Miracle-dz/UniFAR-FTUs huggingface dataset:
Cardiac Valve Operations

To evaluate intraoperative changes in myocardial performance during valvular operations, ventricular functional measurements were obtained in 16 patients before and after elective cardiac valvular replacement. Six patients had mitral regurgitation, four had mitral stenosis, and six had calcific aortic stenosis; all patients underwent isolated mitral or aortic valve replacement. Cold potassium crystalloid cardioplegia, topical hypothermia, and low-flow systemic hypothermia were employed uniformly. Just before and 10 minutes after cardiopulmonary bypass was discontinued, left ventricular pressure and volume data were recorded at four to five different steady-state levels of filling produced by blood infusion or withdrawal from the aortic cannula (mean end-diastolic pressure range, 10-22 mm Hg; mean end-diastolic volume range, 120-168 ml). Portable first-pass radionuclide ventriculography and simultaneous micromanometry were used for construction of left ventricular pressure-volume loops from which stroke work and end-diastolic volume were calculated. Two-dimensional transesophageal echocardiograms also were recorded, and epicardial pacing maintained heart rate as constant
Revised Starling equation predicts pulmonary edema formation during fluid loading in the critically ill with presumed hypovolemia

2741 should include 4,164 patients to show a significant difference in intensive care unit mortality. Additional knowledge concerning reactivation based on CMV DNA polymerase chain reaction would reduce the number of patients needed to show an adequately powered significant outcome difference. Cook and Limaye suggested us to analyze the elevation in anti-CMV immunoglobulin G rather than comparing patients with positive to patients with negative titers. We deliberately chose not to use titers because of a lack of specificity, as stated by Cook and Trgovcich (3). We agree that identifying high-risk patients using clinical and demographic parameters will be difficult. However, we think that an additional prospective study investigating risk factors for reactivation based on CMV DNA polymerase chain reaction would be useful. Identifying patients at risk for reactivation would limit the number of patients unnecessarily exposed to the myelotoxic effects of ganciclovir. Cook and Limaye stated that an interventional study is justified as long as there is a careful safety monitoring and adequate statistical power. Previous studies in mice infected with murine CMV show that reactivation is importantly reduced when administering ganciclovir. Histologic examination showed a reduced pulmonary fibrosis (4). The study funded by the National Heart, Lung, and Blood Institute (NCT01335932) is limited to patients intubated for acute lung injury and has the surrogate markers serum interleukin-6 level and its change between baseline and 14 days postrandomization as primary end points. Prophylaxis using ganciclovir or valganciclovir vs. placebo will be compared in 160 patients. This study is limited to a selected patient population more likely to benefit and is exploratory because surrogate markers are the primary end point. We look forward to the results of this study. The authors have not disclosed any potential conflicts of interest.
Saphenous Vein Graft Patency 1 Year After Coronary Artery Bypass Surgery and Effects of Antiplatelet Therapy

To determine whether antiplatelet therapies improve saphenous vein graft patency after coronary artery bypass grafting, we compared 1) aspirin (325 mg once daily), 2) aspirin (325 mg three times daily), 3) aspirin and dipyridamole (325 mg and 75 mg, respectively, three times daily), 4) sulfinpyrazone (267 mg three times daily), and 5) placebo (three times daily). Therapy with dipyridamole and sulfinpyrazone was started 48 hours before bypass graft surgery, and aspirin treatment was begun 12 hours before surgery as a single 325-mg dose. Postoperative treatment was started 6 hours after surgery and continued for 1 year. Graft patency data were obtained early (median, 9 days) and late (median, 367 days) after surgery. The early graft occlusion rate was decreased with all aspirin treatment regimens compared with that of the placebo regimen. At 1 year, in 406 patients with 1,315 grafts, the graft occlusion rate in all of the aspirin groups combined was 15.8% compared with 22.6% for the placebo group (p=0.029). The patients taking aspirin once daily had a lower occlusion rate (13.2%) compared with the patients receiving placebo (p=0.050). At 1 year, in the vein grafts placed to vessels less than or equal to 2.0 mm in diameter (804 distal sites), the graft occlusion rate in all of the aspirin groups was 20.1% compared with 32.3% for the placebo group (p=0.008). In the vein grafts placed to vessels greater than 2.0 mm in diameter (511 distal sites), there was no diference in the occlusion rates between aspirin and the placebo group at 1 year (8.7% vs. 9.0%30, p=0.918). For all grafts shown to be patent in the early study (353 patients with 1,043 grafts), there was no difference in occlusion rates at 1 year when aspirin groups were compared with the placebo group (8.7% vs. 9.4%, p=0.763). Thus, graft patency is improved at 1 year after bypass graft surgery by aspirin, and the major benefit occurred in vein grafts placed to smaller vessels. Our data indicate that if a vein graft is patent early after coronary artery bypass graft surgery, aspirin might not improve the chance that the vein graft will remain open at 1 year. (Circulation 1989;80:1190-1197)
A meta-analysis

