Miracle-dz/UniFAR-FTUs huggingface dataset:
Microbiological and Susceptibility Profile of Clinical Gram Positive Isolates at a Tertiary Pediatric and Maternity Hospital in Ulaanbaatar, Mongolia.

Introduction Information on microbiological and susceptibility profiles of Monoglian bacterial isolates is scarce. Resistance profiles, patient demographics and microbiological work-up of gram positive isolates were analyzed in order to develop infection control activities and policies at the National Center for Maternity and Children's Health (NCMCH) in Ulaanbataar, Mongolia. Methods All gram positive isolates of specimens submitted to the microbiology laboratory at NCMCH between January 2014 and August 2017 were included. Data collected included demographic data, specimen type, in-/outpatient status, hospital ward of sample origin, and antimicrobial susceptibility testing profile. Susceptibility testing was performed by trained microbiologists at the NCMCH microbiology laboratory. T-test, Mann-Whitney, Chi-square and Fisher exact tests were used as appropriate. Results Of 11,889 isolates, 4012 (33.7%) were gram positive, with most identified as S. aureus (62.6%, n=2512). Rates of methicillin resistance (MRSA) remained stable at a quarter, but was significantly higher among inpatients (inpatients: 630/2002, 31.5%; outpatients 67/290, 23.1%; p≤0.05) and sterile site isolates (sterile: 83/171, 48.5%; non-sterile: 416/1678, 24.8%; p≤0.01). The vast majority of S. pneumoniae isolates (12/14; 85%) was found to be penicillin resistant by oxacillin disk diffusion. While identification of Group B streptococci was rare (n=137) due to of lack of diagnostic measures available, the number of enterococcal isolates identified increased significantly due to implementation of improved microbiological work-up (2015: n=7; 2016: n=26; 2017: n=83). Conclusion Compared with published studies from neighboring nations, the rates of antimicrobial resistance among gram positive isolates at NCMCH, particularly with respect to S. aureus and S. pneumoniae, were much higher. Further improvement of microbiological diagnostics and collaboration of stakeholders is required to address the pressing infection control and stewardship issues and to ensure reliable identification of relevant pathogens in Mongolia.
genuine damage control laparotomy in peritonitis a twenty year review

The term “damage control laparotomy” was first coined by Rotondo et al. in 1993. However, this approach was described more than 10 years earlier as an alternative surgical strategy in the management of severe liver injuries [1-3]. Rather than pursuing prolonged attempts at definitive management of major vascular, solid organ, or visceral injury in the setting of hypotension, acidemia, hypothermia, and multisystem trauma, those surgeons performed an abbreviated laparotomy with a view to controlling hemorrhage and preventing further intestinal contamination of the peritoneum. This strategy was expected to prevent patients from entering a downward spiral into the lethal triad of hypothermia, hypotension, and coagulopathy. In their case control study, Rotondo et al. reported survival rate of 77% in the damage control surgery group compared to 11% in the definitive laparotomy group [2]. That initial report spawned literally hundreds of subsequent publications extolling the virtues of this approach in practically every region of the body such that damage control has now become an integral part of modern trauma care [4-9].
A RETROSPECTIVE ANALYSIS OF EFFICACY OF HEMOADSORPTION (CYTOSORB®) IN REFRACTORY SEPTIC SHOCK PATIENTS AS AN ADJUVANT.

Dysregulated response of cytokines can result in hyper-inflammatory conditions called cytokine storm,commonly seen in sepsis and septic shock.The current study assessed hemoadsorption device - CytoSorb® for its efficiency as an adjuvant in treating patients suffering from septic shock. Total 8 patients enrolled were subjected to hemoadsorption therapy along with the standard treatment.The results of the study revealed significant improvement in clinical and haemodynamic parameters before and after initiation of CytoSorb® therapy. Out of 8 patients, 6 showed a positive outcome while 2 did not survive.The results of this study show that the use of hemoadsorption therapy can be considered in critically ill ICU patients as a safe and effective adjuvant therapy along with the standard treatment for a better outcome in patients.
Adopters' Expectations Prior to Companion-Animal Ownership

