Miracle-dz/UniFAR-FTUs huggingface dataset:
P01 UDCA response criteria identify a sub-group of PBC patients with an inherently good prognosis rather than a specific disease response

Introduction Recent follow-up cohort studies have identified biochemical parameters in UDCA-treated patients which identify “responders” with survival identical to normal control populations, in contrast to “non-responders” who have survival indistinguishable from that predicted by the Mayo Risk Score for untreated patients. The most widely accepted criteria for UDCA “response”, proposed by Corpechot, consist of alkaline phosphatase (ALP) <3× uln, alanine transaminase (ALT) <2× uln and bilirubin <1× uln. However, Bilirubin and ALP levels are independent predictors of outcome in PBC irrespective of UDCA treatment. ALT, in addition, is a biomarker for overlap syndrome, a prognostic feature itself. Aim UDCA response criteria identify a group of patients with an inherently low risk rather than UDCA response per se. Method In a comprehensive cohort of patients, geographically defined in 1999 followed up for 10 years, a group of patients (n=94) not treated with UDCA were identified. This cohort, matched prospectively to individual community case controls, represents an opportunity to study the natural history of non-UDCA treated PBC. Results In the whole cohort (including UDCA treated patients), survival was significantly better in the UDCA-responding patients (defined using the Corpechot criteria) than in the non-UDCA-treated patients (p<0.05 log-rank test) although as in other studies survival was not the same as in age and sex match controls (p<0.05). Of the 94 non-UDCA receiving patients, 80 and 14 had, after 1 year of follow-up, biological features which, if they had received UDCA, would have been compatible with UDCA-response and UDCA-non response, respectively. Un-transplanted survival was significantly better in the non-UDCA patients meeting response criteria (58/80 (72%) at 10 years follow-up) than in non-UDCA treated patients meeting non-response criteria (5/14 (36%), p=0.01; χ2 9.4, p<0.01 log-rank test). The magnitude of this effect was similar to that associated with UDCA response in other series. The absence of UDCA treatment precludes, of course, this being a phenomenon of actual UDCA response. Conclusion UDCA response criteria identify a group of patients who, at the time of criterion measurement, have a good prognosis. It does not appear to matter whether attainment of these parameters is a natural feature of untreated disease or a consequence of treatment. These criteria therefore have an important role in identifying high and low risk patients, and a sub-group of PBC patients with poor prognosis for whom additional therapies should be sought. They do not, however, provide specific information about the actions of UDCA.
Early repolarization in the inferolateral leads of the electrocardiogram : prevalence, prognosis and characteristics

“Early repolarization” (ER), consisting of J waves and ST-segment elevation in the standard 12lead electrocardiogram (ECG), has been considered a benign finding for over 60 years until 2008 an over-presentation of ER ECG pattern in infero-lateral leads was described in patients with idiopathic ventricular fibrillation. The purpose of this thesis was to assess the prevalence and prognostic significance, and to characterize the clinical features of this ECG pattern primarily in the general population. This thesis investigated the electrocardiographic features of a total of 20,308 general population individuals, 565 athletes, 432 victims of sudden cardiac death and 532 survivors of an acute coronary event. The overall prevalence of infero-lateral ER ECG pattern in the general population samples was in range between 3.3 and 6.1 percent. ER seemed to have a heritable basis as siblings of individuals displaying the ER pattern had significantly increased odds for presenting this ECG pattern. Several strong associations between ER pattern and clinical factors were observed in all populations. The ER patterns with horizontal or descending ST-segments were associated with significantly increased arrhythmic mortality during a follow-up of 30±11 years, and high amplitude (>0.2mV) J waves in the inferior leads were associated with a high risk of arrhythmic death (multivariate adjusted hazard ratio 3.13 (95% confidence interval 1.55 to 6.32). The ER ECG pattern was also independently associated with sudden cardiac death during an acute coronary event, with an odds ratio of 2.02 (95% CI 1.04 to 3.61) for suffering sudden death. The ER patterns with rapidly ascending ST-segments, the dominant type of ER ECG in young, healthy individuals, were not associated with any adverse outcomes. A multicentre meta-analysis of genome wide association study of ER ECG pattern performed in a total of 14,633 individuals pointed to an associated locus in KCND3 (Kv4.3) gene, which encodes a subunit of the Ito channel, but the association did not reach genome-wide significance and could not be replicated in all study populations. In conclusion, the results of these studies demonstrated that the ER ECG pattern with horizontal or descending ST-segments, especially in the inferior leads, is associated with an increased risk of sudden arrhythmic death in the general population, and that individuals carrying this ECG pattern are at increased risk of suffering fatal arrhythmia during an acute coronary event. The ER pattern with rapidly ascending ST-segments is common in young healthy athletes and is not associated with any increased risk of fatal events. Although the ER ECG pattern increases the relative risk of arrhythmic events, the absolute risk in an individual is low and therefore this ECG pattern should not be interpreted as a high-risk marker of mortality. The genetic background of this ECG pattern remains to be clarified.
Role of dexamethazone on cervical ripening and induction of labor in term pregnancy