Aim: To evaluate the efficacy and safety of trabeculectomy (Trab) with mitomycin-C (MMC) versus Trab with implant. Methods:Studies published in different languages were retrieved by systematically searching Embase, PubMed, Cochrane library, China Biology Medicine disc, and Google Scholar from 1966 to April 2018, as well as manually examining the references of the original articles. The outcome measures of efficacy covered intraocular pressure, glaucoma medications reductions, and success rate. Safety evaluation was measured by relative ratio of complications. Results:A total of 11 studies involving 443 participants were covered in this meta-analysis. The weightedmean difference (WMD) in the percentage of intraocular pressure (IOP) reduction (IOPR%) comparing Ologen group with MMC group was 3.69 (95% CI: 6.70 to 0.68) at 1 month, 2.69 ( 5.17 to 0.21) at 3 months, 3.67 ( 6.09 to 1.25)at 6 months, 3.24 ( 6.08 to 0.41) at 12 months, 1.24 ( 9.43 to 11.90) at 24 months, and 1.10 ( 10.11 to 12.31) at 60 months, which showed that there was statistically significant difference at 1,3, 6, and12 months after the surgery. A significantly higher incidence of postsurgery hypotony (0.64 (95% Cl: 0.42 to 0.98)) and suture lysis (0.30 (95% CI: 0.10–0.93)) was observed in MMC group. However, there was no significant difference in the reduction in glaucoma medications, success rate, and incidence of other complications. Trab with 0.2mg/mL MMC presented higher rates of complete success compared with Trab with 0.4mg/mL MMC (P= .01). Conclusion: Trab with MMC was associated with a higher IOP-lowering efficacy and a higher incidence of postsurgery hypotony and suture lysis in contrast to that of Trab with Ologen. Abbreviations: IOP =intraocular pressure, IOPR = IOP reduction, MMC = mitomycin C, Trab = Trabeculectomy.
Integrated Approach to Stroke Care

Abstract—We describe the development, implementation, and outcomes of the first 2 years of the Electronic Stroke CarePath, an initiative developed for management of ischemic stroke patients in an effort to improve efficiency and quality of care for patients. The CarePath consists of care pathways for ischemic stroke that are integrated within the electronic health record. Patient-reported outcomes are collected using an external software platform. Documentation tools, order sets, and clinical decision support were designed to improve efficiency, optimize process measure adherence, and produce clinical data as a byproduct of care that are available for future analyses. Inpatient mortality and length of stay were compared before and after CarePath implementation in ischemic stroke patients after adjustment for case-mix. Postdischarge functional outcomes of patients with ischemic stroke were compared between the first 3 months of rollout and remainder of the study period. From January 2011 to December 2012, there were 1106 patients with ischemic stroke on the CarePath. There was a decline in inpatient mortality in patients with ischemic stroke, but not in control patients with intracerebral or subarachnoid hemorrhage. Completion rate of patient-reported questionnaires at postdischarge stroke follow-up was 72.9%. There was a trend toward improved functional outcomes at follow-up with CarePath implementation. Implementation of the Electronic Stroke CarePath is feasible and may be associated with a benefit in multiple different outcomes after ischemic stroke. This approach may be an important strategy for optimizing stroke care in the future. (Circ Cardiovasc Qual Outcomes. 2015;8:S179-S189. DOI: 10.1161/CIRCOUTCOMES.115.001808.)
Weighing in : an analysis of the NASW's web-based content regarding theoretical issues and practice recommendations for social workers working with overweight and obese individuals

