Miracle-dz/UniFAR-FTUs huggingface dataset:
Evaluating Incorporation of Drug Restrictions into Computerized Drug Order Entries after Transition to an Electronic Health Record

Background Incorporation of drug restriction policy into electronic drug order entries (DOEs) can promote responsible medication use and resource utilization when implemented systematically. Objective To identify drugs that require further incorporation of formulary restriction policy into their DOEs after migration to an electronic health record with computerized prescriber order entry (CPOE). Methods After transition to CPOE, test orders for formulary restricted drugs were entered in the CPOE environment. Data were collected about rationale for drug restriction, type of formulary restriction, presence of incorporation of restriction policy into the DOE, and whether incorporation was consistent with a recommended method. Restricted drugs requiring revision of policy incorporation into their DOEs were analyzed to create a prioritized task list based on rationale for the restriction. Results Of all restricted drugs, 63.6% (287/451) did not have restriction policy incorporated into their DOEs consistent with the recommended method and therefore required revision. Eighteen percent (81/451) of restricted drugs had no incorporation of restriction policy in their DOEs. Safety was the rationale for restriction in 21% (17/81) of these, which received highest priority for revision. When drugs were orderable but restricted, 61.9% (78/126) lacked optimal incorporation of policy in DOEs to promote adherence. When drugs were not orderable, 64% (206/322) did not provide guidance to formulary alternatives in DOEs when they should have. Conclusion After transition to CPOE, almost two-thirds of all analyzed restricted drugs lacked optimal incorporation of formulary restriction policies in their DOEs. DOEs with restrictions related to safety reasons were among those most frequently requiring revision. Some DOEs can better promote adherence and provide guidance to prescribers through revision. Predefined, systematic implementation strategies should be used during changes in computerized drug use processes.
Revisión de la literatura sobre tratamiento del cáncer de mama localmente avanzado

Ficha del Articulo Citacion: Ballesteros G, Campos M, Muller B, Ciudad A, Orlandi L, Donoso A, et al. Revision de la literatura sobre tratamiento del cancer de mama localmente avanzado. Medwave 2010 Ene;10(01). doi: 10.5867/medwave.2010. 01.4354 Fecha de envio: 12/8/2009 Fecha de aceptacion: 26/8/2009 Fecha de publicacion: 1/1/2010 Origen: no solicitado Tipo de revision: con revision por pares externa
The dietary and health behaviour of young people aged 18–25 years living independently or in the family home in Liverpool, UK

An individual's dietary habits are largely developed during childhood and adolescence, and are likely to be determined by both nature (the development of sensory perceptions) and nurture (parental influence, and later on the influence of peers). However, diet is likely to evolve throughout the life cycle as circumstances change and new influences are introduced to an individual's lifestyle. An example of this is the changes in diet that occur as a result of the transition young people make away from the family home into independent living. Leaving behind the meals provided and cooked by parents/guardians and learning how to shop on a budget and prepare and cook for themselves may result in the adoption of poor eating habits, which is likely to have a detrimental effect on health. Leaving behind the restrictions of parental control may also result in the adoption of unhealthy lifestyle practices such as smoking and excessive alcohol consumption. This study therefore seeks to investigate the effect of leaving home on a young person's diet and lifestyle. Health behaviour and food intake was assessed by questionnaire. Findings suggest that a young person's diet may change after leaving home, but these changes are not necessarily negative. More negative health behaviour was observed in young people living independently.
Factors influencing the utilisation of PMTCT services in the federal capital territory of Nigeria

