Miracle-dz/UniFAR-FTUs huggingface dataset:
Comparison between emergent and elective delivery in women with placenta accreta

Abstract Objective: To identify possible predictive factors associated with emergent delivery of antenatally diagnosed placenta accreta and to estimate association between emergent delivery and adverse maternal outcomes in comparison to elective delivery. Methods: A retrospective study of all patients with placenta accreta diagnosed antenatally and confirmed pathologically, who were delivered between 2000 and 2010. Baseline characteristics and outcomes of emergent deliveries were compared with elective deliveries. Results: A total of 48 women met inclusion criteria, of which 24 (50%) were delivered emergently. 79.2% of emergent deliveries were preceded by antenatal bleeding (p = 0.0005), and 62.5% were preceded by recurrent bleeding (p = 0.001). Comparison of elective and emergent deliveries revealed no clinical significant difference in maternal outcome. Conclusions: Antenatal bleeding is associated with an increased risk of emergent delivery. Emergent delivery in a tertiary care facility with immediate access to blood bank and ICU capabilities does not appear to be associated with an increased risk of adverse maternal outcomes. Consequently, some patients may be candidates for delivery later than 34 weeks of gestation.
Weight gain regardless of pre-pregnancy BMI and influence of fetal gender in response to labor induction in postdate pregnancy

Abstract Objective: To evaluate whether maternal weight and body mass index (BMI) and their increase throughout pregnancy are associated with the response to labor induction in postdate pregnancies. Methods: A total of 376 nulliparous women carrying singleton postdate pregnancies with unfavorable cervix were enrolled. We considered as primary outcome vaginal delivery within 24 h after induction, and outcomes were divided into responders (n = 258) and non-responders (n = 107) to the induction of labor to perform the statistical analyses. Results: In the total population of study, women who successfully delivered within 24 h differed significantly from the remaining patients in terms of maternal weight gain (p = 0.009) and BMI increase (p = 0.02) during pregnancy. In addition, males were significantly more (p = 0.005) than females among newborns of women not responding to induction of labor. In the multivariate analysis, maternal weight gain and fetal sex significantly influenced the induction response. The occurrence of a failed induction of labor was more likely in patients presenting a greater maternal weight gain (cut-off 12 kg) and male fetus. Conclusion: Weight gain over 12 kg regardless of pre-pregnancy weight and male fetal gender are two novel potential risk factors for the prediction of failure to induction of labor in postdate pregnancy.
Senescence in amniocytes and placentas from trisomy 21 pregnancies

Abstract Objective: Senescence has been described as a stable cell proliferation arrest resulting from the progression of primary human fibroblasts through a finite number of population doublings in vitro. Accelerated telomere shortening was observed in pregnancies complicated by intrauterine growth restriction, in placentas of diabetic mothers and trisomy 21 amniocytes. We hypothesized that under conditions of stress, telomeres in placentas will be shorter and there will be more cells with the senescence phenotype. Methods: The two study groups included placental biopsies from 7 cases of trisomy 21 and amniocytes from 10 cases of trisomy 21. The control groups consisted of placental biopsies from 6 cases and amniocytes from 10 pregnancies with a normal karyotype. The samples were analyzed for the presence of senescent cells based on the number of fragments in each cell. Results: A significantly higher percentage of cells in the senescent state, based on a higher percentage of cells with more fragmentations, were found in the amniocytes (20.8%) and in trophoblasts (94.3%) from placentas with trisomy 21 compared to the control groups. Conclusion: Among other genetic instability parameters, trisomy 21 amniocytes and trophoblasts express a higher prevalence of senescent cells than were previously reported.
Use of Zoledronic Acid in Patients with Prostate Cancer Bone Metastases: Control of pain and Musculoskeletal Complications

Background Patients suffering from prostatic carcinoma are at high risk of having bone complications because of the metastatic progression of the disease to the skeleton and the consequences of androgenic deprivation. Zoledronic acid is a potent inhibitor of the bone resorption mediated by the osteoclasts, and is the only bisphosphonate whose capacity of reducing significantly the skeleton morbidity in patients with bone metastases is statistically proved. Methods TO attest tolerability and efficacy of zoledronic acid in preventing unfavorable skeletal events and in reducing osteomuscular pain, 25 patients - aged 75 years, suffering from hormone-responsive prostatic carcinoma under hormonal therapy with bone metastases, have been followed and subjected to IV monthly infusion of 4 mg zoledronic acid for 12 consecutive months, associated to daily intake of calcium and multivitamin supplementations. Results At the end of the study, a sensible improvement in their clinical conditions and in their perception of the pain has been recorded in 23 patients and valued through a set of questions (Brief Pain Inventory). Conclusions Zoledronic acid is therefore confirmed to be an effective medicine in preventing the skeleton complications and in controlling the painful symptoms in patients suffering from prostatic carcinoma with bone metastases.
Placental Growth Factor in Acute Coronary Syndrome Patients with Non ST-Elevation

