Miracle-dz/UniFAR-FTUs huggingface dataset:
Perspective for Methicillin-resistant Staphylococcus Aureus colonization, Antibiotic Susceptibility Patterns and Risk factors for Colonization among People Living with HIV at Nyenga Hospital, Buikwe District, in Central Uganda

Background Colonization with methicillin-resistant Staphylococcus aureus (MRSA) is recognized as an association towards development of infections that may cause of morbidity among people living with Human Immunodeficiency Virus (PLWHIV). We report on the prevalence, antibiotic susceptibility pattern and risk factors associated with MRSA carriage among PLWHIV at Nyenga hospital, Buikwe district in central Uganda. Materials and Methods We conducted a cross-sectional study among PLWHIV attending Nyenga hospital anti-retroviral therapy (ART) clinic. Nasopharyngeal swab was collected from each participant, cultured to isolate Staphylococcus aureus, and drug susceptibility testing (DST) performed. Sociodemographic data and medical history was recorded. Results We enrolled 219 PLWHIV; of these, 58.4% (N=128) were females. The majority of participants (95.0%) were on ART. Ninety-eight (44.75%) of the nasopharyngeal swabs had growth, of which 41 (41.84%) were S. aureus. Of these, 11 (5.02%, 95% confidence interval: 3.67-7.02) were MRSA. Of 41 isolated S. aureus strains, only 8 (19.51%) were susceptible to all antibiotics tested. A total of three (7.32%) were multi-drug resistant (MDR), while one1 (2.43%) was a possible extensively drug resistant (XDR) strain. Deteriorating immunologic state as indicated by a low CD4 count showed a significant association with the MRSA colonization. Conclusion These results are reassuring that MRSA colonization is high among PLWHIV. As most of the antibiotics in use were resistant, it raises concerns of intricate clinical management in a low resource set up.
Breastfeeding and Reduced Risk of Breast Cancer in Women: A Review of Scientific Evidence

Recent research shows that women who breastfed their children are at considerably less risk of developing breast cancer. Nonetheless, the results of other studies show that this greater protection only applies to pre-menopausal women. Based on the above results, there is still a certain controversy as to whether breastfeeding protects women against breast cancer. The main objective of this chapter is to provide a review of the scientific evidence regarding the relationship between breast cancer and certain aspects of pregnancy as breastfeeding period. For this purpose, it was conducted a systematic review in four databases (Web of Science, MEDLINE, Scopus and CINAHL), using the MeSH terms (Breast Feeding, Primary Prevention, Breast Neoplasms). The available scientific evidence justifies that breastfeeding for periods of over 6 months results in statistically significant reductions in the risk of developing breast cancer, the most common gyneco- logical tumor in young women. However, it remains to be studied further whether the observed risk reduction applies to women with inherited susceptibility to develop breast cancer. Apoptosis induced by a human milk protein 1995 Experimentalstudy A component of milk in a particular physical state – multimeric alpha-lact-albumin – is a potent Ca(2+)-elevating and apoptosis-inducing agent with broad, yet selective, cytotoxic activity.
Mesenchymal Stem Cells Attenuate Acute Liver Failure by Promoting Expansion of Regulatory T Cells in an Indoleamine 2,3-Dioxygenase-Dependent Manner

The influence of mesenchymal stem cells (MSCs) on the phenotype and function of CD4+CD49b+FoxP3- regulatory cells has not been elucidated. We used Concanavalin A (ConA) - and α-galactosylceramide (α-GalCer)-induced acute liver injury to estimate the effects of MSCs on liver-infiltrating CD4+CD49b+FoxP3-regulatory cells. MSCs significantly reduced ConA- and α-GalCer-mediated liver injury in C57BL/6 mice, as demonstrated by biochemical tests, reduced influx of inflammatory CD4+ T cells, and increased presence of CD4+CD49b+FoxP3- regulatory cells in the injured livers. The number of CD4+CD49b+FoxP3-regulatory cells was also significantly increased in α-GalCer-treated mice that received MSC-derived conditioned medium (MSC-CM). The presence of 1-methyltryptophan, a specific inhibitor of indoleamine 2,3-dioxygenase (IDO), in MSC-CM completely abrogated the hepatoprotective eff ect of MSCs and significantly decreased the total number of liver-infiltrated CD4+CD49b+FoxP3- regulatory cells, indicating the crucial importance of MSC-derived IDO for the expansion of CD4+CD49b+FoxP3- regulatory cells and the consequent MSC-dependent attenuation of acute liver injury.
Evaluation of 62 bullous pemphigoid patients

