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Georgian Med News 2021 Mar(312):92-99

Tbilisi State Medical University.

Different studies indicate that cancer stem cells (CSCs) play an important role in the progression and therapy resistance in different cancer types. The aim of our study was to analyse the distribution of CSCs in different thyroid lesions, in reproductive, menopausal and post-menopausal women. Study included altogether 200 formalin-fixed and paraffin-embedded tissue material, with the diagnosis of NIFTP, Hashimoto's thyroiditis, papillary thyroid carcinoma (PTC) and PTC and Hashimoto's thyroiditis co-occurred cases. Read More

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Georgian Med News 2021 Mar(312):52-56

NJSC "Medical University of Karaganda", Kazakhstan.

The new cardiovascular events development remains the main factors limiting its long-term effectiveness despite technological progress and the widespread use of percutaneous coronary intervention (PCI). Objective - to assess the effect of clinical and genetic factors on the development of complication after percutaneous coronary intervention with double antiplatelet therapy (DAT). Case-control. Read More

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Shorter outpatient wait-times for buprenorphine are associated with linkage to care post-hospital discharge.

Drug Alcohol Depend 2021 Apr 20;224:108703. Epub 2021 Apr 20.

Department of Medicine, Boston University School of Medicine, 801 Massachusetts Ave, Boston, MA, 02118, USA.

Background: Inpatient addiction consult services (ACS) lower barriers to accessing medications for opioid use disorder (MOUD), however not every patient recommended for MOUD links to outpatient care. We hypothesized that fewer days between discharge date and outpatient appointment date was associated with improved linkage to buprenorphine treatment among patients evaluated by an ACS.

Methods: We extracted appointment and demographic data from electronic medical records and conducted retrospective chart review of adults diagnosed with opioid use disorder (OUD) evaluated by an ACS in Boston, MA between July 2015 and August 2017. Read More

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Challenges in Predicting Discharge Disposition for Trauma and Emergency General Surgery Patients.

J Surg Res 2021 May 5;265:278-288. Epub 2021 May 5.

Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois. Electronic address:

Background: Changes in discharge disposition and delays in discharge negatively impact the patient and hospital system. Our objectives were to determine the accuracy with which trauma and emergency general surgery (TEGS) providers could predict the discharge disposition for patients and determine the factors associated with incorrect predictions.

Methods: Discharge dispositions and barriers to discharge for 200 TEGS patients were predicted individually by members of the multidisciplinary TEGS team within 24 h of patient admission. Read More

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Alpelisib in combination with everolimus ± exemestane in solid tumours: Phase Ib randomised, open-label, multicentre study.

Eur J Cancer 2021 May 5;151:49-62. Epub 2021 May 5.

Institut Gustave Roussy, Villejuif, France.

Background And Purpose: Combined mTORC1 inhibition with everolimus (EVE) and phosphatidylinositol 3-kinase catalytic subunit p110α blockade with alpelisib (ALP) has demonstrated synergistic efficacy in preclinical models and supports testing the combination of ALP and EVE in the clinical setting. The primary objective was to determine the maximum tolerated dose (MTD)/recommended dose for expansion (RDE) of ALP in combination with EVE and in combination with EVE and exemestane (EXE) and subsequently assess safety, preliminary efficacy and effect of ALP on the pharmacokinetics of EVE and determine the magnitude of the drug-drug interaction.

Patients And Methods: Dose escalation phases were conducted in patients with advanced solid tumours and in postmenopausal women with hormone receptor-positive (HR+), human epidermal growth factor receptor 2-negative (HER2-) advanced breast cancer (ABC). Read More

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Outcomes of Posterior Labral Repair with or without Concomitant High-Grade Glenohumeral Chondral Pathology: a retrospective cohort with minimum 2-year follow-up.

J Shoulder Elbow Surg 2021 May 5. Epub 2021 May 5.

Carolinas Medical Center, Atrium Musculoskeletal Institute, 1025 Morehead Medical Dr., Suite #300, Charlotte, NC, 28204, USA. Electronic address:

Background: The purpose of this study was to compare outcomes of patients who underwent posterior labral repair with and without concomitant glenohumeral chondral pathology.

Methods: A retrospective review was performed on patients ≥ 18 years of age who underwent primary posterior labral repair over 5 years. Charts were reviewed to determine the presence and location of high-grade (Outerbridge Grade III/IV) pathology. Read More

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Pattern and localization of perineural invasion predict poor survival in oral tongue carcinoma.

