Miracle-dz/UniFAR-FTUs huggingface dataset:
Central Venous Catheterization: Comparison between Interventional Radiological Procedure and Blind Surgical Procedure

Purpose: To determine the usefulness and safety of radiological placement of a central venous catheter by prospectively comparing the results of interventional radiology and blind surgery. Materials and Methods: For placement of a central venous catheter, the blind surgical method was used in 78 cases (77 patients), and the interventional radiological method in 56 cases (54 patients). The male to female ratio was 66:68, and the patients’ mean age was 48 (range, 18-80) years. A tunneled central venous catheter was used in 74 cases, and a chemoport in 60. We evaluated the success and duration of the procedures, the number of punctures required, and ensuing complications, comparing the results of the two methods. Results: The success rates of the interventional radiological and the blind surgical procedure were 100% and 94.8%, respectively. The duration of central catheterization was 3-395 (mean, 120) days, that of chemoport was 160.9 days, and that of tunneled central venous catheter was 95.1 days. The mean number of punctures of the subclavian vein was 1.2 for interventional radiology, and 2.1 for blind surgery. The mean duration of the interventional radiological and the blind surgical procedure was, respectively, 30 and 40 minutes. The postprocedural complication rate was 27.6% (37 cases). Early complications occurred in nine cases (6.7%): where interventional radiology was used, there was one case of hematoma, and blind surgery gave rise to hematoma (n=2), pneumothorax (n=2), and early deviation of the catheter (n=4). Late complications occurred in 32 cases (23.9%). Interventional radiology involved infection (n=4), venous thrombosis (n=1), catheter displacement (n=2) and catheter obstruction (n=5), while the blind surgical procedure gave rise to infection (n=5), venous thrombosis (n=3), catheter displacement (n=4) and catheter obstruction (n=8). Conclusion: The success rate of interventional radiological placement of a central venous catheter was high and the complication rate was low. In comparison with the blind surgical procedure, it is a very safe and useful method.
Comparison of dexmedetomidine or ondansetron with haloperidol for treatment of postoperative delirium in trauma patients admitted to intensive care unit: randomized controlled trial

Objective: This study was designed to compare the effect of dexmedetomidine or ondansetron with haloperidol, as a control, for the treatment of postoperative delirium in trauma patients. Methodology: A total of 96 adult trauma patients diagnosed with postoperative delirium were randomized into three equal groups. Patients were given either 1 μg/kg dexmedetomidine (Dexmed group) or 4 mg ondansetron (Ondan group) or 5 mg haloperidol (Halo group), administered twice daily for 3 consecutive days. Number of delirious patients, patients who needed "rescue haloperidol" and the total amount of "rescue haloperidol" during study period was calculated. Results: At the end of the study, the number of remaining delirious patients was 3, 6, and 2 in Dexmed, Ondan, and Halo groups, respectively, without statistical significance. During the study period, there was no significant difference in the number of patients who needed "rescue haloperidol" between Dexmed and Halo groups (5 vs. 3; p = 0.7). However, the difference was significantly higher in Ondan group compared to Halo group (11 vs. 3; p = 0.03). The mean total "rescue haloperidol" dose was significantly higher in Ondan group compared to Halo group (p < 0.001), but there was no difference between Dexmed and Halo groups (p = 0.07). At the same time of delirium assessment, mean arterial blood pressure and mean score on Visual Analog Scale were not statistically different between Dexmed or Ondan group versus Halo group. No serious adverse events were reported. Conclusion: Dexmedetomidine is a potential alternative treatment for postoperative delirium in trauma patients admitted to ICU.
Cost-Effectiveness of Therapeutic Education to Prevent the Development and Progression of Type 2 Diabetes: Systematic Review