Bullous pemphigoid (BP) is an acquired autoimmune disease often manifesting with subepidermal bullae. Autoantibodies against hemidesmosomes constitute the main cause of BP. In this study, we aimed to evaluate the clinical and histopathological characteristics of BP patients and to discuss them in light of the studies conducted in Turkey and around the world. The retrospective study included 62 patients that were diagnosed with BP in our clinic between 2005 and 2017. Diagnosis of BP was established based on clinical, histopathological, and DIF microscopy findings. Age, gender, duration of disease, presence of pruritus, peripheral eosinophilia, significant histopathological findings, history of smoking, and family history were recorded for each patient. Patients under 18 years of age were excluded from the study. The 62 patients comprised 24 (38.7%) men and 38 (61.3%) women with a median age of 72.0 years. The male-to-female ratio was 1.5. The median age at disease onset was 67.0 (range, 50-75) years and the median duration of disease was 1.0 (0.5-3.0) years. Of the 62 patients, 35 (56.5%) had a history of smoking and mucosal involvement was found in 27 (43.5%) patients. BP is a disease of the elderly and more common in women than in men. Oral mucosa should be an integral part of the physical examination in BP patients. Pruritus is a significant clinical symptom and eosinophilia is an important laboratory marker in the diagnosis of BP, particularly in patients with difficult diagnosis.
The Feasibility of Domiciliary Non-Invasive Mechanical Ventilation due to Chronic Respiratory Failure in Very Elderly Patients.

OBJECTIVES The aim of this study was to investigate the use of domiciliary non-invasive mechanical ventilation (NIMV) in very elderly patients (age 80 and over). MATERIALS AND METHODS This retrospective study included a total of 44 patients aged 80 years or older, who were admitted to the Health Sciences University, Süreyyapaşa Chest Diseases and Thoracic Surgery Training and Research Hospital, Pulmonary Intensive Care Outpatient Clinic between 2012 and 2018 and applied NIMV for chronic respiratory failure. The patients were divided into two groups: survivors (n=15) and non-survivors (n=29). Data were obtained from the retrospectively formed hospital database. The characteristics of patients, comorbidities, NIMV compliance, pulmonary function tests, and blood gas analyses were compared between the survivors and non-survivors. RESULTS From the retrospective analysis of 44 cases, the non-survivors were found to have a significantly shorter duration of domiciliary NIMV (737 days vs. 890 days, p=0.027) and lower hemoglobin concentration (11.1 g/L vs. 12.9 g/L, p=0.004). The number of comorbid conditions, pulmonary function test, and blood gas analyses results did not differ significantly between the groups. Compliance was moderate in this elderly population, at 4.9±1.9 h/day (range: 0.8-9.1 h/day). NIMV was well-tolerated in 36 of the 44 elderly patients (81.8%). Overall mortality was 65.9%. CONCLUSION Domiciliary NIMV can be of benefit to very elderly patients, and age is not an obstacle. Therefore, this population should not be excluded from this treatment solely on the basis of age.
Empirical Studies of Effects of High Blood Pressure on Medical Costs and Heart Disease: Is the 2017 ACC/AHA Guideline Supported by Enough Evidence?

Background: The American College of Cardiology (ACC), American Heart Association (AHA) and other organizations announced a new hypertension guideline in November 2017. However, previous studies have pointed out that this new guideline might lack sufficient evidence to justify its use. Data and Methods: The effects of blood pressure (BP) on medical costs and on the probability of having heart disease as anamnesis are analyzed. We used a dataset containing 175,123 medical checkups and 6,312,125 receipts from 88,211 individuals obtained from three health insurance societies from April 2013 to March 2016. The dataset was divided into subgroups based on whether the patients had diabetes and took hypertension medications. The power transformation and probit models were used in the study. Results: We observed negative effects of systolic BP (SBP) on medical costs in most subgroups. We could not find evidence that higher SBP made the medical costs and probability of having heart diseases higher. The results raise uncertainty about the reliability of the new guideline, at least for SBP. Conclusion: The results of this study did not support the new 2017 ACC/AHA guideline, at least for SBP. The new guideline must be more carefully reevaluated by additional studies. Limitations: The dataset was observatory, the sample period was only 3 years, and we could not complete a time-series analysis of individuals.
Surgical outcome of scoliosis in Marfan syndrome: a case series report

