Miracle-dz/UniFAR-FTUs huggingface dataset:
Immunological Aspects of Systemic Sclerosis and New Strategies in Therapy Immunologiczne aspekty twardziny układowej i nowe możliwości terapeutyczne

Systemic sclerosis is a chronic autoimmune disease characterized by multiorgan symptoms such as skin thicken− ing, pulmonary fibrosis, pulmonary arterial hypertension, renal crisis, and gastrointestinal complications. There are two major subtypes of systemic sclerosis: limited and diffuse. The pathogenic process includes inflammatory cell activation, vascular damage, and fibroblast activation. Recent research has focused on understanding its patholog− ical pathways. A new strategy in therapy is developing substances which interfere with the main pathogenic path− ways and which will be able to improve prognostics in systemic sclerosis. The efficacy of current therapies is restricted (Adv Clin Exp Ned 2008, 17, 4, 441–446). Streszczenie Twardzina ukladowa jest autoimmunologiczną, przewleklą chorobą, ktora charakteryzuje sie zajeciem narządow wewnetrznych. Powazne nastepstwa choroby to wloknienie skory i pluc, nadciśnienie plucne, kryza nerkowa oraz zaburzenia ukladu pokarmowego. Istnieją dwie postacie kliniczne choroby: twardzina ukladowa ograniczona i uo− golniona. Na patogeneze choroby skladają sie trzy glowne procesy: aktywacja immunologiczna, uszkodzenie na− czyn oraz aktywacja fibroblastow. Ostatnie badania koncentrują sie na zrozumieniu szlakow patogenetycznych twardziny ukladowej. Nowymi kierunkami w leczeniu tej choroby wydają sie substancje, ktore zablokują specy− ficzny szlak patologiczny choroby, co poprawi rokowanie. Skutecznośc obecnie stosowanych lekow jest niestety
Depression And Anxiety In Patients With Juvenile Idiopathic Arthritis: Current Insights And Impact On Quality Of Life, A Systematic Review

Abstract Depression and anxiety are prevalent in children with rheumatologic diseases, including juvenile idiopathic arthritis (JIA). However, prevalence rates and the relationship with disease outcomes, including quality of life are conflicting in the early literature. To review the current literature, determine gaps in our knowledge, and identify areas in need of further investigation, we conducted a systematic review of studies examining depression and anxiety symptoms among children with JIA and the impact these symptoms may have on disease outcomes and quality of life. Six electronic databases were searched up until January 2019. Of 799 potential articles, 60 articles were included with the main focus on 28 articles from 2009 to 2019, to concentrate on the most current evidence. We found that JIA patients experience symptoms of depression and anxiety similar to other childhood chronic diseases and at higher rates than in healthy children. Patients who experience these symptoms have worse quality of life, with some evidence pointing to depression and anxiety symptoms having a greater impact on quality of life than other disease features, such as active joint count. Family members of JIA patients experience high rates of anxiety and depression symptoms which may impact their child’s mental health and pain symptoms related to JIA. Conflicting reports of associations between depression/anxiety symptoms and disease features/disease outcomes and a paucity of longitudinal studies investigating the impact of treatment on mental health symptoms indicate areas in need of further research to effectively identify patients at greatest risk of depression and anxiety and to better understand how to treat and prevent these symptoms in youth with JIA. Family mental health should also be considered in investigations concerning mental health and disease outcomes of children with JIA.
EFFIACY OF BETAMETHASONE, PLACENTAL EXTRACT AND HYALURONIDASE IN THE TREATMENT OF OSMF: A COMPARATIVE STUDY

