Miracle-dz/UniFAR-FTUs huggingface dataset:
Fungal Rhinosinusitis: Report of uncommon Aspergillus species as etiological agents

Introduction: Rhinosinusitis caused by the usual Aspergillus spp. is very common. However, rare isolates of Aspergillus causing fungal sinusitis is also on the rise. Case Series: We hereby report three cases of fungal sinusitis caused by uncommon Aspergillus such as A. versicolor and A. sydowii. Case 1 was a 40-year-old female came with complaints of nasal block and nasal discharge for past one and a half years with history of previous nasal surgery. Her computed tomography (CT) scan of paranasal sinus (PNS) showed bilateral ethmoidal sinusitis. Case 2 was a 43-year-old male known asthmatic presented with complaints of nasal block for last five years, was diagnosed to have bilateral sinonasal polyposis by anterior rhinoscopy. Case 3 was a 17-year-old female known asthmatic presented with headache, nasal discharge and frequent sneezing for last six months. Her CT PNS showed left side deviated nasal septum with left side pan sinusitis along with right frontal sinusitis. All the three patients underwent functional endoscopic sinus surgery (FESS). The material was sent to the microbiology laboratory for fungal culture and potassium hydroxide mount. Speciation by slide culture was not conclusive. Hence, molecular methods were opted for speciation. Conclusion: Reporting of these cases will ensure awareness among the microbiologists about the not so common Aspergilli as a cause of fungal sinusitis. The need of molecular methods for speciation has also been emphasized here as it is difficult to speciate these Aspergilli using routine conventional methods. (This page in not part of the published article.) IJCRI – International Journal of Case Reports and Images, Vol. 5 No. 01, January 2014. ISSN – [0976-3198] IJCRI 2014;5(1):13–17. www.ijcasereportsandimages. com Nagarajan et al. 13 CASE SEriES OPEN ACCESS Fungal Rhinosinusitis: Report of uncommon Aspergillus species as etiological agents Chadiesh Nagarajan, Premamalini Thayanidhi, Anupma J Kindo, Vijayakumar Ramaraj, Sanjeev Mohanty, Ravikumar Arunachalam
Obstetric brachial plexus injury

All of those injuries are easy to understand. Over the past 15 years, there have been anecdotal reports, chiefly in the American literature, of retrospective studies of clinical notes (or more commonly interrogation of a database) concerning the births of babies subsequently found to have obstetric brachial plexus injuries (OBPIs). In some of those babies, shoulder dystocia was not entered as a diagnosis on the database THE NOBLE PAPER and the impression has therefore arisen that the injury can occur without dystocia. This has significant forensic implications for it allows the defendants, in the absence of recorded shoulder dystocia, to argue that the injury could have occurred without the interference of the accoucheur. For the most part these arguments have been heard only in the courts and many of the cases have been reported in this journal. In November 2002,3 Stirrat and Taylor reviewed some of the American literature and concluded
Impact of Health Insurance on Health Care Treatment and Cost in Vietnam: A Health Capability Approach to Financial Protection

We applied an alternative conceptual framework for analyzing health insurance and financial protection grounded in the health capability paradigm. Through an original survey of 706 households in Dai Dong, Vietnam, we examined the impact of Vietnamese health insurance schemes on inpatient and outpatient health care access, costs, and health outcomes using bivariate and multivariable regression analyses. Insured respondents had lower outpatient and inpatient treatment costs and longer hospital stays but fewer days of missed work or school than the uninsured. Insurance reform reduced household vulnerability to high health care costs through direct reduction of medical costs and indirect reduction of income lost to illness. However, from a normative perspective, out-of-pocket costs are still too high, and accessibility issues persist; a comprehensive insurance package and additional health system reforms are needed.
The basics of viral vaccines

Abstract The family practitioner plays an important role in preventing disease. An estimated two million people die globally from vaccine-preventable diseases each year. Immunisation of children does not only benefit the immunised children, but also their contacts and the community at large. Selective vaccination of adults should be a speciality of every family practitioner. This article discusses the principles of immunisation against hepatitis, mumps, measles, rubella, chickenpox, poliomyelitis, yellow fever and influenza.
The effect of local violence on children's attention and impulse control.