This study investigated the factors influencing the utilisation of PMTCT of HIV services and proposed measures to promote service utilisation by HIV positive pregnant women in the FCT, Abuja, Nigeria. Effective interventions exist that can reduce the transmission of HIV infection to the baby. The study is a quantitative descriptive one, with 190 HIV positive pregnant women from 20 health Centres in three area councils in Abuja, who were interviewed using structured questionnaire to get their opinion. The findings revealed that the majority (90.4%) of the respondents were aware of PMTCT and how HIV can be transmitted from mother-to-child. The respondents (95.9%) were of the opinion that all pregnant women should be tested. Notably, PMTCT services will be hindered by the following: permission from spouse before being tested, couple counselling not done, group post test counselling, non-incorporation of family planning and low support group enrolment. Recommendations made include emphasis on couple counselling, confidentiality and friendly environment.
Advanced Magnetic Resonance Imaging Findings of Renal Hydatid Cyst

Abstract Hydatid Cyst, a serious health problem in the developing countries, is a zoonotic infection formed by echinococcus. Though liver or lung involvement is often, kidney involvement is rarely seen and represents for only 2 to 3 per cent of all cases of hydatid disease. An adult case referred who had multiple cysts in liver and large, solitary cyst in the kidney. We aimed to present magnetic resonance spectroscopy (MRS) and diffusion weighted magnetic resonance (DWI) findings of the hydatid cyst’s. This is the first study that shows the MRS and DWI results of the renal hydatid disease. The mean ADC (apparent diffusion coefficient) value of the renal hydatid cyst was 2554x10-6 mm2/s on DWI and high signal intensity was detected compared with the renal parenchyma. MR spectroscopy at TE of 31 shows prominent alanine peak in addition to small amino acid peaks. Advanced MRI studies such as DWI and MRS can provide supplementary information both in the post-treatment period and in the diagnosis by bringing non-invasive approaches. Key words: Hydatid Cyst, magnetic resonance imaging, magnetic resonance spectroscopy, diffusion weighted imaging
[Cancer in Africa, a new health challenge. Examples of Mali and OncoMali].

Oncology is perceived as a secondary problem of public health in emerging countries. Nevertheless the annual incidence of cancers is rapidly expanding (approximately 100 to 120/100 000 subsaharan Africa). It can explain by the high incidence of the infectious pathologies associated with a high oncogene risk (hepatitis, HIV, Helicobacter .) but also by national and international prevention policies still too much reduced. If this epidemiological tendency continues, Africa will count in 2020 near a million new cases of cancers every year. The incidence increases but the morbi-mortality is also very high in these countries. This observation exceeds the simple consequence of a defect of means. The sociocultural landscape and the mental representations of this disease are also in cause. We shall evoke in this article the situation of Africa by quoting the example of Mali. We shall conclude on the individual contributions which can be made through the example of the association "OncoMali".
Stroke and Visual Rehabilitation

Abstract Many patients will experience some type of visual dysfunction following a stroke. The visual changes associated with stroke can be categorized as sensory (visual acuity and visual field), motor (extraocular muscle motility), and perceptual. These disturbances affect the patient’s quality of life and can impede overall rehabilitation. Many of these impairments can be addressed by simple yet effective techniques. As a result, vision rehabilitation specialists are becoming an important part of the multidisciplinary stroke rehabilitation team.
An Ankle to Computer Virtual Reality System for Improving Gait and Function in a Person 9 Months Poststroke

Abstract Background and Purpose: Repetitive practice improves function and facilitates cortical plasticity after stroke. Virtual reality (VR) systems have the potential to provide motivating and safe repetitive practice with minimal supervision. The purpose of this case study is to look at the effect of a VR system, activated by surface electromyography of dorsiflexors and plantarflexors, on gait velocity, function, and kinematics. Method: The first person randomized to the treatment group of a larger study was chosen for this case. She was 51 years old and 9 months poststroke. She received treatment 3 times per week for 8 weeks. Each 60-minute session consisted of both structured lower extremity exercise and VR ankle activities. Results: After intervention, the subject demonstrated increased gait speed and decreased time to perform the modified Emory Functional Ambulation Profile. Gait kinematics demonstrated improved ankle motion and plantarflexion moments at push off. Discussion: The improved gait speed, possibly due to increased ankle plantarflexion motion and moments, resulted in a more normalized trailing limb posture. This case study suggests that ankle to computer VR systems may help stroke patients improve gait function. This VR system has potential as an adjunctive therapy or home program requiring minimal supervision.
Hospital-Based Stroke Rehabilitation in the United States

