Miracle-dz/UniFAR-FTUs huggingface dataset:
Emergency Repair of Type a Aortic Dissection in Type IV Ehlers—Danlos Syndrome

Ehlers-Danlos syndrome type IV is a distinctive syndrome in which thin and fragile skin. premature ageing. bruising and scarring are combined with lethal or life-threatening arterial weakness. Aortic rupture either at the aortic root and arch. or sometimes lower down the artery. are particularly characteristic. Even quite minor injury can produce dangerous vascular tearing and damage. Technical difficulties encountered in arterial repair or venous ligature are particularly worrying. The authors report the treatment of a ruptured type A aortic dissection associated with Ehlers-Danlos syndrome where the extreme fragility of the tissues and tendency to bleed posed a difficult task for t~e su~geon. © 2000. The International Society for Cardiovascular Surgery. published by ElseVIer SCience Ltd. All rights reserved
Quality of Nursing Work Life

Background and Aim: Nurses suffer from the high demands of their profession, and often complain of overwork and underpay. Problems persist with the nurses’ job satisfaction, burnout, organizational commitment and intent to leave. The aim of this study was to explore how nurses in an Iranian state rate the quality of their work life. Material and Methods: This descriptive survey study was performed at the ISFAHAN Hospitals, IR, during the year 2007. The research instrument used was the Brooks and Anderson scale. A sample of 120 registered nurses (RNs) was enrolled into the study, using a simple random sample method. Data were analyzed using SPSS Version 11.5. Descriptive statistics, item summary statistics, and total scale and subscale scores were computed. Result: Eighty two percent nurses who were included in this study believed that their workload was heavy, salaries were inadequate (95%), nurses were dissatisfied (63%), skill mix was found to be inadequate (72%) and a majority of nurses were unable to complete their work in the time available (54%). 79% nurses indicated that they did not have the autonomy to make patient care decisions. Respondents had little energy left after work (80%), were unable to balance their work and family lives (76%) and stated that rotating schedules negatively affected their lives (69%). Few nurses felt respected by the upper management (35%) and were able to participate in decisions (29%). Many of the nurses felt that society does not have an accurate image of nurses (62%) and indicated that their work settings did not provide career advancement (62%). Discussion and Conclusion: Nurses' job satisfaction, salary, workload, staffing issues, skill mix, communication, autonomy, recognition and empowerment remain problematic.These findings provide information for policy makers and nursing managers on areas that need to be addressed, to retain nurses within community nursing and for important implications for nurse education administrators. Also needed is outcome-driven research examining the effectiveness, efficacy, and cost-benefit of specific strategies aimed at improving the QNWL and organizational productivity.
Negotiating the service system: Professionals and patients talk about healthcare for the homeless in a Midwestern City in the U.S.

Abstract This article presents and discusses themes generated from in-depth interviews with 10 key informants and four homeless adults in a medium-sized city in the Midwest, United States. The purpose of the interviews was to gain an understanding of the healthcare system that was in place for the homeless, both from the perspective of professionals and consumers alike. Key informants represented the major medical and social service agencies involved in the provision of healthcare services for the homeless in this city. Based on these interviews, the following themes were generated and are presented here for analysis and discussion: Lack of Services, Need for Medicaid, Coordination of Care, Lack of End-of-Life Care, and Suggestions for Change. Practice implications are presented.
Heartful Autoethnography

The author seeks to develop an ethnography that includes researchers’ vulnerable selves, emotions, bodies, and spirits; produces evocative stories that create the effect of reality; celebrates concrete experience and intimate detail; examines how human experience is endowed with meaning; is concerned with moral, ethical, and political consequences; encourages compassion and empathy; helps us know how to live and cope; features multiple voices and repositions readers and “subjects” as coparticipants in dialogue; seeks a fusion between social science and literature in which, as Gregory Bateson says, “you are partly blown by the winds of reality and partly an artist creating a composite out of the inner and outer events”; and connects the practices of social science with the living of life. In short, her goal is to extend ethnography to include the heart, the autobiographical, and the artistic text. This article provides a conversation with a student researching breast cancer that introduces issues in heartful autoethnography.
Benefits of Supplementing St Thomas' Hospital Cardioplegic Solution with Tetraethylammonium on Functional and Metabolic Recovery of Isolated Rat Hearts