OBJECTIVES We examined whether the burden of violence in a child's community environment alters the child's behavior and functioning in the classroom setting. METHODS To identify the effects of local violence, we exploited variation in the timing of local homicides, based on data from the Chicago Police Department, relative to the timing of interview assessments conducted as part of a randomized controlled trial conducted with preschoolers in Head Start programs from 2004-2006, the Chicago School Readiness Project. We compared children's scores when exposed to recent local violence with scores when no recent violence had occurred to identify causal effects. RESULTS When children were assessed within a week of a homicide that occurred near their home, they exhibited lower levels of attention and impulse control and lower preacademic skills. The analysis showed strong positive effects of local violence on parental distress, providing suggestive evidence that parental responses may be a likely pathway by which local violence affects young children. CONCLUSIONS Exposure to homicide generates acute psychological distress among caregivers and impairs children's self-regulatory behavior and cognitive functioning.
A síndrome anserina

Dor no joelho e uma condicao comum na clinica diaria e a patologia anserina, tambem conhecida como pata de ganso, tem sido considerada uma das principais causas. O diagnostico tem sido realizado de maneira eminentemente clinica, o que tem gerado equivocos. Os pacientes queixam-se tipicamente de dor na parte medial do joelho, com sensibilidade na porcao inferomedial. Estudos de imagem tem sido realizados para esclarecer se tais pacientes possuem bursite, tendinite ou ambos os disturbios na regiao conhecida como pata de ganso. Entretanto, o defeito estrutural responsavel pelos sintomas permanece desconhecido, motivo pelo qual preferimos intitular como "Sindrome Anserina". O diabetes mellitus e um fator predisponente bem reconhecido. O sobrepeso e a osteoartrite de joelho parecem ser fatores adicionais de risco, contudo, seus papeis na genese da molestia ainda nao sao bem entendidos. O tratamento atual inclui anti-inflamatorio, fisioterapia e infiltracao de corticoide, com evolucao muito variavel, que oscila entre 10 dias e 36 meses. A falta de conhecimento sobre a etiofisiopatologia e dados epidemiologicos exige futuros estudos para esse frequente e intrigante disturbio.
Educating health care professionals in advocacy for childhood obesity prevention in their communities: integrating public health and primary care in the Be Our Voice project.

OBJECTIVES We assessed the perceived need for and the effectiveness of the Be Our Voice advocacy training. In this training, health care professionals learned public health strategies to advocate for environmental systems changes to prevent childhood obesity in their communities. METHODS We assessed 13 trainings across 8 pilot sites. We conducted 2 rounds of surveys with participants-pre-training (n=287, 84% response rate) and immediately post-training (n=254, 75% response rate)-and semi-structured interviews with participants after training (n=25). RESULTS We uncovered essential and promising elements of the training. Primary care providers found the Be Our Voice training effective at building their comfort with and motivation for engaging in public health advocacy; they reported achieving learning objectives, and they had positive responses to the training overall and to specific sessions. They articulated the need for the training and plans for advocacy in their communities. CONCLUSIONS The Be Our Voice training provides an opportunity to integrate primary care providers into public health, community-based advocacy. It may be a model for future educational offerings for health care professionals in graduate and postgraduate training and in practice.
Using the HIV surveillance system to monitor the National HIV/AIDS Strategy.

OBJECTIVES To report on indicators of the National HIV/AIDS Strategy, we analyzed data collected through the national HIV surveillance system. METHODS We analyzed data from adults and adolescents aged 13 years or older diagnosed with HIV in 13 US jurisdictions that have laboratory reporting of CD4+ T-lymphocyte (CD4) and viral load (VL) test results and enter CD4 and VL test results into the national surveillance system. RESULTS Of 4899 people diagnosed in 2009, 81.7% had at least 1 CD4 or VL test performed within 3 months of diagnosis. A higher proportion of Whites (86.2%) than Blacks (78.4%) and Hispanics (82.6%) had a CD4 or VL test. Of 53,642 people diagnosed through 2008 and living with HIV at the end of 2009 who had a VL test, 69.4% had a most recent VL of 200 copies per milliliter or less. The proportion of people with suppressed VLs differed among Blacks (60.2%), Hispanics (70.3%), and Whites (77.4%) and among people aged 13 to 24 years (44.3%) compared with people aged 65 years or older (84.2%). Of men who have sex with men, 74.2% had a suppressed VL. CONCLUSIONS The findings highlight disparities in access to and success of care.
Laparoscopic Ultrasound-Guided versus Percutaneous Radiofrequency Ablation in Treatment of Unresectable Hepatocellular Carcinoma

