Miracle-dz/UniFAR-FTUs huggingface dataset:
Impacto del entrenamiento visual en las vergencias de pacientes présbitas

El motivo del disconfort en pacientes presbitas puede deberse a una disfuncion en las habilidades de vergencia, que no compensan de forma eficiente la posicion forica en vision cercana. Objetivo: determinar el impacto del entrenamiento visual en los rangos de vergencias de pacientes presbitas. Materiales y metodos: se incluyeron 54 sujetos presbitas corregidos. Se formaron dos grupos de 27 pacientes; el grupo de intervencion se sometio a un programa de entrenamiento de vergencias durante diez semanas. Se midieron los rangos de vergencias fusionales negativas y positivas, la relacion acomodacion-convergencia acomodativa, la distancia en centimetros del punto proximo de convergencia y las forias lateral y vertical en vision cercana con el metodo de Von Graefe y el grado de disconfort visual. Resultados: la pueba t de Student confirmo que existe significancia (p < 0,005) en el grupo de intervencion entre: a) el valor del disconfort inicial y el valor final y b) los valores de ruptura y recobro de la vergencia positiva. La media inicial de los valores de ruptura fue de 19,70 dioptrias prismaticas y la final de 26,07 y de 4,48 a 13,33 dioptrias prismaticas en el recobro. El valor de la media del punto proximo de convergencia inicial en el grupo de intervencion fue de 15,63 centimetros y el final de 6,28 centimetros. La variacion en la media del AC/A inicial y final del grupo de intervencion fue de 1,1 dioptrias prismaticas. Conclusiones: el entrenamiento visual tiene impacto sobre las vergencias positivas, normaliza el punto proximo de convergencia y disminuye el disconfort visual
Alterations of intestinal flora and function in acute nonspecific diarrhea of infancy. [Abstract only].

Less than 25% of infants with acute diarrheal disease have isolatable causative pathogens. In this study 4 children with enteropathogenic Escherichia coli (EPEC) and 8 children with nonspecific diarrhea (NSD) were studied to determine any changes in bile acid metabolism glucose absorption and intestinal microflora. Bile acid patterns in the duodenum and feces were altered in children with NSD. Glucose absorption was significantly reduced in NSD patients whereas it was normal among children suffering from EPEC. Cultures obtained by anaerobic aspiration of the duodenum revealed an increased concentration of anaerobic flora in NSD patients. However no differences in aerobic or facultative anaerobic flora were evident. NSD and EPEC groups both had increased jejunal water secretion but children with acute NSD had a more profound change in intestinal function as shown by alterations in intestinal microflora secondary bile acid production and glucose transport.
Combating HCV Recurrence: The Past, Present and Future of Anti-Viral Warfare

textabstractThe face of medicine is changing. Advancements in every aspect of medicine have begun to accelerate. Throughout history doctors have uti lized science to some degree or another but never more than in the last 50 years. Today, doctors are turning to science more and more to answer their unanswerable questi ons. This both increases the ability to treat and manage pati ents as well as provides the necessary funding in order to propel medical sciences at unprecedented speeds. Newly discovered viruses and the complicati ons of their infecti ons present doctors and scienti sts with some of the most complex problems with regard to treatment opti ons. In order to establish a viable therapeuti c opti on to eradicate the virus a thorough understanding of a given virus’s biology and epidemiology must be achieved. Once accomplished, focus shift s to the producti on of a suitable vaccine. While this helps prevent the spread of new infecti ons, established or undetected viral infecti ons sti ll present a large health care puzzle that needs to be solved. Viral infecti ons oft en go unnoti ced unti l symptoms appear, long aft er the initi al infecti on has occurred. Drug development produces the fi rst line, rapid response therapy opti on to new infecti ons and disease but predominately focuses on retroacti vely treati ng the symptoms of infecti on, not oft en the source. Established infecti ons can only be treated with lifelong drug applicati on that are oft en not very effi cacious in viral eradicati on but rather just att empt to control viral replicati on to slow the progression of viral related diseases. These drug therapy opti ons oft en come at a heavy price, in monetary sums as well as in the pati ents well being and quality of life. The Hepati ti s C virus (HCV) is one of those infecti ons, which can remain undetected for many years and is oft en untreatable or with low effi cacy. This thesis aims to explore the development of these therapies, and to provide new informati on and insight about classical, current and future opti ons to HCV therapy.
Relationships among Functional Health Literacy, Asthma Knowledge and the Ability to Care for Asthmatic Children in Rural Dwelling Parents