Adoptersr thoughts and expectations prior to bringing home a companion animal were explored using one-on-one interviews (n=17) at three animal shelters in Ontario. Thematic analysis revealed ladopter concerns of, and perceived challenges to, companion-animal ownershipr, ladopter and animal factors taken into consideration in the decision to adoptr, lperceived emotional benefits of the human-companion animal relationshipr, ladvice and sources.
The acute effect of whole body vibration (WBV) training on power-related measurements of field hockey players : biokinetics and sport science

The purpose of this study was to determine the effect of acute whole body vibration (WBV) training on the speed, agility and explosive power performance measurements of university field hockey players. A two-way randomized, crossover experimental research design was used in the study. Seventeen university field hockey players were randomly chosen from the first hockey teams of the North-West University, South-Africa to participate in the study and were divided into two groups. The players underwent two days of testing once as part of a control group and subsequently as part of the experimental group. After the first testing opportunity, a crossover design was implemented by subjecting the control group to the treatment and allowing the initial experimental group to form the control group. The results showed that no statistical significance was obtained in any of the measurements from pre to post-testing. ANOVA analysis of the speed, agility and explosive power measurements revealed that the sequence of treatment had no significant effect on any of the variables. Main effect ANOVA analysis of the same variables revealed that none of the measurements were influenced significantly by the acute application of vibration training. The investigation of individual results from pre-to post-testing did however show tendencies towards improvement in the performances of 5m sprint (65%) and agility t-test (ATT) (53%) times. The acute application of WBV did not lead to any significant changes in the speed, agility and explosive power measurements of university field hockey players.
The Use of Antidepressants in Patients with Heart Failure

Background Heart failure (HF) is a chronic disease affecting patients’ quality of life (QoL) and may cause depression. Recent studies reported that the prevalence of depression in patients with HF is 21.5%. Antidepressants, mainly selective serotonin reuptake inhibitors, are usually prescribed for HF patients diagnosed with depression. Some evidence supports antidepressant’s role in improving symptoms by enhancing the psychological aspect of their QoL. Depression screening and treatment are important in the multidisciplinary management; however, their survival benefits are inconsistent. In our study, we aim to investigate the prevalence of depression and the use of antidepressants in patients with HF as well as to determine the acceptance of using antidepressants in such patients. Methods This is a cross-sectional study conducted by interviewing HF outpatients at National Guard Hospital in Riyadh. Patients were assessed using Hamilton depression rating scale. Results A total of 306 patients were included, with the majority (69%) being male and aged >61 years (60%). Patients’ medical history was classified into different groups, with the largest proportion (39.9%) in the diabetic-hypertensive group, followed by a diabetic group (21.2%) and a hypertensive group (10.8%). Patients were classified according to the New York Heart Association Functional Classification, and most patients were in Class I (61.8%). Some of the patients (8.5%) had been diagnosed with depression. There was no statistically significant association between HF and depression (p > 0.05). However, 5.6% of patients had been prescribed antidepressants and 17.1% of patients believed that they required antidepressants. Moreover, there was a statically significant association between medical history and development of depression (p = 0.014). Conclusions The prevalence of depression in HF patients in our population was lower than reported. There was no association between HF stage, depression, and antidepressant use.
Researching children's experiences: online across countries:issues and problems in methodology

examines research carried out in 18 member states into how children and young people use the internet and new media. This three-year collaboration aims to identify comparable research findings across Europe and to evaluate the social, cultural and regulatory influences affecting both risks and children's and parents' responses to them, in order to inform policy. It will chart available data, indicate gaps and identify factors that shape the research capability of European research institutions. Finally, it will examine methodological issues relating to cross-cultural analyses and the study of children's online experience in order to develop a best practice guide to research. For more information see www.eukidsonline. net
Folate receptor-positive circulating tumor cells as a predictive biomarker for the efficacy of first-line pemetrexed-based chemotherapy in patients with non-squamous non-small cell lung cancer

