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Prognostic value of inflammatory response biomarkers using peripheral blood and [18F]-FDG PET/CT in advanced NSCLC patients treated with first-line chemo- or immunotherapy.

Lung Cancer 2021 Jul 20;159:45-55. Epub 2021 Jul 20.

Department of Nuclear Medicine, Institut Curie, 92210 Saint-Cloud, France; Laboratoire d'Imagerie Translationnelle en Oncologie, Inserm, Institut Curie, 91401, Orsay, France.

Objectives: We aimed to compare the prognostic value of inflammatory biomarkers extracted from pretreatment peripheral blood and [18F]-FDG PET for estimating outcomes in non-small cell lung cancer (NSCLC) patients treated with first-line immunotherapy (IT) or chemotherapy (CT).

Materials And Methods: In this retrospective multicenter study, we evaluated 111 patients with advanced NSCLC who underwent baseline [18F]-FDG PET/CT before IT or CT between 2016 and 2019. Several blood inflammatory indices were evaluated: derived neutrophil-to-lymphocyte ratio (dNLR), platelet-to-lymphocyte ratio (PLR), C-reactive protein (CRP) and systemic immune-inflammation index (SII). Read More

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Female primary urethral carcinoma: A rare case report.

Int J Surg Case Rep 2021 Jun 10;85:106100. Epub 2021 Jun 10.

Urology Department, Faculty of Medicine, Universitas Syiah Kuala, General Hospital dr. Zainoel Abidin, Banda Aceh, Indonesia.

Introduction: Primary tumors of the female urethra are exceedingly rare and account for <0.02% of the malignant disease occurring in women. This disease usually presents late and, hence, has a poor outcome. Read More

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Long-term analgesic and opioid prescription after surgery under general or neuraxial anesthesia: A retrospective nationwide sampling study.

J Clin Anesth 2021 Jul 23;75:110438. Epub 2021 Jul 23.

Department of Anesthesiology, Chi Mei Medical Center, 901 Zhonghua Road, Yongkang District, Tainan, Taiwan. Electronic address:

Study Objective: Chronic postsurgical pain (CPSP) is a common and underreported but significant outcome following surgery. Pharmacological treatment with analgesics, including non-opioids and opioids, is frequently used. It has been debated whether neuraxial anesthesia can reduce persistent analgesic use. Read More

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A retrospective comparison of organ dose and effective dose in percutaneous vertebroplasty performed under CT guidance or using a fixed C-arm with a flat-panel detector.

Phys Med 2021 Jul 23;88:235-241. Epub 2021 Jul 23.

Department of Medical Imaging, Nimes University Hospital, Univ Montpellier, Medical Imaging Group Nimes, EA 2992, France.

Purpose: To compare the organ-dose and effective-dose (E) delivered to the patient during percutaneous vertebroplasty (PVP) of one thoracic or lumbar vertebra performed under CT guidance or using a fixed C-arm.

Methods: Consecutive adult patients undergoing PVP of one vertebra under CT-guidance, with optimized protocol and training of physicians, or using a fixed C-arm were retrospectively included from January 2016 to June 2017. Organ-doses were computed on 16 organs using CT Expo 2. Read More

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J Am Soc Echocardiogr 2021 Jul 23. Epub 2021 Jul 23.

Department of Medicine and Surgery, University Milano-Bicocca, Milano, Italy; Department of cardiac, neural and metabolic sciences, Istituto Auxologico Italiano, IRCCS, Milano, Italy.

Introduction: Pulmonary capillary wedge pressure (PCWP) plays a pivotal role in cardiac disease diagnosis and management. Right heart catheterization (RHC) invasively provides accurate PCWP measurement, but it is impractical for widespread use in all patients. The left atrial expansion index (LAEI), measured by transthoracic echocardiography (TTE), describes the relative LA volume increase during the LA reservoir phase. Read More

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Clopidogrel, prasugrel, and ticagrelor for all-comers with ST-segment elevation myocardial infarction.

Int J Cardiol 2021 Jul 23. Epub 2021 Jul 23.

Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.

Background: To compare effectiveness and safety of clopidogrel, prasugrel, and ticagrelor among all-comers with ST-segment Elevation Myocardial Infarction (STEMI) and extend the knowledge from randomized clinical trials.

Methods: All consecutive patients with STEMI admitted to Copenhagen University Hospital, Rigshospitalet, from 2009 to 2016 were identified via the Eastern Danish Heart Registry. By individual linkage to Danish nationwide registries, claimed drugs and end points were obtained. Read More

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The impact of radiotherapy protocol adherence on the outcome of patients with locally advanced NSCLC treated with concurrent chemoradiation: results from the radiotherapy quality assurance of the multicentre international randomized PET-Plan trial.

Radiother Oncol 2021 Jul 23. Epub 2021 Jul 23.

