Miracle-dz/UniFAR-FTUs huggingface dataset:
Height-related blood pressure reference values for Shiraz (Southern Iran) school children

Introduction: Blood pressure in children can be affected by a lot of factors such as environmental, cultural, social and genetic factors. This study aims at comparing Blood pressure in Shiraz (Iran) children with American standards and also to determine Blood pressure smoothed centiles on height in 6.5-11.5 elementary school children for the first time. Method: Height, systolic Blood pressure and diastolic Blood pressure were measured with standard methods in 2270 elementary school children that were selected by multistage sampling. We produced Blood pressure percentiles on height percentiles and compared them with National High Blood Pressure Education Program results by using its suggested regression equation. Meanwhile, Blood pressure smoothed centiles on height were drawn by Healy- Rasbash-Yang method. Results: The results of this study showed that Blood pressure levels in Shiraz children were lower than global standards. Then the measurements were adjusted for height, and no significant correlation found between either systolic Blood pressure or diastolic Blood pressure and age (r = -0.03 and p = 0.15 for systolic Blood pressure, r = -0.005 and p= 0.8 for diastolic Blood pressure). Discussion: Due to significant differences between Blood pressure in Iran and American children, it is suggested to use local Blood pressure standards. And also it was decided to produce Blood pressure percentiles on height instead of age because it seems that it would lead to better evaluation for real hypertensive diagnosi
Edge activators and a polycationic polymer enhance the formulation of porous voriconazole nanoagglomerate for the use as a dry powder inhaler

Abstract Purpose: Voriconazole has both low aqueous solubility and stability. We hypothesize that designing voriconazole in the form of a nano powder inhaler at a geometric diameter within 1–5 μm will enhance its stability and solubility. Therefore, we prepared nanoagglomerates of voriconazole which will collapse in the lungs to reform the nanoparticles. Method: The nanoparticles were formulated using both stearic acid and sodium deoxycholate as edge activators. Osmogenic polycation polyethyleneimine (PEI) was used to form agglomerates of controllable size. Results: Voriconazole nanoparticles and agglomerates showed a significant higher cumulative drug release than the pure powder (p < 0.05) with R2 = 0.95. Small-sized particles were formed (353 nm), while their zeta potential was −30.7 mV. The agglomerates were 2.7 μm in size and their zeta potential was −20.9 mV. The formation of porous agglomerates was confirmed using a transmission electron microscope. Cascade impactor was used to evaluate the aerodynamic properties of the nanoparticles and the agglomerates. The aerodynamic characterization of the nanoparticles and the agglomerates resulted in a significant smaller mass median aerodynamic diameter (MMAD) (p < 0.05) and higher fine particle dose (FPD) (p < 0.01), fine particle fraction (FPF) (p < 0.01), and total emitted dose (TED) (p < 0.01) than the pure powder. Conclusion: The results suggest that using the combination of edge activators and diluted polycationic polymer solution provides porous voriconazole nanoagglomerates in a respirable range, which is proved successful in enhancing both the deposition and the dissolution of water insoluble-drugs in the lung.
Clinical audit by a palliative care team

Objective: To develop a method of audit for, and evaluate the work of, a palliative care support team. Methods: Through observation and discussion with the team, 14 items, forming the Support Team Assessment Schedule (STAS), were identified which were considered to represent independent care objectives. Definitions of scale points (0-6) were agreed for each item. The team made ratings at their weekly meeting for each patient during a 12-month period. Results: Of 124 patients seen by the team there were a minimum of two recordings for 82 patients which provided a measure of the outcome of care. The group mean scores showed statistically significant improvements on all items, but there were differences between items in the extent of improvement. The STAS helped to make the team's assessments more systematic, and feedback of the information focused attention on the team's treatment of terminal dyspnoea. Conclusion: Audit of palliative care is practicable by this method. The approach could also be developed for use in inpatient hospital and hospice settings.
Utilização de medidas antropométricas para a avaliação do acúmulo de gordura visceral