Background There is a lack of well-established biomarkers to predict the efficacy of pemetrexed-based chemotherapy. In this prospective phase II study, we investigated the correlation of folate receptor (FR)-positive circulating tumor cell (CTC) level with the clinical outcomes of patients with advanced non-squamous non-small cell lung cancer (nsNSCLC) when treated with pemetrexed-based chemotherapy. Methods A total of 98 nsNSCLC patients were enrolled. Peripheral blood was collected from each patient prior to initiation of treatment. FR-positive CTCs were enriched by immunomagnetic leukocyte depletion and quantified using ligand-targeted polymerase chain reaction (LT-PCR) method. Results Patients with relatively low CTC level (11–16 FU/3 mL, n=32) showed a significantly shorter progression-free survival (PFS) and overall survival (OS) compared with those in the “high CTC level group” (>16 FU/3mL, n=28; median PFS, 133 versus 320 days, P<0.001; median OS, 632 days versus “not reached”, P=0.003). Patients in the “high CTC level group” also achieved superior objective response rate (ORR) and disease control rate (DCR) over those in the “low CTC level group” (ORR, 40.9% versus 9.5%, P=0.0339; DCR, 100% versus 81.0%, P=0.0485). The clinical outcomes of pemetrexed in the “negative-CTC group” (<11 FU/3mL, n=38) fell between the “high CTC level group” and the “low CTC level group” (median PFS, 290 days; median OS, 1,122 days; ORR: 21.2%, DCR: 93.9%). Further multivariate Cox proportional hazards regression analysis demonstrated that “high CTC level” was an independent factor that was significantly associated with better PFS [hazard ratio (HR) =0.26, 95% confidence interval (CI), 0.12–0.58, P=0.001] and OS (HR =0.23, 95% CI, 0.06–0.92, P=0.037). Conclusions Our results implied that FR-positive CTC is a promising biomarker to predict the clinical outcome of pemetrexed-based chemotherapy in patients with advanced nsNSCLC.
THE STUDY OF DIABETIC FOOT INFECTION: BACTERIOLOGY, ANTIMICROBIAL RESISTANCE PATTERN, TREATMENT AND OUTCOME IN INPATIENT CASES IN RASOUL-AKRAM AND FIROOZGAR HOSPITALS, 2005-2006

Background and objectives: Because of diminished inflammatory responses to microbial invasion, the identification and diagnosis of diabetic foot infections remains a complex problem. The aim of this study was to determine the bacterial agents of diabetic foot infection and their antimicrobial susceptibility pattern. Additionally the percent of infections that were lead to amputation was determined. Methods: This retrospective study was conducted on a cross sectional basis at two teaching hospitals. Documents belonging to patients with diabetic foot infections in stages III and IV were studied. All demographic information, clinical manifestations, culture results, outcome of infection and other necessary data were recorded in special data sheets. The SPSS 13 statistical software was used for analyzing data. Statistical significance was assayed by Student’s t-test and chi 2 . The differences were considered to be significant at the p <0.05 level. Results: Fifty two patients were selected, 36 patients (69.2%) were male. The mean age of patients was 60±12.8 years, and the mean duration of diabetes was 17±10.6 years. Amputation was done in 29 patients, and a significant correlation was found between duration of diabetes and amputation ( p =0.04). The most frequently isolated pathogens were Staphylococcus aureus (38.46%) E. coli (15.4%), coagulase negative staphylococci (13.5%), and proteus spp (13.5%). Antimicrobial susceptibility results showed that 55% of Staphylococcus aureus isolates were resistant to methicillin. All the Staphylococcus aureus and coagulase negative Staphylococci isolates were sensitive to vancomycin. 100% and 87.5% of E. coli isolates were resistant to ceftriaxone and ceftazidime respectively. All Pseudomonas aeruginosa isolates were sensitive to ceftazidime. Conclusion: More than half of patients with diabetic foot infection were under amputation and there was significant correlation between amputation and duration of diabetes, so prevention of foot ulcer is very important in those patients. The results showed that the most isolates were resistance against common antibiotics and antibiogram is the best way to choose appropriate therapy in these patients.
bleeding events and factor viii levels in obligate female carriers of haemophilia a