Background: Markers of plaque instability are considered as predictors of future coronary events in patients with non ST-elevation myocardial infarction (NSTEMI) in acute coronary syndrome (ACS). The aim of this study was to determine the role of placental growth factor (PlGF) as a possible predictor of future coronary events such as non-fatal myocardial infarction or cardiac death measured at the admission and 30 days after discharge. Methods: We prospectively collected data from 102 patients admitted to the emergency department (ED) for ACS with chest pain at rest within the preceding 12 hours who were evaluated by risk factors and electrocardiogram changes (ECG). Results: The time course of PlGF levels determined on 102 patients showed a mean value 13.21 ng/L and standard deviation 8.76 ng/L but in the sample of the 53 patients who survived after 30 days, these values decreased to 10.48 ng/L and 5.45 ng/L, respectively. Conclusions: Results of this study indicate a clinically useful role of PlGF in the detection of ACS and NSTEMI patients who are at a higher risk for different cardiovascular disorders within 30 days of admission.
Neonatal cord blood adiponectin and insulin levels in very low birth weight preterm and healthy full-term infants

Abstract Background: There are few studies concerning adiponectin and insulin concentration in cord blood of very low birth weight (VLBW) preterm and full-term newborns, small and appropriate for gestational age (GA). Aim: To compare adiponectin and insulin concentrations between preterm and full-term infants, and to determine their relation with birth weight (BW) and size for GA. Methods: A cross-sectional study of VLBW preterm newborns with GA < 32 weeks and BW < 1500 g, and full-term newborns with GA > 37 weeks born at our hospital between January 2010 and May 2011, was conducted. Exclusion criteria: major congenital malformation, inborn errors of metabolism, chromosomal anomalies. Adiponectin was determined by enzimoimunoassay with ELISA kits (R&D Systems, Minneapolis, MN) and insulin was assayed by chemiluminescence method. Results: A total of 127 newborns were studied, 55 VLBW preterm (28 SGA), and 72 full-term (7 SGA). Insulin cord blood concentrations in preterm and full-term newborns were similar. Adiponectin concentrations were significantly lower in preterm than in full-term infants: 1.57 ± 0.74 pg/ml versus 2.4 ± 0.22 pg/ml (p < 0.001), respectively. Regression analyses showed that, after controlling for several neonatal and maternal factors, preterm birth was the only significant predictor of adiponectin concentrations. Conclusion: Being born prematurely is the main determinant factor for lower adiponectin concentration in umbilical cord blood of newborns.
Estimation of post-mortem interval using biochemical markers

Determining the post-mortem interval (PMI) or time of death is a critical step in most homicide or un-witnessed death investigations. However, the various methods currently used in estimating PMI yield large post-mortem windows and sometimes contradict one another. Traditional biochemical methods have identified a number of metabolites that change post mortem, but these have not been widely adapted for determining PMI because they failed to produce precise, reliable, and rapid results required by the forensic community. Recent developments in biochemical technologies are starting to identify biomarkers that may provide a much more accurate PMI estimation. These techniques are more sensitive and specific than traditional methods and can be standardised and statistically assessed, making them appealing methodologies. In this review, we discuss the use of biochemical methods for PMI determination in the early post-mortem period, with a particular focus on biochemical and cellular changes occurring in the blood. We also provide an overview of current biochemical methods and technologies that can be used to discover novel biomarkers that may help to determine PMI.
Pilot Study on Predictive Value of Plasmatic Levels of 9 Angiogenetic Biomarkers in Selection of Patients Candidate to Prostate Biopsy

To reduce the number of negative prostate biopsies in patients with elevated PSA serum levels represents a major challenge in urological oncology. Angiogenetic factors might be involved in initial stages of prostate cancer and might represent useful tools in patients’ selection for prostate biopsy. The plasmatic levels of Angiopoietin-2, Follistatin, G-CSF, HGF, IL-8, Leptin, PDGF-BB, PECAM-1 and VEGF were measured by BioPlex immunoassay in patients undergoing prostate biopsy for palpable prostate nodule and/or elevated PSA levels (≥4 ng/mL). They were related with biopsy results. ROC curve analysis was exploited to test the diagnostic accuracy of each biomarker by AUC calculation. A potential cut-off level was computed. Fifty patients were entered. Median PSA was 6.8 ng/mL. A prostate nodule was palpable in 18 (36%) patients. The median number of biopsy cores was 12. Prostate cancer was detected in 25 (50%) and ASAP and PIN in 2 more patients (4%) respectively. Among the 9 considered biomarkers, only leptin showed an interesting diagnostic performance with an AUC of 0.781, at a cut-off value of 2.11 ng/mL, demonstrating a sensitivity of 78%, a specificity of 77% and a positive predictive value of 85%. Main limitations of our study are the exploratory design and the criteria adopted for patients’ selection determining a detection rate for prostate cancer above the usual range. Leptin only, in our preliminary study, shows promising diagnostic accuracy for the selection of patients candidate to prostate biopsy. Further studies are required to confirm its diagnostic value and its relation with BMI.
Peritoneal fibromatosis presenting as an acute abdominal emergency

