Miracle-dz/UniFAR-FTUs huggingface dataset:
The impact of mammography utilization on breast cancer incidence in Hawaii

This research is an ecologic study investigating the association between mammography utilization and breast cancer incidence in Hawaii with the hypothesis that geographic areas with high mammography rates have higher breast cancer incidence rates than geographic areas with low mammography rates. Insurance claims for mammograms received during 1992/93 were combined with breast cancer incidence data from the state-wide Hawaii Tumor Registry, the 1990 Census ZIP File, and death records. Insurance claims data were obtained from four private and three public health plans and covered approximately 85% of the state's female population age 40 years old and older. Age-specific breast cancer incidence rates for each of the 79 ZIP code areas were regressed on mammography rates and selected demographic variables using both multiple linear and multiple logistic regression. An estimated 42% of women 40 years old and older had received at least one mammogram during the study period 1992 to 1993, with the highest rate (45%) in women 50 to 64 years old. Overall, 23% of the variation in age-specific breast cancer incidence was associated with mammography utilization, another 23% with age, and 4% with educational attainment. The relation between mammography use and breast cancer incidence was strongest for women 50 to 64 years old and weakest for women 40 to 49 years old. Mammography v utilization predicted 17% of the variance in localized disease, but very little of the variance of in situ or advanced disease. Neither mammography utilization nor demographic variables were found to be good predictors of geographic variations in breast cancer mortality in Hawaii. In summary, geographic areas in Hawaii with high mammography utilization experienced higher breast cancer incidence rates than areas with low mammography utilization. The size of this effect was consistent with the increase in breast cancer rates observed since the mid-eighties, supporting the hypothesis that the increase in breast cancer incidence is attributable to screening and early detection. However, the long term increase in breast cancer incidence requires alternate explanations.
Transcription factors, translocations, and leukemia

The frequent occurrence of TF gene involvement in translocations associated with leukemia is remarkable, although not yet explained. The wide variety of TFs involved in these translocations and the different stages of cellular maturation argue against a unifying mechanism. Recombinases, active during B-cell and T-cell development, have been implicated in gene arrangements involving TCR genes and in the SIL/SCL rearrangement, which involves two genes not normally rearranged. However, other mechanisms must clearly be active in generating these molecular abnormalities and perhaps they relate to the multistep maturation and differentiation processes and continuous cell turnover seen in hematopoietic cells. The difficulties in obtaining human solid tumor samples may make it more difficult to identify translocations involving TF genes in solid tumors. Recently, the cytogenetic analysis of solid tumors has improved and specific cytogenetic abnormalities have been associated with specific types of tumors. With advanced techniques, such as fluorescent in situ hybridization (a technique that does not depend on cell growth) and PCR, abnormalities involving TF genes will be discovered. Abnormalities of TF genes, other than translocations, have been seen in a broad variety of nonhematopoietic malignancies. The p53 protein has been shown to bind DNA in a sequence- specific fashion and interact with a variety of DNA tumor virus oncoproteins. The broad range of cell types that harbor p53 abnormalities suggests that TF abnormalities will likely be implicated in many solid tumors. We have detailed several examples of how gene rearrangements that accompany chromosomal translocations in acute leukemia can alter the expression or activity of cellular TFs. Several translocations generate fusion RNA transcripts and fusion TF proteins with altered functional characteristics. Other translocations result in the expression of a gene not normally detectable in hematopoietic cells or alter the level of its expression, or affect the promoter usage or exon structure of the gene (Table 2). Studies are underway in many laboratories to characterize the biologic activity of these abnormal TFs and it remains to be proven that these molecular abnormalities are directly linked with leukemogenesis. The identification of abnormal fusion transcripts and proteins may allow specific therapies to be directed against “tumor-specific” DNA, mRNA, or protein targets. Therapeutic strategies based on antisense or ribozyme technology may be used to turn off expression of these genes and inhibit leukemia cell growth. Immunologic methods can also be used to direct therapy against the malignant cells.
Assessment of diastolic function in patients with aortic valve diseases