Department of Radiation Oncology, Medical Center, University of Freiburg, Freiburg, Germany; German Cancer Consortium (DKTK) Partner Site Freiburg, German Cancer Research Center (DKFZ), Heidelberg, Germany; Faculty of Medicine, University of Freiburg, Freiburg, Germany; Department of Nuclear Medicine, Medical Center, University of Freiburg, Freiburg, Germany.

Introduction: The success of intensification and personalisation of the curative treatment of non-small cell lung cancer (NSCLC) is strongly associated with the precision in radiotherapy. Here, we evaluate the impact of radiotherapy protocol adherence in a prospective multicentre trial.

Methods: In the open-label, randomised, controlled PET-Plan trial, patients with inoperable NSCLC were randomized at a 1:1 ratio regarding the target volume delineation informed by F-FDG PET and CT plus elective nodal irradiation (arm A) or target volumes informed by PET alone (arm B) and received iso-toxically dose-escalated concurrent chemoradiation. Read More

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Defunctioning stomas may reduce chances of a stoma-free outcome after anterior resection for rectal cancer.

Colorectal Dis 2021 Jul 26. Epub 2021 Jul 26.

Department of Surgical and Perioperative Sciences, Surgery, Umeå University, Sweden.

Aim: To investigate the conflicting consequences of faecal diversion on stoma outcomes and anastomotic leakage in anterior resection for rectal cancer, including interaction effects determined by the extent of mesorectal excision.

Method: Anterior resections between 2007 and 2016 were identified using the Swedish Colorectal Cancer Registry. National Patient Registry data were added to determine stoma outcome two years after surgery. Read More

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Impact of COVID-19 pandemic on liver transplantation and alcohol-associated liver disease in the United States.

Hepatology 2021 Jul 26. Epub 2021 Jul 26.

Section of Gastroenterology and Hepatology, Department of Medicine, Baylor College of Medicine, Houston.

Background & Aims: The surge in unhealthy alcohol use during the COVID-19 pandemic may have detrimental effects on the rising burden of alcohol-associated liver disease (ALD) on liver transplantation (LT) in the US. We evaluated the impact of the pandemic on temporal trends for LT including ALD.

Approach & Results: Utilizing data from United Network for Organ Sharing, we analyzed waitlist outcomes in the US through March 1, 2021. Read More

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Avelumab expanded access program in metastatic Merkel cell carcinoma: efficacy and safety findings from patients in Europe and the Middle East.

Int J Cancer 2021 Jul 26. Epub 2021 Jul 26.

University of Manchester and the Christie NHS Foundation Trust, Manchester, UK.

Incidence rates of Merkel cell carcinoma (MCC), an uncommon skin cancer with an aggressive disease course, have increased in recent decades. Limited treatment options are available for patients with metastatic MCC (mMCC). Avelumab, an anti-programmed cell death-ligand 1 monoclonal antibody, became the first approved treatment for mMCC following the results of the phase 2 JAVELIN Merkel 200 study. Read More

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[Same-day discharge after elective coronary angioplasty: a single-center initial experience].

G Ital Cardiol (Rome) 2021 Aug;22(8):665-669

U.O.C. Cardiologia.

Background: Percutaneous coronary intervention (PCI) is usually a procedure based on patient's hospitalization. However, the increasingly widespread use of radial access, the technical evolution of the devices employed and current pharmacotherapy standards have simplified this procedure with satisfying outcomes and significantly reduced complications. It can be assumed that overnight hospitalization may not impact patient safety. Read More

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Renal impairment in a large-scale HIV pre-exposure prophylaxis implementation cohort.

AIDS 2021 Jul 22. Epub 2021 Jul 22.

Central Clinical School, University of Sydney, Camperdown, NSW 2050, Australia Wagga Wagga Base Hospital, Wagga Wagga, NSW, 2650 Australia Kirby Institute, UNSW Sydney, Sydney, NSW 2052, Australia Department of Renal Medicine, Royal Prince Alfred Hospital, Camperdown, NSW, Australia Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Westmead, NSW 2145, Australia Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Westmead, NSW 2145, Australia Western Sydney Sexual Health Centre, Western Sydney Local Health District, Parramatta, NSW, 2150, Australia Holdsworth House Medical Practice, Darlinghurst, NSW 2010, Australia.

Background: HIV pre-exposure prophylaxis (PrEP) with fixed-dose tenofovir disoproxil fumarate (TDF) and emtricitabine has been associated with low rates of renal impairment in clinical trials. Large-scale PrEP implementation may result in higher rates, as the prevalence of associated risk factors may be higher than in trial populations.

Methods: A post-hoc analysis of EPIC-NSW, a large Australian multi-centre PrEP implementation trial for patients at high-risk of HIV infection. Read More

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Systemic Immunosuppression and Risk of Endophthalmitis After Intravitreal Anti-Vascular Endothelial Growth Factor Injections.