Objective: To update current evidence on the cost-effectiveness (CE) of therapeutic education in prediabetes and type 2 diabetes. Research design and methods: A systematic review of economic evaluations of therapeutic education in prediabetes and type 2 diabetes, based on Randomized Controlled Trials (RCTs) and published in 2002 - 2014. The quality of the clinical evidence was appraised through the Cochrane Collaboration’s tool for assessing risk of bias. Economic studies were evaluated through the Consensus Health Economic Criteria List. The Incremental Cost- Effectiveness Ratios (ICERs) of patient education in prediabetes and type 2 diabetes were compared. Results: Out of 2031 identified publications, eight studies on prediabetes and nine on type 2 diabetes met the inclusion criteria. The level of the underlying clinical evidence was overall high in studies on prediabetes and varied in studies on type 2 diabetes. The mean ICER (95% CI) from the perspective of the healthcare system was €18,000 per QALY (range from dominance to €49,700) in prediabetes and €29,700 (range from €9,100 to €50,300) per QALY in type 2 diabetes. General flaws in the economic evaluations were short time horizons, limited uncertainty analysis and a lack of transparency in the modeling methods. Conclusions: The number of economic evaluations of patient education in prediabetes and type 2 diabetes has been growing in the past years. Our review compares the health economic evidence on therapeutic education for both conditions. The findings suggest that offering therapeutic education already in prediabetes stage may be a better value for money than postponing it till after the diagnosis. More robust methodologies in health economic evaluations are essential in further evidence generation.
The prevalence of A2 and A2B subgroups in blood donors at a tertiary care teaching hospital blood bank of Rayalaseema region: A pilot study

Polymorphisms in the genes coding for A gene leads to subgroups of A. No published data regarding the prevalence of subgroups of A blood group in Andhra Pradesh, India is available. The importance of subgrouping is that the A antigens in various subgroups may differ both quantitatively and qualitatively 1 . Some individuals with blood groups A2, A3, Ax, Ael, Aend, A2B etc., have anti-A1 antibodies and may present problems in blood grouping. At our center, the typing of A subgroup of all blood donors was done using commercial anti A1 lectin, anti-A and anti-AB antisera as per the manufacturer’s instructions. On analysis of a total of 5,505 blood groupings over a period of one year, 1,486(27%) individuals had A antigen. Of these, 1,137 (20.7%) were typed as A group and 349 (6.3%) as AB group based on the presence of associated B antigen. Of the 1,137 A group individuals,1,090(95.9%) had A1 antigen (subgroup A1) and the rest 47(4.1%) had no detectable A1 antigen (subgroup A2). Similarly among the 349 AB group individuals, 282(80.8%) had A1 antigen (subgroup A1B) and 67(19.2%) had no detectable A1 antigen (subgroup A2B). The number of individuals who lack A1 antigen is less among A group individuals in contrast to AB group individuals and this difference was found to be statistically significant (p<0.0001). This may be due to the recessive nature of A2 gene compared to A1 gene and requirement of a single A2 gene and a B gene to develop as A2B blood group phenotypically and two A2 genes or one A2 gene and one O gene to develop as A2 blood group. Some postulate the presence of a strong B gene that would suppress A1 antigen activity. 2 No other subgroups of A could be detected in the present study due to the small number of donors phenotyped for subgroups of A. Similar results were obtained in other studies from Karnataka 3 and Japan. 4 By including a much larger population, the frequency of other A subgroup antigens can also be estimated. In the present study, the prevalence of A2 and A2B sub groups was found to be 0.85 percent and 1.21% in blood donors respectively. REFERENCES 1. Thakral B, Saluja K, Bajpai M, Sharma RR, Marwaha N. Importance of weak ABO subgroups. Lab Med 2005;36:32-4. 2. Voak D, Lodge TW, Reed JV. A possible explanation for the expression of A2B phenotypes observed in some populations. Vox Sang 1970;18:471-4. 3. Shastry S, Bhat S. Imbalance in A2 and A2B phenotype frequency of ABO group in South India. Blood Transfus 2010;8:267-70. 4. Ogasawara K,Yabe R, Uchikawa M, Saitou N, Bannai M, Nakata K, et al. Different alleles cause an imbalance in A2 and A2B phenotypes of the ABO blood group. Vox Sang 1998;74:242-7. I.S. Chaitanya Kumar, A. Yashovardhan, B. Suresh Babu, Anju Verma, K.V. Sreedhar Babu, DS Jothi Bai. Department of Immuno Haematology and Blood transfsion, Sri Venkateswara Institute of Medical Sciences, Tirupati.
Prevalence and Risk Factors of Helicobacter pylori among Adults at Jinka Zonal Hospital, Debub Omo Zone, Southwest Ethiopia

