Miracle-dz/UniFAR-FTUs huggingface dataset:
Coexistent Coronary and Cerebrovascular Disease: Results of Simultaneous Surgical Management in Specific Patient Groups

Objective: Results of synchronous combined revascularization were examined in specific patient groups with coexistent coronary and cerebrovascular diseases. Methods: Between 1.1. 1980 and 31.12. 1998. 408 patients underwent a synchronous combined carotid endarterectomy (CEA) + myocardial revascularization (CABO). In 259 (63.5%) patients. carotid disease was asymptomatic. Remaining patients presented with a previous stroke (n = 35) or a transient ischemic episode (TIA) (n = 114). In 245 (60%) patients. carotid stenosis was bilateral (Group A: bnateral e 80% stenosis. Group B: contralateral occlusion. Group C: contralateral subcrltical disease). A synchronous Ipsilateral CEA + CABG was performed in all patients with an unilateral disease (n = 163) and also In all Group B (n = 33) and Group C (n = 142) patients with bilateral disease. A simultaneous bilateral CEA + CABG was performed in 12 high risk Group A patients. Remaining Group A patients (n = 58). initially underwent an ipsilateral CEA for most dominant lesion + CABG. soon followed by the contralateral CEA. Results were examined in above specif'lc patient Groups. Results: Overall combined hospital mortality from stroke + myocardial infarction was 2.45%. No independent predictor of stroke was identif'led. In general. initial prophylactic CEA. subdued the risk of subsequent strokes for 7-8 yr. Predictors of a late stroke were: progression of bilateral (P = 0.007) and intracranial'(P = 0.04) cerebrovascular disease. Highest risk of an early stroke was recorded in Group A patients. A composite high risk group of patients with multiple risk factors (n = 155) demonstrated a higher risk of both early and late strokes. as compared to the remaining patients (n = 253) (P < 0.04). Observed risk of early and late strokes. In specif'lc patient groups was lower than standard predictions. Conclusions: A regUlar use of combined approach was justif'led in the above patient groups. © 2000 The International Society for Cardiovascular Surgery. PUblished by Elsevier Science Ltd. AIl rights reserved.
Impact of Preoperative Risk and Perioperative Morbidity on ICU Stay following Coronary Bypass Surgery

Prolonged Intensive care unit treatment (> 3 days) contributes to Increased health costs and resource utilization. In order to devise strategies to limit Intensive care unit stay, and provide cost-effective medical care, It Is necessary to IdentifY the preand perloperatlve risk factors of prolonged treatment. Over 100 potential risk variables were collected prospectively In 889 consecutive patients undergoing Isolated coronary bypass surgery between 1990 and 1992. The Incidence of Intensive care unit therapy lasting > 3 days was 6.8%. Univariate statistics Identifted 23 preand perloperative variables that were potential contributors to prolonged Intensive care unit therapy. However, multivariate analysis of preoperative risk variables Identlfted only recent myocardial Infarction (within 30 days of surgery) and continued preoperative smoking (within 30 days of surgery) to be Independent risk factors. Only 6.3% of patients without preoperative myocardial Infarction and 6.1% of non-smokers requlred prolonged Intensive care unit treatment. compared with 14.8% of patients with preoperative myocardial Infarction (p= 0.01) and 10.1% of smokers (P= 0.07). When multivariate analysis was repeated with both preand perloperatlve variables, only Ischemic morbidity (Inotropes, myocardial Infarction and low-output syndrome; 138 patients) and non-Ischemic morbidity (Infection, stroke or bleeding; 37 patients) predicted prolonged Intensive care unit treatment. Intensive care unit treatment for > 3 days occurred In 26.8% of patients with Ischemic morbidity compared with 3.2% of patients without Ischemic morbidity (P= 0.001). Prolonged Intensive care stay occurred In 32.4% of patients who suffered non-Ischemic complications compared with 5.7% of patients who did not suffer these complications. The multiple logistic regression analysisodds ratio for ischemic morbidity was 7.4(95% c.l. 4.0-13.4) compared with 4.8(95% c.l. 1.9-10.1) for non-Ischemic morbidity. Strategies designed to reduce the Incidence of prolonged Intensive care unit treatment should Include prevention of stroke, Infection and bleeding. However, the greatest reduction of Intensive care unit utilization would be mediated by prevention of ventricular dysfunction secondary to myocardial Ischemia or Inadequate myocardial preservation.
ABO-Rh Blood Groups Distribution among King Khalid University Girls Students: A Prevalence Study