Scoliosis in marfan syndrome (MFS) manifests on 60% patients. Moreover, the scoliosis noticeable in earlier age is more progressive, refracted, and rigid compared to idiopathic adult scoliosis. The surgical correction provides notorious higher perioperative risk, whereas conservative treatment using brace is not effective to prevent progressivity of the scoliosis. In this a case report, we reported the surgical outcome of MFS scoliais patients with MFS who operated using posterior fusion instrumentation by mean of the quality of life SF-36 questioner. This was a retrospective case series involving five MFS scoliosis patients who underwent posterior fusion instrumentation with initial Cobb angle of 87.417. 57o and initial kyphotic angle of 32.8 ± 14.52o. Clinical, radiological and quality of life of the patients based on SF-36 questionnaire were evaluated within 6-36 months follow up. Post-operative showed the Cobb angle become 46.2 ± 16.3o and the kyphotic angle become 21.6 ± 9.94o. No intraoperative or post-operative complications were observed. After 6-36 months follow up, the Cobb angle became 45.2 ± 17.48o and the kyphotic angle became 21.6 ± 9.94o. In addition, all patients had physical and mental health scored similar to 2 years post-surgery scoliosis scoring according to SF- 36 orthopedic scoring guidelines. I conclusion, the surgical outcome of posterior fusion instrumentation in MFS scoliosis showed good correction of Cobb angle and Kyphotic angle. The quality of life of the patients based on physical and mental health questionnaire is satisfactory.
Nurses Communication Skills Training and Its Effect on Patients’ Satisfaction in Teaching Hospitals of Shiraz University of Medical Sciences

Background and purpose: Communication skill is a key ability and an integral part of the nursing profession. This study aimed to investigate the effect of communication skills training of nurses on patients’ satisfaction with nursing staff in teaching hospitals affiliated to Shiraz University of Medical Sciences.Method: This Cross-sectional study was carried out in 2017. The research population consisted of the patients visiting 13 SUMS-affiliated hospitals, 581 nurses who participated in communication skills training courses, and 2,207 nurses who did not receive this training. From this population, a total of 400 patients were selected through convenience sampling and 50 trained nurses and 50 untrained nurses were chosen randomly. The data collection instruments were the Nurse Quality of Communication with Patient Questionnaire (NQCPQ) and La Monica-Oberst Patient Satisfaction Scale (LOPSS). Data were analyzed in SPSS using T-test, ANOVA, Tukey test, and Pearson correlation coefficient at α = 5%. Results: A significant correlation was found between nursing-patient commination score and patient satisfaction (LOPSS) score (P=0.021, r = 0.647). Patients under the care of trained nurses were also found to be more satisfied with nursing services than those served by untrained nurses (P=0.011, t=2.56). The results showed that patient satisfaction had a significant relationship with age and marital status (p =0.027). Conclusions: The results of the present study showed that the implementation of communication skills training courses for nurses can lead to improved patient satisfaction. Hospital directors were then recommended to hold regular communication skills training courses for their nursing staff.
Desfechos neonatais em cesarianas eletivas em um hospital privado

15 1. INTRODUÇÃO . 17 2. REVISÃO SISTEMÁTICA DA LITERATURA ESTRUTURADA . 20 2.1 Estratégias de busca . 20 2.2 Mapa conceitual . 22 3. REVISÃO DA LITERATURA . 23 3.1 Cesariana no mundo . 23 3.2 Cesariana no Brasil . 26 3.3 Cesariana no sistema de saúde público e privado . 27 3.4 Cesariana Eletiva . 29 3.5 Cesariana por solicitação materna . 31 3.6 Cesariana eletiva e eventos adversos fetais . 39 4. JUSTIFICATIVA . 46 5. HIPÓTESES . 46
Test-Retest Reliability and the Learning Effect on Isokinetic Fatigue in Female Master’s Cyclists

