Miracle-dz/UniFAR-FTUs huggingface dataset:
Longterm Outcome of Patients with Primary Antiphospholipid Syndrome: A Retrospective Multicenter Study

Objective. To assess the longterm frequency of thrombotic recurrences, obstetrical complications, organ damage, severe comorbidities, and evolution toward connective tissue disease (CTD) in primary antiphospholipid syndrome (PAPS). Methods. Medical records of patients with PAPS followed in 6 centers for ≥ 15 years were retrospectively reviewed. Results. One hundred fifteen patients were studied: 88% women, followed between 1983 and 2014 with a mean (± SD) age at diagnosis of 33 (± 10) years. During a median followup of 18 years (range 15–30), 50 patients (44%) had at least a thrombotic event for a total of 75 events and an annual incidence of 3.5%. Thromboses were more frequent in patients with previous thrombotic history (p = 0.002). A catastrophic antiphospholipid syndrome occurred in 6 patients (5%). The use of oral anticoagulants in patients with thrombotic onset did not appear to be protective against recurrences (p = 0.26). Fifty-two women had 87 pregnancies, successful in 78%. Twenty-nine percent of patients accrued functional damage. Damage was significantly associated with a thrombotic history (p = 0.004) and with arterial events (p < 0.001), especially stroke, but not with demographics, serology, or treatment. Twenty-four major bleeding episodes were recorded in 18 patients, all receiving anticoagulants. Severe infections affected 6 patients (5%), with 1 fatality. A solid cancer was diagnosed in 8 patients (7%). Altogether, 16 patients (14%) developed an autoimmune disease and 13 (11%) a full-blown picture of CTD. Conclusion. Despite therapy, a high proportion of patients experienced new thrombotic events and organ damage, while evolution toward CTD was infrequent.
The prevalence of clinical and subclinical mastitis in dairy cows in the central region of Fars province, south of Iran

Summary Mastitis continues to be one of the economically most important diseases in dairy farming. Forty-six licensed dairy farms in the central region of Fars province were randomly selected in order to participate in a seasonal prevalence study. A cross-sectional study was designed to determine prevalence at cow and quarter level based on clinical signs for clinical mastitis and indirect tests for subclinical mastitis. 6180 quarters from 1545 dairy cows were tested by clinical examination and California mastitis test (CMT). Milk samples from both clinical and subclinical quarters were collected for bacteriological culture. 4714 (76.28%) quarters were healthy, 1335 (21.6%) quarters were positive by results of CMT (as indicated to subclinical mastitis), 44 (0.71%) quarters showed clinical mastitis signs and 87 (1.41%) quarters were blind. The clinical and subclinical mastitis prevalence at cow level was 2.2 and 42.5%, respectively. There was no significant difference in the prevalence of mastitis between different quarters, seasons and cities. The most prevalent isolated bacteria were coagulase positive staphylococci followed by Streptococci, Escherichia coli and coagulase negative staphylococci. Insufficient control measures such as pre and post milking hygiene and dry cow therapy in dairy farms and limited knowledge of farmers on the importance, identification and control of mastitis, especially subclinical forms, can be the main causes for the high prevalence of mastitis in Fars province.
Longterm Safety and Efficacy of Adalimumab and Infliximab for Uveitis Associated with Juvenile Idiopathic Arthritis

Objective. Anti-TNF-α agents have significantly changed the management of juvenile idiopathic arthritis (JIA). We evaluated the safety and efficacy of adalimumab (ADA) and infliximab (IFX) for the treatment of JIA-associated uveitis in patients treated for ≥ 2 years. Methods. Patients with JIA-associated uveitis treated with IFX and ADA were managed by a standardized protocol and data were entered in the ORCHIDEA registry. At baseline, all patients were refractory to standard immunosuppressive treatment or were corticosteroid-dependent. Data recorded every 3 months were uveitis course, number/type of ocular flares and complications, drug-related adverse events (AE), and treatment switch or withdrawal. Data of patients treated for ≥ 2 years were analyzed by descriptive statistics. Results. Up to December 2014, 154 patients with ≥ 24 months followup were included in the study. Fifty-nine patients were treated with IFX and 95 with ADA. Clinical remission, defined as the absence of flares for > 6 months on treatment, was achieved in 69 patients (44.8%), with a better remission rate for ADA (60.0%) as compared to IFX (20.3%; p < 0.001). A significant reduction of flares was observed in all patients without difference between the 2 treatment modalities. The number of new ocular complications decreased in both groups but was lower for ADA (p = 0.015). No serious AE were recorded; 16.4% of patients experienced 35 minor AE and the incidence rate was lower with ADA than with IFX. Conclusion. At the 2-year followup, ADA showed a better efficacy and safety profile than IFX for the treatment of refractory JIA-associated uveitis.
Skin surveillance attitudes and behaviors in relation to skin checks for early signs of skin cancer in a sample of secondary school students and teachers in Palermo, Western Sicily

