bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ultrasound diagnosis of cervical lymph node metastases in patients with first diagnosed papillary thyroid cancer and in patients previously treated surgically and admitted for radioactive iodine therapy
Authors: Parshin V. S. , Kaprin A. D. , Ivanov S. A. , Veselova A. A. , Garbuzov P. I. , Medvedev V. S. 
Published: June 2020

Purpose of the study. To evaluate the potentialities of ultrasound method in diagnosing cervical lymph node metastasis in patients with first diagnosed papillary thyroid cancer (group 1) and in patients previously treated surgically at different clinics of the Russian Federation and subsequently admitted to the A.F.Tsyb Medical Radiological Research Center — Branch of the National Medical Research Radiological Center to receive radioactive iodine therapy (group 2).Patients and methods. Patients with PTC were divided into two groups. Group 1 included 649 patients with first diagnosed PTC. All the patients underwent thyroidectomy and level VI lymph node neck dissection at the clinic of the A.F.Tsyb Medical Radiological Research Center — Branch of the National Medical Research Radiological Center. Of these patients, 92 patients underwent cervical lymph node dissection including levelsII–III–IV and 9 patients underwent cervical lymph node dissection including level VB. Group 2 consisted of 2875 patients who had previously received surgery at different clinics of the Russian Federation. Subsequently, they were admitted to our institution to receive radioactive iodine therapy. In 291 of these patients, cervical lymph node metastases were found and reoperations were performed: in 89 cases at level VI, in 170 cases at levels II–III–IV and in 32 cases at level VB. The detected metastases were verified histologically.Results. Histology confirmed the presence of nodal metastasis in 57.6% of 649 patients in group 1, and in 10.1% of 241 patients in group 2. In group 1, the incidence of metastatic disease in level VI nodes was 73% and in group 2, it was 30.6%. Metastases in levels II–III–IV were noted in 24.6% of patients in group 1, and in 58.4% of patients in group 2. Level VB metastasis was found in 2.4% of patients in group 1, and in 11% of patients in group 2. Multiple metastases were detected in 75.4% of patients in group 1, and in 20.3% of patients in group 2.Conclusion. Central lymph node metastasis was observed in 73% of patients who were first diagnosed with PTC and treated with thyroidectomy and prophylactic level VI cervical lymph node dissection. In group 2, solitary metastases to lateral lymph nodes occurred more frequently after surgical treatment for PTC, which suggested that the primary treatment was insufficiently radical.
Organizational problems and possible ways of its resolve when providing emergency surgical care to patients with comorbid status in a highly specialized medical institution
Authors: Khokhlova I. M. , Kozhevnikov V. B. , Movchan K. N. , Artyushin B. S. , Bartashevich E. V. , Zharkov A. V. , Zheleznyi E. V. 
Published: June 2020

Purpose of the study. To demonstrate the difficulties of objective interpretation of providing medical care to patients with critical limb ischemia.Materials and methods. The results of treatment of more than 29 thousand patients of one of the highly specialized medical organizations of St. Petersburg were studied, in which the main activity of the staff is the examination of patients with surgical infection of soft tissues (particularly, the critical limb ischemia).Results. It has been ascertained that, despite the unconditional success of providing medical care to patients with critical limb ischemia, a high frequency of unsatisfactory treatment results for this category of patients remains (in 2017, among 685 patients of the specialized department of the highly specialized medical organization, the proportion of cases of performing high amputations of limbs and mortality, respectively, was 11,7% (80) and 2,6% (18)). It has been demonstrated on clinical examples that the pronounced comorbidity of critical limb ischemia patients and the severity of their general condition (combined with organizational difficulties in providing them with providing medical care in conditions of highly specialized medical organization) contribute to the formation of complications (up to lethal outcomes) of not only the underlying, but also concomitant diseases. Difficulties in providing medical care of adequate quality in life-threatening conditions for patients of highly specialized medical organization in cases of critical limb ischemia necessitate a wider interaction between specialists in narrow and multidisciplinary hospitals as part of the emergency surgery service.Conclusion. When creating specialized medical centers outside of multidisciplinary medical institutions, the possibilities should be provided for the regulated involvement of highly professional consultants with a reasonable algorithm for routing patients in cases of the need for their emergency re-hospitalization to other medical institutions.
KADINLARIN ANNELİĞE İLİŞKİN GÖRÜŞLERİ
Authors: Uçakcı Asalıoğlu Canan , Ercan Feride , Erdem Esra , Tüfekci Akcan Aysel 
Published: June 2020

Amaç: Çalışmanın
amacı, kadınların bakış açısından anneliğin kadının dünyasında ne anlama
geldiğini belirlemektir.

