Miracle-dz/UniFAR-FTUs huggingface dataset:
Is sorafenib (S) safe and effective in patients (pts) with hepatocellular carcinoma (HCC) and Child-Pugh B (CPB) cirrhosis?

4518 Background: S prolongs overall survival (OS) and time to progression (TTP) in pts with HCC and Child-Pugh A (CPA) (Llovet et al., ASCO 2007). A Phase II study (Ph II) evaluating S in advanced HCC included pts with CPA and CPB pts (Abou-Alfa et al. JCO 2006). Here, we assessed the safety and efficacy of S in subsets of HCC pts with CPA and CPB from the Ph II. Methods: Ph II accrued a total of 137 pts: 98 CPA and 38 CPB, 1 CP unknown. Pts received S standard dose of 400 mg PO bid continuously. Blood samples were collected for pharmacokinetics from 28 pts (21 CPA and 7 CPB) on day 1 of cycle 2 at 0.5, 1, 2, 4, 8 and 12 hours. 12th hour data was missing on few pts. We analyzed toxicity and clinical outcome data. Results: AUC (0–8) (mg.h/L) was comparable between CPA (25.4) and CPB (30.3) pts. Cmax (mg/L) were also comparable: 4.9 (CPA) and 6 (CPB). Incidence rates for all adverse events (AE) were similar in CPA (97%) and CPB (97%), and serious AE (52% vs 68%). Common sorafenib AE, as defined by NCI CTC v.
DESIRE FOR OBSTETRIC ANALGESIA AMONG WOMEN IN NORTHERN NIGERIA

Background : Obstetric analgesia is now routinely provided in most developed countries. However, in developing countries including Nigeria, childbirth is still a painful natural process for most women without choice. This study determined labour pain perception, awareness and desire for obstetric analgesia among antenatal clients of Aminu Kano Teaching Hospital (AKTH) in northern Nigeria. Methods : A hospital based cross sectional study was conducted in the Antenatal clinic of AKTH from March to April 2010. Questionnaires were filled by verbal interviews conducted on 400 antenatal clients. Results : Of those that have delivered at least once previously (n=284), majority (194, 68.3%) scored labour pain as severe 66(23.2%) said it was moderate while 24 (8.5%) claimed it was mild. Only 15% (n=59) of the respondents were aware of at least one method of obstetric analgesia. The methods mentioned include Epidural (57.6%, n=34), injections (18.6%, n=11), breathing and relaxation (6.8%, n=4), social support (6.8%, n=4) and all the above methods mentioned (10.2%, n=6). Their main sources of information were friends (62.7%, n=37), books (17.0%, n=10), health worker (13.6%, n=8) and the Internet (6.8%, n=4). None have been offered any analgesia during labour. Majority 317 (79.3%) were desirous of pain relief during the delivery of their current pregnancy. On multivariate logistic regression analysis, educational attainment, ethnicity and awareness of methods of obstetric analgesia remained significant predictors of desire for obstetric analgesia. Conclusion : There is a gross unawareness regarding pain relief in labour, but there is strong desire for same. Reforms in labour pain management are recommended offering parturients a range of safe methods to choose from. Keywords : Labour pain, obstetric analgesia, awareness, desire, antenatal clients, Nigeria
Well-being of carers of injured individuals from a prospective cohort study in New Zealand

Background: Little is known about the effect on informal carers of caring for injured people. The aim of this paper is to identify characteristics of injured individuals and carers associated with poorer carer well-being. Methods: This study was embedded within a New Zealand cohort study of injured individuals aged 18-64 years. Carers of injured people whose independence was affected 12 months after injury, were eligible. Information was collected about carer demographics, health and work before caring, Bakas Caregiving Outcomes Scale (BCOS), and Personal Well-being Index (PWI). Results: Mean BCOS (53.5/105) and PWI (66.1/100) scores indicated low carer well-being. Anxiety or depression among the injured, and threat of long-term disability at the time of injury were associated with lower carer well-being. Female carers, and those with poor pre-caring health, had significantly lower well-being. Conclusions: Early recognition of characteristics in the injured person, and their carer, may lead to interventions to improve well-being among carers.
EVALUATION OF LIFE SATISFACTION AMONG GUIDANCE TEACHERS WITH RESPECT TO CERTAIN VARIABLES

