Miracle-dz/UniFAR-FTUs huggingface dataset:
Acesso vascular para hemodiálise: experiência do serviço de nefrologia do Hospital da Cidade de Passo Fundo, RS

INTRODUCAO: doenca renal cronica (DRC) e considerada mundialmente uma causa de alta morbidade e mortalidade. Aproximadamente 90% dos pacientes dialiticos no Brasil fazem tratamento por hemodialise (HD). O acesso vascular ideal e aquele que proporciona bom fluxo sanguineo, baixas complicacoes e adequada sobrevida. OBJETIVO: Descrever a prevalencia da patologia de base, idade, genero e dos perfis de acessos vasculares, bem como verificar se existe diferenca das medias dos parâmetros Kt/V e URR em relacao ao tipo de acesso vascular. METODOS: Trata-se de um estudo transversal, sendo analisadas 370 sessoes de HD realizadas em uma populacao de 81 pacientes. Foram avaliadas as seguintes variaveis: sexo, idade, doenca de base, tipo de acesso vascular, valor de Kt/V e URR no periodo de janeiro a junho de 2018 no setor de nefrologia do Hospital da Cidade de Passo Fundo/RS. RESULTADOS: As doencas de base mais frequentes para DRC foram diabetes mellitus (DM) e hipertensao arterial sistemica (HAS) (70%) e o acesso vascular mais utilizado foi a fistula arteriovenosa (FAV) (78%). Nao se observou diferenca significativa entre o tipo de acesso vascular com com os parâmetros laboratoriais, Kt/V com IC de 95% de (-0,052 e 0,0197) e URR com (-2,125 e 3,282). CONCLUSAO: Apesar da pesquisa nao demonstrar diferenca do Kt/V e URR entre os tipos de acesso utilizados, e necessario mais estudos para comprovar tal informacao, pois a pesquisa foi realizada em unico servico com limitado numero de sessoes de HD.
Relationship between right atrium area and right ventricular ejection fraction on magnetic resonance imaging: comparison with other prognostic markers in patients with pulmonary arterial hypertension

Objective: To compare the right atrium (RA) area and right ventricular ejection fraction (RVEF) with other known prognostic markers in patients with pulmonary arterial hypertension (PAH). Materials and Methods: This was a retrospective study of 74 patients diagnosed with PAH by right heart catheterization at a referral center between January 2018 and May 2018. All of the patients underwent cardiac magnetic resonance imaging (MRI) within 3 months of the right heart catheterization (RHC), as well as undergoing echocardiography, a 6-minute walk test, and determination of the level of N-terminal pro-brain natriuretic peptide (NT-proBNP) within a month of the RHC. We attempted to determine whether the cardiac MRI-derived RA area correlated with ions between RVEF and RA area measured by that determined by echocardiography, as well as whether the cardiac MRI-derived RA area and RVEF correlated with the 6-minute walk distance and NT-proBNP level. Results: The MRI-derived RA area demonstrated a weak correlation with the pulmonary vascular resistance measured by RHC (r = 0.268; p = 0.055) and a moderate correlation with the NT-proBNP (r = 0.429; p = 0.003). All correlations between clinical characteristics and the RVEF were statistically significant. In the univariate linear analysis, the RVEF showed stronger correlations with the clinical characteristics than did the RA area. Conclusion: In patients with PAH, cardiac MRI-derived RVEF appears to correlate more strongly with other prognostic factors than does RA area.
Serum high mobility group box protein 1 (HMGB1) levels reflect clinical features of childhood hemophagocytic lymphohistiocytosis