Ophthalmic Surg Lasers Imaging Retina 2021 Jul 1;52(S1):S17-S22. Epub 2021 Jul 1.

Background And Objective: To evaluate the impact of systemic immunosuppressive therapy on the rates and outcomes of endophthalmitis following intravitreal anti-vascular endothelial growth factor (VEGF) injections.

Patients And Methods: A retrospective, single-center, comparative cohort study examining eyes undergoing intravitreal anti-VEGF injections from January 2016 to September 2019. Cohorts were created based on concurrent immunosuppressive therapy at time of injection. Read More

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Postdiagnosis Smoking Cessation and Reduced Risk for Lung Cancer Progression and Mortality : A Prospective Cohort Study.

Ann Intern Med 2021 Jul 27. Epub 2021 Jul 27.

N.N. Blokhin National Medical Research Centre of Oncology, Moscow, Russia (A.M., O.S., D.Z.).

Background: Lung cancer is the leading cause of cancer death worldwide, and about one half of patients with lung cancer are active smokers at diagnosis.

Objective: To determine whether quitting smoking after diagnosis of lung cancer affects the risk for disease progression and mortality.

Design: Prospective study of patients with non-small cell lung cancer (NSCLC) who were recruited between 2007 and 2016 and followed annually through 2020. Read More

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The modified ISUP system improves concordance between biopsy and prostatectomy tumour grade.

BJU Int 2021 Jul 26. Epub 2021 Jul 26.

Department of Urology, Melbourne Health, Royal Melbourne Hospital, Parkville, VIC, Australia.

Objectives: To assess the concordance between biopsy and radical prostatectomy (RP) specimens using the 2005 Gleason Score (GS) and the ISUP 2014/ WHO 2016 modified GS system, accounting for the introduction of transperineal biopsy and pre-biopsy multiparametric MRI (mpMRI).

Patients And Methods: Between 2002 and 2019, we identified 2431 patients with paired biopsy and RP histopathology, from a prospectively recorded and maintained prostate cancer database. Biopsy specimens were graded according to the 2005 GS or ISUP 2014 modified GS system, according to the year of diagnosis. Read More

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Multinational descriptive analysis of the real-world burden of headache using the Migraine Buddy application.

Eur J Neurol 2021 Jul 26. Epub 2021 Jul 26.

Real World Evidence, Sanofi, Boston, USA.

Background: A large proportion of headache sufferers do not routinely seek medical care. App-based technologies permit the collection of real-world data over time and between countries that can help assess true burden of headache. This study used a mobile phone application to collect information on real-world burden of self-diagnosed headache and to describe its impact on daily life in headache sufferers who do not routinely seek medical advice. Read More

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Individualised treatment for multidrug-resistant tuberculosis in New South Wales, Australia.

Aust N Z J Public Health 2021 Jul 26. Epub 2021 Jul 26.

Faculty of Medicine and Health, University of Sydney, New South Wales.

Objective: Multidrug-resistant tuberculosis (MDR-TB) presents a major global health challenge. In high-income countries, treatment is individualised to optimise efficacy and reduce toxicity. We aimed to evaluate the outcomes of patients with MDR-TB receiving individualised antibiotic therapy in Australia. Read More

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Modified layered hand-sewn cervical end-to-side anastomosis for minimally invasive McKeown esophagectomy.

J Surg Oncol 2021 Jul 26. Epub 2021 Jul 26.

Department of Thoracic Surgery, Affiliated Hospital of North Sichuan Medical College, Nanchong, China.

Background: Minimally invasive McKeown esophagectomy (MIE McKeown) with cervical anastomosis is a widely used approach for the treatment of esophageal cancer (EC). Anastomotic leak is one of the most serious complications following esophagectomy. This study aimed to summarize the anastomosis procedure and assess the clinical outcomes of our modified layered hand-sewn cervical end-to-side anastomosis for cervical anastomosis during MIE McKeown. Read More

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Retrospective comparison of reinfusion procedures and subsequent leukopenia in autologous stem cell transplantation.

Int J Hematol 2021 Jul 26. Epub 2021 Jul 26.

Department of Hematology, Oncology and Palliative Care, Vivantes Clinic Neukoelln, Rudower Str. 48, 12351, Berlin, Germany.

Standard operating procedures for autologous stem cell transplantation (SCT) aim to guarantee best possible engraftment. Three procedures are routinely used for transplant infusion: regular bag infusion (Procedure 1), injection via syringe (Procedure 2), and combination of regular bag infusion and syringe (Procedure 3). We conducted a retrospective analysis of all autologous stem cell transplants done in the hematology department of the Vivantes Clinic Neukoelln in Berlin, Germany, between January 1, 2016 and March 4, 2017. Read More

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Mortality in Older Patients with Breast Cancer Undergoing Breast Surgery: How Low is "Low Risk"?