Background: Isokinetic exercise is commonly used as a benchmark for strength and performance. Objective: The purpose of this investigation was to establish isokinetic fatigue test-retest reliability and examine the learning effect when testing without familiarization. Methods: 22 masters-aged [53±5 years), competitive female cyclists completed 3 separate 50-repetition knee flexion/extension tests on a Biodex, separated by one-week with no familiarization. Test-retest reliability [intra-class correlation [ICC]), 95% confidence intervals [CI), technical error of measurement [TEM) were calculated. Results: ICCs between trials exhibited excellent reliability during extension [. 93–. 97) and flexion [. 93–. 97) for all variables except time to peak torque [ICC=. 35 and.45 for extension and flexion, respectively) and fatigue index [ICC=. 47 for flexion). Relative TEM was minimal for extension between trial 1 and trial 2 [0.27%–0.97%) and between trial 2 and trial 3 [0.27%–1.45%) for all variables. Similar results were observed for flexion between trial 1 and trial 2 [0.87%–2.45%) and between trial 2 and trial 3 [0.54%–1.10%). No differences [Wilks Λ>. 05) existed between trials, indicating no learning effect associated with the tests. Conclusions: There was strong test-retest reliability in masters-aged, female athletes and no learning effect was associated with the Biodex during a knee extension/flexion fatigue protocol.
Comparative Study of Anti-Mullerian Hormone, inhibin-B, and Three-Dimensional Ultrasound Determinants of Ovarian Reserve in Patients Undergoing ICSI

Background: Intracytoplasmic sperm injection (ICSI) is an in vitro fertilization procedure in which a single sperm is injected into an oocyte. Objective: Aim of the Work: Comparing three-dimensional ultrasound parameters, with anti-Mullerian hormone (AMH) and other conventional endocrine markers for the prediction of ovarian response in patients undergoing intracytoplasmic sperm injection cycles. Methods: This observational prospective study was conducted at Alexandria Armed Military Hospital, on a sample of 100 women aged between 25 and 35 years, enrolled for intracytoplasmic sperm injection (ICSI). Results: a good correlation between inhibin B and other numerical variables. There was a strong positive correlation between inhibin B and AMH, strong negative correlation between inhibin B and both FSH and LH. Inhibin B correlated moderately negatively with age and moderately positively with AFC, number of collected oocytes. Inhibin B correlated positively with the number of oocytes and number of grade 1 embryos. As regard pregnancy rate, the good-response group had significantly higher chemical and clinical pregnancy rates, as there was no chemical or clinical pregnancy occurred in poor responders. Conclusion: AFC, AMH and Inhibin B are effective in predicting the ovarian reserve as well as the response to induction, and both AFC and AMH are the most significant predictors of response to ovarian stimulation during ICSI. Recommendations: Larger scale studies including higher number of patients are needed to verify the validity of this parameter as a marker of ovarian reserve in patients undergoing ICSI.
Unilateral Fusion of Two Primary Mandibular Teeth: Report of a Portuguese Archeological Case

This paper describes a unilateral fusionof two mandibular teeth in an infant skeleton recoveredfrom the late Roman cemetery of Miroiço (Sintra,Portugal). Morphological and radiographic data wereused for the analysis and interpretation of this dentalanomaly. A brief review of the literature of present dayprimary dental fusion is presented. This report showsthat primary dental fusion was present in Portuguesepast populations, representing a contribution to thehistory of dental anomalies.
The Effect of Low-level Laser Therapy and Calendula Officinalis Linn. On Cutaneous Wound Healing in Rats

Objective: To evaluate the effects of low-level laser therapy and extract of Calendula officinalis Linn. (calendula), alone or in combination, on cutaneous wound healing in rats. Setting: A university research center. Design: A prospective, interventional, randomized, controlled experimental study. Forty-eight female Wistar rats, aged 3 to 4 months, were divided into 4 groups of 12 animals each. A skin wound was surgically made in the dorsal region of each animal and treated for 21 days with either low-level laser therapy (laser group), calendula extract gel (calendula group), laser therapy combined with calendula extract gel (laser + calendula group) or received no treatment (control group). Data collection was performed immediately after surgery and on postoperative days 3, 6, 9, 12, 15, 18 and 21. Main Outcome Measures: Measurement of the wound area was performed by tracing the contour of the wound on a sterile polypropylene film placed over the wound. The drawing was transferred to the Auto Cad software to determine the size of the wound area. Results: No significant differences in wound area size were found among groups up to the postoperative day 6. After 9 days of treatment, the laser group showed a significantly greater reduction in wound area compared to the other groups. Conclusion: Laser therapy alone contributed more to wound healing in rats than the treatment with calendula extract gel alone or combined with laser therapy.
Analysis of the Reconnaissance Project. Phase 2: The Individual