Background: labor induction between 41 and 42 weeks of gestation reduce the adverse perinatal risks. Aim of work : to determine the effect of intravenous dexamethazone administration on preparing the cervix and duration of labor induction in term pregnancy. Patients and Methods: this randomized Case control study on 52 women who were primparous, with a gestational age (40- 42)weeks and had Bishop Score 4 or less, who were admitted to obstetrics and gynecology department, zagazig university hospital during period from (April 2018 – April 2019) for the termination of their pregnancy. 6 hours before induction, experimental group (26 participants) was given 8mg intravenous dexamethasone while control group (26 participants) was given 2 ml saline intravenously. Six hours after the injection, the Bishop Score of participant was measured, and labor induction done by using oxytocin. Interval between induction initiation and starting of the active labor phase, duration of first and second stage of labor and the neonatal outcome of two groups were compared. Results: Bishop Score statistically differ between the studied groups after 6 hours of dexamethasone injection (5.88±1.18, vs. 5.19±0.85 respectively). The interval between induction initiation and beginning of active labor phase was shorter in the dexamethasone group compared to control group (90±26.3 minutes vs. 112.88±48.87 minutes). Dexamethasone group has shorter duration of first stage and second stage of labor than control group. Conclusions: The administration of dexamethasone can play a role in cervical ripening and progress of labor.
Analysis of HLA in Patients with Obstructive Sleep Apnea Syndrome

Background : Obstructive sleep apnea syndrome (OSAS) is believed to have multifactorial causes. The major risk factors for OSAS are obesity, narrowed upper airways, and abnormal cranial-facial structures. A genetic basis for OSAS has been also suggested by reports of families with many members affected. This study analyzed the HLA typing in patients with OSAS to determine the possible role of genetics in OSAS. Methods : Twenty-five Korean patients with OSAS (1 woman and 24 men; age range 30-66 years) were enrolled in this study. A diagnosis of OSAS was made using full-night polysomnography. The control group consisted of 200 healthy Korean people. Serologic typing of the HLA-A and B alleles was performed in all patients using a standard lymphocyte microcytotoxicity test. Analysis of the polymorphic second exons of the HLA-DRB1 gene was performed using a polymerase chain reaction-sequence specific oligonucleotide probe. Results : The allele frequency of HLA-A11 was significantly lower in patients with OSAS compared with the controls (p45) than in the controls (p
The Effects of Maternal Anemia in Pregnant Women with Respect to the Newborn Weight and the Placental Weight in the Delivery Room

Ad dress for Cor res pon den ce Nurdan Tekgül MD, University of Health Sciences, Tepecik Training and Research Hospital, Clinic of Family Medicine, İzmir, Turkey Phone: +90 532 540 20 25 E-mail: nurdantekgul1@hotmail.com ORCID: orcid.org/0000-0001-7495-1798 Re cei ved: 18.09. 2019 Ac cep ted: 26.09. 2019 1 University of Health Sciences, Tepecik Training and Research Hospital, Clinic of Family Medicine, İzmir, Turkey 2University of Health Sciences, Tepecik Training and Research Hospital, Clinic of Obstetrics and Gynecology, İzmir, Turkey Nurdan Tekgül1, Mustafa Yamazhan2
Effect of Adding Dexamethasone or Magnesium Sulphate as an Adjuvant to Bupivacaine in Ultrasound Guided Supraclavicular Brachial Plexus Block for Upper Limb Surgeries; A Comparative Study