THIS rare disease, even more rarely diagnosed clinicsome were calcified and several free calcified bodies up to ally, may remain entirely dormant and unsuspected 1 cm. in diameter were found in the pelvis. One of these for many years, and only then reveal its presence by fibrous processes had undergone torsion accounting for the producing marked abdominal symptoms and signs acute symptoms. This was removed and also two others occasionally of sudden onset. Such a is for histological examination. The abdomen was closed without a drain. reported. The patient made an uneventful recovery. Physical examination and a radiograph of his chest revealed no CASE REPORT evidence of tuberculosis. The Mantoux reaction was very weakly positive (I-10,000). He was discharged on the A man, aged 29 years, was admitted to hospital complaining of moderately severe central abdominal colicky
The effect of facilitated tucking position during endotracheal suctioning on physiological responses and coping with stress in premature infants: a randomized controlled crossover study

Abstract Objective: Premature infants respond more intensively to pain compared with term infants. Facilitated tucking position as a non-pharmacological method of pain in infants has been suggested; however, its effect on acute procedural pain such as endotracheal suctioning remains to be studied. This study examined the effect of facilitated tucking position during suctioning on physiological responses and coping with stress in premature infants. Methods: This was a randomized controlled crossover study. Thirty-four premature infants received an order of either suctioning with intervention – suctioning without intervention, or suctioning without intervention – suctioning with intervention. Neonatal Infant Pain Scale (NIPS) was used to collect the data. Results: No statistical significant difference was seen between intervention and non-intervention cases in terms of the average time duration to reach the pain score to one or zero, and also, in the average of changes in oxygen saturation. However, changes in heart rate were less in intervention cases. Conclusion: The effect of facilitated tucking position on coping with stress was not found in this study. This non-pharmacological strategy can be suggested because of its effect on reducing changes in heart rate during painful procedure. It is suggested to replicate the study with larger number of samples.
Safety Evaluation of Crocin (a constituent of saffron) Tablets in Healthy Volunteers

Objective(s): Crocin is the chemical ingredient primarily responsible for the color of saffron. It has different pharmacological effects such as antioxidant, anticancer and memory improving activities. Crocin tablets were evaluated for short-term safety and tolerability in healthy adult volunteers. Materials and Methods: The study was a randomized, double-blind, placebo-controlled design consisting of one month treatment of crocin tablets. Volunteers who fulfilled inclusion and exclusion criteria were randomized into 2 groups of 22 each (males and females) and received 20 mg crocin tablets or placebo. General measures of health were recorded during the study such as hematological, biochemical, hormonal and urinary parameters in pre and post-treatment periods. Results: No major adverse events were reported during the trial. Crocin tablets did not change the above parameters except that it decreased amylase, mixed white blood cells and PTT in healthy volunteers after one month. Conclusion: This clinical safety evaluation showed a relatively safe and normal profile for crocin in healthy volunteers at the given doses within the trial period.
Musculoskeletal pain rehabilitation A one-year follow-up of occupational performance, psychosocial functioning and disability

Multidisciplinary pain rehabilitation programmes are found decreasing pain and improve back-to-work rates. There is, however, a lack of knowledge in several respects. The overall aim of this thesis was to study outcomes in terms of occupational performance, satisfaction with performance, psychosocial functioning, disability, and coping profiles at a one-year follow-up after a musculoskeletal pain rehabilitation programme. Part of the aim was to evaluate differences among subgroups of participants based on baseline characteristics and pain-related severities, regarding the above described outcomes. Better psychosocial functioning and less severe disability were in a sample of 509 individuals (Paper I) associated with: older age, being at work prior admission, being Nordic born, longer education, a diagnosis of fibromyalgia (compared with neck disorder or low back pain). At a one-year follow-up psychosocial functioning was significantly improved whereas less improvement was found in physical disability. Improvements at one-year follow-up were independently of participants’ characteristics. The participants’ prioritized occupational problems in all sorts of occupations pertaining to looking after one self (self-care), enjoying life (leisure), and contributing to the social and economic fabric of a Community (productivity). The most prioritized subcategory of occupations to be improved on was household management (Paper II). The most frequently reported occupations were reported as: working, sitting and cleaning the house. Occupational performance and satisfaction with performance improved significantly at discharge and at the follow-up (Paper III). Improvements on occupational performance at follow-up were significantly associated with the following factors: female gender, less physical disability, less life interference and more life Control at baseline. However, participants with most perceived severities to perform their prioritized occupations had significantly higher chance to be improved. The pain coping profiles of Adaptive Copers significantly increased at the follow-up, whereas the Dysfunctional profiles significantly decreased (Paper IV). Having an Adaptive Coper profile at follow-up was associated with improvement on occupational performance and was significantly associated with: being Nordic born, having a longer education and an Adaptive Coper profile and higher scores on satisfaction with occupational performance at baseline. Having an Adaptive Coper profile at follow-up was significantly associated with improvements on occupational performance and satisfaction with performance.
The role of pelvic floor muscle training in urinary incontinence