Yöntem: Çalışma
amaçlı örnekleme yöntemlerinden kolay ulaşılabilir örnekleme yöntemi
kullanılarak seçilen 18 yaş üzeri ve evli, çocuğu olmayan, çocuğu olan, gebe ve
çocuğu olamayan 6 kadın ile derinlemesine görüşme yapılarak yürütülmüştür. 45-60 dakika süren tek oturumluk yarı
yapılandırılmış görüşmeler yolu ile veriler toplanmıştır. Görüşme öncesinde
katılımcılardan yazılı bilgilendirilmiş onam ile izin alınmıştır. Görüşmeler
kayıt altına alınıp, araştırmacılar tarafından yazıya geçirilmiştir. Verilerin
analizinde içerik analizi tekniği kullanılmıştır.

Bulgular:
Kadınların anne olmaya ilişkin algılarına yönelik bulgular 3 tema altında
toplanmıştır. İlk temada kadınların annelik algısının toplumsal, fiziksel ve
içsel yönlerini ele alarak kadın olmada anneliğin rolüne odaklanılmıştır. İkinci
tema annelikle gelen değişimlere, anneliğin yarattığı yenidünyaya
odaklanmıştır. Üçüncü tema annelikle beraber kadınların yaşadığı duygusal
yoğunluklar başlığı altında toplanmıştır.

Sonuç:
Çalışmanın sonucunda kadınlarda annelik algısının toplumsal yargı, kadınların
iç dünyası gibi farklı unsurlardan etkilendiği görülmüştür. Annelik ile beraber
kadınların önceliklerinin değiştiği ve çok yoğun duygular yaşadıkları
belirlenmiştir. Bulgularımıza dayanarak kadınların gerek toplum içerisindeki
statüleri gerekse aile yaşantıları göz ardı edilmeksizin hem fiziksel hem de psikolojik
olarak karşılaşabilecekleri anne olma ya da anne olamama durumuna karşı
hazırlanmaları için toplum odaklı eğitimler ve danışmanlık hizmetlerinin
planlanması ve kadınların bu planlamalara katılımlarının sağlanması
önerilmektedir.
ÖĞRETMENLERİN PROGRAM TASARIM TERCİHLERİ FELSEFİ İNANÇLARI VE SINIF İÇİ UYGULAMALARINA YÖNELİK KARŞILAŞTIRMALI BİR BAKIŞ
Authors: Doğan Dolapçıoğlu Sevda 
Published: June 2020

Öğretim programlarının işe yararlılığı için öğretmen sınıf
içi uygulamaları önemlidir. Bu uygulamaların mevcut öğretim programları
felsefesi ve tasarım şekline uygun olması istenen bir durumdur. Bu çalışmanın
amacı 4 farklı ülkede görev yapan öğretmenlerin sınıf içi uygulamalarını
inceleyerek öğretmenlerin PT ve felsefi tercihleri ile uygunluğunu tartışmaktır. Çalışma grubu
Avrupa Birliği projesi kapsamında bir araya gelen 81 öğretmendir. Karma
araştırma metodu ile yürütülen projenin öğretmenleri İtalya, Bulgaristan,
Romanya ve Türkiye devlet okullarında görev yapmaktadır. Sonuç olarak
öğretmenlerin program tasarımı ve felsefi tercih algıları ile sınıf içi
uygulamaları arasında önemli farklılıklar bulunmaktadır. PT ve felsefi tercih
algıları ülke öğretim programlarına yakın iken sınıf içi uygulamalar bu
yakınlığı yansıtmamaktadır.
Common properties and approximations of local function and set operator $\psi$
Authors: MODAK Shyamapada , SELİM Sk , ISLAM Md. Monirul 
Published: June 2020

Through this paper, we shall obtain common properties of local function and set operator $\psi$ and introduce the approximations of local function and set operator $\psi$. We also determined expansion of local function and set operator $\psi$ .
Caracterización del riesgo biológico por accidentes laborales en el personal de salud de un centro ambulatorio en Guayaquil-Ecuador
Authors: Lara Icaza Javier David 
Published: June 2020