Background: Supraclavicular brachial plexus block is a popular and widely employed regional nerve block technique for perioperative anesthesia and analgesia for surgery of the upper extremity. Coadminstration of local anaesthetics and several adjuvants is now a good way to hasten the onset of the block and to increase its duration. The aim of the current study was to evaluate the effects of dexamethasone and magnesium sulfate as additives to bupivacaine in supraclavicular brachial plexus block. Patients and Methods : A Prospective randomized controlled comparative clinical study was conducted on 36 healthy patients of ASA grade I, II of age group 21-60 years scheduled for upper limb surgeries under supraclavicular brachial plexus block. Patients were allocated to three groups of 12 each as a control group (C) received 20 ml 0.5% bupivacaine, group (D) received 18 ml bupivacaine 0.5% + 2 ml (8mg) dexamethasone, group (M) received 18 ml bupivacaine 0.5% + 2 ml (200 mg) magnesium sulfate. Parameters observed were onset and duration of sensory and motor blocks and Timing and total amount of rescue analgesia. hemodynamics and complications were also recorded. Results : D group significantly shorter regard onset of sensory and motor blocks followed by M group then Control Group. Also, D group significantly longer regard duration of sensory and motor blocks and time of first analgesia followed by M group then Control Group. Total rescue analgesia and Number of Rescue Analgesia were significantly lower in group D followed by M group then Control Group. Conclusion : Addition of Dexamethasone or Magnesium sulphate to Bupivacaine 0.5 % for supraclavicular brachial plexus block fastened the onset of sensory and motor blocks and prolonged the duration of sensory and motor blocks, with Dexamethasone showed better results.
Factors Affecting the Number of Medical Faculty Members Required in Iranian Medical Sciences Universities: An Exploratory Factor Analysis

Background: Because of an increased demand for clinical faculty members in medical departments and no comprehensive model, identifying the affecting factors could be effective in planning in this area. So in this study we aimed to identify the key variables (and their weight) influencing the number of medical faculty members required in Iranian medical sciences universities. Methods: This study was an applied analytical descriptive one. It was a cross-sectional survey and done in Iran using the exploratory factor analysis. The main data collection instrument was a questionnaire and SPSS software version 20 was used for statistical analysis. We used expert opinions to assess the questionnaire’s validity and Cronbach’s coefficient alpha to confirm its reliability. The statistical population consisted of faculty members and directors of medical departments of Iranian medical sciences universities and experts of medical education. The sample size was determined to be 320. Results: Exploratory factor analysis indicated that in an optimal system, nine factors (consisted of 40 variables) titled “research/scholarship services” (14.3%) ,“specialty training” (12.9%), “clinical services” (9.5%), “features of faculty members” (7.5%), “undergraduate training” (6.8%), “university development level” (6.1%), “other characteristics of the university or the region” (5.1%), “desertion rate among faculty members” (4.5%), and “the nature and scope of the specialty” (2.9%) could explain 69.623% of total variance of the rrequired number for medical faculty members. Conclusion: Some of the factors like the volume of “research services” and “undergraduate training” should be considered in estimating the staffing requirements of medical faculty members. Keywords: FACULTY, MEDICAL, REQUIRED WORKFORCE, IRAN, FACTOR ANALYSIS
Effectiveness of an empowerment-based educational program in self-efficacy perception in patients with diabetes

Background: Studies suggest that empowerment-based educational models, implemented in patients with diabetes, may encourage the improvement of perceived self-efficacy. This variable is considered relevant in the therapeutic regimen self-management. Objectives: To evaluate the effectiveness of an empowerment-based educational program in patients with type 2 dia- betes mellitus. Methodology: A quasi-experimental study, with two different evaluation moments, with a 6-week interval. A random- ized sample of 42 participants (experimental group = 19; control group = 23), registered in a family health unit of the ARS of Central Portugal. The Diabetes Empowerment Scale - Short Form (DES-SF) was the instrument chosen to determine the program’s effectiveness. All formal and ethical procedures were assured. Results: Patients subjected to the empowerment-based educational program presented a higher self-efficacy perception ( p = 0.000) than those who followed the regular surveillance protocol. Conclusion: Empowerment-based educational programs seem to contribute to an improvement in perceived self-efficacy and should, therefore, be used as an educational strategy for patients with type 2 diabetes mellitus.
Evaluation of the sole morphology of professional football players : original research article