Since Kegel first reported good outcomes for pelvic floor muscle training (PFMT) in women with urinary incontinence this therapy has become used for women with stress and mixed incontinence. PFMT is recommended as first line treatment by various groups and the NICE guidance on tension-free vaginal tape (TVT; www.nice.org.uk) suggests that this should only be used when conservative measures such as PFMT have been unsuccessful. Success rates of 56%–75% have been quoted but the quality of many studies is poor with only a few wellconducted randomised controlled trials. These have been assessed in a Cochrane review that shows that PFMT is better than no treatment or placebo treatments in stress incontinence, but the role in women with overactive bladder and urge incontinence is less clear. At present there is a lack of data to assess the long-term effectiveness of PFMT and it is claimed that many women do not wish to undergo several months of PFMT when minimally invasive surgical alternatives produce good medium-term results. However, in a recent study of preferences for treatment of stress incontinence, 65% of women attending three tertiary referral clinics chose pelvic muscle training rather than surgery (after being given information on all treatment options). This is consistent with the findings of an earlier study suggesting that most women would prefer to avoid surgery. It is essential therefore that PFMT is performed properly and that good results are achieved for these patients.
Musculotendinous Factors Influencing Difference in Ankle Joint Flexibility between Women and Men

Flexibility is often evaluated from the joint range of motion (ROM), but the mechanisms underlying gender differences in joint ROM have not been elucidated. The purpose of this study was to investigate the factors influencing the difference in ankle joint ROM between men and women with respect to the extensibility of muscle-tendon complex. Eighteen men (21-26 yr, 66.4±6.0kg, 173.7±7.4cm mean±SD) and 12 women (19-27yr, 52.9±4.8kg, 163.4±4.3cm) participated in this study. Each subject was seated with the knee extended, and the ankle joint was attached to a foot plate, by which the ankle joint was passively dorsiflexed with torque gradually increasing from zero to a value at which the passive loading to the ankle joint was just tolerable for each subject. During the passive loading, real-time ultrasonogram was taken to track the movement of MTJ (muscle-tendon junction of the gastrocnemius medialis and Achilles tendon) as the elongation of muscle belly (dMus). The change of MTC (muscle-tendon complex) length (dMTC) during the passive dorsiflexion was estimated from changes in ankle joint angle. Tendon elongation (dTen) was calculated by subtracting dMus from dMTC. There was no significant difference in normalized passive torque during passive dorsiflexion between men and women. Women were more flexible, i.e., they demonstrated greater dMTC, which was accompanied by greater dTen at lower torque levels. However, dMus was not different between men and women. It was concluded that gender difference in the joint ROM at the ankle reflects more compliant Achilles tendon in women than in men.
Efficacy and quality of life after transobturator tension-free vaginal tape procedure for female stress urinary incontinence

Background: Nowadays, tension-free transobturator midurethral sling procedures have been gaining popularity in the surgical management of female stress urinary incontinence (SUI). However, quality of life (QoL) assessment following this new procedure is sparingly reported and requires further investigations for credentialing this intervention as a standard of care for women with SUI. Objective: To evaluate the QoL outcome using King’s Health Questionnaires (KHQ) scale following tension-free transobturator tape procedure. Materials and Methods: We evaluated 31 women with genuine SUI in a tertiary medical teaching hospital for QoL before and after the surgery using KHQ. The responses were analyzed for internal consistency, criterion validity, and improvements in various domains in relation to QoL, which could have been affected by their urinary symptoms. Results: Cronbach’s a statistics indicated good correlation between various items of the KHQ scale before and after surgery (0.88 vs 0.81). The criterion validity of the scale against Sandvik Short Format (SSF) indicated a good agreement between these two scales before intervention and during follow-up (Spearman’s rank correlation coefficient: 0.872 vs. 0.638). When it came to various domains of KHQ scale, there were significant improvements in all items (p < 0.0001) except General Health Perception (p = 0.69). There was no procedure-related morbidity. Conclusion: The results of this study indicate that KHQ can be effectively used for assessing QoL after TOT procedures. This procedure is also safe and effective for continence treatment.