate NC, n = 25) with those who were literate (literate NC, n = 25), literate patients with mild Alzheimer's disease (literate AD, n = 25), and illiterate patients with mild AD (illiterate AD, n = 25). Neuropsychological measures included the Mini-Mental State Examination (MMSE), the verbal fluency test, the Boston naming test, the Rosen drawing test, and the verbal learning test. Results: In the between-group analyses, the scores on all tests, except verbal fluency and recognition memory, were lower for illiterate NC compared to the literate NC. The scores on the MMSE, Boston naming test, Rosen drawing test, and immediate free recall could not distinguish the illiterate NC from literate AD. However, the scores on all tests, except the Rosen drawing test, could distinguish illiterate NC from illiterate AD. ROC analyses showed the same pattern of results. In addition, age-, sex-, and education-matched cut-off scores of all tests, except immediate recall and delayed recall trials of the verbal learning test, showed good specificities in participants who were illiterate compared to those in participants who were literate. Conclusion: These findings suggest that the impact of literacy on neuropsychological test performance is an important aspect of cognitive evaluations for elders who are illiterate.
Juvenile Lupus Erythematosus: Fourteen Years of Experience

©2011 Turkish League Against Rheumatism. All rights reserved. Amac: Bu calismada Turk cocuklarda juvenil sistemik lupus eritematozusa (JSLE) iliskin temel klinik ve laboratuvar ozellikler ve yani sira morbidite ve mortalitenin tanimlanmasi amaclandi. Hastalar ve yontemler: Otuz JSLE’li cocuk (27 kiz, 3 erkek; ort. tani yasi 12.3 yil; dagilim 3-16 yil) retrospektif olarak degerlendirildi. Hastalarin hepsi SLE tanisina iliskin revize edilmis 1982 Amerikan Romatoloji Birligi kriterlerini karsilamaktaydi ve 16 yasindan once hastaligin klinik bulgularini sergilemisti. Bulgular: Ortalama takip suresi 2.9 yil (dagilim 2 ay-10 yil), tani oncesi semptomlarin ortalama suresi ise 3.3 ay (dagilim 2 gun-2 yil) idi. Hastalarin klinik ve laboratuvar ozelliklerinin sikligi soyle idi: eritematoz malar dokuntu 17 (%56), discoid dokuntu bir (%3.3), fotosensitivite 16 (%53.3), oral ulser sekiz (%26.7), kas-iskelet tutulumu 26 (%87), serozit 13 (%43), hematolojik anormallikler 21 (%70), renal tutulum 17 (%56), antinukleer antikor pozitifligi 27 (%93), pulmoner tutulum sekiz (%27), kardiyovaskuler hastalik yedi (%23) ve merkezi sinir sistemi tutulumu yedi (%23) hastada goruldu. Izlem sirasinda ucu bobrek yetmezliginden, biri sepsisten olmak uzere dort hasta oldu (%13). Calisma sirasinda iki hasta tedavisiz remisyonda, 22 hasta ise tedavi ile remisyonda takip edilmekte idi. Iki hasta ise takipten cikmis idi. Sonuc: Juvenil sistemik lupus eritematozus ciddi, multisistemik bir organ hastaligidir. JSLE erken tani ve tedavi ile yuksek bir remisyon orani sergilemesine karsin, hala onemli bir mortalite oranina sahiptir.
Effects of phenazopyridine on rat bladder primary afferent activity, and comparison with lidocaine and acetaminophen

The clinical indication of phenazopyridine is unclear, it has been used clinically in conditions with increased bladder sensation as in cystitis and bladder pain syndrome/interstitial cystitis. We explored the effect of phenazopyridine on afferent nerve activity by direct measurement of both Aδ‐ and C‐fibers in the rat, and compared the outcome with the effects of lidocaine (a local anesthetic) and of acetaminophen (an analgesic).
Efficacy and Safety of a New Technique of Conversion from Temporary to Tunneled Central Venous Catheters

The usually applied conversion technique from temporary to tunneled central venous catheters (CVCs) using the same venous insertion site requires a peel‐away sheath. We propose a conversion technique without peel‐away sheath: a guide wire is advanced through the existing temporary CVC; then, a subcutaneous tunnel is created from the exit to the venotomy site. After removing the temporary CVC, the tunneled one is advanced along the guide wire. The study group included all patients requiring a catheter conversion from January 2012 to June 2014; the control group included incident patients who had received de novo placement of tunneled CVCs from January 2010 to December 2011. The main outcome measures were technical success and immediate complications. Seventy‐two tunneled catheters (40 with our conversion technique and 32 with the traditional one) were placed in 72 patients. The technical success was 95% in the study group and 75% in the controls (p = 0.019). The immediate complications were one bleeding in the study group (2.5%) and one air embolism, one pneumothorax, and four bleedings (18.7%) in the controls (p = 0.039). Conversion from temporary to tunneled CVC using a guide wire and without a peel‐away sheath is an effective and safe procedure.
Can be sphincter electromyography reference values shared between laboratories?