Visceral obesity has been associated with the development of cardiovascular diseases and some types of cancer. Therefore, there is an increasing interest in quantifying intra-abdominal adiposity in order to assess the risk of metabolic disorders, such as glucose intolerance, hyperinsulinemia, type 2 diabetes, dyslipidemia and hypertension. Imaging techniques such as computed tomography and magnetic resonance provide an accurate and precise measurement of visceral fat. However, both are costly and inapplicable in routine clinical practice and epidemiological studies. Anthropometric parameters are an option for visceral fat assessment in these situations, since they are innocuous, easy to use and inexpensive. In this context, this work aimed to critically analyze studies that assessed anthropometric parameters as indicators of visceral fat. A bibliographic review of domestic and international articles found in the databases Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior, Scientific Electronic Library Online, Science Direct and Pubmed, published from 1947 to 2007 was done. Emphasis was given to anthropometric parameters, such as body mass index, waist circumference, waist-to-hip ratio and sagittal abdominal diameter.
Determination of the conduction paths from the left to the right atrium using frequency analysis of atrial electrograms in two canine models of atrial fibrillation

Studies of atrial fibrillation (AF) have demonstrated that a stable rhythm of very short cycle length in the left atrium (LA) can cause a fibrillatory conduction in the right atrium (RA). We tested the hypothesis that FFT analysis of atrial electrograms (AEGs) during AF will rapidly and reliably identify the LA to RA conduction path(s). During induced AF, four sec recording segments from 203 bipolar AEGs were subjected to FFT to obtain the frequency analysis. FFT analysis of AF showed a dominant frequency peak in the LA and multiple frequency peaks in the RA. Conduction paths to the RA varied from study-to-study, and were found between the superior vena cava and the right superior pulmonary vein (RSPV), between the RSPV and the right inferior pulmonary vein (RIPV), between the RIPV and the inferior vena cava (IVC), under the IVC, and from Bachmann's bundle to the right atrial appendage. These conduction paths identified by FFT analysis corresponded to the conduction paths found in activation sequence mapping. FFT analysis allowed rapid and reliable detection of the LA to RA conduction paths in AF.
Limitations of 24-hour Recall Method: Micronutrient Intake and the Presence of the Metabolic Syndrome

Dear Editor, Congratulations to authors’ effort on the article entitled “Micronutrient intake and the presence of the metabolic syndrome,”[1] which was recently published in North American Journal of Medical Sciences. However, I have some concerns with the use of 24-hour recall method to assess dietary intake (as done by the authors). This is because, the data generated by using this method may not represent the long-term dietary habits of the patient. So, finding an association between metabolic syndrome (a chronic condition) and micronutrient intake based on 24-hour recall may not be appropriate. Twenty-four hour recall is basically a retrospective method of diet assessment, where an individual is interviewed about their food and beverage consumption during the previous day or the preceding 24 hours. However, a single 24-hour recall is not considered to be representative of habitual diet at an individual level. This methodology is adequate for surveying intake in a large group and estimating group mean intakes of diet. This has been highlighted in a study that was conducted to decide on the methods for conducting dietary assessment in the UK Low Income Diet and Nutrition Survey (LIDNS). [2] Four repeat 24-hour recalls were recommended as the most appropriate method of dietary assessment, according to this study. [2] Furthermore, in a recent Australian study in adults, eight repeat 24-hour recalls were recommended to capture the variation that is usually present in diet. [3]
The “Fit but Fat” Paradigm Addressed Using Accelerometer-Determined Physical Activity Data