This exploratory study was undertaken to determine the model(s) by which the National Association of Social Workers (NASW) understands issues related to overweight and obesity as represented by their published web content. Since two-thirds of the American population is categorized as overweight or obese, it is important that the NASW address social workers' roles in working with these individuals. As one of the public faces of the organization, the NASW website is an ideal forum for communicating an overarching model that represents the NASW's understanding of issues related to working with overweight or obese individuals as well as propose recommendations for best practices in both clinical and social justice work. Nineteen published web articles that discussed issues of overweight and obesity were retrieved from the NASW's website and analyzed. In total, 278 article segments were identified for analysis and were then coded by themes and sub-themes. Based on this analysis of their web content, it appears that the NASW has chosen to frame issues of overweight and obesity primarily as medical issues. The NASW web content also recommends a broad range of roles for social workers in working with overweight individuals. Unfortunately, the NASW's web content does not substantively address issues of prejudice and discrimination against those who are overweight or obese and does not recommend methods for social workers to address these important social justice issues. Since articles on the NASW website represent the organization's public face, it is important that the NASW "weigh in" regarding social justice work for this population. WEIGHING IN: AN ANALYSIS OF THE NASW'S WEB-BASED CONTENT REGARDING THEORETICAL ISSUES AND PRACTICE RECOMMENDATIONS FOR SOCIAL WORKERS WORKING WITH OVERWEIGHT AND OBESE INDIVIDUALS A project based upon an independent investigation, submitted in partial fulfillment of the requirements for the degree of Master of Social Work. M. Elizabeth Kanard Smith College School for Social Work Northampton, MA 01063
Left Ventricular Volume Measurement by Conductance Catheter in Intact Dogs

The conductance catheter is a promising new instrument for continuously measuring left ventricular (LV) volume. Absolute LV volume (V[t]) is related to uncorrected conductance volume, B(t), according to the equation: V(t)=(1/a)(B(t)-aVe). The aV, factor represents parallel-conductance volume due to conducting material outside the LV blood pool, and may be estimated by transiently changing blood conductivity using a bolus injection of hypertonic saline.
The Systemic Inflammatory Response Syndrome in Patients With ST-Segment Elevation Myocardial Infarction*

Objectives:To assess whether systemic inflammatory response syndrome is associated with morbidity and mortality in ST-elevation myocardial infarction. Design and Setting:Secondary analysis of multicenter randomized controlled trials. Patients:Complement and reduction of infarct size after angioplasty or lytics project patients (n = 1,903) with ST-elevation myocardial infarction undergoing fibrinolysis or mechanical reperfusion. Interventions:None Measurements and Main Results:The prevalence of systemic inflammatory response syndrome was described in the 1,186 patients (64.4%) with data available for all systemic inflammatory response syndrome criteria. Using multiple imputations for the 1,843 patients (96.8%) with available endpoints, we compared the 90-day prevalence of death, shock, heart failure, or stroke between patients with and without systemic inflammatory response syndrome at presentation and at 24 hours post admission. Systemic inflammatory response syndrome was defined as ≥ 2 of 1) heart rate > 90 beats/min, 2) respiratory rate > 20 breaths/min, 3) body temperature > 38 or < 36°C, or 4) leukocyte count > 12 or < 4 × 109/L. At presentation, 25.0% of patients met systemic inflammatory response syndrome criteria; at 24 hours, 8.1% of patients met systemic inflammatory response syndrome criteria. The primary outcome was more frequent among patients with systemic inflammatory response syndrome at presentation (31.0% vs 16.7%; adjusted hazard ratio, 1.78 [95% CI, 1.35–2.34]; p < 0.001) and at 24 hours (36.7% vs 11.1%; adjusted hazard ratio, 2.84 [95% CI, 2.03–3.97]; p < 0.001). Mortality at 90 days was also higher among patients with systemic inflammatory response syndrome at either time point. Each additional systemic inflammatory response syndrome criterion was independently associated with 90-day outcomes at the time of presentation (adjusted hazard ratio, 1.41 per systemic inflammatory response syndrome criteria [95% CI, 1.24–1.61]; p < 0.001) and at 24 hours (adjusted hazard ratio, 1.72 per systemic inflammatory response syndrome criteria [95% CI, 1.47–2.01]; p < 0.001). Conclusion:The diagnosis of systemic inflammatory response syndrome and the cumulative number of systemic inflammatory response syndrome criteria were independently associated with 90-day clinical outcomes in a population of patients with ST-elevation myocardial infarction. The independent association of this simple composite measure of the inflammatory response with outcomes underscores the importance of the clinical inflammatory response in ST-elevation myocardial infarction.
Endocavitary Ventricular Tachycardia