Objective: The purpose of this study was to compare laparoscopicultrasound-guided radiofrequency ablation (LUSRFA) versuspercutaneous radiofrequency ablation (PRFA) in treatment of localizedhepatocellular carcinoma (HCC). Methods: From January 2005 through April 2008, for 60 consecutivepatients, who were diagnosed with localized primary liver cancer andunderwent percutaneous RFA (n = 30) or laparoscopic ultrasoundguided radiofrequency ablation (n = 30) at our institution. RFA wasevaluated prospectively intra- and postoperatively (1, 6, 12, 18 and24 months after surgery). Results: Intra and postoperative complications were significantly lowerin the LUSRFA group than in the PRFA group. The Hospital stay,intraoperative complications, early and late postoperativecomplications were significantly reduced with LUSRFA. However,there was insignificant decrease in tumour volume in both groups.Furthermore, Local recurrence and distant metastases in the LUSRFAgroup showed a significant decrease during follow-up periods.Conclusion: LUSRFA could be a valuable alternative treatment forselected patients with localized unresectable hepatic malignancies.
Urinary albumin excretion in pregnancy

Summary. Urinary albumin excretion during pregnancy has been studied using a sensitive radioimmunoassay. One hundred pregnant women attending a high‐risk antenatal clinic and 14 normal pregnant women were investigated serially, during pregnancy and post‐partum. The normal subjects showed a small but significant rise in albumin excretion in the third trimester, which was sustained pre‐delivery and in the first postnatal week. Twenty‐six women were classified as having mild pre‐eclampsia and 44 as having chronic hypertension without evidence of superimposed pre‐eclampsia. In neither group was there evidence of proteinuria by conventional testing, nor was the median albumin excretion different from normal antenatally; in the first week after delivery a significant increase was observed, but this regressed to normal 6 weeks later. Eight patients developed severe pre‐eclampsia, of whom one had evidence of underlying renal disease. Three presented with proteinuria already established. In the remaining five patients, the shift from normal to high albumin excretion occurred rapidly, usually preceded by a rise in uric acid and a decrease in the platelet count. These data suggest that proteinuric pre‐eclampsia, as defined by relatively insensitive routine laboratory measurement, is not preceded by a phase of increasing albumin loss which can be detected by more sensitive assays.
Chronobiology and Chronotherapy of Hypertension – A Review

Hypertension occurs in over 90% of all patients with cardiovascular disease (CVD) in the United States and it is a major risk factor for end-organ damage, CVD and death. In the treatment of hypertension, investigation of chronobiology, chronopharmacology and chronotherapy began a few decades ago. Studies over the last decade have revealed that blood pressure (BP) and CVD are influenced by our behaviour such as what we eat and even conditioned by the time of day. Also, the ability of the night: day ratio of systolic BP predicts the risk for cardiovascular events more accurately compared with office BP measured only at once. Evidence clearly points to the fact that nocturnal BP is indeed the BP as it is most consistently correlated with prediction of cardiovascular risk and provides more close surveillance of safety. Circadian rhythm is a significant input into the regulation of BP. Hence, a circadian disorder such as hypertension requires chronopharmacotherapy. However, different medications have been studied for their chronopharmacology and potential chronotherapy. This article reviews the chronobiology of hypertension, and the chronopharmacology and chronotherapy of the various medications used in its management. Keywords: Hypertension, Circadian rhythm, Chronobiology, Chronopharmacology, Chronotherapy.
Reducing traumatic brain injuries in youth sports: youth sports traumatic brain injury state laws, January 2009-December 2012.

