Miracle-dz/UniFAR-FTUs huggingface dataset:
Morphometric analysis of liver and spleen type I and III collagen of autopsied patients with acquired immunodeficiency syndrome

Acquired Immunodeficiency Syndrome (AIDS) is caused by the Human Immunodeficiency Virus (HIV), a retrovirus capable of invading and replicating in host leucocytes, favoring installation of opportunistic infections and causing important changes in organs such as spleen and liver. The aim of this study was to quantify percentage of type I and III collagen in the spleen and liver of autopsied patients divided in two groups: with AIDS (n=24) and without AIDS (n=24). Quantification of type I and type III collagen was made with Sirius Red and Reticulin stains, respectively, using the image analysis system Leica Qwin Plus®15. From medical records, we retrieved information regarding age, sex, race, Body Mass Index, and spleen and liver weight. We analyzed the data with SigmaStat® 2.03, considering statistically significant values of p<0.05. Patients with AIDS showed higher percentage of type I and type III collagen, with significant difference only between type III in both organs. The virus contributes with increase the amount of type I and type III collagen in liver and spleen of HIV infected patients contributing to morphofunctional changes. These changes may be related to decline of imune function due to viral presence and the increase of these fibers in those organs.
Quality of life in the FOXFIRE, SIRFLOX and FOXFIRE‐global randomised trials of selective internal radiotherapy for metastatic colorectal cancer

Selective internal radiotherapy (SIRT) is a liver‐directed treatment involving the injection of yttrium‐90 microspheres into the blood supply of liver tumours. There are very few studies assessing health‐related quality of life (HRQOL) in patients treated with SIRT. Patients with liver metastases from colorectal cancer (CRC) were randomised in the FOXFIRE (FFr; ISRCTN83867919), SIRFLOX (SF; NCT00724503) and FOXFIRE‐Global (FFrG; NCT01721954) trials of first‐line oxaliplatin–fluorouracil (FOLFOX) chemotherapy combined with SIRT versus FOLFOX alone. HRQOL was assessed using the three‐level EQ‐5D, European Organisation for Research and Treatment of Cancer Quality of Life (EORTC QLQ‐C30) and EORTC Colorectal Liver Metastases cancer module (EORTC QLQ‐LMC21) at baseline, ≤3 months, 6 months, 12 months and annually thereafter from randomisation, and at disease progression. Analyses were conducted on an intention‐to‐treat basis. In total, 554 patients were randomised to SIRT + FOLFOX and 549 patients to FOLFOX alone. HRQOL was statistically significant lower in SIRT + FOLFOX patients ≤3 months after SIRT administration in all three instruments, particularly global health, physical and role functioning and symptoms of fatigue, nausea/vomiting and appetite loss. By accepted thresholds, these differences were deemed not clinically important. Differences between SIRT + FOLFOX and FOLFOX alone over the 2‐year follow up and at disease progression were also not clinically important. Although there is some decrease in HRQOL for up to 3 months following SIRT, the addition of SIRT to FOLFOX chemotherapy does not change HRQOL to a clinically important degree in metastatic CRC patients.
Pre-hospital intranasal analgesia for children suffering pain: a rapid evidence review

Introduction: Pre-hospital analgesic treatment of injured children is suboptimal, with very few children in pain receiving analgesia. Studies have identified a number of barriers to pre-hospital pain management in children which include the route of analgesia administration. The aim of this review is to critically evaluate the pre-hospital literature, exploring the safety and efficacy of intranasal (IN) analgesics for children suffering pain. Methods: We performed a rapid evidence review, searching from inception to 17 December 2018, CINAHL, MEDLINE and Google Scholar. We included studies of children < 18 years suffering pain who were administered any IN analgesic in the pre-hospital setting. Our outcomes were effective pain management, defined as a pain score reduction of ≥ 2 out of 10, safety and rates of analgesia administration. Screening and risk of bias assessments were performed in duplicate. We performed a narrative synthesis. Results: From 310 articles screened, 23 received a full-text review resulting in 10 articles included. No interventional studies were found. Most papers reported on the use of intranasal fentanyl (INF) (n = 8) with one reporting IN ketamine and the other IN S-ketamine. Narrative synthesis showed that INF appeared safe and effective at reducing pain; however, its ability to increase analgesia administration rates was unclear. The effectiveness, safety and ability of IN ketamine and S-ketamine to increase analgesia administration rates were unclear. There was no evidence for IN diamorphine for children in this setting. Conclusion: Interventional studies are needed to determine with a higher confidence the effectiveness and safety of IN analgesics (fentanyl, ketamine, S-ketamine, diamorphine) for children in the pre-hospital setting.
Determination of the frequency of β-lactamase genes (bla SHV, bla TEM, bla CTX-M) and phylogenetic groups among ESBL-producing uropathogenic Escherichia coli isolated from outpatients