The aim of this study was to evaluate with respect to certain variables the life satisfaction levels of guidance teachers working at educational institutions. In this context, the study attempted to determine whether life satisfaction levels among guidance teachers varied according to gender, the type of school/institution they worked at, and their length of service. The study was conducted according to a screening model. The study population consisted of guidance teachers working at educational institutions in Turkey. The study sample group consisted of 251 randomly-selected guidance teachers working at public and private schools, and in counseling and research centers. During the study; a personal information form, the Turkish translation by Simsek (2011) of the ? Satisfaction with Life as a Whole? and the PWI-A Scale were used as data collection tools. The study data were gathered in an internet environment, and analyzed with the SPSS 16.0 package program. Data analysis demonstrated that guidance teachers generally had a high level of life satisfaction. The study results also showed that guidance teachers? level of life satisfaction did not differ significantly with respect to gender, the type of school/institution they worked at (e.g. public school vs. private school), and their length of service.
Evaluating an electronic patient medicine module implementation in two hospital settings: An occasion for new types of errors

In recent years, there has been an increased demand to exploit the possibilities of Information Technology (IT) in health care. In many hospitals, focus is on Electronic Health care Records (EHRs) which are depicted as central technologies in supporting the examination, treatment, and care of patients. One of the modules of the EHR system is the Electronic Patient Medicine (EPM) module which is considered an important means for reducing medical errors. In the literature, focus is primarily on those medical errors that are reduced when introducing EPM modules, whereas there is scarce evidence of the new types of errors that might occur. Purpose: This paper presents an evaluation study of an EPM module implementation in an orthopaedic surgery ward and in a medical ward. The purpose of the evaluation is to investigate the nature of the errors that are reduced and the new types of errors that occur when the doctors are interacting with the EPM module. We argue that systematic evaluation attempts are necessary in order to investigate the unintended consequences that may appear when implementing IT in health care. Setting and methods: The study is explorative. It is carried out in an orthopaedic surgery ward and in a medical ward in two medium-sized Danish hospitals. Through observation studies, semi-structured interviews with health care professionals, and focus group interviews, we investigate the types of errors that may appear when implementing a new IT system such as the EPM module. We compare the findings with existing studies on this topic. Findings: The findings from our study show that earlier types of errors are reduced by the use of the EPM module. At the same time, however, the study shows that new types of errors occur. These errors can be grouped into two main categories: one type is related to the interaction between the doctor and the EPM module; the other type is related to the influence that the EPM system has on the coordination of the clinical work. Discussion and conclusions: The findings are discussed along with ways in which to reduce some of the new types of errors that appear. One of the main conclusions is that there should be more focus on evaluating IT implementations in health care. This should be done in order to pay more attention to the unintended consequences that may emerge when health care professionals are using technology in their clinical practices. On the basis of the evaluation, it is furthermore important for management to set up strategies to improve the use of IT in health care.
Assessment of Parental Satisfaction with Management of a Child’s Nonsyndromic Cleft Lip and/or Cleft Palate

The purpose of this study was to assess parental satisfaction of children with nonsyndromic cleft lip and/or cleft palate concerning feeding and surgery education. This retrospective crosssectional study used an original questionnaire. Four multidisciplinary teams in Ohio and Kentucky distributed the questionnaire to sixty-one parents of children between the ages of 3 months and 4 years with nonsyndromic clefts. Fifty percent of parents were satisfied with their experiences at the birth hospital. Parents who received feeding instructions within 12 hours after their child’s birth felt more adequately prepared to feed their child than those who did not (p=0.0042). Over 90% of parents were satisfied with the care provided by their multidisciplinary team. Since half of the parents in this study were dissatisfied with their experiences at the birth hospital, birth hospitals need to ensure parents of children with orofacial clefts are educated about feeding techniques within 12 hours after birth.
Relapse prevention in remote indigenous mental health