Results: A total of 150 (43%) males and 199 (57%) females were involved in the study. The age of participants were ranged between 20-89 years with a mean age of 36.7+14.7 and median 32 years. The overall prevalence of H. pylori infection was 50.7% (177/349). H. pylori infection were positively associated with those whose occupation were agrarians (OR=1.85 (95% CI 1.02-3.39, p=0.045); being male (OR=1.98 (95% CI 1.42-3.29, p=0.011), more than 5 persons living in the same house, [(OR=1.53(95% CI 1.00-2.34, p=0.048)]; those practiced open field defecation/no toilet use, (OR=6.75 (95% CI 2.11-21.61), p=0.001); those who never wash their hands after toilet, (OR=2.86 (95% CI 1.30-3.27, p=0.009). But a minimum alcohol consumption was negatively associated with H. pylori bacteria, (OR=0.39 (0.23-0.67, p=0.001).
Detection of extended-spectrum β-Lactamasesin members of the family enterobacteriaceae

Objective To detect the extended-spectrum β-lactamases(ESBLs)and resistance rate to usually used antibiotics in members of the family Enterobacteriaceae. Methods:Double disk test and K-B test was performed to detect ESBLs and antibiotic resistance rate. Results:31 ESBL-producing isolates was assessed in 337 clinical isolates;ESBLs-producing isolates usually was mutiple antibiotic resistance, the resistance rate is obviously increasing than non-ESBLs-producing organisms to third-generation cephalosporins, aztreonam augmentin and timentin. Conclusions:It may be clinical necessary to institute additional testing on a routine basis to detect ESBLs production in all clinical isolates of the family Enterobacteriaceae, and the third-generation cephalosporins should be used cautiusly in clinic.
Nove doze — nove moguÊnosti lijeËenja New doses — new treatment options

islipidemija je jedan od najvaænijih i najËeπÊih promjenjivih Ëimbenika rizika za kardiovaskularne bolesti (KVB). Terapija hipolipemicima jedan je od sastavnih dijelova intervencijske strategije u prevenciji KVB. Statini su i dalje jedini hipolipemici koji dokazano smanjuju kardiovaskularnu smrtnost i pobol u bolesnika sa i bez utvrene KVB. To je razlog zaπto su postali temeljna terapija u smjernicama za zbrinjavanje KVB.
The Correlation of General Imaging Features with the Pathology in Extranodal Lymphoma

Objective To explore the imaging features of extranodal lymphoma and evaluate its diagnostic value.Materials and Methods 54 extranodal non-Hodgkin's and 3 extranodal Hodgkin's lymphoma of 57 patients confirmed by surgery and pathology without the history of intranodal lymphoma before surgery had the examination of conventional radiography,CT scan and MR imaging.The acquired images data were reviewed and analyzed retrospectively in comparison with surgical and pathological results.Results The locations of 57 extranodal lymphomas included digestive canal(14),bone(9),kidney(5),brain(7),lung(4),spleen(4),adrenal gland(4),liver(3),muscle(3),pancreas(2),testis(1),vagina(1),respectively.6 of 22 cases underwent routine radiography,17 of 39 cases underwent CT scan and 12 of 19 cases underwent MR scan were diagnosed correctly,41 of 47 lesions underwent CT scan were homogeneous density and 6 of which presented heterogeneous density,17 of 26 lesion underwent MR appeared uniform hypo or isointensity signal.47 cases except brain lymphoma presented low to middle degree dynamic delayed enhanced.Extranodal lymphoma usually remained intrinsic anatomic structures.Conclusion General imaging features of extranodal lymphoma include well-circumscribed solid masses with slightly hyperintensity signal on MR T2-weighted images and low to middle degree dynamic delayed enhanced in which intrinsic anatomic structures are remained.It is important for the radiologist to recognize the typical appearance of extranodal lymphoma to improve diagnostic accuracy.
Reconstruction in Posttraumatic Combined Avulsion of an Accessory Navicular and the Posterior Tibial Tendon

Accessory navicular bones are found often and become symptomatic in a high percentage of these patients. A tear off from the navicular bone may lead to severe pain over the insertion site and to progressive incompetence of the posterior tibial tendon. This article describes arthrodesis of the accessory bone to the navicular bone with fixation of the posterior tibial tendon in posttraumatic combined tear off from the navicular bone.
Doença periodontal na gravidez e baixo peso ao nascer