Abstract Background Escherichia coli accounts for 70–95% of community-acquired urinary tract infections (UTIs). Recently, there has been an increase in the prevalence of extended-spectrum β-lactamase (ESBL) in the community which required an accurate identification for better management. Therefore, the current study was performed to determine the antimicrobial resistance pattern, investigate ESBL phenotypes and genotypes (blaCTX-M, bla TEM and bla SHV genes) and determine the phylogenetic groups among ESBL-positive isolates from outpatients. Methods One hundred and eighty-three positive urine samples were collected from 4450 outpatient clinic attendees. Antibiotic susceptibility was determined and ESBL phenotype screening was carried out using disk diffusion agar and combination disk techniques, respectively. The assessment of the presence of the blaCTX-M, bla TEM and blaSHV genes and phylogenetic grouping were performed using the polymerase chain reaction (PCR) method. Results Out of 183 E. coli isolates, 59 (32.2%) showed a positive ESBL phenotype. The prevalence of ESBL-producing E. coli was higher in males (57.4%). Fifty-seven of the ESBL-producing strains carried at least one of the β-lactamase genes (bla CTX-M, bla TEM, bla SHV). Phylotyping of multi-drug resistant isolates indicated that the isolates belonged to B2, A and D phylogroups. Analysis of resistance patterns among these phylogroups revealed that 74.4%, 55.3% and 29.7% of the isolates in the B2 group were resistant to trimethoprim-sulfamethoxazole, ciprofloxacin and gentamicin, respectively. Most of the strains in the phylogroup B2 carried the bla CTX-M gene. Conclusions All the ESBL-producing isolates were placed in one of the four phylogenetic groups. The presence of CTX-M and resistance to quinolones were more frequent in B2 strains than in non-B2 strains.
Use of Standardized Patients in Endocrinology Fellowship Programs to Teach Competent Transgender Care

Abstract Purpose Transgender and gender-nonconforming individuals have unique health care needs and have difficulty accessing health care services because of a lack of qualified health care providers, insurance coverage, mistreatment, and bias by the medical community. Medical trainees and physicians report a lack of education in, and exposure to, the clinical care and unique aspects of this field. We assessed the use of a standardized patient as a tool to evaluate 4 core medical competencies (patient care, medical knowledge, professionalism, and interpersonal communication) of endocrinology fellows at a single training program. Methods Endocrine fellows were evaluated by faculty in different aspects of transgender care and completed a self-assessment before and after the exercise. Faculty viewed the fellows during the Objective Clinical Structured Examination. Fellows were provided feedback by a faculty member and the standardized patient after the exercise. Results Deficits were found in patient care and professionalism. Fellows scored well in medical knowledge. Fellows did not report an improvement in comfort and communication skills after the exercise. Interestingly, fellows’ self-assessment scores in several domains declined after the standardized patient encounter, highlighting an occasion for self-reflection and growth within the realms of cultural competency and medical knowledge. Main conclusions We conclude that use of standardized patients to teach medical competencies in transgender medicine may be one approach to improve exposure to, and training in, transgender medicine. Endocrine fellows still had discomfort treating transgender individuals after the standardized patient encounter and require other training activities that may include didactics and clinical case discussions.
Implementing family systems nursing through a participatory, circular knowledge-to-action research approach in women’s health