Abstract In this article, we consider (1) the role of Medicare in shaping US inpatient rehabilitation facility (IRF) stroke rehabilitation, (2) admission criteria for IRF care in the United States and medical management while in IRF, (3) the organization and delivery of IRF-level nursing and therapy, (4) post-IRF rehabilitation choices, (5) monitoring of rehabilitation outcomes, and (6) the implications of a multisite stroke outcome study for stroke rehabilitation practice. Inpatient stroke rehabilitation in the United States is a team-oriented, patient-centered, Medicare-driven service provided to stroke survivors. As a field of practice, it strives for continuous quality improvement to optimize patient outcomes. Stroke rehabilitation as a science, however, remains underfunded relative to the scope of the challenge in Western societies and worldwide for that matter. Worldwide sharing of best practices found in the United States and other countries will allow stroke survivors of any country improved chances for functional recovery, greater independence, and life satisfaction.
The Use of Kinetics as a Marker for Manual Dexterity After Stroke and Stroke Recovery

Abstract Stroke is the leading cause of severe, long-term disability among older adults in the United States. Unimanual motor performance of the hemiparetic limb is clearly compromised, and these declines are well documented. An often overlooked aspect of motor function for patients with stroke is the effect of unilateral motor dysfunction on bimanual motor activities. Diminished bimanual function resulting from upper extremity hemiparesis necessarily limits the patient’s daily functioning. In this review we describe a bimanual dexterity task that replicates many daily activities and outline how kinetic analysis of this task may provide insight into diminished bimanual function of patients with stroke and how these variables may be useful in assessing level of recovery and rate of motor recovery associated with behavioral interventions intended to improve upper extremity function. It is argued that the use of objective kinetic measures to quantify hand function may facilitate the clinical adoption of behavioral interventions for stroke, such as constraint-induced movement therapy and other repetitive task practice-based interventions.
Poststroke Fear of Falling in the Hospital Setting

Abstract Purpose: Fear of falling (FoF) has a negative impact on older adults, however there is a paucity of research regarding the development and impact of FoF after stroke. Therefore, our objectives were to determine the proportion of individuals with FoF and the affect of FoF during the immediate poststroke period. Methods: This observational study of baseline data from a pilot cohort study includes a convenience sample of 28 adults with acute stroke before discharge home. Measures include self-reported FoF, the Falls Efficacy Scale–Swedish Version [FES(S)], Stroke-Specific Quality of Life (SS-QOL), performance and satisfaction with performance (Canadian Occupational Performance Measure), anxiety (Generalized Anxiety Disorder-7), and depression (Patient Health Questionnaire-9). Results: Fifteen (54%) of the participants reported FoF. Those with FoF were more likely to have decreased SS-QOL domain scores for energy (p = .013), personality (p = .015), and thinking (p = .008); decreased performance (self-care, productivity, and leisure) (p = .019) and satisfaction with performance (p = .010); and increased anxiety (p = .002) than those without FoF. Conclusions: Those with FoF demonstrated significantly increased anxiety and showed decreased performance and satisfaction with performance, energy, thinking, and personality than those without FoF. This suggests that poststroke FoF is related not only to physical challenges but also to cognitive and emotional factors in the poststroke period. Identifying and treating these conditions should be evaluated as a means to decrease FoF and improve outcomes post stroke.
The influence of nitrous oxide on recovery of bowel function after abdominal hysterectomy