Purpose Hemophagocytic lymphohistiocytosis (HLH) is a potentially lethal hyperinflammatory disorder. For further understanding of the pathogenesis of HLH, we examined serum levels of high mobility group box protein 1 (HMGB1) in children with HLH. Patients and methods Serum HMGB1 levels were measured in 28 patients with HLH and 6 normal controls using a quantitative enzyme-linked immunosorbent assay. The patients were 21 boys and 7 girls, aged from 10 days to 21 years, with a median age of 8.5 years. The underlying conditions of HLH were infection-associated HLH in 18 patients, malignancy-associated HLH in 7 patients, and genetic HLH in 3 patients. The relations between serum HMGB1 levels and clinical symptoms and laboratory parameters were analyzed. Results Serum HMGB1 levels were significantly higher in patients with HLH than in normal controls (median, 6.5 ng/mL, interquartile range, 4.25–13.1). The serial serum HMGB1 levels in one patient fell to reflect the disease activity. Serum HMGB1 levels were significantly higher in patients with disseminated intravascular coagulation (DIC) than in patients without DIC (p<0.001) and were also significantly higher in patients with central nervous system (CNS) complications than in patients without CNS complications (p<0.01). Serum HMGB1 levels were positively correlated with aspartate aminotransferase (rs =0.48, p<0.01, Spearman’s rank correlation coefficient) and negatively correlated with fibrinogen (rs = −0.475, p=0.011) and hemoglobin (rs = −0.465, p=0.013). Conclusion Serum HMGB1 levels reflect clinical features of childhood HLH. HMGB1 is a potential mediator involved in the pathogenesis and determining the clinical findings of HLH.
Improving breast imaging quality standards

Mammography is an important tool for detecting breast cancer at an early stage. When coupled with appropriate treatment, early detection can reduce breast cancer mortality. At the request of Congress, the Food and Drug Administration (FDA) commissioned a study to examine the current practice of mammography and breast cancer detection, with a focus on the FDAa (TM)s oversight via the Mammography Quality Standards Act (MQSA), to identify areas in need of improvement. Enacted in 1993, MQSA provides a general framework for ensuring national quality standards in facilities performing screening mammography, requires that each mammography facility be accredited and certified, and mandates that facilities will undergo annual inspections. This book recommends strategies for achieving continued progress in assuring mammography quality, including changes to MQSA regulation, as well as approaches that do not fall within the purview of MQSA. Specifically, this book provides recommendations aimed at improving mammography interpretation; revising MQSA regulations, inspections, and enforcement; ensuring an adequate workforce for breast cancer screening and diagnosis; and improving breast imaging quality beyond mammography.
Prevalence of anemia in type II diabetes mellitus patients

Background: Anemia is a common haematological finding in diabetic patients. The prevalence of anemia in the patients with diabetes is two or three times higher than in patients with comparable renal impairment and iron stores in the general population. As India is foreseen a diabetic capital of the world, it becomes imperative to recognize co-morbidities such as anemia at the earliest. The aim of this study was to determine the prevalence of anemia among patients with type 2 diabetes. Author conducted a prospective analysis of 100 diabetic patients visiting the outpatient clinic in our institution. Duration of study is One Year (November 2016 - December 2017). Study perform at Om Sai Hospitals, Balapur, Hyderabad, Telangana, India. A 100 patients suffering from type 2 Diabetes Mellitus, attending Outpatient Department of General Medicine, were included in the study.Methods: All the patients were subjected to detailed history, through clinical examination and investigation. Patients’ blood samples were analyzed for Glycated hemoglobin (HbA1C) values and hemoglobin (Hb) levels. The prevalence of anemia was then determined defining anemia by an Hb level <13.0 g/dL for men and <12.0 g/dL for women.Results: The prevalence of anemia in this study population was found to be 43%. The prevalence of anemia is significantly greater in diabetic females than in diabetic males and in poorly controlled diabetics than those with glycemic status under control.Conclusions: We conclude that anemia is a prevalent finding in patients with type 2 diabetes mellitus and represents significant unrecognised burden.
Translational thoracolumbar injury after motor vehicle collision with uretero-thecal fistulization: a case report

