Miracle-dz/UniFAR-FTUs huggingface dataset:
Lipid profile and its relationship with blood glucose levels in Metabolic Syndrome

Background: Metabolic syndrome (MetS) and its associated factors such as dyslipidemia and hyperglycemia are associated with increased risk of cardiovascular disease (CVD). Aims and Objective: To assess lipid profile and its relation with blood glucose levels in patients with MetS. Materials and Methods: This cross-sectional study included 72 male patients with MetS. Anthropometry, lipid profile, blood glucose, and presence of MetS (JIS criteria) were determined. Results: High triglyceride (TG) level (>200 mg/dL, 44.4%) was the most common dyslipidemia followed by low levels of high-density lipoprotein cholesterol (240 mg/dL, 13.8%) and high low-density lipoprotein cholesterol levels (>160 mg/dL, 9.7%) were observed. On comparison, no significant differences in lipid levels of MetS patients with normal fasting glucose, impaired fasting glucose, and type 2 diabetes mellitus were observed. Conclusions: Dyslipidemia was frequent in patients with MetS. High TG was the most common lipid abnormality, and a large number of patients had more than one abnormal lipid parameter. Based on their respective blood glucose levels, an identical pattern of dyslipidemia was observed in the study population.
A comparison of two needs assessments methods: Clinical recall interviews and focus groups

A project was conducted to determine physician learning needs in two areas of psychiatry: panic disorder and depression. Focus groups and clinical recall interviews were both used to determine learning needs, and a comparison was conducted of the two techniques. Both methods provided similar data. Clinical recall interviews gave better quantification of data. Focus groups identified unsolicited information about the problems physicians were having diagnosing illnesses and managing patients. Focus groups were less expensive for the continuing medical education (CME) provider. Recruitment for the clinical recall interviews was more easily done. Both techniques can be helpful for determining learning needs from which to develop CME programming, although an awareness of the strengths and limitations of each technique is important.
Acceptability of HbA1c values as a diagnostic tool for diabetes mellitus in Korea

목적: 2010년 미국당뇨병협회에서 당뇨병의 진단기준으로 당화혈색소 6.5% 이상을 채택하였다. 새롭게 채택된 당화혈색소 6.5% 이상이라는 기준이 한국 성인에서 당뇨병 진단에 적용 가능한지 알아보고자 했다. 방법: 2000년 1월부터 2010년 1월까지 건양대학교병원에 방문한 환자 중 75 g 경구당부하검사 및 당화혈색소를 시행한 1,862명 중 급성 질환을 앓고 있는 환자, 혈색소가 10g/dL 이하인 환자, 크레아티닌 2 mg/dL 이상인 환자, 경구 혈당강하제나 인슐린을 처방 받았던 환자, 임신한 환자를 제외한 1,474명을 대상으로 조사하였다. 결과: 전체 1,474명의 환자에 대한 정보는 서양인에 비해 비만도가 낮은 한국인 당뇨병의 특성을 보였고, HOMA-IR을 통해 제2형 당뇨병의 특징을 보였다. 당뇨병 진단을 위한 당화혈색소의 값을 알아보고자 75 g 경구당부하검사의 결과를 통해 ROC curve를 구하였고, cutoff value로 6.25%라는 값을 얻었다. 또한 당뇨병성 망막병증에 대한 조사 결과를 통해 당뇨병을 진단하기 위한 값은 6.75%였다. 결론: 본 연구의 결과상 미국당뇨병협회에서 권고한 당뇨병 진단 기준으로서의 당화혈색소값과 차이를 보였다. 인종간 또는 문화 간의 차이 등으로 달라질 수 있는 당화혈색소의 특징을 고려하여 6.5% 이상이라는 기준보다는 한국인에게 적용하기 위한 적합한 값을 구하기 위해 당뇨병의 합병증에 관한 대규모 연구 등의 노력이 필요하겠다.
Fine-needle aspiration cytology and scrape cytology of conjunctival squamous cell carcinoma: Report of a rare case

The utility of fine-needle aspiration cytology (FNAC) in the diagnosis of conjunctival tumor is not well-described in the literature. Here, we report a case of conjunctival squamous cell carcinoma (SCC) of the left eye in a 47 year old man. The case was initially diagnosed by FNAC using 24-gauge needle fitted in a 10 ml syringe. Scrape cytology was also done after FNAC. Smears from fine needle aspirates show malignant squamous epithelial cells arranged in aggregates. Intracellular keratin was discernible. Scrape cytology showed similar type of cytomorphological features. A cytodiagnosis of ocular surface squamous neoplasia favoring SCC was made and biopsy was suggested for confirmatory diagnosis. Surgical excision of the tumor was done and histopathological examination confirmed the diagnosis of SCC.
Imaging of anterior cruciate ligament repair and its complications.