The influence of nitrous oxide on the recovery of bowel function was studied in 36 patients anaesthetised for elective abdominal hysterectomy with or without salpingooophorectomy. Patients were randomly assigned to receive either isoflurane in nitrous oxide and 30% oxygen (N2O group) or isoflurane in air and 30% oxygen (Air group). Anaesthetic management included thiopentone, fentanyl, suxamethonium and atracurium. The lungs were not ventilated prior to intubation. Before closing the abdomen, the surgeon assessed the degree of distension of the intestines and the closing conditions. Postoperative nausea and vomiting was assessed 2, 6, 12 and 24 h after recovery from anaesthesia. The lapse of time before mobilisation and passing of flatus and faeces was recorded. The patients in the Air group were significantly older than the patients in the N2O group (48.9 years versus 44.0 years, P = 0.04); otherwise, there were no differences in the demographic data of the patients. We found no significant differences between the groups with respect to nausea and vomiting, distension of the intestines before closure of the abdomen, closing conditions, time elapsing before mobilisation, constipation before recovery of bowel function or time elapsing before passing of flatus. We found a statistically significant delay of 10.3 h in time elapsing before passing of faeces in the N2O group compared to the Air group (P = 0.04), suggesting a potentially adverse effect of nitrous oxide. However, the delay seen in the present study is of dubious clinical significance. In conclusion, regarding operating conditions and time elapsing before recovery of bowel function, our results do not justify the omission of nitrous oxide from anaesthetics lasting approximately 2 h or less.
Occupational Gaps in Everyday Life One Year After Stroke and the Association With Life Satisfaction and Impact of Stroke

Abstract Purpose: To examine the presence, frequency, and distribution of occupational gaps and to explore whether there are associations between occupational gaps and life satisfaction, self-rated recovery, and functioning and participation in activities of daily living (ADLs) 1 year after stroke. Method: Data were collected at onset and at 12 months after stroke from 161 patients admitted to a stroke unit in central Sweden by using Occupational Gaps Questionnaire, LiSat-11, Stroke Impact Scale, Katz ADL Index, and Barthel Index. Spearman rank correlation and Mann Whitney U test were used in the analyses. Results: Occupational gaps were reported by 87% of the participants. The number of occupational gaps was moderately associated with participation and self-rated recovery. There was a significant difference in the number of occupational gaps between the participants who were independent in ADLs and those who were not, both at baseline and at 12 months after stroke. There was, however, no significant association between occupational gaps and life satisfaction. Conclusions: Occupational gaps 1 year after stroke are very common, particularly among individuals experiencing difficulties in ADLs. Increased efforts are vital to enable individuals to do the activities that are important to them, irrespective of whether these are instrumental ADLs or leisure or social activities. Occupational gaps could be reduced by developing rehabilitation interventions that enable desired activities in different contexts that are crucial for individual patients.
Undersökning av global epigenetisk metyleringsstatus hos juvertumörer på hund

Mammary tumors are the most frequent type of tumors in bitches in Sweden. Many studies have been published concerning mammary tumors, but there is still much to be learned about this disease. One has, since some time ago, had the knowledge that addition to or removal of methyl groups to genes can inhibit or activate gene-expression. Methylation and demethylation is a normal phenomenon in the body and it is essential for the development and survival of the individual. The risk of developing a tumor disease is increased if the global methylationstatus is changed; if oncogenes demethylates (activates) or if tumor suppressor genes methylates (inactivates). In the human medicine one has seen that there are differences in methylationstatus between different tumors. In this study tumor and normal tissue from ten dogs were examined with regard to methylationstatus. The results showed that there were not clear connections between the methylationstatus at the normal- or tumor tissue respectively, sometimes the normal tissue was hypermethylated in comparison to the tumor tissue and sometimes it was hypomethylated in comparison. The connection that one could see was that the malignant tumors tended to be hypermethylated in comparison to the benign tumors.
Computed Tomography (CT) Assessment of Visceral Adiposity

Michael N. Patlas1*, Jehonathan H. Pinthus2 and Marina Mourtzakis3 1Department of Diagnostic Imaging, McMaster University, Hamilton, Ontario, Canada 2Department of Surgery, Division of Urology, Juravinski Cancer Centre, Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada 3Department of Kinesiology, Faculty of Applied Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
Correlation Between Tender Points and the Fibromyalgia Impact Questionnaire