Blunt torso trauma leading to translational thoracolumbar injury is a rare and serious injury requiring high amount of energy to produce this injury pattern. Translational thoracolumbar injuries have high association with spinal dural tears and traumatic aortic injuries however, associated traumatic ureteral injury is rare. This case report presents a unique combination of traumatic ureteral and dural injury resulting in an abnormal fistulous communication between the two, in a patient with translational thoracolumbar injury after motor vehicular collision. Unexpected “myelogram-like” appearance was seen with excreted urinary contrast mixing with the CSF in the spinal and intracranial subarachnoid spaces. No other reports of such a traumatic uretero-thecal fistula were found in our comprehensive search through the published English literature.
Type 2 diabetes mellitus, physical activity, yoga and telomere length: A literature review

Background: Type 2 diabetes mellitus (DM), a chronic metabolic disease prevalent in adults, is also prevalent amongst children, adolescents and young adults. On understanding the molecular basis of diabetes, a significant association is found between telomere length (TL) and type 2 DM.Aim: The aim of the study was to review the available evidence on effect of physical activity and yoga on DM including their effect on TL.Setting: The study was conducted in Bangalore.Method: A number of databases such as Google Scholar, PubMed and Cochrane Review were searched for relevant articles using keywords such as ’diabetes’, ‘type 2 DM’, ‘physical activity’, ‘yoga’, ‘TL’ and ‘telomerase activity’. All types of articles were included for the study, such as randomised controlled trial, systematic reviews, literature review and pilot study. Non-English articles were excluded from the study.Results: Studies have demonstrated the effectiveness of yoga and physical exercise in type 2 DM in various ways, such as reducing fasting blood glucose and glycosylated haemoglobin; improving lipid profile, blood pressure and waist-to-hip ratio; reducing inflammatory, oxidative and psychological stress markers; and improving the quality of life of patients. However, limited information is available on the effect of these interventions on TL in type 2 DM and mechanisms involved.Conclusion: Recent studies have shown positive effects of yoga and physical activity on TL. However, there is a dearth of good-quality studies evaluating the effects of yoga on TL in type 2 DM. Future studies need to be conducted with standard treatment protocols, long-term follow-up, appropriate control groups and large sample size.
Mental health of youth orphaned due to AIDS in South Africa: biological and supportive links to caregivers

This research explored the biological and social support relationship between youth orphaned due to AIDS and his/her caregiver to identify protective factors that are related to positive mental health outcomes. These youth have significantly higher levels of depression, anxiety, and post-traumatic stress (PTS) symptoms compared to those orphaned due to other causes and non-orphans. Using a 2009 cross-sectional data-set from South Africa, 254 youth orphaned due to AIDS were purposively selected from the overall sample of 732 to further examine this caregiver relationship. Caregiver relation was analyzed in several combinations to determine if it was significantly related to mental health outcomes, with only anxiety showing significance. Those living with a biological parent had significantly higher anxiety symptoms than those living with a grandparent, other kin, or non-kin. Anxiety was also significantly related to an increased age, lower levels of emotional support, and lower levels of instrumental/financial support (R2 = .153). Age was the only significant variable from the model that was related to depression symptoms (R2 = .111). PTS symptoms were related to increases in age, lower levels of emotional support, instrumental/financial support, and satisfaction with the caregiver (R2 = .194). Gender and age were related to suicidal tendencies, specifically boys were 2.26 times more likely to exhibit suicidal tendencies compared to girls, and every yearly increase in age results in the youth being 1.22 times more likely to exhibit suicidal tendencies. Strengthening the caregiver’s ability to provide social support for the child is critical, irrespective of any biological kin relationship.
Physiological Detection of Anxiety

Anxiety detection from physiological signal has great significance in the healthcare application. Anxiety has negative valence and it keeps individual concentrated on negative emotions. Physiological features of Electrocardiogram signal quantify the anxiety response in individuals. Pan Tompkins algorithm is used for detecting the R peaks in the signal and then determines the interbeat intervals or R-R intervals. Support vector machine (SVM) and Kalman filter are used to detect anxious and non-anxious data. System performance is evaluated on ECG signals from the database for both methods. The system detects physiological changes related to the anxiety stimuli. From the results it can be concluded that the system can detect anxiety state with an accuracy of 71.1 % and 69.35 % using SVM classifier and Kalman filter respectively. The system detects anxiety and it can support individuals with anxiety disorders.
FASD – Fetal Alcohol Syndrome Disorder