Oral Dis 2021 May 8. Epub 2021 May 8.

Department of Clinical Specialistic and Dental Sciences, Marche Polytechnic University, Ancona, Italy.

Background: Survival rate for oral tongue squamous cell carcinoma (OTSCC) is still poor and, despite Tumor-Node-Metastasis staging system has been recently updated, patients included under the same stage still show difference in prognosis. Perineural invasion (PNI) emerged to be an indicator of tumour aggressive behavior and unfortunate events. In this study we investigate the clinic and prognostic value of PNI in a cohort of OTSCC patients. Read More

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Evidence for Reduced Long-Term Potentiation-Like Visual Cortical Plasticity in Schizophrenia and Bipolar Disorder.

Schizophr Bull 2021 May 8. Epub 2021 May 8.

NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway.

Several lines of research suggest that impairments in long-term potentiation (LTP)-like synaptic plasticity might be a key pathophysiological mechanism in schizophrenia (SZ) and bipolar disorder type I (BDI) and II (BDII). Using modulations of visually evoked potentials (VEP) of the electroencephalogram, impaired LTP-like visual cortical plasticity has been implicated in patients with BDII, while there has been conflicting evidence in SZ, a lack of research in BDI, and mixed results regarding associations with symptom severity, mood states, and medication. We measured the VEP of patients with SZ spectrum disorders (n = 31), BDI (n = 34), BDII (n = 33), and other BD spectrum disorders (n = 2), and age-matched healthy control (HC) participants (n = 200) before and after prolonged visual stimulation. Read More

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Evaluation of Dosing Strategies and Trough Concentrations of Vancomycin in Patients Undergoing Continuous Venovenous Hemofiltration.

Pharmacotherapy 2021 May 8. Epub 2021 May 8.

Harper University Hospital, Detroit, Michigan, USA.

Background: Recommendations regarding vancomycin dosing in critically ill patients on continuous venovenous hemofiltration (CVVH) are limited. The purpose of this study was to evaluate current dosing practices of pharmacists for patients treated with CVVH, develop guidelines for optimal dosing and monitoring of vancomycin to improve target trough attainment, and reduce pharmacist workload.

Methods: A retrospective cohort study was performed of critically ill adult patients at an academic medical center in Detroit, Michigan, from January 2015 to December 2018. Read More

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Temporal evolution of metastatic disease: part I-an in-depth review of the evolution of metastatic disease across diverse spectrum of non-neural solid tumors on serial oncologic imaging studies and relevant practical applications.

Jpn J Radiol 2021 May 8. Epub 2021 May 8.

Department of Abdominal Imaging, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Street, Unit 1473, Houston, TX, 77030, USA.

With improved survival rates of patients with metastatic disease due to continuously evolving multimodality treatment options, radiologists are increasingly interpreting imaging studies from patients with protracted metastatic disease. It is thus crucial for radiologists to have an in-depth understanding of the temporal evolution of metastatic spread and the accompanying findings on imaging studies, to provide accurate interpretation that supports optimal management. A general overview of the evolution of cancer spread on serial imaging studies and common pathways of tumor spread across multiple tumor types and tumor locations is not readily available in radiology literature. Read More

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Endothelial glycocalyx degradation and disease severity in Plasmodium vivax and Plasmodium knowlesi malaria.

Sci Rep 2021 May 7;11(1):9741. Epub 2021 May 7.

Menzies School of Health Research and Charles Darwin University, Darwin, Australia.

Degradation of the endothelial glycocalyx is associated with mortality in adult falciparum malaria. However, its role in the pathogenesis of non-falciparum malaria is unknown. In Malaysian patients with knowlesi (n = 200) and vivax (n = 61) malaria, and in healthy controls (n = 50), we measured glycocalyx breakdown products plasma syndecan-1 and urinary glycosaminoglycans, and evaluated correlations with biomarkers of disease severity. Read More

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Illness perceptions predict distress in patients with chronic kidney disease.

BMC Psychol 2021 May 7;9(1):75. Epub 2021 May 7.

Health Psychology Section, Psychology Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 5th floor Bermondsey Wing, Guy's Campus, London, SE1 9RT, UK.

