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Mean Platelet Volume is a Prognostic Marker in Acute Ischemic Stroke Patients Treated with Intravenous Thrombolysis.

J Stroke Cerebrovasc Dis 2021 Apr 6;30(6):105718. Epub 2021 Apr 6.

Stroke Unit, Department of Neurosciences and Mental Health (Neurology), Hospital Santa Maria; Faculty of Medicine, University of Lisbon, Lisbon, Portugal; Instituto de Medicina Molecular, Lisbon, Portugal.

Background And Objectives: There is conflicting data regarding the association between platelet parameters and prognosis of stroke patients treated with intravenous thrombolysis. We aimed to analyze this association in a cohort of patients treated with rtPA.

Material And Methods: Retrospective, observational study in adult ischemic stroke patients treated with rtPA between January 2015 and February 2017. Read More

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Lobular neoplasia detected at MRI-guided biopsy: imaging findings and outcomes.

Clin Imaging 2021 Mar 31;78:171-178. Epub 2021 Mar 31.

Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, United States of America; Department of Imaging, Dana-Farber Cancer Institute, Harvard Medical School, 450 Brookline Avenue, Boston, MA 02215, United States of America.

Objective: To review MRI findings of pure lobular neoplasia (LN) on MRI guided biopsy, evaluate surgical and clinical outcomes, and assess imaging findings predictive of upgrade to malignancy.

Methods: HIPAA compliant, IRB-approved retrospective review of our MRI-guided breast biopsy database from October 2008-January 2015. Biopsies yielding atypical lobular hyperplasia or lobular carcinoma in situ were included in the analysis; all biopsy slides were reviewed by a dedicated breast pathologist. Read More

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Onlay Poly-4-Hydroxybutyrate (P4HB) Mesh for Complex Hernia: Early Clinical and Patient Reported Outcomes.

J Surg Res 2021 Apr 7;264:199-207. Epub 2021 Apr 7.

Division of Plastic Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, PA. Electronic address:

Background: While mesh re-enforcement and advanced surgical techniques are cornerstones of complex ventral hernia repair (CVHR), the risk of complications and recurrence is common. We aim to evaluate the efficacy, safety, and patient reported outcomes (PROs) of patients undergoing CVHR with onlay Poly-4-hydroxybutyrate (P4HB).

Methods: Adult (>18 y old) patients undergoing VHR with P4HB (Phasix) in the onlay plane by a single surgeon from 01/2015 to 05/2020 were reviewed. Read More

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The effects of antibiotics on the efficacy of immune checkpoint inhibitors in patients with non-small-cell lung cancer differ based on PD-L1 expression.

Eur J Cancer 2021 Apr 7;149:73-81. Epub 2021 Apr 7.

Department of Allergy and Respiratory Medicine, Okayama University Hospital, Japan.

Background: Immune checkpoint inhibitors (ICIs) are essential for treatment of various malignancies, including non-small-cell lung cancer (NSCLC). Recently, several studies have shown that the gut microbiome plays an important role in ICI treatment of solid cancers, and antibiotic (ATB) use had a negative impact on the outcomes of ICI treatment via dysbiosis in the gut. However, whether this is applicable to NSCLC remains unclear. Read More

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Quantitating Mitral Regurgitation in Clinical Trials: The Need for a Uniform Approach.

Ann Thorac Surg 2021 Apr 7. Epub 2021 Apr 7.

Division of Cardiac Surgery, University of Maryland School of Medicine, Baltimore, MD.

Background: There is an established relationship between the degree of mitral regurgitation (MR) and prognosis. Quantitation of MR severity guides therapeutic approaches. Inconsistent definitions and categorization of MR severity in clinical studies limit meaningful comparisons between trials and compromise development of an effective evidence base. Read More

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Genotypic and phenotypic profiles of antibiotic-resistant bacteria isolated from hospitalized patients in Bangladesh.

Trop Med Int Health 2021 Apr 10. Epub 2021 Apr 10.

Infectious Diseases Laboratory, Institute for Developing Science and Health Initiatives, Dhaka, Bangladesh.

Objectives: Characterization of resistance phenotype and genotype is crucial to understanding the burden and transmission of antimicrobial-resistance (AMR). This study aims to determine the spectrum of AMR and associated genes encoding aminoglycoside, macrolide and β-lactam classes of antimicrobials in bacteria isolated from hospitalized patients in Bangladesh.