Introduction: It is known for a long time that tooth and gingival infections may have long distance organic repercussions. Recently, it has been suggested that periodontal disease in pregnancy could be a cause of low weight at birth. Objective: To evaluate the influence of periodontal disease in pregnancy on the birth weight of the newborn infants. Patients and Methods: Mothers who gave birth to low-birth-weight infants were randomly selected (Group 1 - G1; n=13). Immediately after inclusion of each mother in group 1, the mother of the next term newborn with birth weight of > 2,500 g (Group 2 - G2; n=13) was included as control. Mothers were examined by a periodontist who was not informed of the group the child belonged to. A probe was used to measure attachment loss of the alveolar bone. The extension index (EI) and severity index (SI) of the periodontal disease were determined. Results: Both groups of mothers were similar in terms of maternal age, parity, color of skin, height, nutrition, smoking, drinking, socioeconomic status, prenatal examinations, premature rupture of membranes, chorioamnionitis, bacteriuria, placenta previa , abruptio placentae, previous hypertensive disease, preeclampsia, and heart disease. The characteristics of the newborns were: birth weight - G1 = 1,804 ± 675 g x G2 = 3,030 ± 516 g; gestational age - G1 = 33 ± 5 weeks x G2 = 39 ± 2 weeks; length of stay in the neonatal intensive care unit (NICU) - G1 = 128 days x G2 = 0 days. Average EI: G1 = 89.788 ± 18.355 x G2 = 72.420 ± 20.717; p=0.033. Average SI: G1 = 1.377 ± 0.626 x G2 = 0.754 ± 0.413 (OR=18.3; CI95%: 2.5-133.3; p = 0.006). After adjustment for risk factors for low birth weight, such as smoking, maternal height, bacteriuria, and previous hypertension, the odds ratio for SI dropped to 7.2 (CI95% = 0.4-125.4; P = 0.176). Conclusion: The multivariate analysis indicated a marked association between periodontal disease measured by SI score and low birth weight. Our data suggested that periodontal disease during pregnancy may be a risk factor for low weight at birth.
Occurrence of Vitamin D deficiency in pregnant women in South India - A preliminary study

Introduction Vitamin D deficiency is suspected to be a public health problem in many parts of the world. In addition, vitamin D deficiency is thought to be common among pregnant women and is associated with an increased risk of pre-eclampsia, gestational diabetes and preterm births. Objective To determine the vitamin D status of antenatal women in the last trimester of pregnancy. Methods Design Cross sectional study. Biochemical screening of vitamin D status was carried out for one hundred pregnant women in their last trimester. Necessary permission was obtained from the Obstetric department of Sri Ramachandra University. Informed consent was obtained from the subjects. Blood samples from subjects were tested for 25-hydroxyvitamin D (25(OH) D) by chemiluminescence immunoassay at SRMC Biochemical laboratory. • Vitamin D deficiency [25(OH)D] < 20 ng/mL or < 50 nmol/L • Insufficiency 25(OH)D between 20-30 ng/mL or 50-75 nmol/L • Sufficiency 25(OH)D>30 ng/mL or >75 nmol/ Results Vitamin D levels have been analyzed for 100 subjects of which 67 were found to be Vitamin D deficient (< 20 ng/ml) 30 were insufficient (between 20-30 ng/ml) and 3 had normal levels of Vitamin D ( >30 ng/ml). Conclusion In view of the high incidence of subnormal vitamin D levels in antenatal women, we recommend biochemical screening in early pregnancy, with subsequent supplementation where indicated.This study may throw light on the need of vitamin D supplementation during pregnancy as a public health intervention for the purpose of improving maternal and infant health outcomes.
Robotic surgery for rectal cancer: A systematic review of current practice

AIM: To give a comprehensive review of current litera-ture on robotic rectal cancer surgery.METHODS: A systematic review of current literature via PubMed and Embase search engines was per-formed to identify relevant articles from january 2007 to november 2013. The keywords used were: "robotic surgery", "surgical robotics", "laparoscopic computer-assisted surgery", "colectomy" and "rectal resection". RESULTS: After the initial screen of 380 articles, 20 pa-pers were selected for review. A total of 1062 patients(male 64.0%) with a mean age of 61.1 years and body mass index of 24.9 kg/m2 were included in the review.Out of 1062 robotic-assisted operations, 831(78.2%) anterior and low anterior resections, 132(12.4%) in-tersphincteric resection with coloanal anastomosis, 98(9.3%) abdominoperineal resections and 1(0.1%) Hart-mann's operation were included in the review. Robotic rectal surgery was associated with longer operative time but with comparable oncological results and anastomotic leak rate when compared with laparoscopic rectal surgery. CONCLUSION: Robotic colorectal surgery has con-tinued to evolve to its current state with promising re-sults; feasible surgical option with low conversion rate and comparable short-term oncological results. The challenges faced with robotic surgery are for more high quality studies to justify its cost.
Pre- and Post-matriculation Correlates of Student Retention Within a Community College Setting

