Miracle-dz/UniFAR-FTUs huggingface dataset:
Duración de lactancia materna exclusiva, estado nutricional y dislipidemia en pacientes pediátricos

Introduccion: el abandono precoz de la lactancia materna exclusiva trae complicaciones a corto y largo plazo. Objetivo: determinar el estado nutricional y las alteraciones lipidicas en pacientes pediatricos segun la duracion de la lactancia materna exclusiva. Metodos: estudio descriptivo de corte transversal en 50 pacientes, de edades comprendidas entre 1 y 18 anos, con diferente tiempo de duracion de la lactancia materna exclusiva, pertenecientes al consultorio medico 25, del area de salud del policlinico "Carlos Manuel Portuondo", en el periodo comprendido desde noviembre de 2012 a noviembre de 2013. Se estudiaron las variables edad, sexo, estado nutricional, tiempo de lactancia materna exclusiva, colesterol y trigliceridos. Los datos fueron incluidos en una base de datos automatizada con la hoja de calculo electronica Excel 2003, y resumidos y representados en tablas estadisticas, y expresados textualmente. Se utilizo la estadistica descriptiva. Resultados: de los 42 pacientes que abandonaron precozmente la lactancia materna exclusiva, el 81 % presento malnutricion, y el 74 % hipertrigliceridemia. Conclusiones: resulta insuficiente la promocion de la lactancia materna exclusiva, expresada por la sustitucion artificial de esta a medida que el nino transcurre por los primeros 6 meses de vida.
Are you man enough to be a nurse? The road less traveled

Although men make up approximately 50% of the general workforce, they continue to be a gendered minority in nursing, representing only 6.6% of the registered nurse workforce in the United States (United States Department of Health Resources and Services Administration, 2010). Why are there not more men in nursing? The purpose of this phenomenological study was to explore how men came to choose nursing as a career, and to describe their perceived experiences in an associated degree ladder nursing program. Guiding the study was the theoretical framework of John L. Holland’s work on career choice (1997). Qualitative methods were used to collect, analyze, and interpret the data. A purposeful sample of men enrolled in an associate’s degree nursing program yielded six participants, who agreed to participate in three semi-structure audiotaped interviews. The interviews were transcribed and, through qualitative analysis, there emerged three categories that defined the experience of males in nursing: (1) the process of deciding to be a nurse, (2) the educational experience of being a male nursing student, and (3) the men’s career choice satisfaction on having decided to become nurses. The participants disclosed that their primary reason for entering nursing was to care for people, a motivation that was evident in their selfless regard for the welfare and rights of the patients for whom they were responsible. Overall, the men described their educational experience positively; however, they reported being challenged by their OB clinical experience, and expressed feelings of anxiety and uncertainty regarding the practice of touch, an integral component of patient care.
Timing of hypertonic saline inhalation for cystic fibrosis.

BACKGROUND Inhalation of hypertonic saline improves sputum rheology, accelerates mucociliary clearance and improves clinical outcomes of people with cystic fibrosis. OBJECTIVES To determine whether the timing of hypertonic saline inhalation (in relation to airway clearance techniques or in relation to time of day) has an impact on its clinical efficacy in people with cystic fibrosis. SEARCH METHODS We identified relevant randomised and quasi-randomised controlled trials from the Cochrane Cystic Fibrosis Trials Register, the Physiotherapy Evidence Database (PEDro), and international cystic fibrosis conference proceedings.Date of the last search of the Group's Cystic Fibrosis Trials Register: 6 December 2011. SELECTION CRITERIA Any trial of hypertonic saline in people with cystic fibrosis where timing of inhalation was the randomised element in the study protocol with either: inhalation up to six hours before airway clearance techniques compared to inhalation during airway clearance techniques compared to inhalation up to six hours after airway clearance techniques; or morning compared to evening inhalation with any definition provided by the author. DATA COLLECTION AND ANALYSIS Both authors independently assessed the trials identified by the search for potential inclusion in the review. MAIN RESULTS The search strategy identified 50 trial reports which represented 24 unique studies. One study, published only as an abstract, is awaiting further assessment. None of the other studies compared timing regimens for the inhalation of hypertonic saline and we excluded these from the review. AUTHORS' CONCLUSIONS This review did not identify any evidence comparing the timing of hypertonic saline inhalation in relation to airway clearance physiotherapy. Until such evidence becomes available, clinicians could advise patients to inhale hypertonic saline before airway clearance, because this is the only regimen evaluated in the studies that established the efficacy of the use of hypertonic saline. This review also did not identify any evidence comparing the timing of hypertonic saline inhalation in relation to time of day. Until such evidence becomes available, clinicians could advise patients to inhale hypertonic saline morning and evening; but if only one dose per day is tolerated, the time of day at which it is inhaled could be based on convenience or tolerability.Given the competing theoretical rationales about why hypertonic saline could be more effective if inhaled at certain times, a trial comparing these various timing regimens should be conducted.
Prevention and treatment of pediatric obesity using mobile and wireless technologies: a systematic review