Consumption of alcohol during pregnancy is a highly undesirable phenomenon, often causing miscarriages or many abnormalities of the child's development. Fetal Alcohol Spectrum Disorder (FASD) describes physical and mental disorders resulting from the effects of alcohol on health and behavioral disorders of the child, which are usually secondary to changes in the central nervous system caused by fetal alcohol intoxication during pregnancy. These changes are usually irreversible and evident throughout the life of a child affected by FASD, but if appropriate therapies are implemented, it is possible to minimize the symptoms of these disorders. Their nature and severity depend on several factors, including the time of exposure to alcohol and the health status of a pregnant woman. Clinical features of FASD include craniofacial anomalies, central nervous system disorders and growth retardation. Alcohol-induced structural changes include anomalies in the cardiovascular, skeletal, renal and urinary systems as well as in the organs of sight and hearing. Time of initial diagnosis plays an important role, because it allows the introduction of appropriate therapy for a child with FASD and the introduction of appropriate education of parents and other members of the family. It is possible to minimize the symptoms and disorders resulting from the Fetal Alcohol Disorders Spectrum, to the extent enabling them proper functioning of the child and his family.
Study of risk, incidence and mortality associated with postoperative pulmonary complications using assess respiratory risk in surgical patients in catalonia score

Background: Postoperative pulmonary complications (PPCs) are one of the major complications that are seen in patients undergoing surgeries and are also a significant cause of increased duration of hospital stay and mortality. Owing to their high incidence the present study was done to assess the risk and incidence of PPCs using the assess respiratory risk in surgical patients in catalonia (ARISCAT) score and to observe the mortality related to PPCS.Methods: The study was done at a tertiary care center over a period of three month and 150 patients were involved. The patients were the categorized into three risk groups and were observed for development of any PPCs.Results: Out of the 150 patients that were studied, 29 developed some form of PPC. 21 out of these 29 (72.41%) patients were from the high-risk category. 11 out of the 29 patients died in a span of 30 days. Pneumonia was seen to be the most common PPC.Conclusions: ARISCAT score can be useful as a preoperative evaluation tool to classify patients into risk groups and predict the development of PPC in the high-risk groups and to take measures to reduce the risk of PPCs. We conclude from our study that anemia, emergency surgery and surgery with duration of more than 3 hours were significant factors contributing to both the incidence and mortality of PPCs irrespective of the risk group.
Drugs in Cardiopulmonary Resuscitation

The outcomes from cardiac arrest remain poor, in spite of advances in medical science. Since its discovery and isolation at the turn of the twentieth century, adrenaline has held primacy amongst the armamentarium of drugs used in cardiopulmonary resuscitation. Evidence supporting its use is scarce, and research has been hampered by the perception that randomised, placebo-controlled trials might be unethical. However, concerns have been raised that some of the wide-ranging effects of adrenaline may be detrimental. This chapter begins with a review of the basic physiology and pharmacology of adrenaline. It discusses the clinical data describing its use in cardiopulmonary rescuscitation, and highlights some of the obstacles to drawing positive conclusions about its efficacy.
Inflammatory responses and healing in the injured abdomen