Objective: A questionnaire–based prevalence study was carried out on a random sample from various girls’ science college, King Khalid University, to find out the distribution pattern of ABO and Rh blood groups among Saudi females, which would not only help in blood transfusion services but also eliminate the risk of erythroblastosis fetalis in the neonates. Method: The procedure for this study was done by giving the questionnaire to 3287 female students. Each participant filled out the questionnaire and gave it back after answering all the questions. The participants were volunteered to fill out the questionnaire. Results: Of the 3287 female students enrolled in this study, 965 students know their blood groups. Amongst ABO system, blood group O was the most common (57.31%) followed by A (32.74%), B (9.22%), and AB (0.73%), respectively. Regarding rhesus system, Rhesus positive was more common (90.3%) than Rhesus negative (9.7%). Conclusion: The current study documents ABO and Rhesus blood group distribution pattern amongst King Khalid University Girls Students. Findings ensured that there is need for educational and community support program for effective management of medical emergencies.
Familial Abdominal Aortic Aneurysms in the Otago Region of New Zealand

Purpose: To investigate the familial incidence and phenotypic characteristics of patients with abdominal aortic aneurysms (AAA) in the Otago region of New Zealand. Methodology: A retrospective audit based pilot study and a prospective study of patients having abdominal aortic aneurysm repair from September 1988 to September 1999 was performed. Results: 248 probands were enrolled. of which 19.4% had one or more first degree relative affected. The age at diagnosis of the familial (70.2) and non-familial (70.S) patients was similar. The proportion of females was increased in the familial subgroup. Hypercholesterolaemia was the only phenotypic feature to differentiate familial from non-familial patients and was associated with an earlier age of presentation. In the familial families. brothers were the most common relative affected and 77% of the families had two patients with AAA. Conclusion: 19.4% of patients operated on in the Otago area for AAA had a familial component to their aneurysm. © 2001 The International Societyfor CardiovascularSurgery. Published by Elsevier Science Ltd. All rights reserved
SOME HEMATOLOGICAL AND PHYSIOLOGICAL CHANGES ASSOCIATED WITH GENTAMICIN AND/OR NOVALGIN INJECTION IN RABBITS

Gentamicin is an aminoglycoside antibiotic, used to treat many types of bacterial infections, particularly those caused by Gram-negative organisms. Gentamicin is also ototoxic and nephrotoxic, with this toxicity remaining a major problem in clinical use [1] . The present study is aimed to assess the risk factors, diagnosed hematological and biochemical alterations associated with Gentamicin and/or Novalgin injection in rabbits. Male rabbits were assigned to one of five groups (12 rabbits each) which received subcutaneous injections for 10 and 20 days: Control; (G) Gentamicin alone; (N) Novalgin alone; (G + N) Gentamicin + Novalgin; (G rec) Gentamicin recovery; (N rec) Novalgin recovery and (G + N rec) Gentamicin + Novalgin recovery. In (G rec) and (G + N rec), rabbits recovered for 14 days after the last injection. Upon Gentamicin and/or Novalgin injection, there were a general decrease in RBCs count, Hb content, hematocrit (HCT) value, mean corpuscular hemoglobin (MCH) and WBCs total count. Whereas mean corpuscular volume (MCV), mean corpuscular hemoglobin concentration (MCHC), and blood platelets were increased. It is clearly pronounced that Gentamicin and Novalgin injection is more effective in experimental duration of 10 & 20 days. Administration of Gentamicin and/or Novalgin caused significant increase of urea, uric acid, creatinine concentration and ALP activity as compared to control. Whereas, there were a non significant decrease in total protein in animals injected with Gentamicin or Novalgin and decreased significantly in animals injected with Gentamicin and Novalgin. Signs of improvements in hematological parameters urea, uric acid, creatinine and total protein and alkaline phosphatase were noticed after drugs stopped.
Implication of Myocardial Lactate Metabolism during Coronary Artery Bypass Grafting