Sphincter electromyography (EMG) is an important method in diagnosis of neuropathic sacral lesions. Quantitative EMG analysis increases utility of the test, but requires valid reference values. Although commonly employed, validity of sharing reference data between electrodiagnostic laboratories has not been confirmed. In this study, this approach was assessed by comparing the reproducibility of data sets obtained by the same and different laboratories.
Dementelcoach: effect of telephone coaching on carers of community-dwelling people with dementia

ABSTRACT Background: Dementelcoach is a new telephone intervention to support informal caregivers of community-dwelling people with dementia. The effectiveness of this intervention was evaluated on burden and mental health problems of informal caregivers. Methods: A pre-test/post-test comparison group design was used with three groups of informal caregivers. Two of the groups were experimental and received either (1) telephone coaching or (2) telephone coaching in combination with respite care (psychogeriatric day care); the third was a comparison group which received day care only. Telephone coaching was offered by trained coaches once every two to three weeks over a period of 20 weeks. Results: Informal caregivers who received telephone coaching in combination with respite care reported significantly less burden compared to caregivers who received telecoaching only, and they experienced significantly fewer mental health problems than those who received day care only. Conclusion: Telecoaching according to the principles of Dementelcoach combined with respite care (psychogeriatric day care) is more effective in reducing burden and health complaints in informal caregivers of community-dwelling people with dementia than telecoaching or day care only.
Estimation of the risk of conversion of mild cognitive impairment of Alzheimer type to Alzheimer's disease in a south Brazilian population-based elderly cohort: the PALA study

ABSTRACT Background: Higher mild cognitive impairment (MCI) prognostic variability has been related to sample characteristics (community-based or specialized clinic) and to diverse operationalization criteria. The aim of the study was to evaluate the trajectory of MCI of Alzheimer type in a population-based elderly cohort in Southern Brazil. We also estimated the risk for the development of probable Alzheimer's disease (AD) in comparison with healthy subjects. Methods: Data were derived from a population-based cohort (the PALA study). MCI outcomes were sub-classified into three categories: conversion, stabilization, and reconversion. The risk of progression to dementia was compared between MCI and normal participants. The analysis was based on 21 MCI subjects and 220 cognitively intact participants (N = 241). Results: Of the 21 MCI subjects, 38% developed dementia, 24% remained stable and 38% improved. The MCI annual conversion rate to AD was 8.5%. MCI was associated with significantly higher risk of conversion to AD (HR = 49.83, p = 0.004), after adjustment for age, education, sex and Mini-Mental State Examination score. Conclusions: Independent of the heterogeneity of the outcomes, MCI of the Alzheimer type participants showed significantly higher risk of developing probable AD, demonstrating the impact of the use of these MCI criteria that emphasize long-term episodic memory impairment.
An evaluation of a national program to implement the Cornell Scale for Depression in Dementia into routine practice in aged care facilities

ABSTRACT Background: Screening tools have been recommended for use in aged care to improve the detection and treatment of depression. This study aimed to evaluate the impact of a program for the routine implementation of the Cornell Scale for Depression in Dementia in Australian facilities, to determine whether use of the instrument by nurses led to further monitoring of depressive symptoms, medical referral, and changes in treatments prescribed for depression. Methods: A file review was completed for 412 participants out of a total of 867 older people (47.5%) who resided in ten aged care facilities. The review examined Cornell Scale assessment data, medication charts, medical history, nursing progress notes, and resident care plans. Nursing staff who administered the Cornell Scale to each participant were also interviewed, and ten facility managers took part in an interview to determine barriers to the effective implementation of the instrument. Results: The Cornell Scale had been administered to 46.8% of the sample in the previous 12 months, with 25% of these participants scoring 9–13 and 27% scoring 14 and above. Less than one third of the residents with high scores were monitored by the staff following the assessment. Only 18% of residents with high scores were referred for further assessment of depression, while 10% received a treatment change. Conclusions: The absence of a protocol for responding to high Cornell Scale scores limited the potential of this program to result in widespread improved treatment of depressed older people. The use of the Cornell Scale by aged care nurses with limited training raised concern.
Beginnings—The Kidney and Nephrology in Ancient Mesopotamian Culture