Background: Patients diagnosed with chronic kidney disease (CKD) report increased distress associated with their clinical diagnosis. Distress in patients with predialysis CKD, has been linked to several adverse events; including increased risk of hospitalisation, early dialysis initiation and even death, suggesting that distress is a matter of great concern during routine care in predialysis CKD.

Aims: The present study aimed to assess the nature of illness perceptions and the level of distress in a CKD cohort diagnosed with different stages of kidney disease. Read More

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Monitoring of patients with microdialysis following pancreaticoduodenectomy-the MINIMUM study: study protocol for a randomized controlled trial.

Trials 2021 May 7;22(1):329. Epub 2021 May 7.

Department of Anesthesiology, Division of Emergencies and Critical Care, Oslo University Hospital, Rikshospitalet, Postboks 4950 Nydalen, 0424, Oslo, Norway.

Background: Postoperative pancreatic fistula after pancreatoduodenectomy is a much-feared complication associated with substantial mortality and morbidity. The current standard for diagnosing postoperative pancreatic fistula, besides routine clinical examination, include radiological examinations, analysis of pancreatic drain amylase activity, and routine blood samples. Another promising method is by intraperitoneal microdialysis to monitor intraperitoneal metabolites measured at the pancreaticojejunostomy, thereby detecting what occurs locally, before chemical events can be reflected as measurable changes in systemic blood levels. Read More

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Phase 3 multicenter randomized trial of PSMA PET/CT prior to definitive radiation therapy for unfavorable intermediate-risk or high-risk prostate cancer [PSMA dRT]: study protocol.

BMC Cancer 2021 May 7;21(1):512. Epub 2021 May 7.

Department of Nuclear Medicine, University of Duisburg-Essen and German Cancer Consortium (DKTK)-University Hospital Essen, Hufelandstraße 55, 45131, Essen, Germany.

Background: Definitive radiation therapy (dRT) is an effective initial treatment of intermediate-risk (IR) and high-risk (HR) prostate cancer (PCa). PSMA PET/CT is superior to standard of care imaging (CT, MRI, bone scan) for detecting regional and distant metastatic PCa. PSMA PET/CT thus has the potential to guide patient selection and the planning for dRT and improve patient outcomes. Read More

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Use of low dose vaginal misoprostol in office hysteroscopy: a pre-post interventional study.

J Obstet Gynaecol 2020 Dec 2:1-5. Epub 2020 Dec 2.

Department of Obstetrics and Gynecology, University of South Florida Morsani College of Medicine, Tampa, FL, USA.

A pre-post interventional study of patients undergoing office hysteroscopy alone and in combination with endometrial biopsy was performed during October 2015-March 2018 to evaluate the effect of low dose vaginal misoprostol on patient's pain. Pain scores were assessed using the visual analog scale at the completion of the procedure. There were 646 patients included in the study. Read More

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December 2020

Combining urine antigen and blood polymerase chain reaction for the diagnosis of disseminated histoplasmosis in hospitalized patients with advanced HIV disease.

Med Mycol 2021 May 7. Epub 2021 May 7.

Laboratório de Biologia Molecular de Parasitas e Fungos, Instituto Adolfo Lutz, São Paulo 01246-000, Brazil.

Disseminated histoplasmosis (DH) is endemic in Latin America and the Caribbean where diagnostic tools are restricted. We carried-out a 1-year prospective cohort study at a referral hospital in São Paulo, Brazil. Participants had > or =18 years old, were hospitalized due to any indication and had CD4+ < 200 cells/µl. Read More

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Pre-clinical evaluation of immunoPET imaging using agonist CD40 monoclonal antibody in pancreatic tumor-bearing mice.

Nucl Med Biol 2021 Apr 21;98-99:8-17. Epub 2021 Apr 21.

Department of Radiology, Molecular Imaging Program at Stanford (MIPS), Stanford University, Stanford, CA, USA. Electronic address:

Background: A novel [Cu]Cu-NOTA-aCD40 immunoPET tracer was developed to image a CD40 pancreatic tumor model in C57BL/6 mice and to study the biodistribution profile of the agonist CD40 (aCD40) monoclonal antibody (mAb) alone or combined with other mAbs.