Background: No studies have addressed the “fit but fat” paradigm using accelerometry data. Aim: The study was to determine if 1) higher levels of accelerometer-determined physical activity are favorably associated with biomarkers in overweight or obese persons (objective 1); and 2) overweight or obese individuals who are sufficiently active have better or similar biomarker levels than normal weight persons who are not sufficiently active (objective 2). Materials and Methods: Data from the 2003-2006 National Health and Nutrition Examination Survey were analyzed and included 5,146 participants aged 20-85 years. Results: Regarding objective 1, obese active individuals had more favorable waist circumference, C-reactive protein, white blood cells, and neutrophil levels when compared to obese inactive individuals; similar results were found for overweight adults. Regarding objective 2, there were no significant differences between normal weight inactive individuals and overweight active individuals for nearly all biomarkers. Similarly, there were no significant differences between normal weight inactive individuals and obese active individuals for white blood cells, neutrophils, low-density lipoprotein cholesterol, total cholesterol, triglycerides, glucose, or homocysteine. Conclusions: Physical activity has a protective effect on biomarkers in normal, overweight, and obese individuals, and overweight (not obese) active individuals have a similar cardiovascular profile than normal weight inactive individuals.
Specific Health-Related Quality of Life Concerns in Children with Intermittent Exotropia

Purpose: To assess the frequency of specific health-related quality of life (HRQOL) concerns in children with intermittent exotropia (XT) using the Intermittent Exotropia Questionnaire (IXTQ). Methods: Eighty children with intermittent XT (aged 5 to <17 years), plus one parent for each child, completed the Child and Proxy IXTQ respectively. Each item was scored from 0 to 100 (worst to best HRQOL). Mean scores were calculated for each item and items were ranked from lowest to highest impact (worst HRQOL). Analysis was repeated for sub-groups of 5- to <8-year-olds (n = 46) and 8- to <17-year-olds (n = 34). Results: Highest impact Child IXTQ items were: “It bothers me that I have to shut one eye when it is sunny,” “I worry about my eyes,” and “It bothers me because I have to wait for my eyes to clear up. ” Highest impact Proxy IXTQ items were: “It bothers my child because he/she has to shut one eye when it is sunny” and “My child worries about his/her eyes. ” Lowest impact Child and Proxy items were “My eyes make it hard to make friends” and “Kids tease me because of my eyes. ” Ranking of items was similar for younger and older children. Conclusions: The greatest HRQOL concerns for children with intermittent XT were shutting one eye when sunny, waiting for their eyes to clear up, and worrying about their eyes. Items related to teasing and making friends were of least concern. Evaluation of HRQOL concerns using the IXTQ may be helpful in the clinical care of individual patients.
Tolerability and safety of commonly used dietary supplements and nutraceuticals with lipid-lowering effects

Introduction: Cardiovascular diseases are one of the highest causes of death and disability in industrialized countries, whereas a large portion of patients in primary prevention have cardiovascular disease risk factors that remain uncontrolled. Lifestyle interventions, including dietary supplementation with natural compounds possessing known lipid-lowering effects, are strongly supported by the international guidelines for cardiovascular disease prevention. Areas covered: This review provides insights on issues concerning the safety of the most commonly used dietary supplements and nutraceuticals with demonstrated lipid-lowering actions. Soluble fibers, phytosterols, soy proteins, omega 3 polyunsaturated fatty acids, monakolines, policosanols, berberine and garlic extracts are all discussed and a specific focus has been placed on their pharmacological interactions. Expert opinion: A relatively large amount of preclinical, epidemiological and clinical evidence has demonstrated the tolerability and safety of the most commonly used dietary supplements and nutraceuticals with demonstrated lipid-lowering action. However, for most supplements and nutraceuticals, no evidence is currently available from long-term trials on morbidity and mortality. Detailed knowledge of specific health risks and pharmacological interactions for each individual compound is needed for the management of frail patients, such as children, the elderly, patients with liver or renal failure, high-risk patients, and patients consuming numerous drugs.
Depressive Symptoms in Cancer Patients Compared with People from the General Population: The Role of Sociodemographic and Medical Factors