Background: Footprint analysis is one of the methods that can be used to diagnose foot pathologies. Football is usually seen as a team sport whereby players attempt to move the ball, primarily with the action of the foot to an opponent's goal area to score. Players have a high risk of injury in this sport. Research question: The aim of this study is to evaluate the sole morphology of professional football players. Type of study: Cross-sectional study. Methods: One hundred and ten professional Turkish football players and healthy volunteers participated in the study. Footprint images of both feet were obtained by means of a specially designed scanner system. By means of this system images of the right and left static weight-bearing footprints were acquired, firstly with 50% of the body weight on each foot and then with 90% of the body weight (standing straight, single-limb, weight-bearing stance) were obtained. Measurements were performed using the AutoCAD 2004 software. Results: Arch angle, Chippaux-Smirak, Staheli, arch length, arch, footprint, truncated arch were calculated for both left and right feet. In the 50% weight-bearing stance of the right foot, the arch angle and Chippaux-Smirak, Staheli, footprint, and truncated arch indices were significantly higher in the professional football players than in the controls. For the left foot, only the arch angle and Staheli index were significantly higher in the professional football players compared with the controls. In the 90% weight-bearing stance of the right foot, the arch angle and truncated arch index were significantly higher in the professional football players than in the controls. For the left foot, the arch angle, and the arch length, footprint, and truncated arch indices were significantly higher in the football players compared with the non-athlete controls. Conclusion: Foot morphology of football players may assist in the design of the best football boots for the sport.
Physiological study for some blood parameters in children with major B-Thalassemia in Al- Najaf governorate / Iraq.

β-Thalassemia is more an inherted anemia publicity that common in the world and especially in Mediterranean region,and the most important cause of mortality in patients with β –thalassemia . The present study carried out on ( 75 ) children of males and females thier age from (1-12 ) years with Bthalassemia in AlNajaf ,there were (60%)child of them infected with Bthalassemia major , who consult the thalassemia center for teaching AlZahra Hospital for birth and children in Najaf governorate, while ( 15 ) healthy child used as a control group.The results presnt study showed that a significant decrease ( p < 0.05 ) in number of red blood cells and the concentration of heamoglobin and packed cell volume ( PCV ) and the values of the mean corpuscular volume ( MCV ) and the number of blood platelets in the blood of infected children with βthalassemia major compared with healthy children, while the results showed a significant increase ( P < 0.05 ) in the total number of white blood cells in children infected with the disease compared with the control group, as the current research distincted that the ratio of males infected with βthalassemia higher than the ratio of females ( % 68. 33 , % 31.67 respectively ) , also children had blood group ( A ) were the most susceptible to the infection with β-thalassemia ( 38.33 % ) compared with the other blood groups , as the infected children who carry the factor rhesus positive ( Rh + ) were ( % 65 ) higher than the patients with rhesus factor negative ( Rh ) (35 %).
Subsegmental Pulmonary Embolism Diagnosed by Computed Tomography: Incidence and Clinical Implications. A Systematic Review and Meta-Analysis of the Management Outcome Studies.