Objectives: To investigate a possible correlation between the number of tender points [TePs] and the myalgic score versus the Activities of Daily Living [ADL] items and the pain visual analog scale [VAS] of the Fibromyalgia Impact Questionnaire [FIQ]. Methods: Consecutive patients with fibromyalgia were included [N = 221; 213 females, eight males, mean age 46 years]. The diagnosis was established using the criteria of the American College of Rheumatology: widespread pain for at least three months and pain on palpation in at least 11 out of 18 specified TeP locations. A 4-point (0–3) scale of pain severity was used. Each patient was evaluated by the number of TePs and by a myalgic score expressed by the summation of the pain severity score multiplied by the respective number of TePs. Before the clinical examination the patients filled in the FIQ. The first 10 subitems of the FIQ, measuring physical functioning [FIQ-ADL], were used. Results: The FIQ-ADL was correlated to the following parameters: pain on the VAS [rs = 0.46; P < 0.001], the myalgic score [rs = 0.30; P < 0.001], and the number of TePs [rs = 0.20; P = 0.003]. Some correlation between the myalgic score and pain on the VAS was seen [rs = 0.15; P = 0.004]. We found no correlation between the number of TePs and pain on the VAS. Conclusion: As an indicator of disability the myalgic score appears to be preferable to the number of TePs. Self-reported pain is correlated to the physical function as expressed by the FIQ-ADL.
Human drug hepatotoxicity: a contemporary clinical perspective

Background: Drug-induced liver injury (DILI) constitutes a significant medical challenge. The rising number of marketed drugs, aging population and polypharmacy make it imperative to understand the clinical presentation of DILI and the processes used in the assessment of causality and early detection. Objective: This article reviews the current clinical understanding of DILI including presentation patterns, causality assessment, risk factor ascertainment and early detection strategies including liver test monitoring. Significant initiatives such as the Drug-Induced Liver Injury Network (DILIN) are also discussed. Methods: A narrative review of clinical studies of DILI, with emphasis on clinical features, causality and surveillance. Conclusion: DILI remains a serious challenge in contemporary clinical practice. Further research and collaboration in the areas of epidemiology, causality and early detection are required to enhance the diagnosis and management of DILI.
Public health nurses' experiences of training in Marte Meo communication skills.

Aim: The aim of this research study was to explore with Public Health Nurses their experiences of training in Marte Meo communication skills. Method: A qualitative design using a phenomenological approach was used. Data analysis was guided by a hermeneutic circle of understanding and drew upon Heideggerian principles of philosophy. Data were gathered by unstructured individual interviews with ten Public Health Nurses who participated in the Marte Meo communication skills training course. Findings: Data analysis led to the development of three principal themes categorised as: looking with an extended lens; being at the other end of the lens and awkwardness in simplicity. The findings of this research study suggest that the Public Health Nurses develop a wider focus that facilitates a shift in their clinical practice toward enhanced understanding, and beyond a task-focused orientation. A public health nursing model of practice that emerges is one which focuses on affirming parents, builds on parents‟ strengths and affirms and enhances the Public Health Nurses in their practice. Conclusion: The Marte Meo communication skills training course is experienced by the Public Health Nurses as an empowering model of interaction in their work with families.
Acrometastasis from a Pancreatic Primary Adenocarcinoma: A First Report in the Literature

A seventy five year male presented with acute onset right foot pain and swelling. Plain imaging revealed a lytic area in the medial and middle cuneiform bones of the right foot. Background history of resected pancreatic cancer and current presentation were consistent early diffuse disease recurrence of a pancreatic primary tumour. The presenting feature in this case was of symptomatic acrometastases, that is, metastases to the feet. Acrometastases have been described in association with multiple primary tumours, but not pancreatic cancer. Our case highlights rare sites of metastatic disease secondary to pancreatic cancer, and we review the literature.