Background: Valvular heart disease (VHD) are prevalent and impose significant impact on heart function. Diastolic Dysfunction (DD) is less appreciated than Systolic Dysfunction (SD). The aim of this study was to assess the Diastolic Function (DF) in patients with Aortic Valve (AV) diseases as risk factors predisposing to DD.Methods: Cross-section study that involved 34 patients with AV diseases and other 10 controls. All patients are assessed for diastolic dysfunction by transthoracic echo Doppler study. M-mode echocardiography was used to measure cardiac dimensions and wall thickness. LV mass was measured on echocardiogram at rest.Results: Among the 34-patients, 19 (55.8%) of them were male patients and 15(44.2%) of them were female patients. The data showed that there were 12 patients with Aortic Stenosis (AS), eight patients with AORTIC regurgitation (AR), six patients with Aortic Sclerosis (ASCL) and 8 patients with combined AR-AS. Around third of the patients (35.3%) had Grade II DD followed by grade I and Grade III. However, around 14.7 % didn’t have any dysfunction. Overall, there was 77% of the patients with AV diseases.Conclusions: Author concluded that Aortic Valve diseases is significantly related to- the development of diastolic dysfunction and the DD is influenced by severity of AV diseases.
Health Systems in Latin America: Principal Components of Attention

This article discusses the evolution of healthcare systems in Latin American countries, their origins and main characteristics and sources of financing, coverage and the availability of services and human resources from the Donabedian perspective, which also considers indicators of behaviors and preferences and social values underlying healthcare in different societies. The method adopted is the estimation of correlations and principal components to explore how health expenditures, poverty and inequalities are associated with healthcare indicators such as life expectancy, immunizations, treatments offered by health systems in transmissible and chronic diseases, considering indirect indicators of patient’s behaviors and preferences, as well as social values and cultural diversity in Latin American societies. The results show that the expansion and actual availability of immunization, treatments against transmissible diseases and hospital beds are the main criteria responsible for the results in healthcare and increase in life expectancy; the availability of health services is an important component for secondary level of care and allows the population to be committed to positive behaviors in a context of poverty and inequalities, with disadvantages for indigenous people.
Drug costs of patients admitted to a government hospital; share of public and private expenditure

Introduction: Government hospitals are expected to provide free health service which includes drugs for in-patients. However, in practice, in-patients have to purchase drugs from outside when they are treated in government hospitals. The objective of the study was to investigate the drug expenditure of patients during their stay in government hospitals. Methods: Cost incurred by 189 patients who were treated in a pediatric unit, a medical unit and a surgical unit in Teaching Hospital, Karapitiya for 3 - 10 days were studied. Details of drug cost incurred by patients were collected by interviewing patients, from BHTs, the hospital pharmacy and private pharmacies. Data were collected in two phases - from May to June and October to November in 2015. Results: The average cost for drugs for a patient was Rs. 1,406.00, Rs. 3,204.00, Rs. 3,678.00 and from government per a patient was Rs. 548.00, Rs. 1,239.00, Rs. 885.00 in pediatric, medical and surgical units respectively. Private expenditure on drugs is significantly higher than that from the government expenditure in all units. The highest percentage was spent for antibiotics both by the government (74%) and by the patients (67.5%). The highest antibiotic cost was recorded in the surgical unit. Surgical unit shows the highest per day difference of expenditure on drug by government and by patient. This difference widened with the number of hospitalised days. Conclusions: Study shows that patients spent more than the government on drugs and the highest fraction of this is for antibiotics. The highest burden is reported among patients admitted to the surgical unit.
Do Parents, Teachers And Health Professionals Support School-Based Obesity Prevention?