Background: Haemophilia A (also known as classical haemophilia) results from heterogenous mutations in factor VIII gene which is located on long arm of X –chromosome (Xq28). Haemophilia A being X linked disorder affects males while females are mostly carriers of the disease. An obligate carrier is the daughter of an affected male (inheriting the X linked mutation from father) or the one who has more than one affected son or one affected son and one or more affected relatives in the family. A carrier can have low factor levels because of X-inactivation or Lyonization (if the X chromosome with the Haemophilia gene is the active chromosome) Being a carrier with low factor levels many aspects of life of the female get affected including her own health, risk of prolonged bleeding, mennorhagia & postpartum bleeding.
Long-term outcomes of percutaneous coronary intervention in grafts and native vessels in coronary artery bypass grafting patients with diabetes mellitus.

Background Atherosclerosis in diabetic patients progresses fast. Evidence on how to choose target vessels of percutaneous coronary interventions (PCIs) in diabetic patients post-coronary artery bypass graft (post-CABG) is insufficient. Methods One hundred and fifty-seven patients with diabetes and previous CABG, who underwent PCI of either a graft vessel (GV) (n=44) or a native vessel (NV) (n=113) in the National Center for Cardiovascular Disease, China, were studied. In-hospital and long-term clinical outcomes were compared between the groups. Results Diabetic patients with prior CABG had more PCI to native arteries, but the proportion of grafts PCI increased as time went on. Both groups had similar baseline characteristics. Group GV patients compared with group NV had more totally occluded NVs, less totally occluded grafts and more in-stent restenosis. However, there was no difference in in-hospital mortality and long-term incidence of major adverse cardiac event (MACE), cardiac death, nonfatal myocardial infarction (MI), or revascularization. Multivariate logistic regression analysis showed that PCI success [hazard ratio (HR), 11.488; 95% confidence interval (CI), 1.135-116.303; P<0.05] was independent predictor of MACE. Conclusions It suggested similar long-term clinical outcomes after PCI in GV or NV in prior CABG patients with diabetes. Thus, the vessel with higher estimated PCI success rate should be prioritized by operators.
PRESCRIPTION OF OPIOIDS TO YOUTH 2005-2016: AN EXAMINATION OF TRENDS, PATIENT CHARACTERISTICS, AND OUTCOMES THROUGH 12 MONTHS

Data on all outpatient opioid prescriptions (N=71,647) to youth below age 21 (N=42,020) from 2005-2016 were extracted from electronic medical records within a university hospital system, including demographic characteristics, markers of morbidity, and mortality. Relative risk was calculated for markers of morbidity and mortality based on sociodemographic characteristics. The sample was primarily male (55.0%), Hispanic/Latino (50.1%), English-speaking (88.9%), and publicly insured(50.1%). Mean age was 13.54 (sd = 6.50). From 2005-2016, overall frequency of opioid prescriptions increased by 86.6% (from 2470 to 4610) with the largest increase (206.2%) observed from 2005-2008 (2470 to 7562). Patients who were older, White, and Non-Hispanic were more likely to receive multiple opioid prescriptions. Large increases in opioid-related morbidity and mortality were documented, although base-rates remained low. Significantly increased risk of adverse outcomes was observed in patients receiving multiple opioid prescriptions, and in patients who were older, of minority race, and publicly insured or uninsured.
Medical treatment of functional dyspepsia