Sixty-six consecutive patients with coronary artery disease were analysed in terms of myocardial lactate extraction during cardiac surgery. Sixteen patients had left main coronary heart diseaseand 50 were without such disease. Mean (s.d.) lactate extraction during empty beating in patients with and without left main coronary tract disease was -29.8(67)% and 12.0(15.3)%. respectively (P<0.001). No significant differences in lactate extraction were recognized during 15 min of reperfusion. Mean (s.d.) preoperative values of haemoglobin were 11.2(1.0) g/dl and these fell to 6.5(0.9) g/dl in an empty beating state during cardiopulmonary bypass (P<0.001). There was no significant difference between the two groups in preoperative and postoperative left ventricular stroke work index. An empty beating state before aortic clamping could induce unexpected ischaemia in the heart with left main coronary tract disease. A short duration of this ischaemic state does not influence functional recovery: however. exposing the left main coronary artery diseased heart to such a condition for long periods would be dangerous. © 1997 The International Society for Cardiovascular Surgery.
The abuse of stimulant drugs within the medical education setting

The rising abuse of stimulant drugs – traditionally reserved for the treatment of attention deficit and hyperactivity disorder (ADHD) – as cognitive enhancers in academic environments has serious implications in medical education and practice. In this article we report on the nature of these drugs, and the prevalence of their abuse in relation to ADHD diagnosis in Europe and abroad. We also highlight the ethical pitfalls of neuroenhancement in medicine to help forecast cultural and administrative changes that may be necessary to protect the integrity of the medical field in the future.
Comparison of Bioprosthesis and Mechanical Valves, a Meta-Analysis of Randomised Clinical trials

The main purpose of this meta-analysis was to compare the outcomes of patients who randomly received mechanical valves or bioprosthesis, over a long-term clinical follow-up. We found only three trials meeting our selection criteria with a total of 1229 patients (8069.5 patient-yr). Bleeding was more frequent in patients with mechanical prostheses both after 5 yr (RR :::: 2.6; IC :::: [1.9;3.5J; P < 0.0001) and 11 yr (RR :::: 1.6; IC :::: [1.2;2.2]; P < 0.001) of follow-up. However, the increased risk of bleeding at 11 yr was only statistically significant with mechanical prostheses in the aortic position (RR :::: 1.93; IC :::: [1.36;2.74J; p:::: 0.0002). Reoperation was significantly more frequent in patients with bioprosthesis after 11 yr follow-up (RR :::: 0.4; IC :::: [0.3;0.6]; P < 0.001). Endocarditis was more frequent after 11 yr (RR:::: 0.6; IC:::: [0.3;0.95]: P < 0.05) in patients with mechanical prostheses but these results were heterogeneous between mitral and aortic valves. The choice of valve type does not significantly influence survival. © 2000 The International Society for Cardiovascular Surgery. PUblished by Elsevier Science Ltd. All rights reserved
Original Contributions Hypertension as a Risk Factor for Spontaneous Intracerebral Hemorrhage

SUMMARY To better define the etiologic importance of hypertension for spontaneous intracerebral hemorrhage, hospital records were studied for all patients sustaining intracerebral hemorrhage during 1982 in the Cincinnati metropolitan area. Hypertension pre-dating the hemorrhage was present in 45% (69 of 154), as determined by history. A more inclusive definition of hypertension, combining those with a positive history with those found to have left ventricular hypertrophy by electrocardiogram or cardiomegaly by chest radiography, applied in 56% (87 of 154). The cases were compared to controls with and without hypertension derived from the NHANESII study of blood pressure (n = 16,204) to determine relative risk. For the presence of hypertension by history, the relative risk of intracerebral hemorrhage was 3.9 (95% confidence interval, 2.7 to 5.7). For the inclusive definition of hypertension, the relative risk was 5.4 (3.7 to 7.9). Relative risk was also determined for hypertension in blacks (= 4.4), age > 70 (= 7), prior cerebral infarction ( = 22), and diabetes ( = 3). We conclude that the term "hypertensive hemorrhage" should be used very selectively, particularly in whites, and propose that hypertension be viewed as one of several important risk factors for spontaneous intracerebral hemorrhage.
Cultured Neonatal Rat Cardiomyocytes and 99mTc-Sestamibi to Assess the Direct Effects of Cardioplegia