This study was designed to evaluate whether the addition of potassium channel blockers, tetraethylammonium, 4-aminopyridine or glibenclamide, to St Thomas' cardioplegia improved myocardial preservation over that achieved by St Thomas' cardioplegic solution alone. Initially, isolated rat hearts were subjected to 30 min of continuous normothermic hypoxic cardioplegia. Control hearts were arrested with St Thomas' cardioplegia followed by tetraethylammonium, glibenclamide or 4-aminopyridine-enriched cardioplegia. Subsequently, in a second experiment, hearts were subjected to 45 min of normothermic global ischaemia, after 3 min of cardioplegia with either tetraethylammonium-enriched or standard St Thomas' cardioplegia. In both regimens, hearts arrested with tetraethylammonium-enriched St Thomas' cardioplegia showed better recovery of contractile function than controls (P<0.001). Creatine kinase levels were significantly lower in the tetraethylammonium group (P<0,001). 4-Aminopyridine treatment caused similar contractility to that of the control group but raised creatine kinase and lactate dehydrogenase levels (P<0.001). Glibenclamide diminished coronary flow autoregulation, and increased lactate dehydrogenase leakage in reperfusion (P<0.05) with similar contractility to controls. The results of this preliminary in vitro study demonstrate that, in rat heart, St Thomas' cardioplegia enriched with tetraethylammonium improves post-ischaemic contractile function and reduces creatine kinase release. It is concluded that high potassium blocks the membrane at the rapid depolarization phase with rapid sodium influx and tetraethylammonium further prevents repolarization by blocking voltage-dependent potassium channels.
Spectrum of Diseases in Patients with Non-Traumatic Acute Abdomen

OBJECTIVE: To identify the spectrum of diseases leading to acute abdomen in local population, presenting in a surgical unit. DESIGN: Retrospective study. SETTING: Department of Surgery Unit-II Chandka Medical College Teaching Hospital Larkana. DURATION: A period of three years, from July 2004 to June 2007. PATIENTS AND METHODS: All patients presenting with non-traumatic acute abdominal pain were included in the study. Patients presenting with gynecological and urological causes were excluded. Their presentation, diagnosis and management were recorded from their case files and OT registers. RESULTS: During the period under review, a total of 586 patients presented with non-traumatic acute abdomen; of which there were 412 (70.30%) males and 174 (29.69%) females, with a male to female ratio of 2.3:1. The highest incidence of acute abdomen 163 (27.81%) was found in patients of 21-30 years age group, followed by under 20 age group 150 (25.59%) and 30-40 years age group 101 (17.23%). The most common cause of acute abdomen was acute appendicitis accounting for 205 (35%) admissions. These patients were mostly young males in teens and twenties. Intestinal obstruction was second leading cause accounting for 167 (28.5%) cases and this affected more commonly the middle aged persons. Five hundred and twelve (87.37%) patients were treated successfully and discharged home while 3% left against medical advice. Mortality was 9.55% and it was highest in patients presenting with perforation peritonitis. CONCLUSION: The most common cause of acute abdomen in this study was acute appendicitis affecting young population. This was followed by intestinal obstruction and gut perforation. Acute cholecystitis commonly affects the middle aged, post-menopausal women. Pancreatitis is a rare cause of acute abdomen in this area.
Modified Petroff's Method: an Excellent Simplified Decontamination Technique in Comparison with Petroff's Method

Tuberculosis is a major public health problem. In India, about 40% of the population is infected with TB bacillus. For diagnosis of TB, smear microscopy is still the most used due to its simplicity though it lacks sensitivity as compared with culture. This study compared the original Petroff's method with Modified Petroff's method. Spot and early morning sputum samples of 225 suspected tuberculosis cases were collected and processed by petroff's and Modified Petroff's method separately. Treated samples were cultured in Lowenstein-Jensen media. Out of 225 processed sputum specimens, 123 (54.67%) were smear positive by direct, 127 (56.44%) by Petroff's method and 129 (57.33%) by Modified Petroff's method. The number of culture positives by Modified Petroff's method was 55.56%, by Petroff's method were 53.33% and 45.33% by Direct method. Culture positives by Modified Petroff's method compared with Direct method are statistically significant (P=0.0249, Chi square test). Negative culture and contamination rate was minimum with Modified Petroff's method. Modified Petroff's method requires lesser time, has lower contamination rate and higher yield in culture positivity as compared with Petroff's method, making it a more suitable and better method of concentration and decontamination. Keyword: Tuberculosis, decontamination, Petroff's method, Modified Petroff's method.
Microperfusion Enhancement after TMLR in Chronically Ischemic Porcine Hearts