INTRODUCTION: Oral submucous fibrosis, an insidious chronic precancerous condition of oral cavity, chiefly occurs in the Indian sub continent. It is characterised by excessive collegen formation and thus stiffness and inelasticity of oral mucosa. It manifests as stiffness of oral mucosa, trismus, burning sensation thus affecting the general well being of patient. Intralesional injection of drugs like betamethasone, placental extract and hyaluronidase helps to improve the condition and thus the health of the patient. OBJECTIVE: To evaluate the efficacy of betamethasone, placental extract and hyaluronidase therapy in the treatment of oral submcous fibrosis. MATERIALS AND METHODS: Fifteen patients with clinico-pathologically diagnosed oral submucous fibrosis were included in the study. All patients underwent hematological and clinical examination to rule out any systemic disease. Patient with TMJ disorder or restricted mouth opening due to pericoronitis and other causes were excluded. Patients were divided randomly into three groups and betamethasone, placental extract & hyaluronidase intralesional injection was given to the separate groups of the patient for a period of 8 weeks. Mouth opening and burning sensation was recorded clinically & subjectively. RESULTS: Observed data were compared statistically using Student’s Paired t test analysis for the efficacy of the drugs used and the results were tabulated. Improvement in mouth opening was observed the maximum with intra lesional injection of hyaluronidase with 9.38mm in average (t= 27.61; p= 0.0000) and improvement in burning sensation was observed maximum with intra lesional injection of betamethasone (t= 12.35; p= 0.0002). CONCLUSION: Oral sub mucous fibrosis is a chronic precancerous condition. Though there is no definitive treatment for the condition, intralesional injection of betamethasone, placentrex and hyaluronidase may provide relief from restricted mouth opening and burning sensation thereby improving the quality of life of the affected individual.
Analysis of T cell receptor V repertoires of annular erythema associated with Sjögren’s syndrome

Sjogren's syndrome (SjS) is characterized by lymphocytic infiltration into the lacrimal and salivary glands leading to symptomatic dry eyes and mouth [1]. SjS frequently accompanies various kinds of cutaneous manifestations other than extraglandular manifestations, including hypergammaglobulinemic purpura, urticarial vasculitis, autoimmune anhidrosis, and annular erythema [2-4]. Immunohistochemical studies have shown that major [. ]
Advanced care planning: an exploratory study of community-based mental health practitioners’ views and experiences of ACP in practice with people with dementia

Purpose Advanced care planning (ACP) involves the discussion of preferences relevant to a possible future time when one’s ability to make decisions may be compromised. ACP is considered as having potential to enhance choice and control and thereby to improve the experience of care for people with dementia and their carers. Care coordinators have been highlighted as possibly playing a central role in facilitating these discussions among people with long-term care needs. However, there is limited evidence of how ACP is facilitated by community mental health professionals who may be supporting people with dementia and carers. The paper aims to discuss this issue. Design/methodology/approach This exploratory study took the form of qualitative semi-structured interviews to explore the views and experiences of community mental health professionals when discussing ACP with people with dementia and/or their carers. A convenience sample of 14 participants working in community mental health services in one NHS Mental Health Trust in London, England, was recruited and interview data were analysed using a framework approach. Findings Five themes emerged from the interviews – knowledge and experience, use of ACP, inhibitors of discussion, service influences and the future. The depth of ACP facilitation appeared dependent on the knowledge, confidence and skills of the individual professional. Limited resources leading to service rationing were cited as a major barrier to ACP engagement. Helping people with dementia and their carers with ACP was not viewed as a priority in the face of competing and increasing demands. A further organisational barrier was whether ACP was viewed by service managers as “core business”. Findings indicate that practice was generally to refer people with dementia to other agencies for ACP discussions. However, pockets of ACP practice were reported, such as explaining proxy decision making options for finances. Research limitations/implications This exploratory study took place in the community mental health services in one NHS Mental Health Trust that may not be representative of other such teams. Case records were not scrutinised or clinical conversations with people with dementia or carers. Practical implications Barriers to initiating ACP discussions were cited, such as limited resources, lack of time and knowledge; unclear role remit, uncertain service direction and poor documentation sharing processes. However, participants held a common belief that ACP for people with dementia is potentially important and were interested in training, a greater team focus on ACP and pathway development. This indicates the potential for staff development and continuing professional development. Originality/value Few studies have asked a wide range of members of community mental health services about their knowledge, skills and confidence in ACP and this study suggests the value of taking a team-wide approach rather than uni-professional initiatives.
Constraints Perceived by Goat Keepers in Adoption of Goat Husbandry Practices in Semi-Arid Rajasthan