OBJECTIVE This article provides a review of anterior cruciate ligament (ACL) reconstruction procedures and their normal postoperative appearance. Then, we review commonly encountered complications: those associated with decreased range of motion (impingement, arthrofibrosis, intraarticular bodies, ganglion cysts) and those associated with laxity (graft tearing, graft stretching). Finally, we review some miscellaneous complications. CONCLUSION Given the number of patients undergoing ACL reconstruction, it is important for radiologists to be familiar with the different reconstruction surgeries and their common complications.
Focal eosinophilic necrosis on superparamagnetic iron oxide-enhanced MRI.

OBJECTIVE The purpose of our study was to evaluate the usefulness of superparamagnetic iron oxide (SPIO)-enhanced MRI for distinguishing focal eosinophilic necrosis (FEN) from hepatic metastasis. MATERIALS AND METHODS Forty-one cases of FEN in 41 patients and 40 hepatic metastases in 40 patients were analyzed on unenhanced and SPIO-enhanced T2-weighted MRI retrospectively. Depending on the extent of the remaining hyperintense area on SPIO-enhanced T2-weighted images compared with the unenhanced images, the lesions were classified into four categories--category 1, less than 25%; category 2, 25-49%; category 3, 50-75%; and category 4, more than 75%--by two independent readers. Contrast-to-noise ratio (CNR) was measured using the same region of interest on unenhanced and SPIO-enhanced T2-weighted images. In three pathologic specimens of FEN, the number of Kupffer cells was compared with that of background hepatic parenchyma. RESULTS All metastases were classified as category 4, whereas FEN showed various distributions overall (category 1, 45.2%; category 2, 24.6%; category 3, 13.4%; category 4, 17.1%). FEN showed a decrease in CNR (from 7.9 +/- 5.8 to 6.1 +/- 5.6, p < 0.05), and metastases showed an increase in CNR (from 33.7 +/- 27.0 to 55.0 +/- 44.3, p < 0.05) after SPIO administration. In biopsy specimens, FEN had many more Kupffer cells (174.7 +/- 120.3 cells/high-power field [hpf]) than background hepatic parenchyma (23.7 +/- 9.8 cells/hpf). When using signal loss categories 1, 2, or 3 or CNR decrease, the accuracy of SPIO enhancement was 88.3%. CONCLUSION Unlike hepatic metastases, most of the cases of FEN showed a reduction in the extent of hyperintense area or a decrease in CNR after SPIO administration on the T2-weighted images. Therefore, SPIO-enhanced T2-weighted MRI can help to differentially diagnose FEN from metastases.
Prostate cancer: Comparison of 3D T2-weighted with conventional 2D T2-weighted imaging for image quality and tumor detection.

OBJECTIVE The purpose of this study was to compare a 3D T2-weighted imaging sequence with a conventional multiplanar 2D turbo spin-echo T2-weighted sequence in terms of tumor detection and staging of prostate cancer, as well as image quality. MATERIALS AND METHODS Before prostatectomy, 38 men (mean age, 60 years) with prostate cancer underwent MRI of the prostate with multiplanar 2D turbo spin-echo T2-weighted sequences (total acquisition time, approximately 11 minutes 4 seconds) and a 3D T2-weighted sampling perfection with application optimized contrasts sequence with different flip angle evolutions (SPACE) (acquisition time, approximately 3 minutes 52 seconds). Two blinded observers in consensus reviewed 2D turbo spin-echo T2-weighted images and SPACE images for detection of peripheral zone cancer, extracapsular extension, and seminal vesicle invasion. The observers also assessed subjective image quality and measured the signal-to-noise ratio (SNR) of normal peripheral zone and tumor-to-peripheral zone contrast. Prostatectomy was used as the reference standard. The diagnostic accuracy of the two sequences was assessed with generalized estimating equations and McNemar tests. The agreement between sequences was assessed with kappa coefficients. A paired Wilcoxon signed rank test was used to compare the subjective image quality, SNR, and tumor-to-peripheral zone contrast of the two sequences. RESULTS For tumor detection and diagnosis of extracapsular extension, there was substantial agreement between the two sequences (kappa = 0.79, kappa = 0.76) with no difference in sensitivity, specificity, positive predictive value, negative predictive value, accuracy (p = 0.25-1), or image quality (p = 0.937). Images obtained with the 2D turbo spin-echo sequence had a significantly higher SNR ratio for normal peripheral zone (p = 0.0010), but SPACE images had significantly greater tumor-to-peripheral zone contrast (p < 0.0001). CONCLUSION In comparison with conventional multiplanar 2D turbo spin-echo MRI of the prostate, 3D T2-weighted SPACE MRI was associated with substantial time saving (nearly 8 minutes), had similar image quality and accuracy in the diagnosis of tumor and extracapsular extension, and had better tumor conspicuity.
Unsuspected pulmonary emboli in pediatric oncology patients: detection with MDCT.