Radiofrequency ablation is now a cornerstone in the management of ventricular tachycardia (VT). VT ablation plays a palliative role in decreasing shocks and improving the quality of life in patients with structural heart disease and is often curative in treating VT in patients with normal hearts.1,2 When compared with other types of ablation, however, VT procedures have lower success rates, have a propensity for complications, and are technically challenging. A recognized cause for difficulty is the need to address the 3-dimensional pathological substrate (endocardial, midmyocardial, epicardial). At present, combined endocardial and epicardial approaches3 have largely addressed this problem and, along with a larger electrode and irrigation-based ablation, may allow success for the midmyocardial substrate as well.
Systemic arterial pressure and fluid responsiveness: Not only a swing story*

Clin Infect Dis 2000; 30:25–28 8. Moens L, Van Hoeyveld E, Verhaegen J, et al: Fc[gamma]-receptor IIA genotype and invasive pneumococcal infection. Clin Immunol 2006; 118:20–23 9. Solé-Violán J, Garcı́a-Laorden MI, MarcosRamos JA, et al: The Fc receptor IIA-H/H131 genotype is associated with bacteremia in pneumococcal community-acquired pneumonia. Crit Care Med 2011; 39:1388–1393 10. Cooke GS, Aucan C, Walley AJ, et al: Association of Fc{gamma} receptor IIa (CD32) polymorphism with severe malaria in west Africa. Am J Trop Med Hyg 2003; 69:565–568 11. Wu J, Stevenson MJ, Brown JM, et al: C-reactive protein enhances tissue factor expression by vascular smooth muscle cells: Mechanisms and in vivo significance. Arterioscler Thromb Vasc Biol 2008; 28:698–704 12. Rello J, Lisboa T, Lujan M, et al: Severity of pneumococcal pneumonia associated with genomic bacterial load. Chest 2009; 136: 832–840 13. Ikram MA, Seshadri S, Bis JC, et al: Genomewide association studies of stroke. N Engl J Med 2009; 360:1718–1728
Linkage disequilibrium between tumor necrosis factor (TNF)- – 308 G/A promoter and TNF- NcoI polymorphisms: Association with TNF- response of granulocytes to endotoxin stimulation

W estendorp et al. (1) showed that 60% of tumor necrosis factor (TNF)release is caused by inherited factors. The promoter region of the TNFgene carries polymorphic sites at several positions (2). However, only the –308 polymorphism consisting of a single nucleotide exchange (G/A) was found to be of biological relevance. In a study of 89 patients, this –308 G/A polymorphism was associated with an increased risk for septic shock. Carriers of the A allele had a 3.7-fold increased risk of dying from septic shock (2). By contrast, Tang and colleagues (3) could not confirm the increased susceptibility to septic shock, but they found a higher mortality rate from septic shock in patients with an A allele. Higher transcriptional activity of the A allele was observed in vitro by using reporter gene constructs (4, 5). These results were challenged by Brinkman et al. (6) and Stueber et al. (7), who did not find a relation between the two TNF–308 alleles and the TNFproduction. In extension of these data, Louis et al. (8) genotyped 57 healthy blood donors for the –308 promoter polymorphism. After ex vivo stimulation of whole blood with lipopolysaccharide, TNFproduction was significantly higher in the 16 heterozygous individuals compared with the 41 G homozygotes. In contrast to this finding, Westendorp et al. (1) did not observe a significant difference between the TNF–308 genotypes when using an ex vivo TNFstimulation assay. In addition to this polymorphism in the TNFgene, a polymorphic site in the TNFgene was reported to influence TNFproduction (9, 10). The TNFor lymphotoxin gene carries an NcoI restriction fragment length polymorphism in the first intron. The B1 allele contains an NcoI restriction site (AAC), whereas B2 has a cytosine at this position (ACC) (11). Two studies including patients with sepsis and severe trauma found an association between the TNFplasma concentrations and this NcoI polymorphism (9, 10). Patients homozygous for the TNF-B2 allele had a higher mortality rate due to severe sepsis compared with heterozygous individuals (9). Trauma patients developed severe sepsis more frequently From the Department of Anesthesia (MH), Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands; the Department of Clinical Chemistry and Pathobiochemistry (DK) and the Department of Dermatology (HFM, BB), University Hospital of Aachen, Aachen, Germany; and the Institute for Anesthesia (BB-M), Klinikum Minden, Minden, Germany. Supported by the Deutsche Forschungsgemeinschaft (DFG), He 2578/3-2. Copyright © 2003 by Lippincott Williams & Wilkins
The Role of Elective Courses in Students′ Professional Development: Foreign Experience