The present study was undertaken to investigate the constraints faced by goat farmers in semi arid part of Rajasthan. Data collected from 240 households revealed that feeding was the main constraint faced by 78.75% goat farmers followed by marketing, health and breeding by 77.50, 74.25 and 71.11% farmers, respectively. The main constraint regarding feeding management was lack of knowledge about balanced feeding, high cost of feeds and fodder, lack of irrigation facilities, non availability of green fodder, lack of knowledge about importance of mineral mixture, and shrinking grazing land. Regarding breeding, main constrains were inadequate availability of breeding buck, lack of knowledge about breeding practices and indiscriminate breeding practice. With respect to health care the major constraints were lack of veterinary services in villages, high cost of treatment, ignorance about importance of deworming, lack of knowledge about common diseases and vaccination programme not carried out by any agency. With respect of marketing, the main constraints were lack of marketing infrastructure, middleman not fetching remunerative price to male kids, unorganized goat owners and not even a single agency helped in marketing. Considering above facts, it is suggested that appropriate strategy might be formulated for the development of goat farming and also for the goat farmers.
Improving the provision of nutrition advice and referral to dietetics professionals in the general practice setting | NOVA. The University of Newcastle's Digital Repository

1. Mitchell, L.J., MacDonald-Wicks, L. , & Capra, S. (2010). Improving the delivery of nutrition advice in General Practice. Nutrition & Dietetics, 67(1), S9 (Abstract from 2010 DAA National Conference). 2. Mitchell, L.J., MacDonald-Wicks, L. , & Capra, S. (2010). Increasing referrals through enhanced relationships. Nutrition & Dietetics, 67(1), S49 (Abstract from 2010 DAA National Conference). 3. Mitchell, L. J., Capra, S. , & MacDonald-Wicks, L. (2007). Structural change in Medicare funding – what does it mean for dietetics? Nutrition & Dietetics, 64(Supp 1), S28. (Abstract from 2007 DAA National Conference)
INFLUENCE OF FOOT POSITION IN THE PERFORMANCE OF SIT TO STAND IN POST STROKE HEMIPARETIC PATIENTS

Background: Sit to stand is one of the functional tasks that may have been altered in post stroke hemiparetic patients. This transfer may have been altered affected by various extrinsic conditions, among them the position of the feet. Objective: systematize the knowledge about the influence of foot placement in the performance of standing up in post stroke hemiparetic patients. Method: a non systematic review in the period of March to September 2014 was performed, including original articles published from January 2002 to September 2014. Results: 35 articles were found, 8 met the inclusion criteria and were included, 6 of them of observational feature, 1 controlled biomechanical experiment and 1 randomized clinical trial. Conclusion: the findings suggest that the choice of foot position interferes in the standing up performance. This aspect should be considered for the evaluation and treatment, allowing the control of variables that interferes on the performance of this task.
Systematic review and meta-analysis of maternal secondhand smoke exposure and neonatal outcomes

Objectives: To determine the risk of adverse pregnancy and foetal outcomes among nonsmoking women exposed to secondhand smoke (SHS) while pregnant and compare the quality of studies in middleand high-income countries (MIC and HIC). Material and methods: To assess the effect of maternal SHS exposure on preterm birth, low birth weight, stillbirth, and orofacial clefts, the authors searched three databases (2004-2015) and applied strict inclusion/exclusion criteria. Crude odds ratios (ORs), adjusted ORs, associated 95% confidence intervals, and raw data were used to estimate pooled ORs using random-effects models. Models were stratified by adjusted/unadjusted data, high study quality vs. low quality, and country income level. Results: The authors identified 39 studies that assessed the effect of maternal SHS exposure on the four outcomes. Of these studies, the 20 conducted in MICs were of lower quality on average than those conducted in HICs. Evidence of a statistically significant effect of SHS exposure was found using adjusted pooled ORs among the high-quality studies for low birth weight (pOR: 1.282 [95% CI: 1.103-1.490]), preterm birth (pOR: 1.290 [95% CI: 1.127-1.476]), and stillbirth (pOR: 1.230 [95% CI: 1.037-1.459]). Using the high-quality adjusted ORs, the effect of SHS exposure in nonsmoking pregnant women on cleft palate with or without cleft lip did not reach significance (pOR: 1.307 [95% CI: 0.893-1.9]). Conclusions: In all analyses, the odds of having negative outcomes were greater among studies conducted in MICs than in HICs. More research is needed in middle-income countries to inform policy and practice.
Study of Knowledge and Practices of Self-medication among Medical Students at Jammu