OBJECTIVE The purpose of this study was to determine the prevalence, distribution, risk factors, and clinical outcome associated with the detection of unsuspected pulmonary emboli (PE) in routine thoracic MDCT examinations of pediatric oncology patients. MATERIALS AND METHODS We used our hospital information system to retrospectively identify all consecutively registered pediatric oncology patients 18 years old and younger who underwent contrast-enhanced thoracic MDCT for indications other than PE from July 2004 to May 2008. Two pediatric radiologists in consensus reviewed diagnostic-quality images from consecutive routine thoracic MDCT examinations for the presence and anatomic distribution of PE. The distribution of PE was assessed according to pulmonary arterial level and lobe. Clinical and radiology reports were reviewed for demographic data, type of underlying neoplasm, prospective embolus detection, risk factors, treatment, and outcome. Subgroups of patients with and without PE were compared with respect to type of neoplasm and risk factors. RESULTS The study sample consisted of 468 children (249 boys, 219 girls; mean age, 9.5 +/- 5.7 years) who underwent a total of 1,002 thoracic MDCT examinations. Nine of the 468 children (1.9%) had PE, including seven with venous thromboembolism and two with tumor emboli. In these nine patients, the pulmonary arterial locations of 17 emboli were nine (53%) segmental, five (29%) lobar, two (12%) central, and one (6%) subsegmental. Classified by lobar location, six of 11 PE (55%) were in the left lower lobe, four (36%) were in the right lower lobe, and one (9%) was in the right upper lobe. PE were not detected prospectively in five of the nine patients (56%). All PE in this subgroup were solitary and located either within the segmental pulmonary arteries (four PE) or a lobar pulmonary artery (one PE). Underlying coagulation disorder (p < 0.001) and history of deep venous thrombosis or PE (p < 0.01) were risk factors for unsuspected PE. Two of nine patients (22%) with unsuspected PE died of causes not directly related to PE. The other seven patients survived, four of whom were not treated for PE. CONCLUSION PE are unsuspected findings at nearly 2% of routine thoracic MDCT examinations of pediatric oncology patients. More than one half of PE were not detected prospectively at initial CT image interpretation, but lack of diagnosis and treatment did not appear to have a negative influence on patient outcome. Underlying coagulation disorder and a history of deep venous thrombosis or PE were risk factors for unsuspected PE.
Everyday life with rheumatoid arthritis: A phenomenographic study

The aim of this study was to survey rheumatoid arthritis patients’ conceptions of their management of everyday life. Interviews with nine female, functionally independent patients with rheumatoid arthritis (median age 46 years, median duration of symptoms 6 years) were analysed using a phenomenographic methodology. Uncertainty was a central theme of the thoughts of all nine patients. Conceptions of needs accentuated after the onset of the disease, and mediated by uncertainty, were categorised, as were conceptions of strategies/attitudes for satisfying the needs and/or reducing uncertainty. A theoretical framework is presented, and recommendations for physical therapy are made.
High-resolution susceptibility-weighted imaging at 3 T with a 32-channel head coil: technique and clinical applications.

OBJECTIVE The purpose of this article is to illustrate the utility of susceptibility-weighted imaging (SWI) as an adjunct to routine MRI of the brain in neurologic disorders. CONCLUSION SWI is a 3D spoiled gradient-echo sequence that combines phase and magnitude information to provide a high sensitivity for the detection of blood degradation products, calcifications, and iron deposits.
Improving Access for Limited English-Speaking Consumers: A Review of Strategies in Health Care Settings

This paper describes models and strategies currently used in various health care settings around the country to improve health care access for limited English-proficient (LEP) individuals and examines a spectrum of strategies that overcome barriers to care, including the use of bilingual providers, bilingual/bicultural community health workers, professional and nonprofessional interpreters, the role of written translations, and new approaches to interpretation that use technological advances. The paper also considers how these strategies are applied in a variety of health care organizations, such as community health centers, public health departments, hospitals, and managed care organizations. Specific examples of model programs and strategies in each of these health care settings are described. Finally, recommendations are reviewed that may assist institutions in improving the provision of health care for LEP populations.
Noninvasive risk assessment for stroke: special emphasis on carotid atherosclerosis, sex-related differences, and the development of an effective screening strategy.