Introducción: Los accidentes ocupacionales por riesgo biológico son tan habituales, que para su prevención se han diseñado estrategias nacionales e internacionales de registros para documentar y responder a las eventualidades de carácter biológico; más de 20 agentes patógenos pueden diseminarse por vía hemática a través de los fluidos corporales y la sangre, siendo los más relevantes para identificación y seguimiento hospitalario, los virus de hepatitis B, C, virus del VIH.
Objetivo: Caracterizar los accidentes biológicos de los profesionales de la salud del Centro Ambulatorio en Guayaquil;
Métodos: Estudio de tipo descriptivo con diseño retrospectivo y cohorte transversal; la muestra correspondió a 250 trabajadores de la salud en el periodo 2017-2018. La información fue adquirida del sistema de vigilancia ocupacional de la institución, del formulario estandarizado nacional. Las variables evaluadas fueron exposición a sangre y fluidos corporales a través de pinchazos, laceraciones, raspaduras, cortes, también en mucosas o piel no incólume (salpicadura), en el lapso de la actividad laboral.
Resultados: La tasa de prevalencia por riesgos biológicos fue de 6 por cada 100 trabajadores, La edad media 36.06 años, 80% de los casos fueron mujeres; el accidente con mayor prevalencia fue el pinchazo percutáneo por aguja hueca contaminada (60%). El corte con bisturí y la aguja no hueca fue 13.3 % y 6.7% a salpicadura a la mucosa ocular.
Conclusiones: la punción percutánea presentó la mayor incidencia para accidentes en esta categoría, a pesar que el 94% de los trabajadores accidentados reportó el uso de los guantes de látex como elementos de protección personal.
Dipstick urine analysis for detection of renal abnormalities among school children
Authors: Mishra Atindra , Thakur Ruby 
Published: June 2020

Background: Urine analysis by dipstick is a useful tool to identify children with asymptomatic renal diseases. Dipstick urinalysis screening was conducted in asymptomatic school children to detect prevalence of renal disease.Methods: A cross sectional study was carried out in 862 children of age 6 to 15 years studying in different schools of Birgunj, Nepal between January 2019 to June 2019. First morning mid-stream urine samples were obtained from students and tested by dipstick method. Children with abnormal findings were re-tested after fifteen days.Results: Ninety-six (11.13%) children had urinary abnormalities at the first screening; 8 children had specific urinary abnormalities after second screening. 4 children had urinary tract infection, followed by glomerulonephritis, type 1 diabetes, hydronephrosis and nephrotic syndrome. Urinary abnormalities were more common in females than in males.Conclusions: Asymptomatic urinary abnormalities are detected by urine screening program at school age. Further work-up reveals the specific diagnosis and effective interventions help reduce the renal disease in future.
Forecasting the possibility of neonatal early onset sepsis based on perinatal risk factors
Authors: Pankaj Kiran C. , Ganguly Sristi , Upadhyay Manas R. 
Published: June 2020

Background: Neonatal sepsis remains a leading cause of neonatal mortality and morbidity, diagnosis of which remains difficult due to variable presentations. With the increasing threat of antimicrobial resistance, it is important to identify perinatal risk factors which are associated with higher incidence of definite sepsis, to initiate empirical antibiotics, while awaiting blood culture reports.Methods: This was hospital based cross-sectional study done in SVPPGIP, Cuttack, Odisha during January 2019 to April 2019, enrolling all neonates ≥37 weeks gestation and aged less than 72 hours, with suspected early onset sepsis. Neonates with TORCH infections, congenital anomalies, syndromic baby or with surgical conditions were excluded. After obtaining informed consent, blood culture was sent for all and their perinatal risk factors noted. Blood culture positive newborns were considered to have definite sepsis. Data was analysed with Chi-square test and percentages, using SPSS 18.Results: Among the 200 cases, incidence of definite sepsis was 26%. The most common risk factor was low birth weight and birth asphyxia. Majority (67%) had single or lesser risk factor and number of risk factors was significantly associated with definite sepsis. A significant association was seen between blood culture positivity with low birth weight (p=0.003), foul smelling liquor (p= 0.025), birth asphyxia (p 0.018) and premature rupture of membranes (p= 0.016). The combination of maternal fever and unclean vaginal examination was also significantly associated with the same.Conclusions: Protocols for initiating empiric antibiotics need to be formulated, taking into account the significant risk factors, in resource limited settings, to avoid resource and time wastage.
A prospective study of functional outcome of closed displaced mid-shaft clavicle fractures treated with intramedullary titanium elastic nail system
Authors: Kumar Mallepogu Kiran , Prasad Rajana Siva 
Published: June 2020