Background: Moving towards more family-centred care cultures in acute settings requires attention to the relational connectedness in which persons who seek acute care are situated. To promote such a family-centred culture and to shift the systemic approach to care from an individual one to a relational one, there is a need to integrate family nursing knowledge and skills into everyday acute care practices. Aim: The aim of this knowledge-to-action project was to create a family-centred care culture by integrating a family system nursing approach into clinical practice within the women’s health division in an acute care hospital. Methods: An action research methodology, using the action cycle of look-think-act, was used to guide knowledge translation and to develop a family-centred practice culture. The ‘think’ phase entailed an ongoing, critical dialogue among the study’s core group members about the meaning of family systems nursing, a shared definition and adaptation of the approach and instruments to the local context, and the development of an action plan for implementation. Lastly, family systems nursing was interprofessionally piloted through education and training activities in neonatal intermediate care. Findings: During the ‘look’ phase, 20 SWOT analyses with 312 health professionals revealed a shared commitment to individualised, participatory care, but a lack of continuity and inconsistent communication. Documentary analysis demonstrated that family engagement was evident in fewer than half of the cases. Conclusions: The use of a participatory, recursive process to tailor and introduce family systems nursing was important in order to gain momentum for change across different units and professions. A shared vision, leadership commitment, participatory collaboration and facilitation were essential for the change process, while the diversity of practice settings and scope of the project were the main challenges to starting the culture change required to achieve family-centred care.
Computed Tomography Evaluation of the Caudate-to-Right Lobe Ratio in Patients with Liver Cirrhosis and Subjects with Normal Liver in Benin City, Edo State, Nigeria

Liver cirrhosis is the end stage of a range of chronic diffuse liver diseases and is forever progressive leading to hepatic dysfunction, portal hypertension and hepatocellular carcinoma. It is the major cause of morbidity and mortality in developing countries. This study was designed to compare the caudate-to-right hepatic lobe ratio of normal subjects with that of patients with liver cirrhosis with the view of elucidating the value of the ratio in the diagnosis of liver cirrhosis.
Comparative study of intravenous labetalol vs oral nifedipine in controlling blood pressure in pregnant women with hypertensive disorder

Introduction: Oral nifedipine & parenteral labetalol are most commonly recommended for treating hypertension disorders in pregnancy. The aim of the study was to compare the effectiveness & safety of both the drugs. Methods: Every pregnant woman with severe gestational hypertension >160/110 mmHg who came to our university hospital at Chidambaram were taken for the study. They received acute treatment by either nifedipine (10 mg tablet, orally, up to five doses) or intravenous labetalol injection (in an escalating dose regimen of 20, 40, 80, 80 and 80 mg) and a placebo tablet or 0.9% saline every 15 minutes until the target blood pressure of <150/100 mmHg was reached. Results: All the patients recruited in the study achieved blood pressure control. Most patients in both groups achieved the target blood pressure within 45 minutes or less (36.8 ± 15.3 minutes and 38.1 ± 12.2 minutes respectively in the labetalol and nifedipine) and received 3 or lesser number of doses (averaged 2.4 and 2.5 times in the labetalol and nifedipine). No crossover & not statistically significant adverse maternal or fetal outcomes were noted in both groups. Conclusions: Oral nifedipine and intravenous labetalol are similarly effective & safe in the acute control of severe hypertension in pregnancy.
Elevated unidentified antibodies in sickle cell anaemia patients receiving blood transfusions in Cape Town, South Africa