Purpose: This Orem-based study examined the relationships among functional health literacy, asthma knowledge, the ability to care for asthmatic children and sociodemographic factors among rural parent/guardians. Method: A descriptive correlation design was used. The convenience sample of 57 parents and one guardian who cared for asthmatic children was recruited from three rural health districts in the eastern United States (Virginia, North Carolina, and upstate New York). Subjects completed the Test of Functional Health Literacy in Adults (TOFHLA) and the Asthma Questionnaire-Parent Survey (AQ-P) and provided additional demographic and health status information. Findings: The results show that TOFHLA scores were directly related to asthma knowledge (AQ-P scores), p=. 04. Subjects who had not completed high school had significantly lower TOFHLA scores than those who had completed high school, and their children were hospitalized more often (p=.05). Those with higher income also had higher health literacy (TOFHLA scores) (p=.008) and regression analysis revealed that smoking status was also directly associated with functional health literacy (p=.004). Conclusions: The findings confirm that rural health care providers need to be diligent in assuring that health education materials and verbal instructions are presented in the most simple and easy to read format in order to maximize understanding. Keywords: Health Literacy, Asthma Knowledge, Orem’s Theory of Dependent Care Agency
Impacto de la intervención farmacéutica en la adherencia al tratamiento antirretroviral en pacientes de un hospital de Lima (Perú)

Introduccion: La atencion farmaceutica mejora la adherencia del paciente al tratamiento, por lo que es necesario que el farmaceutico cuente con instrumentos para evaluarla y mejorarla mediante su intervencion en el seguimiento farmacoterapeutico (SFT). Objetivos: Evaluar el impacto de la intervencion farmaceutica en la mejora de la adherencia de los pacientes con virus de la inmunodeficiencia humana (VIH) y sida, e identificar los factores que influyen en ella y que pueden ser modificados por la intervencion farmaceutica en el SFT. Metodos: Se realizo SFT durante 23 meses a 52 pacientes mayores de 18 anos de edad, con tratamiento antirretroviral durante mas de 3 meses, que dieron su consentimiento informado. La adherencia se evaluo con el CEAT-VIH (cuestionario para evaluar la adhesion al tratamiento antirretroviral) al inicio y al final de 6 meses de SFT. Resultados: La puntuacion total del CEAT-VIH (p <0,05; intervalo de confianza del 95%), el cumplimiento del tratamiento (p <0,001) y la percepcion del paciente respecto a su enfermedad y tratamiento antirretroviral (p <0,001) incrementaron significativamente su valor. La educacion al paciente para incrementar la adherencia al tratamiento (46%) fue la intervencion farmaceutica mas frecuente. Conclusiones: Se demuestra que la intervencion del farmaceutico, mediante el SFT, mejora la adherencia al tratamiento antirretroviral. El farmaceutico mejoro los aspectos de cumplimiento y percepcion del paciente sobre su tratamiento y enfermedad. Los farmaceuticos pueden utilizar el CEAT-VIH como instrumento para evaluar la adherencia en la practica del SFT.
Hospital death rates to be published for England

Comparative mortality rates for NHS hospitals in England are to be published in October, the health secretary Frank Dobson announced this week. The move has been contemplated for over a year but has been accelerated by the case in Bristol, where death rates of children after heart surgery were unacceptably high (6 June, p 1691). Mr Dobson has decided that reassurance to patients …
The role and future development of supportive housing for older people in Ireland