RESULTS: A total of 282 students participated in the study, among which 96 were from 1st semester, 88 from 3rdand 98 from 6th semester. Knowledge of self-medication was adequate in 68% of 1st semester, 81% of 3rd and 87% of 6th semester students.85% of respondents from 1st semester, 79% from 3rd and 78% from 6th practised self-medication. CONCLUSION: Since seniors had better knowledge of drugs , self medication was practised less as compared to juniors. There is a need to review educational programs especially clinical pharmacology, focusing on rational use of drugs. JMS 2012;15(2):141-44
Insulin-like growth factor receptor 1 (IGFR-1) and outcome measures in advanced non-small cell lung cancer (NSCLC) patients treated with gefitinib

8036 Background: Increased expression of IGFR-1 has been hypothesized to impart resistance to epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors. Our objective was to associate clinical outcomes of advanced NSCLC gefitinib treated patients (pts) with IGFR-1 expression. Methods: Consecutive Expanded Access Trial pts with > 1 week gefitinib were included for analysis. Tissue was evaluated for IGFR-1 immunohistochemistry (IHC). IGFR-1 positivity was defined as any staining present. Results: The characteristics of the 83 pts with tumor available for IGFR-1 staining were: 38 male (45.8%), median age 66, 13 never- smokers (15.7%), 51 with adenocarcinoma histology (61.4%), 78 pts with ECOG performance status 0–1 (94.0%). For the entire group of 83 pts, the objective response rate (complete response (CR) + partial response (PR)) was 14.5 %, disease control rate (CR + PR+ stable disease) was 57.8%. The median progression free interval (PFI, censored at 1 yr) was 3.0 months (mo); the median overall .
P2452Application of left atrial strain for differentiation between pre- and post-capillary pulmonary hypertension

Pulmonary hypertension (PH) is classified as pre- or post-capillary PH, and pulmonary capillary wedge pressure (PCWP) >15 mmHg is used as criterion for post-capillary PH. Elevated left atrial (LA) pressure is associated with reduced LA reservoir strain. Thus, LA strain may potentially serve to differentiate between these diagnoses. This study tested the hypothesis that LA strain can be used as a noninvasive parameter to differentiate between pre- and post-capillary PH. We analyzed 103 patients (mean age: 58 years, 51 female) referred to right heart catheterization due to unexplained dyspnea or suspected heart failure. Echocardiography was performed within 24 hours of the invasive procedure. Mean pulmonary artery pressure (PAP) was noninvasively estimated from tricuspid regurgitation (TR) velocity and inferior vena cava (IVC) diameter and collapsibility. LA reservoir strain was calculated from apical four-chamber view by speckle tracking echocardiography, and was feasible in 101 patients. Twenty-eight patients were invasively confirmed with pre-capillary PH and 43 patients with post-capillary PH. The remaining 32 patients had no PH. LA reservoir strain was significantly lower in patients with post-capillary PH than patients with pre-capillary PH (9.9±5.5% vs. 24.6±8.2%, p<0.01). At a cut-off value of 15.4%, LA reservoir strain could predict elevated PCWP >15 mmHg with AUC=0.88, sensitivity=84.8% and specificity=81.8%. As shown in the figure, echocardiography with LA reservoir strain correctly differentiated 82% of patients into pre- and post-capillary PH. These results suggest that LA reservoir strain can be used to predict elevated PCWP, thus allowing discrimination between pre- and post-capillary PH.
Tumour Prosthetic Replacement in Paediatric Bone Cancer

Surgical management of paediatric bone sarcoma is challenging. Effective chemotherapy and advances in surgical techniques make limb sparing surgery possible and offers adequate disease control comparable to the results obtained by amputations. With advances in design, material technology and surgical techniques, modern implanted tumor prostheses are more durable, less short term complications and can achieve good limbs function. This study is to review the experience of using prostheses in limb sparing surgery for 35 patients with paediatric bone sarcoma managed at one of quaternary referral centers in Hong Kong.
Teen pregnancy: Tailoring a pregnancy app to the needs of pregnant adolescents