PREAND POST-MATRICULATION CORRELATES OF STUDENT RETENTION WITHIN A COMMUNITY COLLEGE SETTING by Pamela E. Goodman In the 1990s, due in part to declining enrollment numbers and prolonged budget constraints, student retention became a primary focus in higher education. Aligned with the nationwide interest, this longitudinal, archival study focused on the correlates o f student retention at Walters State Community College, located in Morristown, Tennessee. The population involved 17,497 students enrolled from the fall semester o f 1992 through the fall semester o f 1997. Four sets o f variables were investigated—demographic variables, pre-matriculation variables, post-matriculation variables related to grades, and post-matriculation variables related to enrollment. The data were collected through the use of a computer program written to access the Tennessee Board o f Regents’ Student Information System database, and the data obtained were analyzed through the application o f two univariate approaches—the chi-square and the t test for independent samples. The major findings o f the study were: (1) Younger, White, females persisted at higher rates than did other students at Walters State; (2) students who: had higher high school GPAs, had higher admission test scores, attended public high schools, had pre-college residences that were located within the college’s service area, and made applications for college less than two months prior to the first day o f classes persisted at higher rates than did other students at Walters State; (3) students who: had higher college GPAs, were required to take one or two remedial and developmental courses, had not received any “F” grades, and had greater than zero reported absences persisted at higher rates than did other students at Walters State; and (4) students who: attended on a full-time basis, were enrolled in programs designed for transfer to four-year institutions, changed their major programs of study more than one time, and received financial assistance persisted at higher rates than did other students at Walters State. These findings should be communicated with all college personnel in an effort to increase their sensitivity to the “special” needs o f these “at-risk” constituencies. Furthermore, the findings should be used in developing a retention plan that incorporates programs and services designed to address the needs o f targeted audiences as identified in this study.
Prevalence of hepatitis A in southern part of Delhi, India -

Background: Hepatitis A virus (HAV) infection is one of the important causes of hepatitis in developing countries. It is transmitted through orofecal route. They pose major health problems. Objective: To determine the prevalence of HAV in patients presenting with acute viral hepatitis. Materials and Methods: Serum samples of the patients presenting with fever, nausea, vomiting, and jaundice were collected and analyzed by using commercially available mini VIDAS (Biomeriux, France) to detect immunoglobulin M (IgM) against HAV. A one-year retrospective study was conducted in the Department of Microbiology, Hamdard Institute of Medical Sciences and Research, New Delhi, India. Result: Of the 89 serum samples subjected to mini VIDAS for detection of HAV IgM in patients, 30 (33.7%) were found to be positive. The prevalence was found to be more in male patients than in female patients, that is, 21 (70%) and 9 (30%), respectively, and was predominantly seen in the 5–15 years of the school-going age group. Peak cases were found in the monsoon season. Conclusion: Regular monitoring of clinical, serological, and molecular characteristics would help in understanding the epidemiology of HAV and in planning the intervention studies. Prevalence was lower in the age group of 0–5 years, which shows epidemiological shift and improvement in hygiene and in socioeconomic conditions.
Lost in Limbo: An Exploratory Study of Homeless Mothers' Experiences and Needs at Emergency Assistance Hotels

Increases in family homelessness have led several states to use hotels and motels as shelters. Except for investigations into “welfare hotels” of the 1980s, research on this practice is largely nonexistent. This study explored the experience of living in an emergency assistance hotel through in-depth interviews with 10 homeless mothers, triangulated with proximity analyses of the walking distance and public transit time between emergency assistance hotels in Massachusetts (n = 49) and 6 basic need types. Four themes emerged from interviews: living in limbo, profound isolation, role conflict, and immense difficulty meeting basic needs—which proximity analyses further illustrated. Findings suggest the need for systems to consider homeless families' mobility barriers and assess the built environment around hotels used to shelter families.
Long-term safety and effectiveness of sildenafi l citrate in men with erectile dysfunction

James G McMurray1 Robert A Feldman2 Stephen M Auerbach3 Herb DeRiesthal4 Neal Wilson5 On behalf of the Multicenter Study Group6 1Medical Affiliated Research Center, Huntsville, AL, USA; 2Connecticut Clinical Research Center, Waterbury, CT, USA; 3California Professional Research, Newport Beach, CA, USA; 4Pfizer Inc, New York, NY, USA; 5Formerly Pfizer Global Research and Development, Sandwich, UK, currently PPD Inc, Cambridge, UK; 6Members of the multicenter study group are listed in the appendix.