Procedures: Copper-64 ([Cu]Cu) labeled NOTA-aCD40 and NOTA-IgG (10 μg; 7 MBq) were injected intravenously into C57BL/6 mice with subcutaneous mT4 tumors to assess specificity 48 h post injection (p.i. Read More

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Use of An Animal Model of Disease for Toxicology Enables Identification of a Juvenile No Observed Adverse Effect Level for Cyclocreatine in Creatine Transporter Deficiency.

Regul Toxicol Pharmacol 2021 May 4:104939. Epub 2021 May 4.

Lumos Pharma, 4200 Marathon Blvd Suite 200, Austin, TX, 78756, USA.

In standard general toxicology studies in two species to support clinical development, cyclocreatine, a creatine analog for the treatment of creatine transporter deficiency, caused deaths, convulsions, and/or multi-organ pathology. The potential translatability of these findings to patients was evaluated by comparing toxicity of cyclocreatine in wild-type mice to creatine transporter-deficient mice, a model of the human disease. A biodistribution study indicated greater accumulation of cyclocreatine in the brains of wild-type mice, consistent with its ability to be transported by the creatine transporter. Read More

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Coexistent Alcohol-Related Liver Disease and Alcohol-Related Pancreatitis: Analysis of a Large Heath Care System Cohort.

Dig Dis Sci 2021 May 7. Epub 2021 May 7.

Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.

Introduction: Although coexistence of alcohol-related liver disease (ALD) and pancreatitis (ALP) is seen in clinical practice, a clear understanding of the overlap between these diseases is lacking. Moreover, the relative risks for certain population groups have not been studied. We determined the prevalence and coexistence of ALD and ALP in patients with an alcohol use disorder using retrospective analysis of a large patient cohort from Western Pennsylvania. Read More

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Pheochromocytoma and Paraganglioma in Pregnancy: a New Era.

Curr Cardiol Rep 2021 May 7;23(6):60. Epub 2021 May 7.

Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, 200 First St. SW, Rochester, MN, 55905, USA.

Purpose Of Review: Pheochromocytoma and paraganglioma (PPGL) in pregnancy is a rare entity and management of these patients is fraught with uncertainty. Our objective is to review current literature and discuss diagnosis and management of these patients.

Recent Findings: Outcomes of PPGL in pregnancy have improved in recent years. Read More

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Association of ACO Shared Savings Success and Serious Illness Spending.

J Healthc Manag 2021 May-Jun 01;66(3):227-240

Duke-Margolis Center for Health Policy.

Executive Summary: Accountable care organizations (ACOs) need confidence in their return on investment to implement changes in care delivery that prioritize seriously ill and high-cost Medicare beneficiaries. The objective of this study was to characterize spending on seriously ill beneficiaries in ACOs with Medicare Shared Savings Program (MSSP) contracts and the association of spending with ACO shared savings. The population included Medicare fee-for-service beneficiaries identified with serious illness (N = 2,109,573) using the Medicare Master Beneficiary Summary File for 100% of ACO-attributed beneficiaries linked to MSSP beneficiary files (2014-2016). Read More

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Examining the Business Case for Patient Experience: A Systematic Review.

J Healthc Manag 2021 May-Jun 01;66(3):200-224

RAND Corporation, Arlington, Virginia.

Executive Summary: Hospitals, physician groups, and other healthcare providers are investing in improved patient care experiences. Prior reviews have concluded that better patient care experiences are associated with less healthcare utilization and better adherence to recommended prevention and treatment, clinical outcomes, and patient safety within hospitals. No comprehensive review has examined the business case for investing in patient experiences. Read More

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Interlocked Pins Increase Strength by a Lateral Spread of Load in Femoral Neck Fixation: a Cadaver Study.

Acta Chir Orthop Traumatol Cech 2021 ;88(2):144-152

Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Norway.

PURPOSE OF THE STUDY To improve the important torsional, bending and compressive stability in femoral neck fixation, locking plates have been the latest contribution. However, increased strength by restricted fracture motion may come at expense of an altered load distribution and failure patterns. Within locking plate technology, the important intermediate fracture compression may principally be achieved by multiple sliding screws passing through a sideplate fixed to the femur or connected to an interlocking plate not fixed to the femur laterally, sliding "en bloc" with the plate. Read More

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January 2021

Fast synaptic excitatory neurotransmission in the human submucosal plexus.

Neurogastroenterol Motil 2021 May 7:e14164. Epub 2021 May 7.

Department of Human Biology, TU München, Freising, Germany.