The essential units for testing hypotheses about the influences of ageing and urbanization in the CRONOS (Cross-Cultural Research on the Nutrition of Older Subjects) process are the responses to the questions on the questionnaire and the physical measurements of individuals, aggregated into distributions by age, sex, geography, and their combinations. In the Reconnaissance experience, the number of subjects per country (about 24) was insufficient to provide meaningful group or subgroup averages. However, the process allowed the investigators to get a sense of which measurements were consistent across countries and which were aberrant in some sites. In general, despite the lack of inter-site standardization, most of the items in the protocol seem to have been measured with acceptable consistency and accuracy across geographic areas. Problem areas identified were in the measurement of arm span, the determination of arterial blood pressure, and the accuracy of 24-hour recall methods for total energy and nutrient intakes.
Preventive antibiotic therapy in acute stroke

Stroke is the second most common cause of death and the third most common cause of disability worldwide. Infections complicate stroke in about one-third of patients and they are associated with unfavourable disease outcome and mortality. This thesis is focused on the ‘Preventive Antibiotics in Stroke Study’ (PASS), a multicenter randomised clinical trial aimed at prevention of infections with antibiotic therapy to improve functional outcome in stroke patients. 2550 stroke patients were randomised to ceftriaxone in addition to standard therapy, or standard therapy alone. Preventive antibiotic therapy did not improve functional outcome at 3 months. It did prevent infections, but this was merely due to prevention of urinary tract infection, pneumonia was not prevented. We also described the cost-effectiveness analysis of the PASS in this thesis. This showed that preventive antibiotic therapy was likely to be a cost-effective treatment, although the possible costs of future antimicrobial resistance were not included in this analysis. Patients are vulnerable for infection after stroke due to immune suppression, partly mediated by the sympathetic nervous system. We also investigated whether pre-stroke use of beta-blockers could decrease infection rate, but found that infection rates were increased in patients with pre-stroke beta-blocker use. Finally, we describe a prediction rule for pneumonia and infection after stroke. This prediction rule can be used to select the patients at the highest risk for these infections for future trials. Future trials should be focused on diagnosis of post-stroke infection and combined treatment approaches for fever, infection and aspiration.
Preliminary characterisation of the neuropeptide melanin concentrating hormone in humans

Melanin concentrating hormone (MCH) is an orexigenic neuropeptide expressed centrally in the zona incerta and lateral hypothalamus. Evidence from rodent studies implicates hypothalamic MCH in the modulation of varied and diverse physiological functions most notably in energy homeostasis but also emerging as a candidate mediator in reproductive activities. These two aspects of normal physiology are intimately related though the pathways through which they integrate are only just being explored. Currently little is known about the actions, sources or targets of peripheral or circulating MCH. This study is the first to describe normal physiological concentrations of circulating MCH in humans. Particular emphasis has been devoted to aspects which might further understanding of the dual roles of circulating MCH in energy balance and reproductive function. A primary objective was to develop and validate a tool with which to quantifiably measure circulating MCH concentrations since previous work in this area has failed to reconcile this objective. Following the successful validation of a radioimmunoassay (RIA), three studies were undertaken with human subjects drawn from 3 distinct sample populations. The chief objectives were 1) to detect changes in circulating MCH post-prandial in association with other metabolic markers of energy homeostasis; 2) to determine associations between circulating MCH concentrations and resting metabolic rate (RMR); and 3) to detect changes in circulating MCH concentrations during the menstrual cycle. The results indicate that circulating MCH concentrations may be involved in glucose homeostasis since there were associations between the post-prandial MCH and the post-prandial insulin response. Circulating MCH may also convey information regarding the nutritional status of the individual, though this appears to be influenced by a combination of gender and adiposity status. Circulating MCH concentrations remained stable over the course of the menstrual cycle and were not strongly aligned to RMR. Whilst there were emergent patterns and trends there were also inconsistencies between the sample populations. This initial characterisation may be constructive for future exploration of the physiological relevance of circulating MCH in humans.