This report presents the results of a study to investigate the role and future development of supportive housing for older people in Ireland. For purposes of the study, supportive housing was defined as group or sheltered housing schemes for older people where the residents have their own apartments or houses. The key feature is having one’s own home but within a purpose-built, clustered arrangement rather than individual homes dispersed throughout the community. Within this definition there is a continuum in the amount of support and care that is provided for residents. This focus on supportive housing as defined above is timely in view of the increasing policy attention being given to this area in Ireland, in particular to sheltered housing. High expectations are being placed on it in relation to meeting housing and care needs of older people and delivering on the policy objective of avoiding, or at least delaying, the necessity for older people to move to residential care because they can no longer live independently in their own homes.
Diet and Asthma, Allergic Rhinoconjunctivitis and Atopic Eczema Symptom Prevalence: An Ecological Analysis of the International Study of Asthma and Allergies in Childhood (ISAAC) Data

Purpose of the Study. To provide a global analysis of prevalence rates of wheeze, allergic rhinoconjunctivitis, and atopic eczema in relation to diet, as defined by national food intake data. Study Population. A total of 721 601 children of 2 age groups (6- to 7- and 13- to 14-year-olds) from 156 collaborating centers in 56 countries from the International Study of Asthma and Allergies in Childhood (ISAAC). Methods. Symptom prevalence data was collected by video questionnaires assessing asthma symptoms and severity, allergic rhinoconjunctivitis symptoms, and atopic dermatitis symptoms. Using the 1995 …
Recommendations for Conduct, Methodological Practices, and Reporting of Cost-effectiveness Analyses: Second Panel on Cost-Effectiveness in Health and Medicine.

IMPORTANCE Since publication of the report by the Panel on Cost-Effectiveness in Health and Medicine in 1996, researchers have advanced the methods of cost-effectiveness analysis, and policy makers have experimented with its application. The need to deliver health care efficiently and the importance of using analytic techniques to understand the clinical and economic consequences of strategies to improve health have increased in recent years. OBJECTIVE To review the state of the field and provide recommendations to improve the quality of cost-effectiveness analyses. The intended audiences include researchers, government policy makers, public health officials, health care administrators, payers, businesses, clinicians, patients, and consumers. DESIGN In 2012, the Second Panel on Cost-Effectiveness in Health and Medicine was formed and included 2 co-chairs, 13 members, and 3 additional members of a leadership group. These members were selected on the basis of their experience in the field to provide broad expertise in the design, conduct, and use of cost-effectiveness analyses. Over the next 3.5 years, the panel developed recommendations by consensus. These recommendations were then reviewed by invited external reviewers and through a public posting process. FINDINGS The concept of a "reference case" and a set of standard methodological practices that all cost-effectiveness analyses should follow to improve quality and comparability are recommended. All cost-effectiveness analyses should report 2 reference case analyses: one based on a health care sector perspective and another based on a societal perspective. The use of an "impact inventory," which is a structured table that contains consequences (both inside and outside the formal health care sector), intended to clarify the scope and boundaries of the 2 reference case analyses is also recommended. This special communication reviews these recommendations and others concerning the estimation of the consequences of interventions, the valuation of health outcomes, and the reporting of cost-effectiveness analyses. CONCLUSIONS AND RELEVANCE The Second Panel reviewed the current status of the field of cost-effectiveness analysis and developed a new set of recommendations. Major changes include the recommendation to perform analyses from 2 reference case perspectives and to provide an impact inventory to clarify included consequences.
Fathers' Mental Health and Wellbeing - Why is it significant to Health Visiting?

Mental health and wellbeing is a public health priority in the UK. The transition to parenthood can be a stressful time bringing new challenges, which can significantly affect the mental wellbeing of both mothers and fathers. While the importance of maternal mental health is widely recognised, fathers' mental health needs are less well understood. Poor mental health in fathers can have an adverse effect on the child's health and development. Health visitors can play a key role in improving fathers' mental health during this crucial time. This paper is the second of a two-part series on fatherhood, which explores the importance of improving mental health and wellbeing in fathers in the postnatal period.
The conserved hypothetical protein PSPTO_3957 is essential for virulence in the plant pathogen Pseudomonas syringae pv. tomato DC3000