Background: Acetylcholine is the main excitatory neurotransmitter in the enteric nervous system (ENS) in all animal models examined so far. However, data for the human ENS is scarce.

Methods: We used neuroimaging using voltage and calcium dyes, Ussing chamber, and immunohistochemistry to study fast synaptic neurotransmission in submucosal plexus neurons of the human gut. Read More

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Loss of Function MPZ Mutation causes milder CMT1B Neuropathy.

J Peripher Nerv Syst 2021 May 7. Epub 2021 May 7.

Institute of Experimental Neurology (InSpe) and Division of Neuroscience, IRCCS Ospedale San Raffaele, Milano, Italy.

Introduction: Mutations in Myelin Protein Zero (MPZ) cause CMT1B, the second leading cause of CMT1. Many of the >200 mutations cause neuropathy through a toxic gain of function by the mutant protein such as ER retention, activation of the Unfolded Protein Response (UPR) or disruption of myelin compaction. While there is extensive literature on the loss of function consequences of MPZ in heterozygous Mpz +/- null mice, there is little known of the consequences of MPZ haploinsufficiency in humans. Read More

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Elabela as a novel marker: Well-correlated with WIfI amputation risk score in lower extremity arterial disease patients.

Anatol J Cardiol 2021 May;25(5):330-337

Department of Cardiology, Faculty of Medicine, Gaziantep University; Gaziantep-Turkey.

Objective: Worldwide, over 200 million people are diagnosed with lower extremity arterial disease (LEAD). LEAD significantly increases the risk of death and amputation of the lower limb. A new classification system (WIfI) has been proposed to initially assess all patients with ischemic rest pain or wounds and also predicts 1-year amputation risk. Read More

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Non-invasive urine markers for the differentiation between RCCs and oncocytoma.

J Clin Lab Anal 2021 May 7:e23762. Epub 2021 May 7.

Department of Urology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.

Background: Recently, our group showed that Vim3 is overexpressed in tissue samples of renal oncocytomas and Mxi-2 in clear cell renal carcinoma (ccRCC). The mechanism leading to the truncation of both proteins is known and involves with two miRs, both detectable in urine. Since the analysis of miRs is time-consuming, our aim was to identify the truncated proteins in urine instead. Read More

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Comparison of slot-scanning standing, supine, and fulcrum radiographs for assessment of curve flexibility in adolescent idiopathic scoliosis: a pilot study.

Spine Deform 2021 May 6. Epub 2021 May 6.

Department of Orthopedic Surgery, Mayo Clinic, 200 1st St SW, Rochester, MN, USA.

Purpose: With the goal of reducing radiation dosing for patients, we sought to compare the results of slot-scanning (EOS) standing flexibility radiographs to supine bending and fulcrum radiographs for surgical planning in adolescent idiopathic scoliosis (AIS). We hypothesized that slot-scanning standing bending radiographs provide similar mean curve flexibility as supine bending and fulcrum radiographs.

Methods: This is a retrospective review of 224 AIS patients with concomitant upright standing and flexibility images. Read More

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Correlation between Stable Hyperglycemia and Mortality in Children Admitted to the Pediatric Intensive Care Unit of Imam Hossein Hospital.

Adv Biomed Res 2021 27;10. Epub 2021 Jan 27.

Department of Pediatric Endocrinology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

Background: Stress-induced hyperglycemia is an important issue among pediatrics admitted in the pediatric intensive care unit (PICU). Former studies have declared that hyperglycemia has a high prevalence rate and could increase the risks of mortality among pediatrics. Here, we aimed to investigate the prevalence rate of hyperglycemia and its effects on mortality among pediatrics in the PICU of the hospital. Read More

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January 2021

Electrospray Mediated Localized and Targeted Chemotherapy in a Mouse Model of Lung Cancer.

Front Pharmacol 2021 20;12:643492. Epub 2021 Apr 20.

Department of Pulmonary Medicine, University Hospital Bern, Bern, Switzerland.

An advanced stage, centrally localized invasive tumor is a major cause of sudden death in lung cancer patients. Currently, chemotherapy, radiotherapy, laser ablation, or surgical resection if possible are the available state-of-the-art treatments but none of these guarantee remedy or long-term relief and are often associated with fatal complications. Allowing localized chemotherapy, by direct and confined drug delivery only at the tumor site, could be a promising option for preoperative down staging or palliative therapy. Read More

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