Abdominal surgery itself, and implants used in abdominal wall reconstruction, are associated with intra-abdominal inflammation that can go on to cause complications such as adhesions, fistulae or failure of the implant. The pathophysiology of these complications is not fully understood but it would be desirable to produce an in vitro model that can reliably study these peritoneal responses. The use of â€˜temporary abdominal closureâ€™ (TAC) systems following laparotomy for abdominal trauma is increasing, and can lead to the requirement for abdominal wall reconstruction using an implant. It was hypothesised that many Servicemen injured in the Iraq and Afghanistan campaigns would subsequently suffer inflammatory complications as a result of these reconstructions, and so these patientsâ€™ hospital and primary care records were searched to find evidence of this. Very few of these patients required abdominal wall reconstruction, and no evidence was found that TAC was associated with an increased frequency of complications when compared to early closure of the abdominal fascia. In order to develop an in vitro model of peritoneal inflammation that can be used to study cytokine responses to various stimuli, donated human peritoneum was incubated with and without LPS in the presence of implants used for abdominal wall reconstruction. Incubation with BiodesignÂ® and Stratticeâ„¢, non-crosslinked biological implants, was associated with significant reductions in supernatant IL-6, IL-1I² and TNFI± concentrations when compared to control. As generally this was matched by drops in mRNA for these cytokines, this seemed to be a true effect on the tissues rather than an artefact of the experiment, such as cell death or cytokine adsorption by the implant. This effect may be mediated by glycoproteins in these implants binding growth factors in the supernatant. This model, although a long way off direct clinical application, shows promise in further studying peritoneal inflammatory responses.
The Importance of Prenatal Stress on the Development of ADHD in Children Literature Review 2019

Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder that affects children and often persists into adulthood. Research suggests that there is a link between maternal stress levels and the development of this condition. According to the Centers for Disease Control and Prevention (CDC), 6.1 million children living in the United States in 2016 had received a diagnosis of ADHD. The symptoms of ADHD can vary from person to person, but they typically include difficulties with concentrating, paying attention, and controlling impulses.It is not clear what causes ADHD, but scientists believe that genetics, certain environmental factors, and brain changes may play a role in its development. Researchers have also investigated the role of nutrients, such as vitamin D and hormone, such as prenatal testosterone. In this article, wewill reviewed the latest literature assessing the relationship between prenatal exposure to psychosocial stress during pregnancy and to the risk of developing behavioral problems related to attention deficit hyperactivity disorder (ADHD) in Childhood.
HIV-1-resistens mot antiretrovirale midler

Background. Failure of antiretroviral drugs to completely suppress HIV-1 replication inevitably leads to selection of drug-resistant variants. Emergence of drug resistance plays a major role in limiting the long-term success of antiretroviral therapy. Material and methods. From August 1998 until April 2001, a total of 183 samples from 152 patients were analysed for HIV-1 drug resistance using genotypic analysis. Results. Mutations associated with resistance were found in virus from 112 patients who received antiretroviral therapy. Mutations were frequently identified in the reverse transcriptase gene and to a lesser extent in the protease gene. Mutations associated with reduced drug susceptibility or polymorphisms were identified in 22 treatment naive patients. In addition, resistance mutations were observed in three out of eight patients with a recent infection. Interpretation. Genotypic resistance testing is a valuable tool for rational decision-making when the current therapy is failing. In addition, patients with a recent HIV-1 infection should be tested for the surveillance of transmission of drug-resistant genotypic variants.
Gait kinematic analysis of the osteoarthritic knee : pre- and post- total knee arthroplasty

Patients with knee osteoarthritis tend to modify spatial and temporal parameters during walking to reduce the pain. There are common gait features which are consistently shown to be significantly linked to osteoarthritis severity such as knee adduction moment, knee flexion angle, stiffness and walking speed. Total knee arthroplasty (TKA) is considered the gold standard treatment for end-stage knee osteoarthritis. Nearly a million of total knee prosthesis are implanted worldwide each year. However, reduced physical function of the knee is partly, but apparently not fully, remedied by surgery. The purpose of this thesis was to investigate the in vivo, three dimensional knee kinematics during gait at the patients with knee osteoarthritis and the influence of total knee arthroplasty on restoration of normal kinematics. Weight bearing kinematics in medial OA knees differ from normal knee kinematics. Knee OA group showed an altered “screw-home” mechanism by decreased excursion in sagittal and axial tibial rotation and a posterior translation of the tibia. Following TKA, patients had better clinical, spatiotemporal and kinametic parameters. They walked longer, faster and with a better range of motion. Despite improvements, the knee kinematics during gait in TKA group differed from healthy control group. They had a lower extension, lower range of axial rotation and an increased tibial posterior translation. Future research should be focused on comparing different designs of prosthesis pre- and post operatively in a longer follow-up delay