The efficacy of cardioplegia in neonatal myocardial protection is still a matter of debate. 99mTcsestamibi cellular accumulation reflects sarcolemmal and mitochondrial electrical gradients. It was used to monitor the direct effects of two cardioplegic solutions, modified St Thomas' Hospital and Bretschneider, on normoxic and metabolically-inhibited cultured cells. Cellular accumulation of 99mTc-sestamibi, expressed by the ratio between intra and extra cellular concentrations, was assessed in three different sets of neonatal rat cardiomyocytes. Cells were either treated with different concentrations of modified St Thomas' solution (SO. 75. 100%). they were treated or recovering from a treatment with modified St Thomas and Bretschneider solutions a t SO% concentrations, or were recovering from treatment with modified St Thomas' and Bretschneider solution a t 50% concentrations mixed with metabolic inhibitors. Cardioplegia depressed the tracer accumulation in a concentration-dependent manner. This effect was independent of the type of cardioplegia (120-min uptake, as a percentage of control values, modified St Thomas' 68 f 12 and Bretschneider 59 + 7) and was rapidly reversible. Cardioplegia was unable to prevent the depression of tracer accumulation induced by metabolic inhibitors and even induced a deleterious effect ( 1 20-min uptake. as a percentage of control values, metabolic inhibitors 69 f 12, metabolic inhibitors + modified St Thomas 38 f 14, metabolic inhibitors + Bretschneider 43 f 6) during recovery after 30 min of metabolic inhibition. I t was concluded that cardioplegia has an apparent detrimental effect on neonatal cardiomyocytes accumulation of ggmTc-sestamibi during recovery from an ischaemic-like insult. O 1998 The lnternational Society for Cardiovascular Surgery. Published by Elsevier Science Ltd. All rights r e s e ~ e d
Effect of Progressive Muscle Relaxation on depression, anxiety, and stress of primigravid women

Background: Hormonal changes in pregnancy can alter a person's emotions and feelings. The most common mental disorders during pregnancy are anxiety and depression. Relaxation is one of the interventions that increases comfort through affecting the sympathetic system, and can probably reduce psychological tension in pregnant women. Aim: To investigate the effect of progressive muscle relaxation on depression, anxiety and stress of primigravid women. Methods: This randomized clinical trial was conducted on 66 primigravid women from April to September 1393(2014) in two health care centers covered by health center No-1 in the city of Mashhad. Subjects were randomly divided into two groups of progressive muscle relaxation and control. After two sessions of relaxation within two weeks, the intervention group was doing exercises at home for 4 weeks. The instrument used in this study, was Depression Anxiety Stress Scale (DASS 21). Data were analyzed with SPSS statistical software version 11.5, using descriptive statistics and Mann-Whitney U and independent t-tests. Results: The mean age of subjects in this study was 25.5±4.3 years. Before the study, the two groups showed no significant differences in depression (p=0.24), anxiety (p=0.36) and stress (p=0.58); but after the intervention, depression (p=0.001), anxiety (p<0.001) and stress (p<0.001) of the pregnant women was significantly lower in the progressive muscle relaxation group than those of the control group. Conclusion: Due to the relaxation effect on reducing depression, anxiety and stress, and also lack of side effects and its easy applicability, this method can be recommended to use as an approach to reduce depression, anxiety and stress in women during pregnancy.
Duration and Regularity of Therapy Attendance as Predictors of Treatment Outcome in an Adult Outpatient Population

The authors extend previous research examining the dose-effect relationship in psychotherapy (e.g., K. I. Howard, S. M. Kopta, M. S. Krause, & D. E. Orlinsky, 1986) by using a measure of amount of treatment that included both number of sessions attended and treatment duration. Participants were 74 adult patients attending an outpatient community mental health clinic. A multiple regression analysis found no main effects for either measure of treatment length, but their interaction added a significant increase (DR2 = 6.2%, p < .05) in the prediction of patient outcome. For patients attending 11 or fewer sessions, more months in treatment was associated with worse outcome (r = 0.34, p < .05). Duration of treatment was unrelated to improvement for those attending more sessions. The findings of this study underscore the importance of regular therapy attendance for those patients scheduled for fewer sessions and suggest that clinicians should reconsider any temptation to spread allotted sessions over the course of a longer period when afforded fewer sessions by managed care.
Fibrinogen and Fibrinolysis in Blood and in the Arterial Wall: Its Role in Advanced Atherosclerotic Disease