Background : Malignant melanoma (MM) can be readily treated in its earliest stages: survival rate, when detected early, is up to 95,0%. This justifies investigations on contributive factors and measures for precocious detection of skin tumors to improve early detection and to increase survival rates. The purpose of this survey was to collect information about knowledge, attitudes and behaviors on prevention in relation to skin checks for early signs of skin cancer on a sample of secondary school students and teachers. Methods : A sample of secondary school students and teachers from Palermo, was recruited using the clustersampling method. A self-administered questionnaire, consisting of twenty four multiple choice questions was used as the survey instrument. Statistical analysis of data obtained was performed using Openstat software. Results : The research showed a good level of awareness about skin cancer risk factors, which seemed to be strictly correlated with age. On the contrary, practice of skin self-examination (SSE) is not as widespread, and only 4,8% regularly checked the parts of their bodies most exposed to the risk of developing skin cancer. Both students and teachers indicated that school-based health education programs are the best way to promote the importance of prevention. Conclusions : In many countries mortality is not increasing at the same rate as incidence for MM. The practice of SSE may play a vital role in improving early detection and survival rates. Therefore, school interventions to promote knowledge of the benefits of regular SSE should be implemented.
WORK RELATED MUSCULOSKELETAL DISORDERS OF THE UPPER LIMBS AMONG STEEL INDUSTRY POPULATIONS

For high occurrences of upper extremity disorders in working populations and in order to compare the occurrence of musculoskeletal alterations due to ergonomic risk factors such as highly force exertion, repetition, awkward posture between exposed and non-exposed groups, the research was carried out in Tabarestan steel industry. All 526 male workers (316 as exposed group : 132 aged 20-35 years, 184 aged >35 years; 210 as Non-exposed group: 89 aged 20-35 years, 121 aged > 35 years) performing tasks exposed / not exposed to risk factors for WMSDS of the upper limbs underwent a clinical examinations as well as completing standardized Nordic Musculoskeletal Questionnaires. The anamnestic cases were defined on the basis of pain, paraesthesia, hyposthenia, and vegetative disorders during previous months. Mean age of exposed and non- exposed groups were obtained 36.3 years (SD= 5.9) and 37.9 years (SD = 7.3) respectively. There were distinguished differences in occurrences of WMSDS of upper limbs between two mentioned groups. The major occurrence was found for the right and left hands. Nocturnal and diurnal paraesthesia obtained an occurrence of about 54% and 53% respectively. Data bears witness to the greater occurrence of affected individuals in exposed group, with a non- exposed / exposed ratio of 1:7.2. The greater occurrences of affected individuals in exposed group (P = 0.006) and in subjects>35 years (P = 0.002) were significant. Structural, organizational and educational measures can be applied to prevent WMSDS or diminish the relative effects to acceptable limit.
Bacterial Contamination of Platelet Concentrates: Perspectives for the Future

Several risks are still associated with blood transfusions. Reduction of transfusion-related viral transmission has been a priority during recent decades. Nevertheless, hemovigilance systems implemented in different countries clearly highlighted the impact of other severe adverse events related to transfusions, such as acute lung injury or bacterial sepsis. The latter still remains associated with a high morbidity and mortality and constitutes the most frequent infectious hazard of transfusion. This complication specifically concerns platelet concentrates because of their favorable bacterial growth conditions. This paper gives a brief overview on platelet transfusion-related bacterial contamination as well as strategies to reduce this risk, notably by employing either bacterial detection or inactivation methods.
The spectrum of acute heart failure after venlafaxine overdose