OBJECTIVES I sought to describe current state-wide youth sports traumatic brain injury (TBI) laws and their relationship to prevailing scientific understandings of youth sports TBIs, and to facilitate further research by creating an open-source data set of current laws. METHODS I used Westlaw and LexisNexis databases to create a 50-state data set of youth sports TBI laws enacted between January 2009 and December 2012. I collected and coded the text and citations of each law and developed a protocol and codebook to facilitate future research. RESULTS Forty-four states and Washington, DC, passed youth sports TBI laws between 2009 and 2012. No state's youth sports TBI law focuses on primary prevention. Instead, such laws focus on (1) increasing coaches' and parents' ability to identify and respond to TBIs and (2) reducing the immediate risk of multiple TBIs. CONCLUSIONS Existing youth sports TBI laws were not designed to reduce initial TBIs. Evaluation is required to assess their effectiveness in reducing the risk and consequences of multiple TBIs. Continued research and evaluation of existing laws will be needed to develop a more comprehensive youth TBI-reduction solution.
Doula care, birth outcomes, and costs among Medicaid beneficiaries.

OBJECTIVES We compared childbirth-related outcomes for Medicaid recipients who received prenatal education and childbirth support from trained doulas with outcomes from a national sample of similar women and estimated potential cost savings. METHODS We calculated descriptive statistics for Medicaid-funded births nationally (from the 2009 Nationwide Inpatient Sample; n = 279,008) and births supported by doula care (n = 1079) in Minneapolis, Minnesota, in 2010 to 2012; used multivariate regression to estimate impacts of doula care; and modeled potential cost savings associated with reductions in cesarean delivery for doula-supported births. RESULTS The cesarean rate was 22.3% among doula-supported births and 31.5% among Medicaid beneficiaries nationally. The corresponding preterm birth rates were 6.1% and 7.3%, respectively. After control for clinical and sociodemographic factors, odds of cesarean delivery were 40.9% lower for doula-supported births (adjusted odds ratio = 0.59; P < .001). Potential cost savings to Medicaid programs associated with such cesarean rate reductions are substantial but depend on states' reimbursement rates, birth volume, and current cesarean rates. CONCLUSIONS State Medicaid programs should consider offering coverage for birth doulas to realize potential cost savings associated with reduced cesarean rates.
Positive Association of Complement Factor H Gene Variants with the Effect of Photodynamic Therapy in Polypoidal Choroidal Vasculopathy

Purpose: To clarify the association of complement factor H (CFH) gene polymorphisms with the effects of photodynamic therapy (PDT) in polypoidal choroidal vasculopathy (PCV). Methods: Ninety-three PCV subjects treated with PDT were recruited. Patients who showed anatomical success after the treatments with a single or two consecutive PDT sessions were classified as PDT responders. All others were classified as non-PDT responders. Three single nucleotide polymorphisms (SNPs), rs800292 (I62V), rs1061170 (Y402H) and rs1410996 were genotyped using the TaqMan assay. Results: The genotype and allelic frequency of rs1061170 (Y402H) and rs1410996 were significantly different between PDT responders and non-responders. In these SNPs, the risk alleles for PCV prevalence were beneficial for PDT response. In the time course analysis, the cases with C/C genotype in rs1410996 showed a significant increase of mean visual acuity at 6 and 12 months after the first PDT. Conclusions: The coding variants in CFH may be associated with the effects of PDT in PCV.
Efficient targeting of homelessness prevention services for families.

OBJECTIVES We developed and evaluated a model to target homelessness prevention services to families more efficiently. METHODS We followed 11,105 families who applied for community-based services to prevent homelessness in New York City from October 1, 2004, to June 30, 2008, through administrative records, using Cox regression to predict shelter entry. RESULTS Over 3 years, 12.8% of applicants entered shelter. Both the complete Cox regression and a short screening model based on 15 risk factors derived from it were superior to worker judgments, with substantially higher hit rates at the same level of false alarms. We found no evidence that some families were too risky to be helped or that specific risk factors were particularly amenable to amelioration. CONCLUSIONS Despite some limitations, an empirical risk model can increase the efficiency of homelessness prevention services. Serving the same proportion of applicants but selecting those at highest risk according to the model would have increased correct targeting of families entering shelter by 26% and reduced misses by almost two thirds. Parallel models could be developed elsewhere.
Fatores perinatais associados ao óbito precoce em prematuros nascidos nos centros da Rede Brasileira de Pesquisas Neonatais