A defining period in the history of civilization occurred in ancient Mesopotamia. While some of Mesopotamian contributions to knowledge (writing, mathematics, astronomy) have been recognized, those made to medicine are just beginning to be studied and appreciated. The medicine of the time developed in a theocratic society where local gods controlled all aspects of life and their healers were learned scribes who established the priestly medicine of old. For their use of prayers and incantations as a component of therapy Mesopotamian medicine has been belittled and relegated to magic. In fact, the Mesopotamian healers established the basic medical skills of observation, diagnosis, prognosis and treatment and, over time, systematically produced an expanding corpus of medical knowledge that had not existed theretofore. The kidney as an organ, the components of the urogenital tract, some signs and symptoms of renal diseases, and the art of urinalysis were first conceptualized, studied, and codified in Mesopotamia. In doing so, the Mesopotamians set the foundations of rational medicine that would follow after the introduction of the phonetic alphabet and the Socratic method of questioning and debate to stimulate critical analysis.
Comparison of air‐charged and water‐filled urodynamic pressure measurement catheters

Catheter systems are utilized to measure pressure for diagnosis of voiding dysfunction. In a clinical setting, patient movement and urodynamic pumps introduce hydrostatic and motion artifacts into measurements. Therefore, complete characterization of a catheter system includes its response to artifacts as well its frequency response. The objective of this study was to compare the response of two disposable clinical catheter systems: water‐filled and air‐charged, to controlled pressure signals to assess their similarities and differences in pressure transduction.
We Avoid Antibiotic Lock Solutions due to Fear of Antibiotic Resistance

Hemodialysis catheter‐related bacteremia (CRB) is the most common complication associated with catheter use in dialysis patients and portends a high morbidity and mortality. Current CDC and KDIGO guidelines recommend treating CRBs with systemic antibiotics in conjunction with catheter replacement, although the latter has limitations. Antibiotic lock solutions (ABLs) are very effective in both prevention and treatment of CRBs in hemodialysis patients and may be a preferred alternative to catheter replacement especially in patients where catheter salvage is a priority. Previous smaller observational studies have raised concerns of a potential increase in antibiotic resistance associated with the widespread use of ABLs. Review of the recent literature does not support this claim.
Stopping them starting: evaluation of a community-based project to discourage teenage smoking in Cardiff

A project in Cardiff in 1994/95 aimed to delay the onset of smoking among Year 7 pupils (11-12-year-olds) through a combination of school-based education and community interventions. Pupils' intention to smoke and attitudes towards smoking were compared before and after a six-month intervention period. There was evidence that fewer young people thought that they would become smokers in those schools where there was local agency involvement, althouth the numbers of pupils smoking increased over the intervention period. The study period was insufficient to allow conclusive statements about the effects of the community initiatives to be made. This modest experiment used limited resources to encourage community-wide participation in tackling the smoking issue and requires sustaining to counter positive images of smoking. Practical examples of such community interventions to support school-based education are given.
Interpersonal conflict strategies and their impact on positive symptom remission in persons aged 55 and older with schizophrenia spectrum disorders

ABSTRACT Background: Although interpersonal interactions are thought to affect psychopathology in schizophrenia, there is a paucity of data about how older adults with schizophrenia manage interpersonal conflicts. This paper examines interpersonal conflict strategies and their impact on positive symptom remission in older adults with schizophrenia spectrum disorders. Methods: The schizophrenia group consisted of 198 persons aged 55 years and over living in the community who developed schizophrenia before age 45. A community comparison group (n = 113) was recruited using randomly selected block-groups. Straus’ Conflict Tactics Scale (CTS) was used to assess the ways that respondents handled interpersonal conflicts. Results: Seven conflict management subscales were created based on a principal component analysis with equamax rotation of items from the CTS. The order of the frequency of the tactics that was used was similar for both the schizophrenia and community groups. Calm and Pray tactics were the most commonly used, and the Violent and Aggressive tactics were rarely utilized. In two separate logistic regression analysis, after controlling for confounding variables, positive symptom remission was found to be associated significantly with both the Calm and Pray subscales. Conclusions: The findings suggest that older persons with schizophrenia approximate normal distribution patterns of conflict management strategies and the most commonly used strategies are associated with positive symptom remission.
Hemodialysis Ultrafiltration Rate Targets Should Be Scaled to Body Surface Area Rather than to Body Weight