Methods: 430 bacterial isolates from patients with respiratory, intestinal, wound infections, and typhoid fever, presenting to clinical care from 2015-2019, were examined. Read More

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Association of anaemia and all-cause mortality in patients with ischaemic heart failure varies by renal function status.

ESC Heart Fail 2021 Apr 10. Epub 2021 Apr 10.

Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, China.

Aims: The aims of the current study were to evaluate the association between anaemia and all-cause mortality according to chronic kidney disease (CKD) status and to explore at what level of haemoglobin concentration would the all-cause mortality risk increase prominently among CKD and non-CKD patients, respectively.

Methods And Results: This is a prospective cohort study, and 1559 patients with ischaemic heart failure (IHF) were included (mean age of 63.5 ± 11. Read More

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Phase II study of propranolol feasibility with neoadjuvant chemotherapy in patients with newly diagnosed breast cancer.

Breast Cancer Res Treat 2021 Apr 10. Epub 2021 Apr 10.

Winship Cancer Institute at Emory University, 1365 Clifton Road, Suite B4112, Atlanta, GA, 30322, USA.

Purpose: Propranolol regulates angiogenesis in pre-clinical models and reduces distant breast cancer (BC) metastases in observational studies. We assessed the feasibility of combining propranolol with neoadjuvant chemotherapy (NAC) in patients with BC.

Methods: Women with clinical stage II-III BC undergoing NAC [weekly paclitaxel × 12, followed by dose-dense adriamycin/cyclophosphamide (AC) × 4] started propranolol 20 mg PO BID with paclitaxel #1, and increased to 80 mg extended release (ER) PO daily, as tolerated. Read More

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Peroral endoscopic myotomy for advanced achalasia with megaesophagus.

Esophagus 2021 Apr 10. Epub 2021 Apr 10.

Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017, Japan.

Background: The outcomes of peroral endoscopic myotomy for advanced achalasia are not well known. This study aimed to evaluate the outcomes of peroral endoscopic myotomy for achalasia with megaesophagus, which is one of the characteristics of advanced achalasia.

Methods: In total, 234 patients with achalasia who underwent peroral endoscopic myotomy in our hospital from April 2015 to March 2019 were included in this retrospective observational study. Read More

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Ultrasound-guided percutaneous needle tenotomy using Tenex system for refractory lateral epicondylitis; short and long-term effectiveness and contributing factors.

Skeletal Radiol 2021 Apr 10. Epub 2021 Apr 10.

Department of Radiology, Musculoskeletal Imaging and Intervention, University of Virginia Health System, Charlottesville, VA, USA.

Background: Ultrasound-guided percutaneous needle tenotomy (USPNT) has been proposed as an alternative treatment to surgical intervention for lateral epicondylitis (LE). The Tenex system (Tenex Health Inc., Lake Forest, CA, USA) for USPNT is an ultrasonic device involving a needle which oscillates at high frequency to debride and aspirate diseased tendon under ultrasound image guidance. Read More

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Characteristics of insulinopenic and non insulinopenic diabetes related to immune checkpoint inhibitors: A French pharmacovigilance study.

Therapie 2021 Mar 24. Epub 2021 Mar 24.

Regional Pharmacovigilance Center, Department of Pharmacology, Pitié-Salpêtrière Hospital, 47-83, boulevard de l'Hôpital, 75013 Paris, France. Electronic address:

Introduction: Immune checkpoint inhibitor-induced diabetes mellitus (ICI-DM) is an immune-related adverse drug reaction (irADR). Hyperglycemia can be linked to endogenous insulin deficiency with ketoacidosis or associated with preserved beta-cell function.

Objectives: We aimed to identify the characteristics of both types of ICI-DM (type 1 and type 2 DM), to improve our understanding of this irADR and its management. Read More

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Feasibility of PTSD Risk Identification in Pediatric Traumatic Patients using PsySTART: A Pilot Study.

J Pediatr Surg 2021 Mar 18. Epub 2021 Mar 18.

Department of Pediatrics, Lundquist Institute at Harbor-UCLA Medical Center, David Geffen School of Medicine at UCLA, Los Angeles, CA USA.

Background: Trauma patients undergo a standardized history and physical, however identification of mental health risk factors is not typically included. We aimed to assess the feasibility of using a modified version of Psychological Simple Triage and Rapid Treatment (PsySTART) to identify post-traumatic stress disorder (PTSD) risk factors in pediatric trauma patients. We hypothesized that PsySTART could identify risk factors and be integrated into the electronic medical record (EMR). Read More

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Evaluation of the PRADO Home Discharge Support Programme for Orthopaedic Surgery in 2018.