Teenage pregnancy is an important issue; adolescence is associated with various challenges and changes, as a result, pregnant adolescents have fewer cognitive, emotional, and social resources to meet the challenges of pregnancy. Stress and distress are often associated with these challenges and many adolescents lack the coping strategies to manage them. Research suggests that stress during pregnancy can have a significant impact on the wellbeing of both mother and child. E-health interventions are being used more frequently to support adolescents with their challenges however, only a small number of these are aimed at pregnant adolescents. Psychosocial interventions for pregnant adolescents have been developed and evaluated, and most of them aim to provide social support, access to professionals and pregnancy related resources. Psychosocial interventions targeting adolescents in general often focus on improving or maintaining their emotional and social wellbeing. E-health interventions are a relatively new yet highly successful mode of support for teenagers as they are easily accessible, less time consuming, inexpensive and therefore more widely available than face to face interventions. ‘Positively Pregnant’ is an E-health intervention using a resilience-focussed model to improve the wellbeing of pregnant women. The purpose of this study was to introduce the ‘Positively Pregnant app’ to pregnant adolescents and professionals working alongside them, to gain their feedback on how we might tailor the app to the needs of pregnant adolescents. Three professionals working alongside pregnant adolescents were recruited through email and social media. One parenting teen and one pregnant teen were
Nursing Activites Score: avaliando a carga de trabalho de enfermagem no cuidado intensivo

Objetivo: mensurar a carga de trabalho de enfermagem em uma Unidade de Terapia Intensiva Adulto por meio da Nursing Activites Score, identificar o perfil dos pacientes, bem como dimensionar o número de profissionais de enfermagem. Método: estudo transversal, descritivo-exploratório, de abordagem quantitativa, desenvolvido em uma UTI Adulto no interior do Rio Grande do Sul. O escore foi aplicado uma vez ao dia durante o período de um mês, após realizou-se análise estatística. Resultados: A pontuação média encontrada foi de 62,14 pontos, equivalente a uma média de 14,91 horas de assistência por paciente nas 24 horas. Constatou-se que o processo de trabalho da enfermagem era realizado por quatro enfermeiras e 24 técnicos de enfermagem. Conclusão: Identificou se uma alta carga de trabalho de enfermagem, sendo que o quadro de pessoal é inadequado conforme estabelecido pelo Conselho Federal de Enfermagem, porém atende ao que estabelece a Agência Nacional de Vigilância Sanitária.
Risk factors for cerebrospinal fluid leak following endoscopic transsphenoidal pituitary adenoma surgery

Purpose: To evaluate risk factors for intraoperative and/or postoperative cerebrospinal fluid (CSF) leak following endoscopic transsphenoidal surgery in patients with pituitary adenomas. Methods: A retrospective cohort study of 219 pituitary adenomas submitted to transsphenoidal endoscopic surgery (2007 – 2017) at the Centro Hospitalar São João was performed. Age, sex, body mass index, smoking status, diabetes mellitus, hypertension, dyslipidemia, chronic obstructive pulmonary disease, asthma, obstructive sleep apnea syndrome (OSAS), tumor size and type, prior transsphenoidal surgery or radiotherapy were collected by clinical documentation analysis and phone interview. An univariate statistical analysis was performed to evaluate the association of risk factors with the occurrence of CSF leaks. Results: 201 patients were included in the study (18 excluded due to insufficient data). The prevalence of intra and postoperative CSF leaks was 14.9% (30/201) e 5.0% (10/201), respectively. There was a statistically significant association between the appearance of intraoperative CSF leaks and the following risk factors: tumor size (19.9% macroadenomas, p=0.001) and tumor type (26.3% growth hormone (GH) secreting adenomas, p=0.009). Despite being non-statistically significant, intraoperative CSF leaks occurred with more frequency on patients with hypertension, asthma and OSAS. The risk of postoperative CSF leaks was significantly associated with the previous occurrence of intraoperative CSF leak (p<0.001) and they also appeared with more frequency on patients with asthma, OSAS and on GH-secreting tumors; every postoperative CSF leak occurred on macroadenomas. Conclusion: Knowledge of patient’s risk factors is an important tool in the preoperative assessment, especially given the risk arising from CSF leaks (meningitis).