Abstract This study examined depressive symptoms in 475 patients with cancer and in a reference group of 255 individuals without cancer from the general population and the associations of those symptoms with sociodemographic and medical factors. Depressive symptoms were measured at 3 months (Time 1) and 15 months (Time 2) after diagnosis. Patients reported more depressive symptoms than the reference group did at Times 1 and 2. Younger age, especially, was related to the onset of depressive symptoms after a cancer diagnosis. Better-educated patients and those with a lower stage of disease reported a greater decrease in depressive symptoms over time. The authors conclude that cer- tain sociodemographic factors may primarily reflect general dysfunction or vulnerability rather than risk factors for developing depressive symptoms after a diagnosis of cancer.
Influence of Thyroxine on Blood Parameters and Liver Enzymes in Adult Male and Female Rats

This study investigated and compared the influence of exogenous thyroxine with restricted feeding and sex on the blood parameters and liver enzymes in adult male and female Wistar rats. Twelve adult wistar rats (six males and females) were given thyroxine in drinking water at dosage of 50mg/100ml of water/pair/day with restricted pellet feed of 16gm/pair/day for 28 days. Another set of twelve adult Wistars (six males and six females) received 100ml of water/pair/day for 28 days. The control group of twelve adult rats (six females and six males) received feed and water ad-labitum for the same period of 28days. Thyroxine with restricted feeding significantly increased (P< 0.05) haemoglobin level, the alanine aminotransferase values as well as pyruvate aminotransferase values in Wistar rats of both sexes while it significantly reduced the values of white blood cells in both sexes of wistar rats and has no significant effect on values of blood glucose of both sexes. Restricted feeding without thyroxine treatment significantly decreased the values of haemoglobin, white blood cells and red blood cells in wistar rats of both sexes while it significantly increased the levels of alanine aminotrasferase and pyruvate aminotransferase (P<0.05). The results suggest that exogenous thyroxine with restricted feed has significant effects (P <0.05) on blood parameters and liver enzymes in wistar rats of both sexes. Key-words : Exogenous thyroxine, restricted feed, Wistar rat, blood parameters, Liver enzymes.
Difference by Race in Long-Term Care Plans

The underrepresentation of African American elders in institutional care is attributed to their greater desire for family care compared to Whites. Data from in-home interviews with 604 African Americans and Whites aged 65 and older are used to explore whether differences by race in long-term care plans substantiate this claim. Contrary to expectations, African American elders were more likely than Whites to have made long-term care plans and to include institutional as well as family care in their plans. Multivariate findings were that African American elders with more education were more likely than others to have made long-term care plans and educational attainment predicted plans for institutional care. Findings suggest that long-term care decision making is likely idiosyncratic rather than the result of careful consideration of care options in light of impending long-term care needs.
Baseline Characteristics of Participants in the Natural History Study of Macular Telangiectasia (MacTel) MacTel Project Report No. 2

Purpose: To describe the baseline characteristics of a large international cohort of patients with macular telangiectasia type 2 (MacTel Type 2) in anticipation of a longitudinal natural history study to evaluate structural and functional changes, identify potential risk factors and related outcomes. Methods: Images including fundus photographs, fluorescein angiograms, optical coherence tomography and fundus autofluorescence were collected. A grading system for MacTel type 2 was developed by the central reading center to evaluate lesion characteristics. Relationships between lesion characteristics and visual acuity were evaluated. Results: A total of 310 participants have been enrolled in the study. The mean time since diagnosis was 3 years (range 0 to 25 years). The mean age at the baseline examination was 61 ± 9 years. The mean visual acuity in the better eye was approximately 20/32 Snellen equivalents and approximately 20/50 in the worse eye. The visual acuity in the better eye of half of the participants was 20/32 or better. We found some relationships between visual acuity and lesions characteristic of MacTel Type 2. Conclusions: This is the first large-scale study of patients with MacTel Type 2. More than half of the patients had 20/32 or better vision in their better eye, which is a sign that decreased function in these participants may not be reflected in central visual acuity. These findings highlight the limitation of using visual acuity measurements as a measure of function and as an outcome measure in potential clinical trials in patients with MacTel Type 2.
Relationships in Glaucoma Patients Between Standard Vision Tests, Quality of Life, and Ability to Perform Daily Activities