Abstract The article considers the role of elective courses in professional development of students of economics. Modern European education is developing on the principles of democratization and humanization, where democratization implies the involvement of all agents/participants of the education process into forming its content and solving numerous related problems. Moreover, in order to be competitive in global labour market, modern specialists must develop such features as mobility, cultural, language and religious empathy, professionalism, commitment to the human virtues, etc. The content of education expressed in the curriculum is now not a rigid unity. Offering elective courses, university curricula can be easily modified to the students′ needs and aspirations. The analysis of the curricula of the economic faculties at some leading European universities has showed a great amount of elective courses mainly in general subjects such as Psychology, Pedagogy, Philosophy, History, Politology, Social Science, etc. These courses make up approximately 10 % of the total study load and are meant to realize interdisciplinary links, deepen students′ understanding of economic phenomena and develop analytical and strategic thinking. On the one hand, by choosing elective courses students are more agitated in learning, more interested and motivated. On the other hand, universities think harder over the supply of subjects and their content. At the same time, it increases lecturers′ motivation to consider new approaches, update information, and on the whole do their best to make their subjects appealing to students. The research has proved that elective courses realize an important role in students′ professional and personal development by integrating knowledge of many subjects, through their participation in tailoring the curricula and enriching their professional portfolio.
3PC-011 Hplc method development and validation to determinate resorcinol for quality control in pharmaceutical formulations

Background The hidradenitis suppurativa (HS) is an inflammatory skin disease. Resorcinol is a phenol derivate, and in topical self-treatment decreases the size and pain of HS lesions. Topical 15% resorcinol is prepared as a pharmaceutical compound. In current literature, high performance liquid chromatography (HPLC) methods have been reported for determination of resorcinol, using different gradients of mobile phase mainly. Purpose To assess the correct formulation, our objective is to develop an isocratic HPLC method for quality control. Material and methods To develop and validate the method, an Agilent 1260 HPLC system was used. Performed at 25°C, the separation was carried out in reverse phase column (Agilent Zorbax Eclipse XDB-C18 4.6 mm x 250 mm, 5 µm i. d.) (USA) with an isocratic mode. The mobile phase was methanol:water 40%:60%, the flow rate was 1 mL/minute and the injection volume was 10 mcL. A diode array detector was used (=280 nm). All reagents were analytical grade and bought from Sigma-Aldrich (USA). The calibration line was generated by least squares linear regression. The method accuracy (acceptance criterion of 99%–101%) and precision performed in a within-day and between-day anaylisis (five consecutive days) was assessed by five replicates run (low-, medium- and high-level concentration) and <1% variability as acceptance criterion. Spectral analysis 2D and 3D was performed to assess specificity and selectivity of method. Results There was an adequate separation under the chromatografic conditions presented. The retention time (mean ±SD) was 3.62±0.006 min. UV spectrum analysis demonstrated the specificity and selectivity of the method, since there were no co-eluates at the same retention time of resorcinol. The calibration line was y=8.6584x+11.8571(‘Y’:area under the curve and ‘X’:experimental concentration). It was linear (R2=0.99993). All the standards passed the acceptance criteria. The mean recovery percentage was 99.994% in all concentration levels. The coefficient of variation within-day was 0.082%, 0.042% and 0.128% for low-, medium- and high-point respectively, and between-day was 0.016%, 0.199% and 0.221% for low-, medium- and high-point respectively. Conclusion The presented method shows a simplified way to analyse resorcinol by HPLC using UV detector. The performance of the method has been proven in terms of linearity, accuracy, precision, selectivity and specificity by a validation assay. References and/or Acknowledgements doi:10. 5740/jaoacint. 14–123 doi:10.1007/s40265-015-0516-5 doi:10.1111/j.1365–2230.2009. 03 377.x doi:10.1155/2014/632591 No conflict of interest