OBJECTIVE:To evaluate perinatal factors associated with early neonatal death in preterm infants with birth weights (BW) of 400-1,500 g. METHODS: A multicenter prospective cohort study of all infants with BW of 400-1,500 g and 23-33 weeks of gestational age (GA), without malformations, who were born alive at eight public university tertiary hospitals in Brazil between June of 2004 and May of 2005. Infants who died within their first 6 days of life were compared with those who did not regarding maternal and neonatal characteristics and morbidity during the first 72 hours of life. Variables associated with the early deaths were identified by stepwise logistic regression. RESULTS: A total of 579 live births met the inclusion criteria. Early deaths occurred in 92 (16%) cases, varying between centers from 5 to 31%, and these differences persisted after controlling for newborn illness severity and mortality risk score (SNAPPE-II). According to the multivariate analysis, the following factors were associated with early intrahospital neonatal deaths: gestational age of 23-27 weeks (odds ratio - OR = 5.0; 95%CI 2.7-9.4), absence of maternal hypertension (OR = 1.9; 95%CI 1.0-3.7), 5th minute Apgar 0-6 (OR = 2.8; 95%CI 1.4-5.4), presence of respiratory distress syndrome (OR = 3.1; 95%CI 1.4-6.6), and network center of birth. CONCLUSION: Important perinatal factors that are associated with early neonatal deaths in very low birth weight preterm infants can be modified by interventions such as improving fetal vitality at birth and reducing the incidence and severity of respiratory distress syndrome. The heterogeneity of early neonatal rates across the different centers studied indicates that best clinical practices should be identified and disseminated throughout the country.
Cost-effectiveness of pit-and-fissure sealants on primary molars in Medicaid-enrolled children.

OBJECTIVES We compared the incremental cost-effectiveness of 2 primary molar sealant strategies-always seal and never seal-with standard care for Medicaid-enrolled children. METHODS We used Iowa Medicaid claims data (2008-2011), developed a tooth-level Markov model for 10 000 teeth, and compared costs, treatment avoided, and incremental cost per treatment avoided for the 2 sealant strategies with standard care. RESULTS In 10 000 simulated teeth, standard care cost $214 510, always seal cost $232 141, and never seal cost $186 010. Relative to standard care, always seal reduced the number of restorations to 340 from 2389, whereas never seal increased restorations to 2853. Compared with standard care, always seal cost $8.12 per restoration avoided (95% confidence interval [CI] = $4.10, $12.26; P ≤ .001). Compared with never seal, standard care cost $65.62 per restoration avoided (95% CI = $52.99, $78.26; P ≤ .001). CONCLUSIONS Relative to standard care, always sealing primary molars is more costly but reduces subsequent dental treatment. Never sealing costs less but leads to more treatment. State Medicaid programs that do not currently reimburse dentists for primary molar sealants should consider reimbursement for primary molar sealant procedures as a population-based strategy to prevent tooth decay and reduce later treatment needs in vulnerable young children.
Sources of racial/ethnic differences in awareness of HIV vaccine trials.

OBJECTIVES We explored the relative effects of 2 awareness components-exposure and attention-on racial/ethnic differences in HIV vaccine trial awareness among men who have sex with men (MSM). METHODS Surveys assessing awareness of and attitudes toward HIV vaccine trials were administered to 1723 MSM in 6 US cities. Proxy measures of exposure included use of HIV resources and other health care services, community involvement, income, and residence. Attention proxy measures included research attitudes, HIV susceptibility, and HIV message fatigue. Using logistic regression models, we assessed the extent to which these proxies accounted for racial/ethnic differences in vaccine trial awareness. RESULTS White MSM reported significantly (P < .01) higher rates of HIV vaccine trial awareness (22%) compared with Latino (17%), Black (13%) and "other" (13%) MSM. Venue-based exposure proxies and research-directed attitudinal attention proxies were significantly associated with awareness, but only accounted for the White-Latino disparity in awareness. No proxies accounted for the White-Black or White-"other" differentials in awareness. CONCLUSIONS Sources of disparities in awareness of HIV vaccine trials remain to be explained. Future trials seeking to promote diverse participation should explore additional exposure and attention mediators.