Nutr Diet 2004;61:137–44) Objective: This study aimed to investigate the attitudes of parents, teachers and health professionals on factors contributing to childhood obesity and the role of the school in preventing childhood obesity. The prevalence of overweight and obesity was also assessed to compare to current national figures. Design: A large primary school concerned about childhood obesity approached the local area health service for assistance in developing appropriate health promotion strategies. This research was carried out as a formative approach to strategy development. A cross-sectional random sample of classes representing each grade (Kindergarten to Year 6) in the school participated. The parents of children in randomly selected classes made up the parent sample. All school staff and health workers currently working with schools were invited to participate. Subjects: A total of 170 parents (85%), 31 school staff (89%) and 40 (80%) health workers completed the attitude survey. There were 167 (83.6%) school children, from randomly selected classes representing Kindergarten to Year 6, who had their height and weight measured. Setting: The study was conducted in one primary school on the Central Coast of NSW. Main outcome measures: Attitudes were assessed via a 21-item attitude survey based on a literature review. Content validity and test retest reliability (κ = 0.61–0.85) were assessed prior to the study. Overweight and obesity was assessed using the Cole et al. (35) cut-off points which are the equivalent of adult Body Mass Indices of 25 (overweight) and 30 (obese). Statistical analyses: Kruskal-Wallis (P = < 0.05) was used to determine where attitudes differed between the three groups. Results: Of the 167 children who had their height and weight measured, 37.7% (n = 63) were either overweight (n = 43, 25.7%) or obese (n = 20, 12.0%). The most noticeable differences in opinion related directly to weight. Health professionals are clearly in support of the school taking a leading role in obesity prevention, with teachers displaying the least support (P = 0.014). In light of teachers’ current stance, providing support is crucial if obesity prevention is to become a school role. More research is needed to determine if providing continuing professional development along with upto-date resources improves teachers’ support for school-based prevention.
Pathology of Diabetes Mellitus and the Association of Physical Activity, Nutritional Status, and Related Factors with Diabetes Mellitus Development: A Literature Review

Diabetes mellitus has been occurred at high prevalence worldwide, WHO estimated that 408 million people have been diagnosed with diabetes in 2014. The disease is non-communicable disease which indicated that lifestyle and food consuming behavior are high level of association with diabetes development. Repeated researches have been concluded that physical activities and nutritional level of non-diabetic people contribute to the development of diabetes mellitus but the clarified picture of physical activity and nutrition elements in the diabetes progress has not been systematic reviewed, some inconsistency result from different research has been made. By reviewing articles of this issue, we concluded that physical activity and nutrition might contribute to diabetes development by permanently changing the carbondydrate metabolism leading to diabetes of both type1&2. Modifying physical activity and nutrition of diet in prediabetic period reduce significant
Treatment of Obstructive Sleep Apnea Using Temporary Mandible Advancement Device: A Case Report

Obstructive sleep apnea (OSA) is the most prevalent type of sleep apnea that is characterized by the predominant recurrence of obstructive events, resulting from a partial or complete collapse of the upper airway during sleep. Risk factors for OSA include age, male sex, familial history, excess body fat, central obesity, large neck circumference, and craniofacial & upper airway abnormalities like micrognathia, macroglossia, and tonsillar hypertrophy.1 The oral appliance (OA) may be one of the therapeutic options for the OSA. According to the treatment guideline,2 its use is recommended in the cases of patients who present with primary snoring, mild or moderate sleep apnea, continuous positive airway pressure (CPAP) intolerance, and failed surgical interventions as a substitutive therapy. Also, because the advancement of tongue or mandible by OA would increase the diameter of the upper airway tract, it seems to be a good indication for OSA. However, there are some problems for the treatment of OSA with OA. There are a small number of dentists who are specifically trained to deal with sleep disorders, and the cost for OA is high. Even if the treatment with OA is initiated, it may be stopped due to jaw discomfort, occlusal change, or temporomandibular disorder.3 Therefore, there is a need for the development of an appliance that can be maneuvered easily, with low cost, which can also indicate whether improvements can be made through mandible advancement by wearing the device during sleep. In this article, we described an OSA case that was successfully improved by using a temporary mandible advancement device, which was designed for the therapeutic effect of mandible advancement with low cost and simplified fabrication procedure at chair-side.
Kronisk intermitterende stimulering av nervus vagus – en ny behandlingsform ved epilepsi