Background. Sickle cell disease (SCD) is an inherited haemoglobinopathy in which homozygous individuals suffer from numerous complications including vaso-occlusion, infection and haemolytic anaemia. Patients therefore often require blood transfusions, which may lead to elevated levels of allogeneic antibodies. In South Africa (SA), the number of patients with SCD has risen significantly owing to migration and changing demographics, leading to an increased need for blood products. Objectives. Against the above background, to determine the incidence of alloimmunisation and the presence of clinically significant antibodies in SCD patients requiring transfusions in Cape Town, SA. Methods. Information on SCD patients receiving blood products between 2010 and 2012, including demographics, number of units transfused and the presence and type of alloantibodies, was collected. The results were compared with those for non-SCD controls who had received a similar number of transfusions. Results. Of 182 patients analysed, 91 had SCD. Twenty-two percent of the SCD patients and 13.2% of the controls had become alloimmunised ( p =0.12), while the proportions of those receiving transfusions and acquiring clinically significant antibodies were similar between the two groups ( p =0.17 and p =0.19, respectively). However, the total number and amount of unidentified antibodies were significantly increased in patients with SCD ( p =0.02 and p <0.001, respectively). Conclusions. This study concluded that patients with SCD develop increased numbers of unidentified antibodies, which may be important in the selection of suitable donors.
Postoperative Wound Infections and the Antimicrobial Susceptibility in Baghdad Hospitals

Nosocomial infections are one of the most important causes of mortality and morbidity in hospitals. These are major public health problems worldwide, but particularly in developing countries. The purpose of this research was to analyze the frequency of the microorganisms in the specimens taken from the surgical wounds, and to examine antimicrobial susceptibility for some isolates . Wound swabs were examined from June 2010 to January 2011. The isolates were identified by conventional methods, antimicrobial susceptibility testing was performed by Kirby-Bauer disc diffusion method as per NCCLS guidelines.A total of 102 wound swabs were examined 22(21.56%) swabs were sterile and 80(78.43%) were positive for microorganisms. The results showed 27.2% positive for Pseudomonas aeruginosa , 25.0% positive for Coagulase positive Staphylococci, 20.0% positive for Enterococcus spp. , 17.5% positive for Escherichia coli ,15.0% positive for Klebsiella pneumonia ,13.7% for Proteus mirabilis, and10.0% for Acinetobacter baumannii. Antimicrobial susceptibility testing showed that the rate of isolates of Imipenem Resistance Pseudomonas aeruginosa (IRPA) were 3.7% , 11.2% positive for Vancomycin Resistance Enterococci(VRE) ,13.7% positive for both Methicillin Resistance Staphylococcus aureus (MRSA)and Vancomycin Resistance Staphylococcus aureus (VRSA) ,and 11.2% positive for Vancomycin Intermediate Staphylococcus aureus (VISA). We found that postoperative wound infections increase with pre and post operative hospitalization that's mean the infections can be decrease by shortening the hospitalization time.Our results appear to be maintained with strategies for preventing nosocomial infection,permanent education, strong application of protocols and urging the implementation of strict infection control policy.
Maternal Parity and Onset of Lactation on Postpartum Mothers

Onset of lactation is one of indicators of lactogenesis stage II which is the important phase in infants breastfeeding. Breastfeeding is important as it gives many health benefits for both mother and babies. The early initiation of breastfeeding is not always going smooth as sometimes mothers or babies experience various difficulties that complicate the lactation process, especially in primipara women with less knowledge of lactation. Those obstacles and difficulties will influence the practice of breastfeeding which may lead to delay onset of lactation. Thus, this study was conducted to identify the onset of lactation and analyze parity factor on postpartum mothers in DKT hospital in Gubeng Pojok, Surabaya, East Java. It was an observational analytic study with prospective cohort design. 50 respondents were randomly selected using systematic random sampling. Regression logistic showed a correlation between parity and onset of lactation (p = 0.024; RR = 7.277), in which primipara mothers were 7.277 times more likely to have delay onset of laction than multipara mothers. It was concluded that maternal parity associated with onset of lactation on postpartum mothers. Keywords: Parity, Onset of lactation, Postpartum
Changes in the relationship between hepatitis B virus and liver transplantation in the last decades