Abstract 4002 Poster Board III-938 Background Multiple-detectors CTPA appears to have a higher sensitivity for PE as compared to single-detector CTPA. In particular, multiple-detectors CTPA allows better visualization of segmental and subsegmental pulmonary arteries, hence the proportion of patients with suspected PE in whom isolated subsegmental thrombus are reported might be higher using multiple-detectors CTPA. The clinical significance of subsegmental PE is unknown. In the PIOPED study, PE limited to subsegmental pulmonary arteries were most prevalent among patients with low-probability ventilation/perfusion (V/Q) scans. Patients with non diagnostic (low or intermediate probability) V/Q scans can be safely managed without anticoagulation. Nonetheless, patients with isolated subsegmental PE detected on CTPA are more commonly receiving anticoagulation than not. Purpose To determine whether multiple-detectors CTPA increases the proportion of PE diagnosis limited to subsegmental arteries and to assess the safety of diagnostic strategies based on CTPA. Data Source: A systematic literature search strategy was conducted using MEDLINE, EMBASE, the Cochrane Register of Controlled Trials and all EBM Reviews. Study Selection Twenty four articles met all the inclusions criteria (21 prospective cohort studies; 3 randomized controlled trials). Data extraction Two reviewers independently extracted data onto standardized forms. Data Synthesis A total of 2674 patients with suspected PE were included in the analyses. Of these, 1140 and 1534 patients underwent a single and multiple-detectors CTPA respectively. Conclusion The use of multiple-detectors CTPA in diagnostic strategies for PE appears to increase the proportion of patients diagnosed with subsegmental PE with comparable outcomes in patients with negative tests. This suggests that patients with subsegmental PE appear to not require anticoagulation. Disclosures: Rodger:Biomerieux: Research Funding; Boehringer Ingelheim: Equity Ownership, Membership on an entity9s Board of Directors or advisory committees; Pfizer: Research Funding; Leo Pharma: Research Funding; Bayer: Research Funding; GTC Therapeutics: Research Funding.
Health education effects on nutritional behavior modification in primary school students

چکیده: زمینه و هدف: تغذیه ناسالم در بروز بیماری‌هایی مانند بیماری قلبی و عروقی، سکته، انواع سرطان ها، دیابت، ناراحتی های گوارشی، انواع بیماری های استخوانی و مفاصل تأثیر به سزایی دارد. از آنجایی که ریشه اغلب رفتارهای غلط بهداشتی به تجارب دوران کودکی بر می گردد لذا پژوهش حاضر با هدف بررسی تأثیر آموزش بهداشت بر تغییر آگاهی و رفتارهای تغذیه ای دانش آموزان ابتدایی انجام گرفت. روش بررسی: پژوهش حاضر یک مطالعه نیمه تجربی (Quasi experimental) است که میزان آگاهی و عملکرد تغذیه ای دانش آموزان با استفاده از پرسشنامه سه قسمتی (مشخصات دموگرافیک، آگاهی و عملکرد) و چک لیست مشاهده مستقیم مورد بررسی و مقایسه قرار گرفت. تعداد 89 نفر از دانش آموزان پایه پنجم ابتدایی در سال 1384 در شهرستان قزوین به روش نمونه گیری خوشه ای برای شرکت در پژوهش در گروه مورد و 87 نفر نیز جهت گروه شاهد انتخاب شدند. پس از اجرای برنامه آموزش بهداشت برای گروه مورد که به دو روش مستقیم (حضوری و چهره به چهره همراه با پرسش و پاسخ) و غیر مستقیم (با استفاده از جزوه و سایر مواد آموزشی) و با توجه به نیازسنجی اولیه طراحی شده بود، میزان تأثیر آموزش بر آگاهی و عملکرد دانش آموزان مورد سنجش قرار گرفت. یافته ها: یافته های تحقیق نشان داد آگاهی دانش آموزان از 21/6±61/23 به 96/4±62/30 و عملکرد تغذیه ای آنها از 08/7±19/13 به 63/6±98/19 افزایش یافت (001/0p
Young Breast Cancer Survivors’ Experiences of Uncertainty

Evidence indicates recent increases in breast cancer diagnoses among young women. Research also suggests that younger women diagnosed with breast cancer may experience more psychological distress than older women. In-depth interviews with 25 breast cancer survivors age 40 and under were conducted to explore the uncertainties young women face throughout survivorship. Results indicate that young women experience unique sources of uncertainty and that communication may facilitate or hinder the management of uncertainty across the survivorship trajectory. Implications of these findings for theorizing on uncertainty, healthcare providers’ interactions with young women, and social networks’ communication with survivors are discussed. These data also have important implications for the practical treatment of young breast cancer survivors and applied, communicative recommendations for providers are proposed.