Objective. The purpose of this study was to determine the effect of transmyocardial laser revascularization (TMLR) on myocardial perfusion and function in chronically ischemic myocardium. Methods. In the first operation a stenosis of the left anterior descending artery was created in 20 open-chest anesthetized pigs to implement this ischemic model. In contrast. four pigs served as controls (thoracotomy only). Seven days later (2nd operation). all animals were studied at baseline by analyzing different parameters of perfusion (radioactive microspheres). function. and intramyocardial pressure. Afterwards. pigs who received a left anterior descending artery stenosis were randomized into one of three groups: animals in laser group 1 (n = 7) received one and in laser group Z (n = 7) two laser channels per cm in the left anterior descending artery territory. Animals of the ischemicgroup (n =6) underwent the same procedures without transmyocardiallaser revascularization. Three months later. the animals were re-studied (3rd operation) and additional analysisof histochemistry and myocardial water content was performed. Results. Regional myocardial blood flow (RMBF) in laser group 2 revealed statistically higher RMBF values compared to the ischemic group (0.39±O.13 versus 0.14±O.12 mVminlg; p= 0.043). after 3 months. whereas the absolute RMBF had not increased compared to the 1-week baseline values. Left ventricular stroke work index (LVSWI) at rest and under stress did not show any improvement compared to the initial values In all stUdy groups (P= ns). Nevertheless. laser group 1 demonstrated relatively higher LVSWlmax values compared to the ischemic (1.33±O.19 versus 0.93±0.16 mJlkg; P = 0.03) and laser group 2 (1.33±O.19 versus 1.02±O.1S; P=0.024). Regionalcontractility of laser groups 1 and 2 recovered after 3 months (which had deteriorated shortly after transmyocardial laser revascularization) and increased under stress (100% versus 144.33±46.42. P= 0.029 and 100% versus 116.26±21.06. P= 0.034; respectively). In contrast. the corresponding ischemic group values were not different from intial values (P = ns). Conclusions. This model of chronic regional ischemia demonstrates that CO2-laser revascularization significantly improves microperfusion and regional function. whereas the overall
A STUDY ON DRUG USE PATTERN AND COST IMPACT OF ANTIDIABETIC DRUGS IN TYPE 2 DIABETIC PATIENTS IN A SECONDARY CARE HOSPITAL

In this prospective observational study, a total number of 77 diabetes inpatients were selected in a secondary care hospital. The demographic details, disease and treatment data from the patient case sheets were collected in a separate proforma, updated timely and analyzed. The prescribing pattern of antidiabetic drugs and the mean prescription cost were determined. Higher percentage of male patients was affected with diabetes when compared to the female patients. Age group of 50-59 years had a higher prevalence of type 2 diabetes. Hypertension with diabetes was the predominating co morbidity condition. By analyzing the prescriptions 64.65% of drugs were prescribed in generic. 46% of the drugs were prescribed from WHO essential drug list. Premixed insulin mixtures were the highest prescribed medication. Polypharmacy was seen in more number of prescriptions. The average prescription cost was found to be lesser for treating diabetes (hypoglycemic) alone compared to diabetes associated complaints.
Association of Bisphenol A and C-Reactive Protein Concentrations with Cardiovascular Diseases

Association of Bisphenol A and C-Reactive Protein Concentrations with Cardiovascular Diseases by Hassan S. Naji MA, Everest University, 2009 BS, American University of Beirut, 1993 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Public Health Walden University November 2015
Immunophenotypic Analysis of the Aortic Aneurysm Wail Suggests That Vascular Dendritic Cells are Involved in Immune Responses