Functional dyspepsia (FD) is a condition in which upper abdominal symptoms, such as epigastralgia, postprandial discomfort, and bloating, occur in the absence of any organic or metabolic disease that could explain the symptoms. The prevalence of FD is increasing, presumably because of an increasingly stressful environment, as well as overlap with other motility disorders such as gastroesophageal reflux diseases and irritable bowel syndrome. Numerous studies have attempted to determine the pathophysiological mechanisms of FD and establish effective FD treatment, with little success. Several therapeutic options have been explored, including Helicobacter pylori eradication, proton pump inhibitors, prokinetic agents, anti-depressant and anxiolytic agents, and acotiamide, a recent emerging drug. Through the many trials evaluating the efficacy of drugs for FD treatment, we found that it is necessary to treat according to the symptoms of FD and to use a combination of therapeutic options. Additional well-designed, prospective studies are needed to confirm the management of FD.
Relationship of oral hygiene status and practices with oral lesions in a group of HIV positive patients in Lagos, Nigeria

Objective: The oral health of HIV positive patients may be compromised because of their depressed immunity and may increase their risk of developing some oral lesions. This study was carried out to assess the relationship of the oral hygiene status and practices with oral lesions in HIV positive patients at a dedicated HIV clinic in Nigeria. Method: A cross sectional study of adult HIV positive patients aged 18 years and above at the HIV outpatient clinic of the Lagos University Teaching Hospital. Data on age, gender, marital status, level of education and oral hygiene practices were collected. Their CD4 counts were recorded. Oral examination was carried out on all patients to assess their oral hygiene status using the Simplified Oral Hygiene Index. Oral lesions were recorded when present. Result: A total of 134 HIV positive patients were seen, most (71.6%) of whom had never visited a dentist. The mean oral hygiene index (OHI-S) score of the patients was 1.85 and 55.2% had a fair oral hygiene status. The majority (77.6%) cleaned their teeth once daily. Oral candidiasis and linear gingival erythema (LGE) were the two most prevalent oral lesions being 26.1% and 11.2% respectively. The mean oral hygiene index (OHI-S) score was higher in males [2.10] compared with females [1.71] (p<0.05), in patients who had never visited the dentist [1.99] compared with those who had visited the dentist previously [1.49] (p<0.05) and in patients with linear gingival erythema compared with those without the lesion (p< 0.05). The CD4 + Tlymphocyte count was not associated with the OHI-S (p>0.05). Conclusion: Poorer oral hygiene was significantly associated with male gender, no previous dental visits and linear gingival erythema lesions in the HIV positive patients in this study. Regular oral health education programmes should be incorporated into the treatment protocol of HIV positive patients at the HIV clinic to improve their overall health status.
Clusterin and psoriasis, what is the relation?

Background: Atherosclerotic infarction accounts for a sizable proportion of cerebral infarcts whether occurs from extracranial or intracranial atherosclerotic disease. Despite recent studies on stroke risk factors; it is still unclear whether or not single risk factor specifically affect extracranial or intracranial arteries in stroke patients. Aim of the work: To determine the difference between intracranial and extracranial steno-occlusive atherosclerosis and its correlation with risk factors of acute ischemic stroke using Magnetic Resonance Angiogram (MRA) and/or Computed Tomography Angiography (CTA) with Duplex. Patients and methods: All cases diagnosed as acute ischemic stroke were subjected to detailed history, full neurological examination, routine laboratory tests, extracranial vessels assessed by duplex, intracranial vessels assessed by MRA and/or CTA. Results: 61 patients included in the study (38 males and 23 females), with mean age (64.5 ± 11.4). Extracranial stenosis was (57 patients, 93.4%), while intracranial stenosis was (49 patients, 80.3%). But the intracranial significant stenosis was (45 patients, 73.77%), while the extracranial significant stenosis (26 patients, 42.62%). Hypertension (72.1%), obesity (62.3%), diabetes (57.4%), dyslipidemia (54.1%) and smoking (39.3%), were risk factors equally affecting the extracranial and the intracranial systems in the same descending order. There was a higher prevalence of hypertension among patients with intracranial significant stenosis showing a significant P-value of 0.048. Conclusion: Extracranial stenosis was more common than the intracranial stenosis, but the intracranial significant stenosis is more prevalent than the extracranial. Hypertension is a significant risk factor for intracranial significant stenosis