Mobile health (mHealth) is a relatively nascent field, with a variety of technologies being explored and developed. Because of the explosive growth in this field, it is of interest to examine the design, development and efficacy of various interventions as research becomes available. This systematic review examines current use of mHealth technologies in the prevention or treatment of pediatric obesity to catalogue the types of technologies utilized and the impact of mHealth to improve obesity‐related outcomes in youth. Of the 4021 articles that were identified, 41 articles met inclusion criteria. Seventeen intervention studies incorporated mHealth as the primary or supplementary treatment. The remaining articles were in the beginning stages of research development and most often described moderate‐to‐high usability, feasibility and acceptability. Although few effects were observed on outcomes such as body mass index, increases in physical activity, self‐reported breakfast and fruit and vegetable consumption, adherence to treatment, and self‐monitoring were observed. Findings from this review suggest that mHealth approaches are feasible and acceptable tools in the prevention and treatment of pediatric obesity. The large heterogeneity in research designs highlights the need for more agile scientific processes that can keep up with the speed of technology development.
Adhésion au traitement médicamenteux et suivi électronique : une approche clinique de la prise en charge à long terme du patient chronique dans un réseau ambulatoire patient, pharmacien et médecin

Ce travail aborde, via deux etudes, la problematique de l'adhesion therapeutique en milieu ambulatoire, dans le cadre d'un reseau de patient, pharmacien et medecin. Il demontre que le suivi electronique chez des patients hypertendus ou dyslipidemiques a l'aide du pilulier electronique (MEMS[TM suscrit]) permet d'atteindre plus frequemment les objectifs therapeutiques et que cette approche est appreciee tant par les patients que par les pharmaciens et medecins, bien que sa mise en oeuvre necessite d'importants moyens et une etroite collaboration entre les partenaires. La comparaison du nouvel appareil IDAS II[TM suscrits] avec le MEMS[TM suscrits] a confirme le benefice du suivi electronique dans la prise medicamenteuse de patients hypertendus. Le suivi electronique est donc une approche pertinente de la prise en charge de l'adhesion therapeutique en ambulatoire. Il est important de sensibiliser medecins et pharmaciens a la problematique de l'adhesion et de les former a sa prise en charge en pratique clinique ambulatoire.
Idiopathische Pulmonale Fibrose – ein Update

Update on Idiopathic pulmonary fi brosis. Idiopathic pulmonary fi brosis (IPF) is a specifi c form of diffuse parenchymal lung disease of unknown origin, occurring primarily in older adults. Although periods of transient clinical stability may be observed, it is a chronic disease, characterized by progressive worsening of lung function. It is associated with a poor prognosis and as so far limited therapeutic options. The article presents the proposed diagnostic algorithm and recently published advances in pharmacolocic treatment options. J Pneumologie 2015; 3 (1): 11–7.
High waist circumference is associated with elevated blood pressure in non‐Hispanic White but not Hispanic children in a cohort of pre‐adolescent children

Hispanics comprise the most rapidly growing demographic in the US, but little is known about the cardiometabolic risk factors in Hispanic children. This study examined the association of high waist circumference (WC) and elevated blood pressure by race/ethnicity in a cohort of 9 to 13 year olds in New Haven, CT (n = 824).
The effect of adding inhaled corticosteroids to tiotropium and long-acting beta(2)-agonists for chronic obstructive pulmonary disease.