OBJECTIVE Stroke accounts for a significant degree of morbidity, mortality, and health care expenditure in this nation despite the many medical and surgical preventive measures we have in place. This article discusses how developing a universally accepted effective screening examination will help decrease this health care burden. Risk factors for the development of cardiovascular disease are explored. Special attention is given to the pathogenesis and diagnosis of carotid atherosclerosis because it accounts for a large percentage of both embolic and ischemic strokes. Current diagnostic testing, in particular duplex carotid sonography, and proposed screening strategies for the detection of carotid atherosclerosis and other risk factors are reviewed. Sex-related differences proposed in the current literature are also explored in this article because they may affect how we screen for and prevent stroke. CONCLUSION Developing an accurate, cost-effective, and universally acknowledged screening test will allow us to maximize the preventive medical and surgical measures we already have in place. Doing so will in turn lead to a significant decrease in the morbidity, mortality, and health care expenditure associated with stroke.
A comparison of the Barthel index and Nottingham extended activities of daily living scale in the assessment of disability in chronic airflow limitation in old age

Introduction: there is no disease-specific instrument for measuring activities of daily living (ADLs) in elderly patients with chronic airflow limitation (CAL). We assessed sensitivity, specificity and positive and negative predictive values of two ADL scales: the Barthel index and the Nottingham extended ADL scale in elderly people with and without CAL. Methods: the Breathing Problems Questionnaire was used as a measure of quality of life (a low score indicates good quality of life) in 96 outpatients (56 men) with CAL aged 70-93 (mean 78) years and 55 community-dwelling controls (23 men) aged 71-90 (mean 78) years with normal lung function drawn from a recent community survey. CAL subjects had been clinically stable for >6 weeks. All subjects were cognitively intact. Results: mean best 1 s forced expiratory volume/forced vital capacity was 45.5% (SE 1.4) in CAL subjects and 71.4% (SE 1.3) in controls. All CAL subjects considered themselves disabled and had higher breathing questionnaire scores [geometric mean scores: 395 (range 13-112) vs 4.8 (range 0.6-40) for controls; t= 13.4, P 18) discriminated better than the Barthel index (threshold >17) in terms of sensitivity (76% vs 19%; x2 = 60.9, P< 0.0001) and negative predictive value (75% vs 40%; x2 = 20.2, P< 0.0001). Altering the Barthel threshold did not improve its performance. Multiple regression analysis showed that variability in physiological and psychological variables related to CAL predicted variability in Nottingham extended ADL score (R2 = 0.71) but not in Barthel score. Conclusions: the Barthel index underestimates disability in CAL in old age. The Nottingham extended ADL discriminates better between normal old people and those with CAL.
Imaging of stroke: Part 1, Perfusion CT--overview of imaging technique, interpretation pearls, and common pitfalls.

OBJECTIVE Perfusion CT is being increasingly used as a diagnostic tool for the evaluation of acute ischemic stroke. It can be performed rapidly and aids in the detection of salvageable tissue (penumbra) from the unsalvageable core infarct. The purpose of this article is to provide an overview of the imaging technique, interpretation pearls, and common pitfalls encountered in perfusion CT of the brain. CONCLUSION Perfusion CT has proven to be a valuable tool in the diagnosis of acute ischemic stroke. The knowledge provided by these cases will allow the reader not only to confidently identify the presence of acute ischemic stroke, but also to recognize the common pitfalls and limitations of perfusion CT in this setting.
Intraindividual comparison of gadobutrol and gadopentetate dimeglumine for detection of myocardial late enhancement in cardiac MRI.