<p class="abstract"><strong>Background:</strong> Clavicle fractures are most common injuries in young and active individuals, especially those who participate in sports where high-speed falls (e.g., bicycling, motorcycles) or violent collisions (e.g., Football, hockey) are frequent. In contrast, in children and elderly, they are related to falls, and they account for approximately 2.6% of all fractures. The most common site of fracture is a middle-third shaft; it accounts for 80% of all clavicle fractures.</p><p class="abstract"><strong>Methods:</strong> This was a prospective study carried in 20 patients with simple mid third clavicular fractures, who were treated with closed intra-medullary fixation with TENS nailing. Post-operatively range of movements, ability to get back to routine work were assessed and noted. <strong></strong></p><p class="abstract"><strong>Results:</strong> At the end of the study, all the 20 patients in the follow-up group with 14 male and 6 female patients. The mean age was 34.9 years (between 22-55 years) in the group. The mean time interval between injury and surgery was 3.55 days (range 1-6 days). All the patients are achieved clinical and radiological union at a mean of 8.6 weeks (range, 6-12 weeks).</p><p class="abstract"><strong>Conclusions:</strong> Thus, the intramedullary fixation of a displaced midshaft clavicle fracture is a safe minimally invasive technique. The present study advises the use of minimally invasive antegrade titanium elastic nail for fixation of displaced midshaft clavicle fractures. Although, for comminuted fractures plating remains the procedure of choice.</p>
Evaluation of patients with cervical spine injury and predicting the risk and severity of acute spinal cord injury after a minor trauma
Authors: Maloth Ramdas 
Published: June 2020

<p class="abstract"><strong>Background:</strong> Acute spinal cord injury (SCI) after a minor trauma to the cervical spine has been reported in patients without preceding neurologic symptoms. Spinal canal stenosis may be the reason for the discrepancy between the severity of the injury and that of the trauma. The objective of this study was to investigate MRI parameters of the cervical spine in patients suffering from acute SCI and to investigate the use of these parameters for predicting the risk and severity of acute cervical SCI after a minor trauma to the cervical spine. </p><p class="abstract"><strong>Methods:</strong> Retrospective radiological study was conducted in Meenakshi Medical College and Research Institute Kanchipuram with fifty patients suffering from acute cervical SCI and 130 patients showing no neurologic deficits after a minor trauma to the cervical spine. The following calculations were performed using measurements from MR images the spinal canal to vertebral body ratio, the space available for the cord, and the canal-to-cord ratio. SPSS version 21 was used for analysis.<strong></strong></p><p class="abstract"><strong>Results:</strong> All investigated MR image parameters in the SCI group were significantly (p&lt;001) smaller compared with the control group. However, there was no significant difference in any parameter among the different American spinal injury association impairment score groups. A cut-off value of 8.0 mm for the minimal sagittal disc-level canal diameter yielded the largest positive predictive value and likelihood ratio for predicting SCI.</p><p class="abstract"><strong>Conclusions:</strong> Patients at risk of acute SCI after a minor trauma to the cervical spine can be identified by applying a disc-level canal diameter cut-off value measured on MR images. Supplementary factors to the radiological characteristics of the spinal canal affect the severity of acute SCI after trauma.</p>
Extremity chronic osteomyelitis in a population of North East India: epidemiology, clinical characteristics and management
Authors: Khonglah Tashi G. , Borgohain Bhaskar , Khongwir Wanlamkupar , Ahmed Kashif A. 
Published: June 2020