BACKGROUND Long-acting bronchodilators comprising long-acting beta(2)-agonists and the anticholinergic agent tiotropium are commonly used, either on their own or in combination, for managing persistent symptoms of chronic obstructive pulmonary disease. Patients with severe chronic obstructive pulmonary disease who are symptomatic and who suffer repeated exacerbations are recommended to add inhaled corticosteroids to their bronchodilator treatment. However, the benefits and risks of adding inhaled corticosteroid to tiotropium and long-acting beta(2)-agonists for the treatment of chronic obstructive pulmonary disease are unclear. OBJECTIVES To assess the relative effects of adding inhaled corticosteroids to tiotropium and long-acting beta(2)-agonists treatment in patients with chronic obstructive pulmonary disease. SEARCH STRATEGY We searched the Cochrane Airways Group Specialised Register of trials (February 2011) and reference lists of articles. SELECTION CRITERIA We included parallel group, randomised controlled trials of three months or longer comparing inhaled corticosteroid and long-acting beta(2)-agonist combination therapy in addition to inhaled tiotropium against tiotropium and long-acting beta(2)-agonist treatment for patients with chronic obstructive pulmonary disease (COPD). DATA COLLECTION AND ANALYSIS Two review authors independently assessed trials for inclusion and then extracted data on trial quality and the outcome results. We contacted study authors for additional information. We collected information on adverse effects from the trials. MAIN RESULTS One trial (293 patients) was identified comparing tiotropium in addition to inhaled corticosteroid and long-acting beta(2)-agonist combination therapy to tiotropium plus long-acting beta(2)-agonist. The study was of good methodological quality, however it suffered from high and uneven withdrawal rates between the treatment arms. There is currently insufficient evidence to know how much difference the addition of inhaled corticosteroids makes to people who are taking tiotropium and a long-acting beta(2)-agonist for COPD. AUTHORS' CONCLUSIONS The relative efficacy and safety of adding inhaled corticosteroid to tiotropium and a long-acting beta(2)-agonist for chronic obstructive pulmonary disease patients remains uncertain and additional trials are required to answer this question.
Autophagy, plant senescence, and nutrient recycling.

Large numbers of publications have appeared over the last few years, dealing with the molecular details of the regulation and process of the autophagy machinery in animals, plants, and unicellular eukaryotic organisms. This strong interest is caused by the fact that the autophagic process is involved in the adaptation of organisms to their environment and to stressful conditions, thereby contributing to cell and organism survival and longevity. In plants, as in other eukaryotes, autophagy is associated with longevity as mutants display early and strong leaf senescence symptoms, however, the exact role of autophagy as a pro-survival or pro-death process is unclear. Recently, evidence that autophagy participates in nitrogen remobilization has been provided, but the duality of the role of autophagy in leaf longevity and/or nutrient recycling through cell component catabolism remains. This review aims to give an overview of leaf senescence-associated processes from the physiological point of view and to discuss relationships between nutrient recycling, proteolysis, and autophagy. The dual role of autophagy as a pro-survival or pro-death process is discussed.
Effect of Melatonin on the Formalin-Induced Pain in White Male Rats

Introduction : Melatonin is the main prod-uct of pineal gland that has been associated with body's physiologic rhythms. New evidence suggests that melatonin plays a role in pain system. For example, the per-ipheral co-administration of melatonin and morphine produce additive analgesic effect. The purpose of this study was to evaluate the effect of central injection of melatonin on the formalin-induced pain in white male rats. & : this study, 40 NMRI white were divided into four equal groups (each group=10 rats) inclu-ding: control, sham (having canola without melatonin injection) and 2 melatonin group that received melatonin 0.5 and 0. 1µg /kg, respectively. The canola was implemented in the right brain ventricle of the rats via sterotaxic method. After 7 days of resting and then returning to normal condition, first dose of melatonin was injected and a half hour after it 50 microliter formalin (2.5 %) was injected at the floor of right foot to evaluate the acute and chronic pain. Data acquisitions were done through counting the number of licking the injected foot and accumulation of dorsal area skin (flinching) for 1 hour. Then, the acquired data were statistically analyzed . sign of behind skin flinching significantly decreased with using of 0.5µg of melatonin compared to the control group, particularly at the acute phase and beginning time of the chronic phase (P<0.05). This behavior was increa-sed in both groups receiving melatonin at the end of chronic phase, mainly at 55 and 60 minutes of formalin test (P<0.01, 0.001). Discussion & Conclusion : Our study sho-wed that the central injection of melato-nin has a significant analgesic effect; how-ever, the analgesic pattern may vary depen-ding on time.
Beyond Fluid Therapy: Treating Acute Renal Failure