This study was designed to provide important new information about relapse prevention in Indigenous1 people with chronic mental illness. A key cause of the burden of disease of mental illness is the high frequency of relapse of common mental disorders. National and international best practice guidelines recommend a range of biological and psychological strategies to prevent recurrence of mental illness. There is good evidence that many of these relapse prevention strategies improve outcomes, but there has been a paucity of clinical research into Indigenous-specific interventions. The study was conducted in two remote Indigenous communities in the Top End of the Northern Territory (NT). It targeted Indigenous clients, carers, and Aboriginal Mental Health Workers (AMHWs) and sought to answer two questions as follows: ‘can a culturally appropriate brief intervention be developed which incorporates local Indigenous perspectives of mental health and mental illness? ’ and ‘does the brief intervention improve client mental health outcomes compared with treatment as usual’? Assessment, psychoeducation, and care-planning resources were developed with local AMHWs in the two communities. These were gathered into a focused brief intervention. The study then implemented a randomised trial of the intervention compared with ‘treatment as usual’. Clients were randomised to an ‘early treatment’ group, which received the intervention at baseline, and a ‘late treatment’ group, which received the intervention six months later. Client outcomes were assessed six monthly for eighteen months. Participants showed significant reductions in emotional distress and substance use and significant improvements in self-management. The results confirm that promotion of selfmanagement through psychoeducation and goal-setting is an effective relapse prevention strategy. The study contributes important new information about cross-cultural perspectives of mental health, and provides a strategy to deliver treatment in the remote setting that is brief and effective.
The role of BACH1 , BARD1 and TOPBP1 genes in familial breast cancer

Approximately 5–10% of all breast cancer cases are estimated to result from a hereditary predisposition to the disease. Currently no more than 25–30% of these familial cases can be explained by mutations in the known susceptibility genes, BRCA1 and BRCA2 being the major ones. Additional predisposing genes are therefore likely to be discovered. This study evaluates whether germline alterations in three BRCA1-associated genes, BACH1 (i.e. BRIP1/FANCJ), BARD1 and TOPBP1, contribute to familial breast cancer. Altogether 214 Finnish patients having breast and/or ovarian cancer were analysed for germline mutations in the BACH1 gene. Nine alterations were observed, four of which located in the protein-encoding region. The previously unidentified Pro1034Leu was considered a possible cancer-associated alteration as it appeared with two-fold higher frequency among cancer cases compared to controls. All the other observed alterations were classified as harmless polymorphisms. Mutation analysis of the BARD1 gene among 126 Finnish patients having family history of breast and/or ovarian cancer revealed seven alterations in the protein-encoding region. The Cys557Ser alteration was seen at an elevated frequency among familial cancer cases compared to controls (p = 0.005, odds ratio [OR] 4.2, 95% confidence interval [CI] 1.7–10.7). The other alterations appeared to be harmless polymorphisms. To evaluate further the possible effect of Cys557Ser on cancer risk, a large case-control study was performed, consisting of 3,956 cancer patients from the Nordic countries. The highest prevalence of Cys557Ser was found among breast and ovarian cancer patients from BRCA1/BRCA2 mutation-negative families (p < 0.001, OR 2.6, 95% CI 1.7–4.0). In contrast, no significant association with male breast cancer, ovarian, colorectal or prostate cancer was observed. The current study is the first evaluating the role of TOPBP1 mutations in familial cancer predisposition. The analysis of 125 Finnish patients having breast and/or ovarian cancer revealed one putative pathogenic alteration. The commonly occurring Arg309Cys allele was observed at a significantly higher frequency among familial cancer cases compared to controls (p = 0.002, OR 2.4, 95% CI 1.3–4.2). The other 18 alterations observed were classified as harmless polymorphisms.
Plasma Procalcitonin and Proadrenomedullin Concentrations as Predictive Markers for Early Onset Neonatal Sepsis