Objective: Inflammatory infiltrates similar to those in atherosclerotic plaques are prominent in the abdominal aortic aneurysm wall. Antigen presenting vascular dendritic cells are present in both early and advanced atherosclerotic lesions but their possible participation in abdominal aortic aneurysms has not been previously examined. This study reports the presence of vascular dendritic cells in abdominal aortic aneurysms and their participation in immune responses. Methods: Samples of the anterior wall were collected from 18 atherosclerotic infrarenal abdominal aortic aneurysms ranging in diameter from 5-8 cm. All the patients were operated upon electively and no ruptured or rapidly expanding abdominal aortic aneurysms were included. Specimens were immediately frozen or fixed in 10% buffered formalin. Vascular dendritlc cells were Identified with anti-CDl a or with S-100. T cells and T cell subpopulations were identified with anti-CD3, anti-CD4 and anti-CD8. B cells were studied with anti-CDZO. Analyses were carried out in sets of C O ~ S ~ C U ~ ~ V ~ parallel sections immunostained with these antibodies and double immunostaining included different combinations of antigens such as CDI aICD3, S-1 001CD4, S-I00/CD8. Results: Most inflammatory infiltrates were found in the adventitia. These infiltrates contained B cells (CDZO + ) and T cells (CD3 + ) with their CD4 + and CD3 + cell subpopulations. In the aneurysm wall, CDl a + /S-100 + cells exhibiting dendritic appearance were detected and double immunostaining demonstrated that these vascular dendritic cells contained different lymphocyte PoPUlatlons including C D 3 + . CD4 + , CD8 + and CD20 + cells. In some inflammatory infiltrates, B cells (CDZO + ) represented the predominant cell population (60-8046). Double immunostaining demonstrated that. in these infiltrates, vascular dendritic cells contacted CD20 + cells. C O ~ C ~ U S ~ O ~ S : vascular dendritic cells are involved in immune reactions in the aneurysm wall, and this process mostly occurs in the adventitia. Vascular dendritic cells contact both T cells and B cells, suggesting that these vascular dendritic cells differ from other dendritic cells, subtypes of which associate with T cells (Langerhans cells, interdigitating cells) and B cells (follicular dendritic cells). O 1998 The International Society for Cardiovascular Surgery. Published by Elsevier Science Ltd. All rights reserved
LES LESIONS OCULAIRES CHEZ LE PATIENT MELANODERME ATTEINT D'INSUFFISANCE RENALE CHRONIQUE. Ocular lesions in melanodermia patients with chronic renal failure.

SUMMARY Aim : To describe the and the factors that influence their occurrence. Material and Methods: A prospective study was performed over a year in the Ophthalmology clinic of Aristide le DANTEC Hospital, including 112 eyes of chronic renal failure patients followed up in the internal medicine unit of the same hospital. For each patient data of his follow up in the nephrology ward were recorded, even as the ophthalmological clinical examination which included colour test and angiography. All the lesions found were recorded on a questionnaire, seeking for any influence as far as age, sex, duration of signs, dialysis, and general complications were concerned. The analysis was performed using the 2005 Epi-info 6.0 software. Results: Sex ratio was 1.54. 70% were above 40 years old. Blindness was found on 44.6% of the eyes. There were 20.5% cases of eye lids oedema, 15.8% conjunctival calcifications, 26.8% cataracts, 3 cases of ocular hypertension, 7.1% comeallesions. Hypertensive retinopathy was found on 75.9% of the cases, amongst 14.3% classified stage 3, and retinal oedema signs associated on 13.8%, arteriosclerosis on 14.3% of the cases. 88.1% had confirmed signs of dyschromatopsia. On angiography, there was evidence of chorioretinallesions due to high blood pressure, including decrease of the choroidal blood flow, choroidal ischemic areas, and halo peripapillary oedema. Age was a risk factor for eye lid oedema. Corneal and conjunctival lesions, even as eye lid oedema and hypertensive retinopathy were more frequent on patients, sick for less than a year. High blood pressure was a risk factor for papillary lesions, hypertensive retinopathy, and dyschromatopsia. Corneal and conjunctival calcifications were found mostly on patients on dialysis, whereas they had less eye lid oedema, hypertensive retinopathy, and maculopathy. Conclusion: Retinal lesion, especially due to high blood pressure is the most described. It permits to establish the prognostic of the disease. Patients on dialysis show a decrease of that retinopathy, but some sequels might persist which are invalidating, irreversible and may lead to blindness. This can be
Distribution of ABO and Rh (D) Allele Frequency Among the Type 2 Diabetes Mellitus Patients

The aim of the present study was to study the distribution of ABO and Rh (D) blood groups in type 2 diabetes mellitus (T2DM) patients. We evaluated 106 T2DM patients and 58 control subjects. Samples were tested for ABO and Rh (D) blood groups and allele frequencies were calculated. The blood group O (43.40%) was distributed with highest frequency among T2DM patients while AB (6.60%) was least frequent. Frequency of O allele (0.549) was the highest among T2DM patients. Chi-square values were found to be highly significant for ABO blood groups.
Progress in Abdominal Aortic Aneurysm Surgery: Four Decades of Experience at a Teaching Center