CE Send comments/questions via email compendium@medimedia.com, fax 800-556-3288, or web CompendiumVet.com Acute renal failure (ARF) is a serious disease, and affected patients have a guarded prognosis. The best success in managing the disease is in preventing it whenever possible. Treatment of spontaneous ARF should be aimed at eliminating ongoing damage and supporting patients until the renal parenchyma can regenerate. Specific therapeutic aims include correction of fluid imbalances and electrolyte derangements, provision of adequate nutrition, and symptomatic supportive care to control ulceration and vomiting. Successful outcome depends on early, aggressive treatment and supportive care. are urinary obstruction (i.e., ureteroliths, cystic calculi, urethral calculi) or urinary tract rupture. Postrenal azotemia should resolve once the obstruction has been cleared unless it has been long-standing enough to cause secondary tubular damage. Accurately monitoring urinary output (UOP) after correcting the obstruction is critical in detecting postobstructive diuresis, in which UOP may easily exceed 7 ml/kg/hr. If UOP is not adequately monitored, fluid supplementation may not meet demand and animals may become dehydrated and develop prerenal azotemia. True parenchymal renal failure is characterized by the presence of azotemia with isosthenuria. Common causes of parenchymal renal failure include toxins, infection, and ischemic insults. Toxic agents include ethylene glycol, lilies, grapes and raisins, aminoglycosides, NSAIDs, contrast agents, anesthetics, and other therapeutic medications. When prescribing potential nephrotoxicants, practitioners should ensure that animals are adequately hydrated before administering medications, review conditions that may increase risk (e.g., hypokalemia, concomitant diuretic use), and COMPENDIUM 288 April 2005 Beyond Fluid Therapy: Treating Acute Renal Failure Jacqueline C. Whittemore, DVM Craig B. Webb, PhD, DVM, DACVIM (SAIM) Colorado State University
O MÚSCULO TRANSVERSO ABDOMINAL E SUA FUNÇÃO DE ESTABILIZAÇÃO DA COLUNA LOMBAR

OBJETIVO: conduzir uma revisao de literatura observando evidencias sobre a relacao do musculo Transverso do Abdomen e a estabilizacao da coluna lombar. METODO: uma busca em bancos de dados bibliograficos foi realizada utilizando as palavras-chave: musculo Transverso do Abdome, estabilizacao da coluna lombar, musculos abdominais. Por meio da pesquisa em livros e em bancos de dados, como Scielo, Medlne, Lilacs e Pubmed, foram selecionados resumos de estudos que preenchiam os criterios iniciais da selecao, sendo solicitadas copias dos artigos originais. RESULTADO: o Transverso do abdome tem um importante papel, na estabilizacao da coluna lombar. Ele possui uma relacao com a lombalgia. E, para executar suas funcoes de forma mais efetiva, seu treinamento deve ser especifico. CONCLUSAO: O estudo esclareceu e reforcou a funcao de estabilizador do musculo transverso. Contudo, ainda necessita realizar estudos mais detalhados e com uma maior representacao da amostra, para haver uma maior compreensao deste assunto.
Purine enzymes and thiopurine methyltransferase in childhood acute lymphoblastic leukemia