Abstract Objective. Venlafaxine is a bicyclic antidepressant that may be associated with severe cardiotoxicity following large overdose. The purpose of this short case series is to present different patterns of venlafaxine-related cardiotoxicity and to discuss the potential mechanisms. Case series. Between January 2010 and July 2011, four patients were admitted to an ICU with acute left ventricular failure following large venlafaxine overdoses. The age of the four female patients ranged from 35 to 65 years. None of them had no history of cardiovascular disease. The amount of venlafaxine ingested by history ranged from 3150 to 13500 mg (extended-release preparation in two cases). The peak serum venlafaxine concentration was between 2153.3 and 9950 ng/ml. Three patients died and one recovered rapidly. The initial ECG revealed only mild abnormalities in two cases. In two patients, at least one ECG recording demonstrated a widening of QRS interval. In three patients, echocardiography disclosed a left ejection fraction of 15%–18%. Two patients presented a severe serotonin syndrome, with major rhabdomyolysis. Seizures were noted in two cases, including one patient with status epilepticus. Three patients were mechanically ventilated. The causes of death were refractory hypoxemia, malignant arrhythmias, and cardiogenic shock, respectively. Discussion. Severe and diffuse left ventricular dysfunction may be observed after large venlafaxine overdoses and this is not always associated with severe cardiac conduction function abnormalities. The mechanisms underlying venlafaxine-related cardiac failure with preserved normal cardiac conduction are discussed. A possible explanation may be a catecholamine-induced myocardial damage in relationship with the inhibition of norepinephrine (and dopamine) reuptake.
Randomized, double-blind trial of anti-interferon-? antibodies in rheumatoid arthritis

Introduction: An increasing body of evidence indicates that interferon (IFN)-γ is an immunoregulator and may play a key role in the pathogenesis of autoimmune diseases, including rheumatoid arthritis (RA). Objective: To assess the efficacy and tolerability of anti-IFN-γ in patients with active RA. Methods: In a randomized, double-blind trial, 30 patients with active RA were randomly assigned to receive intramuscular injections of anti-IFN-γ, anti-TNF-α, or placebo for 5 consecutive days. Results: Both anti-cytokines were significantly superior to placebo. Patients stopping treatment due to lack of efficacy included 1 receiving anti-TNF-α, 2 receiving anti-IFN-γ, and 9 receiving placebo. According to the physician's assessment, improvement was achieved by the 7th day in 9 patients receiving anti-TNF-α, 7 receiving anti-IFN-γ, and 2 receiving placebo. By day 28 the corresponding figures were 8, 8, and 0, respectively. Conclusion: Antibodies to IFN-γ could be a promising approach to treating RA, especially i.
Examining the Geriatric Content of Canada’s Newest Undergraduate Medical Program: Are Graduates of the Northern Ontario School of Medicine Acquiring the Basic Competencies to Care for an Increasingly Aging Population?

iii Acknowledgments . iv List of Figures . vi List of Tables . vii List of Diagrams . vii Operational Definitions . ix Chapter I Introduction 1.1 Purpose of Study . 1 1.2 Literature Review . 5 1.2.1 Theoretical Orientation . 5 1.2. 2 The Demographic Shift . 7 1.2. 3 Health Status of Today’s Older Adult and Service Utilization . 8 1.2. 4 Geographic Distribution of Older Adults in Northern Ontario . 13 1.2. 5 Access to Services . 15 1.2. 6 Caring for an Aging Population . 18 1.2. 7 The Social Accountability of Medical Schools and the Northern Ontario School of Medicine . 30 1.2. 8 Project Rationale . 32 1.2. 9 Research Questions . 33 1.2.10 Hypothesis . 34 Chapter II – Methodology 2.1 Research Design . 35 2.1.1 Evaluation Framework . 38 2.1.2 Permission and Ethics . 41 2.1. 3 Curriculum Review . 42 2.1. 4 Data Collection . 44
CUMPLIMIENTO DE LAS CONDICIONES ÉTICAS RELACIONADOS CON EL USO DE PLACEBOS EN LOS ESTUDIOS DE EXPERIMENTACIÓN EN COLOMBIA

Use of placebos in clinical trials represents an important need in the measurement of the variability of the course of certain diseases and the possibility of spontaneous cure, but despite the existence of regulatory issues regarding use has been many studies use them indiscriminately threatening to those who receive. Use of placebos in clinical trials represents an important need in the measurement of the variability of the course of certain diseases and the possibility of spontaneous cure, but despite the existence of regulatory issues regarding use has been many studies use them indiscriminately and this represent a threatening to those who receive. The objective is review some concepts about placebo and determine compliance of the ethical issues about use of placebo in clinical trials conducted in Colombia by analyzing of the registry in the database of the Food Drug Administration. We found on December 2013 a total of 713 clinical trials registered in Colombia, of which 242 used placebos and 49 of them did not meet the ethical conditions on the use of placebo. This situation leads to think that the information available local and globally for the use of placebo may be insufficient and incomplete and lead to misinterpretation, which could allow the wrong approving of these studies by ethics committees. We don’t have an information system on clinical trials and we cannot determine what the consequences caused this situation in the affected population.
An investigation of emotional labor strategies on the basis of empathy among nurses working at intensive care and inpatient units