Purpose: To determine the relationships among three methods of assessing visual loss caused by glaucoma: (1) standard clinical tests of vision, (2) self-reported quality of life, and (3) the ability to perform activities of daily living. Methods: One hundred and ninety two glaucoma patients with a full range of glaucomatous visual loss were selected from the Glaucoma Service of Wills Eye Institute. Subjects were evaluated clinically by visual acuity, contrast sensitivity, visual field, stereopsis, the Disc Damage Likelihood Scale, and intraocular pressure. Subjects were evaluated subjectively by the 25-item National Eye Institute’s Visual Functioning Questionnaire (NEI-VFQ-25) and objectively by a performance-based measure of visual function, the Assessment of Disability Related to Vision (ADREV). Statistical analysis, including Spearman coefficients, was performed on the data from the clinical measures, NEI-VFQ-25, and ADREV. Results: The clinical tests had higher correlations with ADREV than with the NEI-VFQ-25. There was a moderate, but not strong, connection between how patients rated their own visual ability with how they performed when objectively tested. Conclusions: ADREV provides valid estimates of how visual loss due to glaucoma affects the ability to perform activities of daily living. Performance-based testing and quality of life evaluations are both independently important measures of health, which are related, but by no means the same.
Retrorectal Cystic Hamartoma: A Problematic ‘Tail’

The retrorectal space is an uncommon seat for neoplastic masses. Retrorectal hamartoma or tailgut cyst (TGC) is an uncommon developmental cystic lesion occurring in this space which mostly occurs in middle-aged females. We recently cared for a 16-year-old girl who presented with vague lower abdominal pain and occasional constipation. Per rectal examination revealed an extraluminal mass bulging from posterior rectal wall. Preoperative radiological investigations revealed by suggested it to be a mature cystic teratoma. The patient underwent exploratory laprotomy with en masse excision of the cyst. Histopathological examination of the specimen showed it to be a TGC. This case highlights the possibility of a TGC as a differential for retrorectal cystic lesions and the need to completely excise them given the possibility of future malignant transformation.
Impact of a Brief Educational Intervention on Glaucoma Persistence: A Randomized Controlled Clinical Trial

Abstract Purpose: To determine whether two sessions of a glaucoma educational intervention resulted in better persistence to glaucoma eye drop therapy compared to normal care. Methods: A total of 165 patients newly diagnosed with glaucoma who required eye drop therapy were recruited into a randomized clinical trial from the glaucoma clinic at Maisonneuve-Rosemont Hospital in Montreal, Canada. Patients were randomized to either an immediate intervention or normal care. The intervention consisted of two 60–90 minute sessions of education on glaucoma and its management, given in a small group format by a non-practicing ophthalmologist. Persistence to glaucoma medication was examined for 1 year by the use of Hospital medical records and by pharmacy claims records from the Régie de l’assurance maladie du Québec (Quebec Health Insurance Program). A questionnaire was administered, and medication possession ratio calculated. The primary outcome was persistence, defined as having medication available at least 75% of the time. Secondary outcomes included eye drop instillation technique and perception of the importance of eye drop therapy. Results: The intervention group achieved better persistence to eye drop therapy, as 77% of controls and 89% of people receiving the intervention were persistent (p = 0.049). The intervention also resulted in better eye drop instillation technique (p < 0.001) and greater perception of the importance of eye drop therapy (p < 0.001). Conclusions: Brief instructional sessions offered to newly diagnosed glaucoma patients can result in better persistence rates over 1-year follow-up. Strategies to permanently offer these types of initiatives should be considered.