Background: Adrenomedullin (ADM), a peptide with 52 amino acids, has immune- modulating, metabolic and vascular actions, it is mainly released from endothelial cells, epithelial cells of various origins and some other tissue-specific cells types. The mid-regional fragment of pro-adrenomedullin (MR-Pro-ADM), included between amino acids 45-92 is the most stable part of ADM, and it has been detected in the plasma of patients with septic shock as a consequence of the ADM active peptide degradation. Elevation of pro-ADM has been reported in systemic inflammatory response syndrome (SIRs), sepsis, and septic shock in adults. Aim of the work: Establishment the diagnostic utility (sensitivity, specificity, and predictive values) of plasma procalcitonin and proadrenomedullin in comparison to commonly used laboratory for sepsis (CRP, total leucocytic count), both individually and combination, for diagnosis of early onset neonatal sepsis. Subjects and methods: This study was included 80 newborns (50 newborn with neonatal sepsis and 30 control healthy newborns). The fifty septic cases all are full term and their gestational age ranged between 36-40 weeks, Plasma CRP concentrations were measured using an immunoturbidimetric method, Procalcitonin was measured by ELFA technique; enzyme linked fluorescent assay and Pro-adrenomedullin was measured using enzyme linked immuno sorbent assay (ELISA). Results: The mean plasma pro-adrenomedullin level in sepsis groups was (4.7±3.2) nmol/L which is significantly higher compared to control group (0.79±0.31)nmol/L with P<0.001. At a cut-off value 3.9 nmol/L the sensitivity of pro-ADM in detecting early onset neonatal sepsis was 91.6, its specificity was 87.4, its positive predictive value was 91.3, and its negative predictive value was 90.4, which represent highest sensitivity and specificity than the other studied markers. The plasma level of pro-ADM was significantly higher in non-survivor group with mean (8.8 ± 2.2) nmol/L compared to (2.6 ± 1.7) nmol/L in survived groups, while there were no significant differences of plasma CRP and Procalcitonin levels between survivors and non-survivors groups. Conclusions: Pro-adrenomedullinis sensitive, independent biomarker that can be used as a good tool for diagnosis of early onset neonatal sepsis, addition of procalcitonin slightly improve diagnostic accuracy by increasing sensitivity, specificity, predictive values and AUC. Pro-adrenomedullin might become a new promising prognostic marker for predicting the outcome of early onset neonatal sepsis as its plasma level was significantly higher in these patients with sepsis who did not survive than in survivor.
PERINATAL OUTCOMES OF NEWBORN INFANTS CONCEIVED BY ASSISTED REPRODUCTIVE TECHNIQUES IN ROYAN INSTITUTE

Background: The outcomes of such pregnancies have been rarely evaluated in our country. A descriptive study was planned to assess the health and condition of neonates conceived with assisted techniques in a one year period. Materials and Methods: At Royan Institute, Tehran, 443 women who became pregnant by one of the assisted techniques in vitro fertilization (IVF), intrauterine insemination (IUI) and intracytoplasmic sperm injection (ICSI) enrolled in a descriptive study during 16 month period beginning on September, 2007. The sampling method used was non-incidental, consecutive. Questionnaires regarding the contents of the baby birth card were completed after interviews with the mothers. The time from fertilization of the ovum until delivery was considered as the gestational (conception) age. Pregnant mothers were under periodic evaluation until delivery. Women with stillborn babies were followed via phone contact. Results: From a total of 443 conceptions, there were 13 (2.9%) pregnancies demised in utero (stillbirths) and 10 (2.6%) who died during the neonatal period. Additionally, 133 (43%) infants were born after multifetal pregnancies and 96 (31%) infants were prematurely born. There were 106 (34.3%) infants with low birth weight (LBW; less than 2500 g), of which 83 (78.3%) LBW infants were multiplets. After completion of the study, 71 women were still passing their pregnancy period
Prevalence of Cryptosporidiosis among HIV Seropositive Patients in a Tertiary Health Institution, Nigeria