This thesis aims to get more insight into the metabolism of the drug 6-mercaptopurine (6MP) in pediatric patients with ALL. 6MP is a hypoxanthine analogue. The course of three key enzymes involved in 6MP metabolism is described during ALL treatment: inosine monophosphate dehydrogenase (IMPDH), 5'-nucleotidase (5'NT) and thiopurine S-methyltransferase (TPMT). TPMT activities and genotypes have been determined in patients with ALL and in control children. Median red blood cell (RBC) TPMT activity in ALL patients at diagnosis was significantly lower than in controls. This reduction of TPMT activity in ALL patients was not due to differences in the frequency of mutations in the TPMT gene. In concordance with other authors, we found a higher TPMT activity during maintenance treatment with 6MP than at diagnosis and in controls. However, we observed that TPMT activity was already significantly increased to a maximal level after the induction therapy, before the patients received 6MP. In vitro experiments showed that the early increase of TPMT activity during treatment was presumably caused by the use of antifolates, e.g., methotrexate and trimethoprim. Monitoring IMPDH activity during ALL treatment, previously described findings showing that IMPDH activity at diagnosis was related to the number of lymphoblasts in peripheral blood of the patients with ALL were confirmed. The median IMPDH activity at diagnosis was significantly higher than for controls. IMPDH activity significantly decreased during treatment, compared to that at diagnosis, following the eradication of lymphoblasts. One year after cessation of treatment, IMPDH activity has returned to normal values. To investigate whether total purine 5'NT activity was correlated with the efficacy and toxicity of 6-thiopurine nucleotides, we studied substrate affinity of purine 5'NT for (thio)purine nucleotides in human lymphocytes. The results did not show a distinct preference. The enzyme kinetic studies furthermore revealed substrate inhibition by thio-IMP, and especially by thio-GMP as a substrate. Inhibition by thio-GMP also seems to occur in ALL patients during treatment with 6MP. We also showed a negative correlation between purine 5'NT activity and thio-GMP concentration in patients' pMNC. This may lead to hematological toxicity in thiopurine-treated patients. So, by the measurement of purine key enzyme and TPMT activities, we have gained more knowledge on 6MP metabolism in ALL treatment. This knowledge can be used for further investigations on individualisation of thiopurine treatment in order to optimise efficacy and circumvent too much toxicity.
Minimally invasive versus open surgery for reversal of tubal sterilization.

BACKGROUND Although tubal sterilization procedures are considered to be permanent, requests for reversal of the procedure (re-canalisation) are not infrequent. The reversal procedure can be done either by an open laparotomy or by minimally invasive surgery (laparoscopic or robotic approach). OBJECTIVES To compare the relative effectiveness and safety of reversal of tubal sterilization by open laparotomy, laparoscopy and robotically assisted endoscopy. SEARCH METHODS On 23 October 2012 we searched the Cochrane Menstrual Disorders and Subfertility Review Group Specialised Register; the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library (Issue 10, 2012); MEDLINE; EMBASE; LILACS; clinical trials registries; regional databases; conference proceedings; and references for relevant published, unpublished and ongoing trials. SELECTION CRITERIA Randomised trials comparing the different methods of surgical reversal of tubal sterilisation. DATA COLLECTION AND ANALYSIS No trials that met the selection criteria were identified. MAIN RESULTS No data for evaluation were obtained AUTHORS' CONCLUSIONS Currently there is no evidence from randomised controlled trials to recommend or refute the use of a minimally invasive surgical approach (laparoscopic or robotic) or open surgery for reversal of tubal sterilization. There is a need for well conducted and reported randomised clinical trials to generate reliable evidence to inform clinical practice.
The Reunification Process in Substitute Care

This analysis focuses on the foster child's movement through foster care placements and back to the home of the parent. Specifically, this analysis is concerned with how the probability of reunification changes with duration in substitute care. The main hypothesis is that this probability decreases with time in placement. How children with different characteristics vary in the probabilities of movement is also examined. A sample of nearly 1,200 of the 50,000 children who entered the care of the Illinois Department of Children and Family Services between July 1, 1976, and May 31, 1984, was selected. Using event-history models, it was shown that (1) there is a decreasing probability of reunification in the first three transitions to the home of the parent as duration in placement increases, (2) there is a great decline in the probability of reunification after the first few weeks in placement, (3) the greatest decrease in the probability of reunification occurs for abused and neglected children, and (4) the home of the relative as a type of placement is the most stable placement.
Midazolam versus dexmedetomidina en sedación para procedimientos endoscópicos de tubo digestivo alto

Antecedentes: La endoscopia diagnóstica digestiva alta (EDDA) es un procedimiento seguro, aunque 50% de la morbilidad y 60% de la mortalidad se deben a complicaciones cardiopulmonares. Objetivos: Comparar la seguridad y eficacia de dexmedetomidina vs. midazolam en EDDA. Métodos: Se realizó un ensayo clínico, prospectivo, doble ciego y aleatorizado para comparar ambos fármacos. Los pacientes con indicación de EDDA fueron sorteados a recibir sedación con midazolam o dexmedetomidina durante el procedimiento. Se comparó: edad, sexo, estado físico ■ Abstract