Orthop Traumatol Surg Res 2021 Apr 6. Epub 2021 Apr 6.

EY Consulting, Tour First, 1 place des Saisons, TSA 14444 92037 Paris-La Défense Cedex, France. Electronic address:

Background: Between 2015 and 2017, nearly 80 000 hospital stays in orthopaedic surgery were entered into a home discharge support programme (PRADO) offered by the statutory health insurance system. The objective of this study was to assess the impact of the PRADO programme on enrolled stays in orthopaedic surgery over the last three years.

Hypothesis: The home discharge support programme used in orthopaedic surgery shortens hospital stays and decreases the rate of re-admission within 30 days. Read More

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Seroprevalence of chikungunya virus infection among HIV-infected adults in French Caribbean Islands of Martinique and Guadeloupe in 2015: A cross-sectional study.

PLoS Negl Trop Dis 2021 Apr 9;15(4):e0009267. Epub 2021 Apr 9.

INSERM Centre d'Investigation Clinique Antilles-Guyane, Cayenne, France.

Background: In 2014, a first outbreak of chikungunya hit the Caribbean area where chikungunya virus (CHIKV) had never circulated before.

Methodology/principal Findings: We conducted a cross-sectional study to measure the seroprevalence of CHIKV immediately after the end of the 2014 outbreak in HIV-infected people followed up in two clinical cohorts at the University hospitals of Guadeloupe and Martinique. Study patients were identified during the first months of 2015 and randomly selected to match the age and sex distribution of the general population in the two islands. Read More

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The Value of Managing Acute Pancreatitis With Standardized Order Sets to Achieve "Perfect Care".

Pancreas 2021 Mar;50(3):293-299

Clinical Research Institute, Methodist Health System, Dallas, TX.

Objectives: We aimed to define perfect care index (PCI) metrics and to evaluate whether implementation of standardized order sets would improve outcomes without increasing hospital-based charges in patients with acute pancreatitis (AP).

Methods: This is a retrospective, pre-post, observational study measuring clinical quality, processes of care, and hospital-based charges at a single tertiary care center. The first data set included AP patients from August 2011 to December 2014 (n = 219) before the implementation of a standardized order set (Methodist Acute Pancreatitis Protocol [MAPP]) and AP patients after MAPP implementation from January 2015 to September 2018 (n = 417). Read More

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Validity of Congenital Malformation Diagnoses in Healthcare Claims from a University Hospital in Japan.

Pharmacoepidemiol Drug Saf 2021 Apr 9. Epub 2021 Apr 9.

Laboratory of Clinical Pharmacy, Tohoku University Graduate School of Pharmaceutical Sciences, Sendai, Miyagi, Japan.

Purpose: This study aimed to assess the validity of diagnoses of congenital malformations (CMs) recorded in claims of a university hospital in Japan.

Methods: Congenital malformations were identified according to Code Q00-Q89 of the International Classification of Diseases, 10th revision. All the children who had been diagnosed with CMs based on their claims in 2015 and within 1 year from their birth month were selected for this study. Read More

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Teaching Medical Students to Help Patients Manage Their Weight: Outcomes of an Eight-School Randomized Controlled Trial.

J Gen Intern Med 2021 Apr 9. Epub 2021 Apr 9.

Department of Social and Behavioral Sciences, Harvard School of Public Health, Cambridge, MA, USA.

Background: Given the rising rates of obesity there is a pressing need for medical schools to better prepare students for intervening with patients who have overweight or obesity and for prevention efforts.

Objective: To assess the effect of a multi-modal weight management curriculum on counseling skills for health behavior change.

Design: A pair-matched, group-randomized controlled trial (2015-2020) included students enrolled in eight U. Read More

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Effectiveness of a Culturally Tailored HIV and Sexually Transmitted Infection Prevention Intervention for Black Women in Community Supervision Programs: A Randomized Clinical Trial.

JAMA Netw Open 2021 Apr 1;4(4):e215226. Epub 2021 Apr 1.

Social Intervention Group, Columbia University School of Social Work, New York, New York.

Importance: Concentrated epidemics of HIV and sexually transmitted infections (STIs) have persisted among Black women in community supervision programs (CSPs) in the United States. Accumulating research has highlighted the effectiveness of culturally tailored HIV/STI interventions for Black women; however, there is a dearth of such interventions for the large number of Black women in CSPs.