Objective: Intensive care nurses produce emotional labor through Deep Acting by generating empathetic emotional and cognitive reactions during their interactions with patients. On the other hand they produce emotional labor through Surface Acting whereby they forge empathic behaviors towards patients in the absence of appropriate emotional and cognitive actions. The present study explored emotional labor strategies on the basis of empathy among nurses working at intensive care and in-patient units. Methods: The present study was carried out in a state hospital in Istanbul. The sample of the study consisted of 116 nurses. Emotional Labor Scale, the Empathy Scale and a demographic questionnaire were used to gather data. Results: The hypotheses that as compared with in-patient care nurses, the empathy levels of intensive care nurses would be higher; nurses who have high levels of empathy would show higher levels of deep acting and emotional effort than nurses who have medium or low levels of empathy; nurses who have high levels of empathy would show lower levels of surface acting than nurses who have medium or low levels of empathy; and as compared with in-patient care nurses, intensive care nurses would show higher levels of deep acting and emotional effort and lower levels of surface acting, were not supported by the data. Conclusion: The results have shown that intensive-care nurses do not have higher levels of empathy, and they do not use deep acting and emotional effort more than inpatient clinic nurses. These findings indicate that regardless of the characteristics of the working environment, the nurses show empathy and use emotional labor strategies. More research is needed to understand these findings. Key words:
The difficult access to morphology of the heart: clinical implications.

The literature on the morphology of the heart is reviewed within the context of recent histological findings. There is strong evidence for a dualistic myocardial function, whereby both ventricular constricting and expanding forces are supposed to act synchronously although with variable effect over the heart cycle.The morphological basis of this dualistic myocardial function is the contorted rope-like structure worn into the bulk of the heart muscle. Opinions are divided about the invasiveness of blunt preparation on the heat denatured heart by which the fascicular architecture is carved out of the muscle. Histology confirms the existence of a fascicular substructure. It results from an inhomogeneous repartition of myocardial fibre branchings and the arrangement of the delicate connective tissue netting by which myocardial strands are bundled and wrapped. One important feature of the fascicular structure of the heart muscle is an oblique transmurally arranged element which yields a force vector opposing systolic wall thickening. This structural element which acts in the direction of ventricular dilation probably gains pathological import in some cases of architectural remodelling, namely in myocardial fibrosis and hypertrophy.
Chronic Fatigue Syndrome: 3 Cases and a Discussion of the Natural History of Attention-Deficit/Hyperactivity Disorder

Abstract Fatigue is commonly reported in the primary care setting; however, its cause is often unclear. This article presents 3 cases involving patients with chronic fatigue syndrome who responded poorly to treatment. After clinical evaluation, all patients were found to meet criteria for attention–deficit/hyperactivity disorder (ADHD) and underwent a standard regimen of a psychostimulant medication. After treatment with psychostimulants, the 3 patients reported improved symptoms of fatigue and pain, and cognitive and core ADHD symptoms. These cases suggest that ADHD and chronic fatigue syndrome (and possibly fibromyalgia) share a common underlying mechanism. This article presents a model suggesting that over time, ADHD (predominantly inattentive type) develops into a syndrome of chronic fatigue and pain. These cases indicate that fatigue may be an important presenting symptom of adult ADHD. These cases also suggest the need for additional research to determine the prevalence of ADHD in patients who present with fatigue, and, in those meeting criteria for ADHD, the responsiveness of fatigue to psychostimulant treatment.
The exhaustion of nursing: A integrative review of the burnout syndrome in icu