<p class="abstract"><strong>Background:</strong> The purpose of this study was to review the epidemiology, clinical features and the management of extremity chronic osteomyelitis in a population of North East India and to provide evidenced based guidelines for early diagnosis and treatment.</p><p class="abstract"><strong>Methods:</strong> We retrospectively reviewed patients who were diagnosed and treated for extremity chronic osteomyelitis at a tertiary care hospital at Shillong in North East India. Medical records for all patients were analysed and details on gender, age at incidence, anatomical site, infecting organisms, levels of inflammatory markers, and the various treatment modalities were evaluated.<strong></strong></p><p class="abstract"><strong>Results:</strong> A total of 131 patients (96 males and 35 females) were included in this study. The median age at first diagnosis was 17 years for all. Infections caused by hematogenous osteomyelitis was found to be slightly more than those of traumatic origin. All patients had single site infections with a majority of lesions affecting the lower extremities. The tibia was the most common site in traumatic osteomyelitis while the femur was mostly involved in hematogenous osteomyelitis. The positive rate for all cultures was at 57.25% with the most commonly encountered organism being <em>Staphylococcus aureus</em>. Treatment methods used in our study included radical debridement with the use of local and systemic antibiotics and reconstruction of bony or soft tissue defects. The overall infection control rate was 96.18%.</p><p><strong>Conclusions:</strong> The findings from this study can provide information for early diagnosis and treatment of this form of bone infection particularly in this part of the country. </p>
Cutaneous manifestations in patients with chronic renal failure on hemodialysis
Authors: P Premananth , R Gnanasekaran , R Saravanan , A S Krishnaram , K Shanmugarpriya 
Published: June 2020

Chronic renal failure (CRF) associated with many cutaneous manifestations starts from xerosis, dark pigmentation, to life threatening severe uncontrolled itching. Cutaneous problems with CRF having different and newer manifestations after hemodialysis interventions.To assess the prevalence of cutaneous manifestations including hair and nails in chronic renal failure (CRF) patients on hemodialysis .One hundred patients of CRF undertaking hemodialysis were examined for various cutaneous presentations.cutaneous manifestations seen in eighty six patients. The commonest finding was xerosis (81%),had wide range of clinical presentation with pruritus (56%) produced distress symptoms skin color changes presented commonly as pallor (65%), and cutaneous hyperpigmentation (53%) manifesting physical and psycological disturbance s respectively. Othera skin problem found peculiar to chronic renal failure are acquired perforating dermatoses of kyrles diease (20%); prevalence of cutaneous infections especially dermatophytosis and other superficial fungal infections (28%), pyoderma(10%) and viral (13%) infections; other important cutaneous manifestation are purpura (10%); and eczema(2%). The nail changes sharing significant presentations in majority of renal failure patients which included half and half nail (20%),as important clinical marker followed by koilonychia (16%), onychomycosis (16%), onycholysis (11%), Mees’ lines (7) Hair changes also contributing significant clinical finding as sparse body hair (27. Wide array of oral mucosal changes presented mainly as macroglossia (36%), xerostomia (28%), ulcerative stomatitis (27%), and uremic odour(7%).CRF had a significant cutaneous changes mainly as xerosis, pruritus acquired perforating dermatoses, uraemic odour and hyperpigmentation. These changes served as clinical clue in diagnosis and therapeutic management. These changes were attributed by disease (CRF) as well as hemodialysis. Management aimed as alleviation of sufferings and improve life quality.
Clinical study of cutaneous lesions in neonates at a tertiary care centre
Authors: Ravindra Kumar P , Dyavannanavar Veeresh , Malkud Shashikant 
Published: June 2020

Cutaneous problems in neonates have always been a significant part of paediatric dermatology. They range from physiological transient conditions at one end to serious pathological entities at the other.To study the clinical pattern of various dermatoses in neonates at a tertiary care centre.This is a hospital based cross-sectional observational study conducted at tertiary care centre. Total 100 neonates (≤ 28 days old) having any kind of cutaneous lesion were included in the study. Detailed history, clinical examination was done in all neonates followed by recording each finding and their statistical analysis.In the 100 neonates analysed, 53 were females (53%) and 47 (%) were males. 15 patients were born preterm, 78 in term and 7 in post term. Most of the skin lesions were asymptomatic but only 16 were having symptomatic skin lesion. Skin lesions in the study were physiological in 70%, pathological in 20% and mixed in 10%.Studying neonatal skin lesion is important to all dermatologists so that they are able to differentiate physiological and pathological conditions, thereby avoiding unnecessary therapy for neonates in circumstances not requiring any and also facilitating to allay undue anxiety among parents.