Objective: To determine the effectiveness of a 5-session culturally tailored group-based intervention (Empowering African-American Women on the Road to Health [E-WORTH]) with individualized computerized modules and streamlined HIV testing in reducing STIs and condomless sex vs a 1-session streamlined HIV testing control condition. Read More

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The Utility of the Subalar Graft in Nostril Symmetry in Rhinoplasty.

Plast Reconstr Surg 2021 Apr 7. Epub 2021 Apr 7.

From the Department of Surgery, Divisions of Otolaryngology and Surgical Outcomes and Epidemiology, Yale School of Medicine; the Department of Surgery, Division of Plastic and Reconstructive Surgery, University of Massachusetts Medical School-Baystate; and the Department of Otolaryngology Head and Neck Surgery, Icahn School of Medicine at Mount Sinai.

Background: A deviated nose can be attributable to multiple anatomical factors, including asymmetric maxilla. A subalar graft helps to correct maxillary hypoplasia and may be a useful tool for correcting a deviated nose. The authors' objective is to show the effects of the subalar graft in improving nostril symmetry and to propose an algorithm for using this graft in open and endonasal rhinoplasty. Read More

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[Safety of administration of norepinephrine through peripheral vein line in patients with septic shock].

Zhonghua Wei Zhong Bing Ji Jiu Yi Xue 2021 Mar;33(3):276-280

Department of 2nd Intensive Care Unit, Lanzhou University Second Hospital, Lanzhou 730000, Gansu, China.

Objective: To analysis the risk factors and safety of administration of norepinephrine (NE) via peripheral vein line (PVL) in patients with septic shock.

Methods: A single-center retrospective study was conducted. According to the Lanzhou University Second Hospital information system (HIS) and nursing adverse events report cards, patients with septic shock administrated with NE via PVL to correct the hypotension from January 1st 2015 to December 31st, 2019 were enrolled. Read More

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Paclitaxel-Coated Balloons for the Treatment of Symptomatic Central Venous Stenosis in Vascular Access: Results From a European, Multicenter, Single-Arm Retrospective Analysis.

J Endovasc Ther 2021 Apr 9:15266028211007471. Epub 2021 Apr 9.

Interventional Radiology, Patras University Hospital, Patras, Greece.

Introduction: This was a European, multicenter, investigator-initiated and run, single-arm retrospective analysis to assess the safety and the clinical benefit of the use of paclitaxel-coated balloon (PCB) for the treatment of symptomatic central venous stenosis (CVS).

Materials And Methods: Eleven centers from 7 countries across Europe, submitted 86 cases performed during the period between October 2015 and June 2018. Minimum follow-up was 6 months. Read More

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Postoperative Infection Rate and Associated Factors Following Endoscopic Sinus Surgery.

Ann Otol Rhinol Laryngol 2021 Apr 9:34894211007240. Epub 2021 Apr 9.

Division of Rhinology and Endoscopic Skull Base Surgery, Department of Otolaryngology-Head and Neck Surgery, University of Washington, Seattle WA, USA.

Objectives: There is a paucity of data on postoperative infections after endoscopic sinus surgery and associated risk factors. Our objective was to evaluate a cohort of patients undergoing endoscopic sinus surgery (ESS) for chronic rhinosinusitis to determine which perioperative factors may be associated with infection in the 30-day postoperative period.

Methods: A retrospective cohort study of adults who underwent ESS at a tertiary academic medical center from 2015 to 2018 was performed. Read More

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Association between Big Five Personality Factors and medication adherence in the elderly.

Trends Psychiatry Psychother 2021 Apr 9. Epub 2021 Apr 9.

School of Medicine and Graduate Program in Biomedical Gerontology, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil.

Background: Adherence to medications can be associated with circumstances related to the patient, the pathology, cultural health beliefs, habits and quality of life. The behavioral patterns can also directly influence the pharmacological adherence of a patient, as these relate to the perception and understanding of their own health status and the drug and non-drug. therapies. Read More

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The Acute and Late Toxicities of MRI-Guided External Beam Partial Breast Irradiation Delivered Using a Once-Per-Day Regimen.

Front Oncol 2021 23;11:649301. Epub 2021 Mar 23.

Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, South Korea.

Background And Purpose: The use of external beam accelerated partial breast irradiation (APBI) using a twice-per-day regimen has raised concerns about increase rates of late toxicities. We compared toxicity outcomes of external beam APBI using a once-per-day regimen and accelerated hypofractionated whole breast irradiation (AWBI) in patients with early-stage breast cancer.