Hepatit B virus (HBV) enfeksiyonu prevelansindaki ve HBV iliskili mortalitesindeki azalma son yillarda oldukca dikkat cekicidir. Dunya capinda yaygin olarak uygulanan HBV asi programlari ve HBV’ye karsi kullanimda olan anti-viral ilaclarin etkinligi bu basarida basat rol oynamaktadir. HBV ile mucadelede, sadece HBV’ye bagli karaciger fibrozunun ilerlemesi veya geriye dondurulmesi degil, ayni zamanda HBV iliskili siddetli akut hepatit tablosunun tedavisinde guzel sonuclar alinmaktadir. Gelismekte olan ulkelerde HBV iliskili siroz karaciger nakli konusunda halen esas sebep iken, gelismis ulkelerde zaman icinde HBV nedenli karaciger nakil sikliklari ciddi oranda dusus gostermistir. Anti-viral ilaclarin karaciger nakli oncesi etkin kullanimi, HBIg tedavisinin nakil sonrasinda yaygin olarak kullanimi sayesinde karaciger nakli sonrasi HBV nuksu, mortalite ve greft kaybi konusunda eskisi kadar sorun olmaktan cikmistir. Bu basarinin nakil sonrasi surviler uzerine bariz bir yansimasi henuz olmamistir. Buradaki esas sebep ise, alici ve verici yasinin son yillarda onemli oranda artis gostermesi olarak gosterilmektedir. Ekolarak, Milan kriterlerinin yaygin olarak klinik pratige girmesiyle karaciger nakli yapilan hepatoselluler kanser (HCC) hasta sayisi da neredeyse ikiye katlamistir. Ancak, HCC rekurrensi, nakil sonrasi en onemli olum nedeni olarak devam etmektedir.
High expression of fibronectin 1 indicates poor prognosis in gastric cancer

Fibronectin 1 (FN1) is involved in the occurrence and development of various tumors and is upregulated in multiple cancer types. FN1 has been demonstrated to promote cell proliferation and migration in gastric cancer cell lines. However, the relationship between the expression of FN1 and clinicopathological factors and prognosis is not clear in gastric cancer (GC). The aim of the present study was to investigate the association between FN1 expression and clinicopathology and prognosis of gastric cancer. In this study, 17 publicly available GC cohorts (n=2,376) with gene expression data from the Gene Expression Omnibus (GEO), The Cancer Genome Atlas (TCGA) and Oncomine databases were tested. In addition, FN1 protein expression was validated by immunohistochemistry in a separate cohort (n=190). The meta-analysis results demonstrated an increase in FN1 expression at the protein and mRNA level in GC tissues, and the FN1 gene was highly expressed at the mRNA level in the advanced T stage (T2 + T3 + T4) group compared with that in the early T stage (T1) group. In addition, the expression of epithelial FN1 at the protein level was positively correlated with tumor size. FN1 expression at the protein and mRNA level was a predictor of poor prognosis following radical resection of GC. In conclusion, the expression of FN1 in GC tissues is upregulated compared with adjacent normal tissues, and it is a potential biomarker of poor prognosis in patients with GC.
The epidemiological profile of burn patients in L.G. hospital, Ahmedabad

Epidemiological evaluation of burn cases is poor in India. Past data can help us to move into future of prevention & treatment of burns cases. India is poor country where we still have unsafe and obsolete uses of fire as source of light & cooking. These greatly increase the number of burns in country but unfortunately we do not have a registration center where whole data can be collected and definite conclusions can be made. This presentation is a humble attempt for the same. We hope more of such studies will be done and we will be able to get some direction for prevention and treatment of burns.
Primary cutaneous mucinous carcinoma of the scrotum: A rare tumor at a rare site – A case report and review of literature

Primary cutaneous mucinous carcinoma (PCMC) is a rare malignant adnexal tumor of eccrine origin with a higher incidence in the head and neck region of the body while scrotal skin involvement is rare. We report a case of a 72-year-old man with ulceration of painless scrotal lesions of 10 years' duration. Histology of the wedge biopsies of the lesions was mucinous carcinoma. Clinical workup excluded noncutaneous primary sites of mucinous carcinoma and distant metastasis. He had wide excision of the scrotal skin lesions with histological findings of nests of malignant cells separated from pool of mucin by fibrocollagenous septae. Periodic acid–Schiff stain was positive; however, immunohistochemical stains for estrogen and progesterone receptors were negative. No local recurrence was observed after 12 months of follow-up. Scrotal PCMC is a rare tumor; this may probably be the first reported case of this tumor in the scrotum. Prognosis was good following surgical excision.