Abstract The plant pathogen Pseudomonas syringae accounts for substantial crop losses and is considered an important agricultural issue. To better manage disease in the field, it is important to have an understanding of the underlying genetic mechanisms that mediate virulence. There are a substantial number of genes in sequenced bacterial genomes, including P. syringae, that encode for conserved hypothetical proteins; some of these have been functionally characterized in other Pseudomonads and have been demonstrated to play important roles in disease. PSPTO_3957 encodes a conserved hypothetical protein of unknown function. To evaluate the role of PSPTO_3957 in P. syringae pv. tomato DC3000, a PSPTO_3957 deletion mutant was constructed. Here, we show that PSPTO_3957 does not influence growth on rich media, motility or biofilm formation but is necessary for nitrate assimilation and full virulence in P. syringae. Our results have revealed an important role for PSPTO_3957 in the biology of P. syringae. Given the conservation of this protein among many bacteria, this protein might serve as an attractive target for disease management of this and other bacterial plant pathogens.
Role of Infliximab in Pediatric Fistulizing Crohn’s Disease

Background: Crohn’s disease, a chronic inflammatory bowel disease (IBD) that was once considered rare in the pediatric population, is currently recognized as one of the most important chronic diseases that affects children and adolescents. Extra-intestinal manifestations rarely can precede IBD leading to a late diagnosis. Case Report: This is a case report of a 13 year old boy admitted for draining abdominal fistulae. The patient refers a six year history of musculoskeletal manifestations with low back pain, recurrent fever and limping. Six months ago he underwent surgery for pelvic abscesses. After surgery he was referred to our service for draining an abdominal fistula. We performed a colonoscopy which shows images and histology compatible with Crohn’s disease. We decided to treat the patient with infliximab, 5 mg per kilogram of body weight administered intravenously at weeks 0, 2, and 6. After the second dose of infliximab we noticed the complete closure of the fistula. Conclusion: Infliximab is a good treatment alternative in patients with Crohn’s disease preceded by musculoskeletal manifestations and complicated by abdominal fistula.
Proton Pump Inhibitors and Clopidogrel: A Review of the Interaction

Current consensus guidelines recommend the use of proton pump inhibitors (PPIs) for the prevention of gastrointestinal bleeding in patients receiving dual antiplatelet therapy (DAPT) with clopidogrel and aspirin. Metabolism of both PPIs and clopidogrel involves the cytochrome-P450 (CYP450) system. Concomitant use of these drugs may result in the competitive inhibition of CYP2C19 and reduced clopidogrel action. The evidence available to date for a drug interaction is conflicting and relies heavily on observational data. Until further evidence become available, it is recommended that health care professionals avoid the concomitant use of clopidogrel and PPIs unless absolutely necessary and only when there is a clear indication such as for peptic ulcer disease or H. pylori eradication. Pantoprazole may be the preferred PPI although current evidence are inconclusive. H2 antagonists may be a suitable alternative to PPIs.
A malaria fingerprint in the human genome?

Malaria, a tremendously successful pathogen that is responsible for more than 300 million cases and 1 million deaths annually,1 has had a large impact on the shape of the human genome. Malaria-selected mutations in human genes promote survival in areas where malaria is endemic. The parasite's substantive effect on the human genome is due to its high prevalence in areas where it is endemic and its long history of coevolution with humans. Moreover, its marked genetic diversity, generated by its sexual stage, provides the organism with many opportunities to maximally adapt to host defenses and continue transmission. In this issue .
Percutaneous intervention vs. coronary-artery bypass grafting in left main coronary disease.

A recent meta-analysis, report, and editorial all agreed with the need for a randomized trial of percutaneous coronary intervention (PCI) as compared with coronary-artery bypass grafting (CABG) in patients with left main coronary artery disease.1–3 The meta-analysis reported results of 16 observational studies on 1278 patients undergoing PCI with drug-eluting stents for unprotected left main coronary artery disease.1 Mortality was 2.3% during hospitalization and 5.5% at the time of last follow-up, at a median of 10 months. Five randomized comparisons of PCI and CABG were noted to be ongoing, with combined enrollment goals exceeding 2400 patients with unprotected left .
Gestational diabetes--setting limits, exploring treatments.