Materials And Methods: This was a single-institution, retrospective cohort study. Read More

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Outcomes of Surgical Excision and High-Dose-Rate Brachytherapy for Earlobe Keloids.

World J Plast Surg 2021 Jan;10(1):78-84

Plastic and Reconstructive Surgery Department, Hospital Universitario de Caracas, Universidad Central de Venezuela, Los Chaguaramos, Distrito Capital, Venezuela.

Background: Radiotherapy as an adjuvant therapy to surgical resection has shown variable rates of recurrence treating earlobe keloids. The purpose of this study was to describe our experience with surgical excision followed by high-dose-rate brachytherapy and present our outcomes after 24 months of follow-up.

Methods: Retrospective chart of 14 patients with 14 earlobe keloids treated with surgical excision followed by high-dose-rate brachytherapy, between January 2015 and May 2016 were enrolled. Read More

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January 2021

Non-responsive celiac disease in children on a gluten free diet.

World J Gastroenterol 2021 Apr;27(13):1311-1320

Division of Gastroenterology, Hepatology and Nutrition, Boston Children's Hospital, Boston, MA 02115, United States.

Background: Non-responsive celiac disease (NRCD) is defined as the persistence of symptoms in individuals with celiac disease (CeD) despite being on a gluten-free diet (GFD). There is scant literature about NRCD in the pediatric population.

Aim: To determine the incidence, clinical characteristics and underlying causes of NRCD in children. Read More

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Dual plating or dual plating combined with compression bolts for bicondylar tibial plateau fractures: a retrospective comparative study.

Sci Rep 2021 Apr 8;11(1):7768. Epub 2021 Apr 8.

Department of Orthopaedic Surgery, the Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, 050051, People's Republic of China.

The aim of this study was to compare secondary loss of reduction outcomes in dual plating fixation and dual plating combined with compression bolt fixation for bicondylar tibial plateau fractures (TPFs). We performed a retrospective study from January 2015 to April 2019. A consecutive series of 72 bicondylar TPFs underwent surgical treatment and was divided into two groups: group 1 (dual plating, n = 46) and group 2 (dual plating combined with compression bolts, n = 26). Read More

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RCVS-TCH score can predict reversible cerebral vasoconstriction syndrome in patients with thunderclap headache.

Sci Rep 2021 Apr 8;11(1):7750. Epub 2021 Apr 8.

Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, 06351, South Korea.

Reversible cerebral vasoconstriction syndrome (RCVS) is one of the most important differential diagnosis in patients with thunderclap headache (TCH). We aimed to develop a new scoring system for RCVS in patients with TCH. We retrospectively analyzed 72 patients enrolled in the prospective study of TCH conducted in 2015-2016 (derivation set). Read More

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Epidemiology, treatment patterns and healthcare utilizations in multiple sclerosis in Taiwan.

Sci Rep 2021 Apr 8;11(1):7727. Epub 2021 Apr 8.

Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Room 220, 33, Linsen S. Rd, Taipei, 10050, Taiwan.

"Real-world" data on the nationwide epidemiology and treatment patterns of multiple sclerosis (MS) is very scarce in Asia. This study is aim to evaluate the 10-years trends in epidemiology and treatment patterns of MS with Taiwan's National Health Insurance Database (NHIRD). Patients aged 20 years or older and were newly diagnosed with MS between 2007 and 2016 were identified. Read More

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Subglottic Post-Extubation Upper Airway Obstruction Is Associated With Long-Term Airway Morbidity in Children.

Pediatr Crit Care Med 2021 Apr 8. Epub 2021 Apr 8.

Department of Pediatrics, Division of Pediatric Critical Care Medicine, Cedars-Sinai Medical Center, Los Angeles, CA. Department of Anesthesiology Critical Care Medicine, Keck School of Medicine of University of Southern California, Children's Hospital Los Angeles, Los Angeles, CA. Department of Pediatrics, Keck School of Medicine of University of Southern California, Children's Hospital Los Angeles, Los Angeles, CA.

Objectives: Post-extubation upper airway obstruction is the most common cause of extubation failure in children, but there are few data regarding long-term morbidity. We aim to describe the frequency of long-term airway sequelae in intubated children and determine the association with post-extubation upper airway obstruction.

Design: Retrospective, post hoc analysis of previously identified prospective cohort of children in the pediatric/cardiothoracic ICU at Children's Hospital Los Angeles from July 2012 to April 2015. Read More

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