Rasmus Lossius Statens senter for epilepsi G.F. Henriksens vei 23 1337 Sandvika Kronisk intermitterende stimulering av nervus vagus er en ny ikke-farmakologisk behandling av pasienter med vanskelig kontrollerbar epilepsi. Behandlingen, som ble introdusert i USA i 1988, er basert på dyreeksperimenter som viste at elektrisk stimulering av vagusnerven kunne forebygge eller redusere frekvens og varighet av epileptiske anfall. Ved Rikshospitalet er det siden juni 1993 implantert vagusstimulator hos i alt 47 behandlingsresistente pasienter. Det er benyttet Neuro-Cybernetic Prosthesis-systemet fra Cyberonics, som består av en programmerbar, batteridrevet pulsgenerator, en bipolar nervestimuleringsledning, en programmeringsenhet med ledsagende programvare og en bærbar magnet. Alle pasientene hadde en langvarig, alvorlig epilepsi med høy anfallsfrekvens, 36 av pasientene (77%) hadde daglige anfall. Majoriteten (89%) hadde lokalisasjonsrelatert epilepsi. Gjennomsnittsalderen var 34,4 år (12–70 år), oppfølgingstiden gjennomsnittlig 2,7 år (0,4–6,5 år). 16 pasienter (34 %) hadde god effekt av behandlingen, definert som 50 % anfallsreduksjon. Ingen ble helt anfallsfri. 20 pasienter (43 %) fikk ingen reduksjon av anfallsfrekvensen. 24 av pasientene (51%) angav å ha hatt nytte av magneten. Stimuleringen så ut til å ha gunstig innvirkning på flere anfallsformer, men effekten var best ved sekundært generaliserte tonisk-kloniske anfall. 36 pasienter (77 %) angav å ha bivirkninger, hovedsakelig i tilslutning til stimuleringen, i form av heshet, hosting og kribling i halsen. Hos 14 av pasientene (30 %) er stimulatoren blitt eksplantert, hovedsakelig på grunn av manglende effekt. Tatt i betraktning at behandlingen er gjennomført på den mest refraktære gruppen av epilepsipopulasjonen, er resultatene lovende. De overensstemmer godt med resultatene fra andre studier. Hvilken plass vagusstimulering vil få i den fremtidige epilepsibehandling er uavklart. Mange ubesvarte spørsmål gjenstår, f.eks. hva er virkningsmekanismene og hvilke pasientgrupper er særlig egnet for denne behandlingsformen? Nakken KO, Henriksen O, Røste GK, Lossius R.
Phase I trial of hepatic arterial infusion (HAI) with floxuridine (FUDR) and dexamethasone (DEX) in combination with systemic oxaliplatin (OXAL), fluorouracil (FU) + leucovorin (LV) after resection of hepatic metastases from colorectal cancer

3579 Background: Our earlier studies using HAI plus SYS chemotherapy after liver resection demonstrated significant decrease in hepatic recurrence. In order to decrease extrahepatic recurrence in resected patients (pts), combinations of HAI and new SYS therapies are needed. We designed a Phase I trial of HAI FUDR + DEX and SYS OXAL, FU + LV. Methods: OXAL was kept constant (85mg/m2) while FU was escalated: 1000–1400 mg/m2 (48-hour infusion). Then OXAL was escalated (100 mg/m2) and FU from 1400–1800 mg/m2. LV was fixed at 400 mg/m2. HAI FUDR dose was fixed at 0.12 mg/kg x pump volume (PV) divided by pump flow rate (PF), and infused Day (D) 1–14 with DEX, heparin and saline. SYS therapy was given on D14 and D28 of a five-week cycle. Results: 21 pts have been enrolled: median age 58 (range 41 -74); margin of resection ≤ 0.3 cm (28%); number of lesions ≥ 2 (71%); synchronous disease (38%); received previous chemotherapy (71%). Dose-limiting toxicity (DLT) was reached when FU was 1800mg/m2 and OXAL 100mg/m2, w.
A case of imported dengue fever