Pregnancy is associated with relative carbohydrate intolerance and insulin resistance. Gestational diabetes mellitus (carbohydrate intolerance first diagnosed during pregnancy) has long been recognized as a risk factor for a number of adverse outcomes during pregnancy, including excessive fetal growth, an increased incidence of birth trauma and cesarean delivery, and neonatal metabolic abnormalities such as polycythemia, hyperbilirubinemia, and hypoglycemia.1 This recognition has led to recommendations to screen all pregnant women for gestational diabetes mellitus and to treat those whose glucose-tolerance tests exceed threshold criteria.2 The threshold criteria for diagnosing gestational diabetes were initially specified rather arbitrarily as values greater than 2 .
The secret lives of monoclonal B cells.

It seems that B cells, the lymphocytes responsible for producing antibodies, are eager to share their secrets. Their revelations were first uncovered indirectly in serum through reactions with microbes, cells, and toxins; increases in gamma globulin after immunization; agammaglobulinemia associated with immune deficiency; and the paraproteins in multiple myeloma and related disorders that ultimately revealed the structure of immunoglobulins and prompted the two-gene–one-antibody hypothesis. Further revelations, often surprising and unique, came from the B cells themselves: clonal expansion, allelic exclusion, light-chain restriction, somatic recombination of immunoglobulin V genes, isotype switching, and the deliberate hypermutation of V genes that leads to .
Strategic Planning and Service Delivery in the School Setting

Approximately 10% of the audiologists working in the Uni ted States repor t the school setting as their primary site of employmen t (American Speech-Language-Hearing Association, 1995). The provision of audiology services in the educational setting has resulted in the evolution of a relatively new specialty. Over the past 20 years, the field of educational audiology has established two goals: (1) to make audiology services available to all students, and (2) to clarify the role of the audiologist in the school setting. Much of the strategic planning conducted in the interest of meeting these goals has been developed by the Educat ional Audiology Association (EAA); some of the efforts of this organization are detailed here . Fundamental differences in the school env i ronment have a direct effect on audiology service delivery, and these differences are also described. However, a mere understanding of the goals of educational audiology will not adequately address the concerns of children with hearing impairment. Therefore, this article concludes with a proposal for "cross-setting communication" among clinical and educational audiologists to share information across work settings. Thereby, the delivery of services to children with hear ing impai rment may be improved.
Resultados en reducción abierta de cadera por via interna: necrosis avascular y concordancia interobservador

Introduccion: la luxacion tipica de la cadera es una patologia con alta incidencia, de ahi la necesidad de metodos efectivos para lograr una reduccion de esta. Han surgido varios metodos de reduccion, uno de estos metodos es la reduccion abierta por via interna. Metodologia Estudio descriptivo retrospectivo, incluyo los casos operados de reduccion abierta por via interna en el Instituto de Ortopedia Infantil Roosevelt y Clinica Jorge Pineros Corpas por uno de los tutores, desde enero de 2006 hasta junio de 2011, valorando estas caderas segun los criterios de Salter de necrosis avascular (NAV), con un seguimiento minimo de 18 meses. Se evaluo la concordancia interobservador para la clasificacion de Salter en tres ortopedistas infantiles. Resultados Se evaluaron 20 caderas en 16 pacientes a los que se realizo reduccion abierta de luxacion tipica de cadera por via interna. El 40 % de las caderas presentaron NAV, el 75% de estas caderas presentan NAV tipo I segun la clasificacion de Kalamchi. El indice Kappa para la clasificacion de Salter en tres ortopedistas infantiles fue 0.6. Discusion El abordaje por via interna para la reduccion de luxacion de cadera tipica en ninos menores de 18 meses es una alternativa mas para el manejo de estos pacientes, que puede producir NAV en la cadera, pero esta NAV es tipo I de Kalamchi en la mayoria de casos. La reproducibilidad de la radiografia para la evaluacion de NAV, realizada por personas expertas es buena, medida con indice kappa de 0.6.