The purpose of this study was to examine the changing trends in surgical management of patients with abdominal aortic aneurysms at a tertiary care teaching hospital over the past 40 years, by analysis of demographic data, perioperative variables and outcomes on all patients having abdominal aortic aneurysm surgery between 1955 and 1993. Some 1604 abdominal aortic aneurysms were assessed. The annual rate of abdominal aortic aneurysm surgery increased from 17.6 to 67.8 cases per year. The non-ruptured to ruptured abdominal aortic aneurysm ratio increased from 2.4: 1 in the first decade to 3.4: 1 in the last 5 years. In non-ruptured abdominal aortic aneurysm repairs, the following variables changed over the four decades: patients age over 80 years increased (2.4% to 8.0%; P<0.04), concomitant lower-limb occlusive disease increased (12.2% to 23.7%; P<0.02), prevalence of smaller aneurysms (4–6 cm) increased (16.0% to 54.2%; P<0.0001); intraoperative hypotension decreased (9.0% to 0.7%; P<0.0001). postoperative hemorrhage decreased (8.2% to 0.0%, P<0.0001), postoperative leg ischemia decreased (5.7% to 1.1%; P<0.02) and postoperative amputation rate decreased (3.2% to 0.0%; P<0.03). There was a significant decrease in perioperative mortality (17.0% to 3.4%; P<0.0001). For ruptured aneurysms, early operation (within 1 h of admission) increased from 8.7% to 55.8% (P<0.0001), prevalence of intraoperative hypotension decreased (50.0% to 23.5%; P<0.001), and major venous injury decreased (18.0% to 5.2%; P<0.05). Mortality, however, did not decrease significantly (54.2% to 44.2%; P= 0.32). In conclusion, there was a significant decrease in mortality and morbidity associated with non-ruptured abdominal aortic aneurysm repair over the four decades studied. In addition, older patients with smaller aneurysms and more co-morbid conditions were operated on during this period. Mortality for patients operated on for ruptured abdominal aortic aneurysm repair has not changed significantly.
COMPARATIVE TRIAL OF COMBINED METOCLOPRAMIDE AND DEXAMETHASONE VERSUS DEXAMETHASONE IN POSTOPERATIVE NAUSEA AND VOMITING IN GYNAECOLOGICAL SURGERY

AIM: Metoclopramide is a drug that has been used in the dose of 10 mg iv for postoperative nausea and vomiting (PONV) prophylaxis for many years and has been reported to be ineffective at this dose. That a higher dose of this drug, when used in combination with 8 mg dexamethasone, is more effective when compared with 8 mg dexamethasone only is worth validating and this study was designed to do. The aim is to compare the effectiveness of adding 50 mg metoclopramide (in two divided doses) to 8 mg intravenous dose of dexamethasone versus 8 mg dexamethasone only as a prophylactic anti-emetic in gynaecological surgery under spinal anaesthesia at University of Ilorin Teaching Hospital, Ilorin. MATERIAL AND METHOD: This was a prospective, controlled study in which seventy-four ASA physical status 1 and 2 eligible gynaecological patients with 37 patients per group, were randomly allocated to either the metoclopramide and dexamethasone group or the dexamethasone only group for the purpose of this study. A simple random technique of balloting was used for randomization of the study population. Every participant was preloaded with one
Nutritional Effects of Mechanically Deboned Chicken Meat and Soybean Proteins Cross-linking by Microbial Transglutaminase

This work studied the nutritional effects of protein cross-linking as mediated by microbial transglutaminase (TGase) using rats as biological models. Rats were divided into six groups that received diets containing casein (standard protein diet), cross-linked meat protein (CMP), meat protein (MP), cross-linked soy protein, or soy protein (SP) as the protein sources of their diets, which were compared against an aproteic diet (basal diet). The cross-linking process showed a significant (p< 0.05) impact on the true digestibility (TD) of meat and SPs, decreasing it for the first and increasing it for the second. As a consequence, the TD of modified SP became similar to that observed for CMP, although, the biological value, net protein utilization, net protein ratio, and protein retention efficiency values of meat and SPs were not affected in the process. These results suggest that the use of TGase for the reticulation of isolated SP can improve its nutritional quality.