Dengue fever (DF) is an acute febrile viral disease frequently presenting with headache, bone or joint and muscular pain, rash and leukopenia. Dengue hemorrhagic fever (DHF) is characterized by four major clinical manifestations: high fever, hemorrhagic phenomena, often with hepatomegaly and in severe cases, signs of circulatory failure. Such patients may develop hypovolemic shock resulting from plasma leakage. This is called dengue shock syndrome (DSS) and can be fatal. The disease is one of the leading causes of hospitalization and death in children in several Asian, central and south American and African countries. Dengue fever and Dengue hemorrhagic fever have steadily increased in both incidence and distribution over the past 40 years. With an increased air travel, more travelers to the tropics and subtropics are returning within the incubation period of acute febrile infection.We experienced a Korean engineer with complaints of fever, chill, headache, nausea and myalgia after return from Malaysia and co irmed as dengue fever.
Patologías obstructivas de la vía aérea: Crisis asmática

Asthma is a chronic disease that is characterized by recurrent attacks of breathlessness and wheezing, which vary in severity and frequency from one person to another. Symptoms may come several times a day or week, and some people are aggravated during physical activity or in the evening. The recurring symptoms often cause insomnia, daytime fatigue, a decrease of the activity and truancy and labor. The fatality rate of asthma is relatively low compared with other chronic diseases, but in 2005 killed 255,000 people.
Bilateral Sudden Deafness as the First Manifestation of Streptococcus Suis Capsular Type 2 Meningitis

Streptococcus suis meningitis is an occupational hazard of pork handlers. Hearing loss is one sequela of this illness. We report one butcher with Streptococcus suis capsular type 2 meningitis who initially presented with bilateral profound sensorineural hearing loss; meningitis was diagnosed by cerebrospinal fluid analysis. The organism was isolated and showed susceptibility to penicillin. After treatment with intravenous penicillin, all symptoms of meningitis improved except for his bilateral deafness. The clinical course and histological cause of this case are reported herein.
Non-medical direct and indirect costs related to primary open-angle glaucoma in Brazil

1 Postgraduate Program in Health, Universidade Federal de Juiz de Fora. Juiz de Fora, MG, Brazil; 2 Instituto de Olhos PalettaGuedes Juiz de Fora, MG, Brazil; 3 Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil; 4 Academic Course in Medicine, Faculdade Presidente Antônio Carlos, Juiz de Fora, MG, Brazil; 5 Instituto de Olhos Paletta Guedes, Juiz de Fora, MG, Brazil; 6 Department of Statistics, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil. AbstrAct
Oncologists' Perceptions of a Digital Tool to Improve Cancer Survivors' Cardiovascular Health

Abstract Background Cardiovascular (CV) disease continues to be a leading cause of morbidity and mortality with higher rates among cancer survivors than in the general population. Objective This study was aimed to understand oncology providers' attitudes toward a digital CV health tool, delivered via a tablet, to promote CV health in cancer survivors. Methods Using qualitative methods, 14 oncologists, from community and academic practice sites, were interviewed while they used the tool. Interviews were videotaped then analyzed using NVivo 11 software. Themes were inductively developed from the interviews. Results Three major themes emerged from the interviews as follows: (1) system functionality, (2) facilitators and barriers to integration, and (3) appropriate end-users. Oncologists recognized the critical role of CV health promotion among cancer survivors and identified features about the tool that would be helpful for CV health promotion. Workflow (subtheme) was a barrier to tool use. This feedback enabled tool redesign for further testing in the context of survivorship care. Conclusion Our findings emphasized the importance of identifying appropriate End-users which may include other survivorship care providers, patients, and primary care providers. Implications Our research addresses the knowledge gap in the use of digital tools in cancer survivorship care, specifically digital tools to promote CV health. Future research is needed to evaluate digital tools in cancer survivorship care. Research investigating patients as users of digital tools may provide additional insight.