Introduction: Cryptosporidiosis is a neglected disease. At this critical moment in the fight against HIV/AIDS, when the world has made incredible progress in reducing the HIV/AIDS scourge, the fight against opportunistic infections should be encourage especially war against Cryptosporidium parvum. Cryptosporidiosis causes prolong or persistent diarrhoea in HIV/AIDs patients and the cost of rehydration and management of such patients is huge, therefore this research set to determine the prevalence of Cryptosporidiosis among HIV seropositive patients attending a tertiary health centre in Nigeria. Methodology: This is a prospective descriptive cross – sectional study and 182 consecutive adults and children of both sexes between one year and sixty-five years who were HIV seropositive and receiving treatment at Prof Sadiq Wali treatment center in Aminu Kano Teaching Hospital (AKTH), Kano. Result: The mean age of subjects studied was 26 years ± 14.7. There were 74 males (40.7%) and 108 females (59.3%). Out of the 74 males investigated for C. parvum 21 (28.3%) were positive for the parasite representing 36% of the total seropositive population sampled. Thirty seven (37, 34.2%) females tested positive with the parasite representing 63.7%. Fifty six (56, 56.5%) of the fifty eight C. parvum ELISA seropositive were obtained from subjects who presented with mucoid diarrhoea. An isolate rate of 55.0% was obtained from those with CD4 counts of less than 200 cell/cmm, 12 (15.6% C. parvum. ELISA seropositive subjects were obtained from those with CD4 counts of 200-500 cell/cmm. This was stastically significant with p=0.001, Pearson ChiSquare= 35.167, positive Spearman Correlation coefficient of 0.340. Conclusion: The prevalence of Cryyptosporidiosis in this study was 31.9%. Improved health education and prompt referral to tertiary health institution will improve the quality of life of people living with HIV.
Prevalence and risk factors for inappropriate birth weight for gestational age

Abstract Background Infants with an inappropriate birth weight for their gestational age are more likely to develop complications during pregnancy and postpartum, and have increased long-term health risks. Objectives To determine the prevalence and risk factors for infants with inappropriate birth weight for their gestational age. Methods We enrolled 820 women with uncomplicated, singleton pregnancies who gave birth to a live born infant at term. Prepregnancy baseline and obstetric information were extracted from medical records, including body mass index (BMI), gestational weight gain, and infant birth weight. Prevalence of small-for-gestational age (SGA) and large-for-gestational age (LGA) infants was determined. We compared variables between groups to identify associated factors. Results Prevalence of SGA was 2.6% and LGA was 10.5%. Prepregnancy BMI and gestational weight gain were significantly higher in the LGA than in the SGA group (P = 0.041 and < 0.001, respectively). The birth weight and gestational weight gain, but not the prepregnancy BMI, were significantly different (P < 0.001). Logistic regression analysis determined that inadequate gestational weight gain significantly increased the risk of SGA (adjusted OR 3.20, 95%CI 1.06 to 9.64, P = 0.039), and significantly reduced the risk of LGA (adjusted OR 0.43, 95% CI 0.20 to 0.91, P = 0.028). Excessive gestational weight gain significantly increased the risk of LGA (adjusted OR 2.00, 95% CI 1.21 to 3.30, P = 0.006). There was no significant association with prepregnancy BMI. Conclusions Controlling gestational weight gain may improve maternal and neonatal outcomes.
Pathophysiology and Prognostic Factors in Carpal Tunnel Syndrome after Median Nerve Decompression

Purpose: To identify factors associated with patient satisfaction after the decompression of the median nerve at the carpal tunnel, fifty five patients with carpal tunnel syndrome (CTS) who underwent surgery for median nerve decompression were distributed into two groups in relation to the degree of satisfaction with surgical outcome. The dissatisfied group was younger (39.8±8.7 vs. 50.5±10.2; p=0.0005) and also showed a higher body mass index (29.0±3.6 vs. 25.5±3.9, p=0.0028) and preoperative intensity of pain (8.5±1.4 vs. 7.2±2.6, p=0.0168) compared to the satisfied group. In relation to the sensitive conduction velocity, the percentage of hands with abnormal values was higher in the satisfied group (90.3% vs. 62.5%, p=0.0454). On the logistical regression model, satisfaction with surgical outcome increased with age (p=0.0181) and decreased with obesity (p=0.0069) and when motor distal latency was greater than 4 ms (p=0.0342). Therefore, it can be concluded that patients with CTS who are older, having a longer preoperative motor distal latency and not obese have a greater chance of satisfaction after median nerve decompression.