High plasma fibrinogen appears to be an important risk factor for the development of atherosclerosis. The aim of our study was to measure fibrinogen and fibrin degradation products (D-dimer), interleukin-6 tissue plasminogen activator, plasminogen activator inhibitor-1 and urokinase-type plasminogen activator in the plasma and arterial walls of 45 patients who had arterial surgery between April 1993 and November 1995. The arterial specimens were also examined by immunohistochemists for these same factors. The serum fibrinogen and fibrin degradation products were high in all patients, and fibrinolysis was depressed. Few leukocytes were seen in the arterial walls, which had poor fibrinolytic activity. Plasminogen-activator inhibitor activity in the wall was also reduced in the affected arterial walls. The abdominal aorta appeared to have the highest levels of fibrinogen and this may be related to its ability to form aneurysms. Fibrinogen may play an important role in the progression of atherosclerotic disease. @ 1998 The International Society for Cardiovascular Surgery. Published by Elsevier Science Ltd. All rights reserved.
Myocardial β-Blockade as an Alternative to Cardioplegic Arrest during Coronary Artery Surgery

U. Mehlhorn*, H. Sauer*, F. Kuhn-Regnier"', M. Sudkamp*, S. Dheint, F. Eberhardtt, S. Grondt. M. Horst", K. Hekmat*, H.J. Geissler§, R. D. Warters§, S.J. Allen§ and E. Rainer de Vivie'" *Department of Cardiovascular Surgery. University of Cologne. Joseph-Stelzmann-Str. 9. 50924 Cologne. Germany and tDepartment of Pharmacology. University of Cologne. 50924 Cologne. Germany and :tDepartment of Anaesthesiology. University of Cologne. 50924 Cologne. Germany and §Department of Anesthesiology. The University of Texas-Houston Medical School. Houston. Texas 77030. USA
A Prospective Randomized Multicentre Comparison of Expanded Polytetrafluoroethylene and Gelatin-Sealed Knitted Dacron Grafts for Femoropopliteal Bypass

Purpose: To compare graft patency between expanded polytetrafluoroethylene (PTFE) and gelatin-sealed knitted Dacron for femoropopliteal bypass. Methods: A prospective. multicentre trial was performed in 108 patients randomized to receive either a PTFE or Dacron prosthetic graft. Distal anastomosis was aboveknee in 75 and below knee in 33 patients. Results: Primary patency at 1.2 and 3 years was 72. 52 and 52% for PTFE. and 70. 56 and 47% for Dacron (P = 0.87). Secondary patency at 1. 2 and 3 years was 74.54 and 54% for PTFE and 78. 70 and 53% for Dacron (P = 0.39). The most significant predictors of early graft failure were poor vessel run-off (P = 0.04) and critical limb ischaemia (P = 0.04). Conclusion: There was no difference in graft patency between PTFE and Dacron for femoropopliteal bypass. © 1999 The International Society for Cardiovascular Surgery. Published by Elsevier SCience Ltd. All rights reserved.
On robust stability of time-delay systems with block-diagonal uncertainty

This paper considers the robust stability problem of time-delay systems with block-diagonal uncertainty. A new stability criterion is derived using the refined discretized Lyapunov functional method. The criterion is written in the form of a linear matrix inequality. Numerical examples show the new criterion significantly improve the estimate of the stability limit over some existing results in the literature.
A User's Guide to Qualitative Research in Health Care

At a Monday morning meeting of your hospital's Continuous Quality Improvement Committee, the last agenda item is an initiative "to enhance patient-clinician communication. " The Chair proposes that all medical charts include a form to record patient wishes about cardiopulmonary resuscitation and end-of-life care. The Committee members agree in principle on the goals of enhanced communication and more accurate documentation of patient preferences. However, you raise potential concerns about how these forms might change the nature of end-of-life decision-making, and even impair communication. As the meeting draws to a close, you pose a fundamental question to the group for discussion the following week: Could life support preference forms unduly routinize and constrain dialog between clinicians and patients or family members?
Factors influencing student choice : A study of a Malaysian Public University

This paper discusses a study of the information sources employed by students to get information regarding University Malaysia Sarawak (UNIMAS) and also the factors influencing students' choice of UNIMAS. In addition, differences in sources of information and factors of influence based on types of faculty and selected student demographics were also examined. This crosssectional survey research was carried out with a sample consisting of 1,396 first-year students in UNIMAS. The findings of the study showed that "Word of mouth through friends and relatives" and "UNIMAS website" were the two main sources of information. Furthermore, "Academic Program Choice ", "Quality of Teaching and Academics", "Employment Prospect" and "University Choice" were factors contributing towards students selecting UNIMAS to pursue their studies. Inferential statistical analyses consisting of independent t-tests and One-way ANOVA yielded mixed results that could have implications for UNIMAS and other public higher education institutions in employing appropriate strategies to target different segments of prospective students.