The association between higher ultrafiltration rates and poor outcomes in hemodialysis patients has received increased attention, to the point that various regulatory entities are considering adding ultrafiltration rate as a quality measure to be monitored and controlled. Most of the discussion to date has focused on ultrafiltration rate scaled to body weight, or more correctly, body mass (ml/hour per kg). One outcome study suggests that ultrafiltration rate might best be not scaled at all to body size, as modestly higher ultrafiltration rate in very small‐size patients may be associated with some survival benefit, probably via increased dietary intake. Outcomes studies also suggest that the risk of exceeding a weight‐scaled ultrafiltration target may be magnified in very large patients, and that body weight‐scaled ultrafiltration targets in such patients should be set a lower level. Here, we present an analysis, based on physiological hemodynamic arguments, that it would be better to scale ultrafiltration rate to body surface area rather than to body mass. Whatever ultrafiltration rate is scaled to, attempts to restrict ultrafiltration rate by limiting interdialytic weight gain in small, possibly malnourished patients, should be done cautiously, to prevent an inadvertent lowering of intake of calories and dietary protein.
The effect of lifetime cumulative adversity on change and chronicity in depressive symptoms and quality of life in older adults

Abstract Background: Lifetime cumulative adversity (LCA) has a detrimental effect on mental health. However, it is less clear whether it also increases the risk for mental health deterioration across time, and whether it is related to a continuous impairment in mental health among older adults. The current study aimed to examine whether LCA is related to deterioration and to continuous vulnerability in depressive symptoms and quality of life. Method: Nine thousand one hundred fifty four older adults (mean age = 63 at Wave 1) who participated in the first three waves of the Survey of Health, Ageing and Retirement in Europe (SHARE) reported exposure to negative life events, depressive symptoms, and quality of life. Results: Respondents with more LCA were at greater risk of high level of depressive symptoms and low level of quality of life. Those with more adversity were at greater risk of reporting an increase in depressive symptoms and a decrease in quality of life between waves. LCA was also related to continuous high level of depressive symptoms and low level of quality of life. The effect of LCA was stronger for depressive symptoms than for quality of life. Conclusions: LCA is associated with decline, as well as with continuous impairment, in major markers of mental health at the second half of life. The overall modest effects imply that resilience to LCA is widespread among older adults. Still, prevention and intervention programs should target old people with cumulative adversity, as they are in risk for deterioration and chronic vulnerability in important components of mental health.
Case conferences as interventions dealing with the challenging behavior of people with dementia in nursing homes: a systematic review

ABSTRACT Background: Challenging behaviors such as aggression, screaming, and apathy are often encountered when caring for people with dementia in nursing homes. In this context, a case conference is often recommended for healthcare professionals as an effective instrument to improve the quality of care. However, the subject case conference has not had great consideration in scientific literature. The aim of this review is to describe the effects of case conferences on people with dementia and challenging behavior and the staff in nursing homes. Methods: A search of intervention studies in nursing homes in the German or English language was performed in the following databases: Medline, Cinahl, PsycINFO, Cochrane library, Embase, and Google Scholar. The selection and the methodological quality of the studies were assessed independently by two authors. The results were summarized and compared based on categories such as study quality or outcomes. Results: Seven of 432 studies were included in the review. A total of four of seven studies showed a reduction in the challenging behavior of people with dementia, and five showed an influence on the competence, attitudes, and job satisfaction of the staff. However, due to the middle-range quality of several studies, the methodological heterogeneity and differences in the interventions, the results must be interpreted with caution. Conclusions: In summary, little evidence exists for the positive effects of case conferences in the care of people with dementia. This review highlights the need for methodologically well-designed intervention studies to provide conclusive evidence of the effects of case conferences.
Personal injury compensation: no claim without pain?

AIMS AND METHOD To identify the experiences of patients pursuing a personal injury claim, we carried out a retrospective questionnaire survey. RESULTS Sixty-one patients from a regional traumatic stress clinic took part. Most were satisfied with the conduct of legal, medical and psychiatric personnel. Thirty-two (53%) reported that the legal proceedings had had an adverse effect on their health/well-being, and about a third reported an adverse effect on domestic relationships. Twenty-four patients (40%) were dissatisfied with the provision of information. More information about the whole legal process would have been welcomed by means of an information leaflet ( n =57, 93%), a helpline ( n =48, 79%), or a videotape ( n =42, 68%). CLINICAL IMPLICATIONS Although seeking redress may contribute to the patient’s adjustment, this survey demonstrates that it is not a step to be taken without consideration. As part of their therapeutic management, mental health professionals should consider the implications of such a step with their patients.