Objetivo: Diagnosticar o conhecimento sobre estresse psicologico, como gerador da sindrome de burnout (SB) na equipe de enfermagem; verificar a influencia da SB na atuacao destes profissionais que trabalham em UTI. Metodos: Revisao integrativa realizada em tres dias consecutivos nas bases de dados MEDLINE, LILACS, Scielo, Cochrane Library, CINAHL e EMBASE. Resultados: A metodologia descritiva foi a mais utilizada (44,11%). Melhor qualificacao profissional significa menor predisposicao a SB. Ambientes saudaveis e melhores condicoes de trabalho refletem diretamente na saude e na qualidade da assistencia prestada pelos profissionais. O trabalho em UTI aliado a SB geram alteracoes psicologicas (depressao e ansiedade) e nos niveis de felicidade. Sao considerados fatores estressores: situacoes que envolvam morte, doacao de orgaos e o relacionamento com familiares. Sofrimento moral (sentimento de estar fazendo a coisa certa) foi uma questao encontrada nos estudos como possivel causadora da SB. Conclusao: O estresse psicologico na UTI influencia na atuacao do profissional de enfermagem, sendo a fonte geradora de conflitos e SB. Descritores: Esgotamento Profissional; Estresse Psicologico; Enfermagem; Unidade de Terapia Intensiva.
Perfil antropométrico de funcionários de banco estatal no Estado do Rio de Janeiro/Brasil: I ­ índice de massa corporal e fatores sócio-demográficos

This study first describes the anthropometric profile of employees at Banco do Brasil and then compares these results to those of the Brazilian National Health and Nutritional Survey, PNSN/1989, for the Southeastern region of the country. It is a cross-sectional study with a sample comprising 647 bank clerks. Weight and height informed by respondents were used to compute the body mass index (BMI). Among bank clerks, 8.8% were underweight, 27.8% were overweight and 6.4% were obese. Overweight increased with age and was about 3 times greater in men than in women. Among social and demographic variables, sex, age, and schooling best explained BMI variance. For men, proportion of overweight was higher in bank clerks than in the PNSN population, while for women, PNSN showed higher frequencies of overweight as compared to female bank clerks. High prevalence of overweight in the general population, as well as in specific groups like bank clerks, highlights the urgent need for definition and development of prevention and control policies capable of impacting risk factors and ultimately leading to a decrease in social cost due to mortality from chronic diseases.
Epilepsia y antiepilépticos de primera y segunda generación. Aspectos básicos útiles en la práctica clínica

EPILEPSY IS VERY COMMON DISORDER OF THE CENTRAL NERVOUS SYSTEM, AFFECTING APPROXIMATELY I TO 2% OF THE WORLD S POPULATION. USUALLY THERE IS NO RECOGNIZABLE CAUSE, ALTHOUGH IT MAY DEVELOP AS A CONSEQUENCE OF DIFFERENT KIND OF BRAIN DAMAGE , SUCH AS TRAUMA, INFECTION CEREBRAL VASCULAR DISEASE, TUMOR GROWTH AND NEUROCITERCISCOSIS IN OUR CONTRY. THIS RIVIEW IS CONCERNED ABOUT SOME RELEVANT ASPECTS OF THE EPILEPSY SUCH AS SOME BASISC CELLULAR MECHANISM ABOUT EPILEPTOGENESIS . THESE FINDINGS HAVE BEEN UNDERTAKEN FROM THE EXPERIMENTALS MODELS AND SUGGEST SOME MECHANISMS OF ACTION OF ANTICONVULSANT DRUGS THAT ARE CLINICALLY EFECTIVE IN CONTROLLING SEIZURES.
Anestesia do Membro Pelvino de Ovinos

Realizou-se o experimento em 30 ovinos, sem raca definida, machos e femeas, adultos, clinicamente sadios, com o objetivo de se estabelecer uma anestesia regional para o membro pelvino, atraves do bloqueio anestesico dos nervos isquiaticos e femoral. O bloqueio foi realizado por meio da administracao de 5ml de lidocaina a 2% com adrenalina, em dois pontos. Demonstrou ser eficiente e de facil aplicacao, permanecendo seus efeitos por periodo suficiente para a realizacao das principais intervencoes cirurgicas no membro pelvino, com margem de seguranca adequada, podendo ser aplicada nos casos em que a anestesia geral for contra indicada. Palavras-chave: Anestesia, Membro-pelvino; Ovinos: Cirurgia. ABSTRACT In this research, 30 male and female adult sheep's, without determinate race, clinically healthy, were utilized in order to produce anesthesia in their hind limb through the sciatic and femoral nerves blocking, with the administration in two points. This procedure has showed to be available, efficacious and widely applicable in the surgery of the sheep's hind limb. Key words: Anesthesia, hind limb; sheep: surgery.