OBJECTIVE Gadobutrol is an extracellular macrocyclic gadolinium chelate recently introduced in MRI, and it has already been used for cardiac late enhancement imaging; however, until now it has never been compared with gadopentetate dimeglumine. The purpose of our study was to compare 0.1 mmol/kg gadobutrol to 0.2 mmol/kg gadopentetate dimeglumine for the detection of myocardial late enhancement in the same group of patients. SUBJECTS AND METHODS This was an exploratory single-blind parallel group study comparing gadobutrol (0.1 mmol/kg) to gadopentetate dimeglumine (0.2 mmol/kg) in 20 adult patients scheduled for cardiac late enhancement MRI with gadopentetate dimeglumine and whose MR images showed late enhancement. MR images were acquired at 10, 15, and 20 minutes after peripheral injection of gadobutrol by using a 3D turbo field echo inversion recovery T1-weighted sequence. Volume and percentage of late enhancement, number of involved segments, late enhancement localization and pattern, and late enhancement signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were compared between contrast agents. RESULTS Late enhancement was not significantly different with gadobutrol and gadopentetate dimeglumine both in terms of total volume of myocardium (mean ± SD, 37.8 ± 56.1 and 35.1 ± 46.7 cm(3), respectively; p = 0.33) and percentage of myocardial wall involvement (22.5% ± 19.1% and 22.0% ± 17.2%, respectively; p = 0.67). The number of segments involved was not different (138 with gadobutrol vs 134 with gadopentetate dimeglumine). Furthermore, SNR and CNR were not different (gadopentetate dimeglumine, 123.8 ± 82.9 and gadobutrol, 117.2 ± 88.6, p = 0.58 and gadopentetate dimeglumine, 96.2 ± 68.9 and gadobutrol, 88.4 ± 72.9, p = 0.53, respectively). CONCLUSION A single dose of gadobutrol seems to be as effective as a double dose of gadopentetate dimeglumine for the detection of late enhancement.
Macaluso et al. Respond to “Condom Effectiveness and Prostate-specific Antigen”

Steiner et al. are concerned by the high exposure frequency we observed and question its validity because they perceive the boundaries of the semen exposure rate to be arbitrary and believe some PSA results may have been due to sample contamination. We cannot directly address the hypothesis that contamination (i.e. contact of the sampling device with semen outside of the vaginal cavity) may explain the exposures detected but the design of the device and procedures together with the rarity of self-reported problems during sampling lead us to believe this explanation unlikely. We chose quantitative criteria to specify the boundaries of a “semen exposure rate” to simplify presentation of what seems to be a distribution of exposure levels of varying intensity rather than a dichotomous exposure that should yield a PSA value below or above a threshold. (excerpt)
OPTICAL/DIGITAL CHROMOENDOSCOPY DURING COLONOSCOPY USING NARROW‐BAND IMAGING SYSTEM

This review is regarding the narrow‐band imaging (NBI) system which has been developed at National Cancer Center Hospital East, Japan. The technology of the NBI system is based on modifying the spectral features by narrowing the bandwidth of spectral transmittance using various optical filters. The NBI system consists of three filters, 415–30 nm, 445–30 nm, and 500–30 nm, which are used as observing the fine capillaries in the superficial mucosa is essential to identify gastrointestinal neoplasms. The NBI system has been in development since 1999 and the first report of it's efficacy for gastrointestinal tract use was reported in 2001. In our pilot study, the NBI system may be sufficient to differentiate hyperplastic polyp from adenomatous polyp, and to visualize neoplasia with image processing in real‐time during colonoscopy without the need for dye spraying. Herein, we propose the term ‘optical/digital chromoendoscopy’ using the NBI system and hope that this instrument will become standard endoscopy for in the 21st century. To estimate the feasibility and efficacy of using the NBI system for surveillance or screening examination, randomized control trials should be conducted in the future.
Factors Influencing Childhood Swimming Instruction: Evaluation of the "Safe Water Initiative: Maryland" Program for Drowning Prevention

Title of thesis: FACTORS INFLUENCING CHILDHOOD SWIMMING INSTRUCTION: EVALUATION OF THE SAFE WATER INITIATIVE: MARYLAND PROGRAM FOR DROWNING PREVENTION Erinn Hurley Monteiro, Master of Public Health, 2010 Thesis directed by: Assistant Professor Kerry M. Green Department of Behavioral and Community Health Increasing swimming ability is a key preventive step in decreasing childhood drowning, but it remains unclear what factors influence parents to ensure that their children learn how to swim. The Safe Water Initiative: Maryland community-based program provided a series of free swimming lessons to children who had previously never received formal swimming instruction. Parents/guardians completed surveys on the first and last days of the program, and six weeks after the program ended. Results revealed significant increases in parents‟ attitudes and beliefs about swimming importance, perceptions of drowning risk, and intentions to enroll children in lessons; both attitudes/beliefs and perceived susceptibility were significant predictors of intentions. Intentions did not significantly predict behavior, as only 14% of participants‟ children had received additional instruction at second follow-up. This study provides preliminary findings for future research investigating factors influencing childhood swimming instruction and ways to decrease morbidity and mortality due to drowning. FACTORS INFLUENCING CHILDHOOD SWIMMING INSTRUCTION: EVALUATION OF THE SAFE WATER INITIATIVE: MARYLAND PROGRAM FOR DROWNING PREVENTION