Ann Surg Oncol 2021 Jul 26. Epub 2021 Jul 26.

Department of Surgery, Duke University Medical Center, Durham, NC, USA.

Background: Breast surgery carries a low risk of postoperative mortality. For older patients with multiple comorbidities, even low-risk procedures can confer some increased perioperative risk. We sought to identify factors associated with postoperative mortality in breast cancer patients ≥70 years to create a nomogram for predicting risk of death within 90 days. Read More

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Microvascular decompression for trigeminal neuralgia due to vertebrobasilar artery compression: a systematic review and meta-analysis.

Neurosurg Rev 2021 Jul 26. Epub 2021 Jul 26.

Department of Neurosurgery, Azienda Ospedaliero Universitaria Pisana (AOUP), Via Paradisa 2, 56100, Pisa, Italy.

Trigeminal neuralgia (TN) caused by vertebrobasilar artery (VBA) compression is a rare event, reported between 2 and 6% (Linskey et al. J Neurosurg 81:1-9,1992, Vanaclocha et al.World Neurosurg 96:516-529,2016) of the time. Read More

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Selective non-operative management of penetrating abdominal injuries at Northern European trauma centers: the NordiPen Study.

Eur J Trauma Emerg Surg 2021 Jul 26. Epub 2021 Jul 26.

Department of Surgery, Institute of Clinical Medicine, University of Tartu, Tartu, Estonia.

Purpose: A selective nonoperative management (SNOM) of penetrating abdominal injuries (PAI) is a standard of care in numerous established trauma centers. However, available evidence supporting SNOM of PAI in European settings remains scarce. Thus, we performed a multi-center study at selected Northern European trauma centers to investigate the management and outcomes of PAI. Read More

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Comparison of HIV Screening Strategies in the Emergency Department: A Randomized Clinical Trial.

JAMA Netw Open 2021 Jul 1;4(7):e2117763. Epub 2021 Jul 1.

Denver Public Health, Denver, Colorado.

Importance: The National HIV Strategic Plan for the US recommends HIV screening in emergency departments (EDs). The most effective approach to ED-based HIV screening remains unknown.

Objective: To compare strategies for HIV screening when integrated into usual ED practice. Read More

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One Decade of Online Patient Feedback: Longitudinal Analysis of Data From a German Physician Rating Website.

J Med Internet Res 2021 Jul 26;23(7):e24229. Epub 2021 Jul 26.

Institute of History and Ethics in Medicine, Technical University of Munich, Munich, Germany.

Background: Feedback from patients is an essential element of a patient-oriented health care system. Physician rating websites (PRWs) are a key way patients can provide feedback online. This study analyzes an entire decade of online ratings for all medical specialties on a German PRW. Read More

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Audiologic Characteristics of Hearing and Tinnitus in Occupational Noise-Induced Hearing Loss.

J Int Adv Otol 2021 Jul;17(4):330-334

Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Kyung Hee University, Seoul, Republic of Korea.

Background: To analyze the characteristics of patients with noise-induced hearing loss (NIHL) by comparing audiologic test findings between groups with and without tinnitus.

Methods: This study involved patients with noise-induced hearing loss (NIHL) who presented to the otolaryngology clinic between January 2016 and April 2019. Tests including 3 pure-tone audiometry (PTA) tests at intervals greater than 1 week, and auditory brainstem response (ABR) were evaluated and patients were screened for tinnitus. Read More

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Clinical and histological features of fixed drug eruption: a single-centre series of 73 cases with comparison between bullous and non-bullous forms.

Eur J Dermatol 2021 Jun;31(3):372-380

Pathology department, Henri Mondor hospital, AP-HP, 94010 Créteil Cedex, France, Intensive care unit, Henri Mondor hospital, AP-HP, 94010 Créteil Cedex, France, Reference centre for toxic bullous diseases and severe cutaneous adverse reactions TOXIBUL, Créteil, France.

The clinical and pathological aspects of fixed drug eruption (FDE) have been described based on a few case series. To compare bullous FDE (BFDE) and non-bullous FDE (NBFDE) and to determine whether BFDE can be histologically distinguished from other dermatoses presenting with an apoptotic pan-epidermolysis. In this retrospective monocentre study (2005-2016), FDE was classified as BFDE or NBFDE and localized (one anatomical site) or generalized (≥ two sites; GBFDE). Read More

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[Helicobacter pylori eradication with a clarithromycin-based triple therapy in elderly patients: a case-control study].

Panminerva Med 2021 Jul 26. Epub 2021 Jul 26.

Unit of Gastroenterology, Città della Salute e della Scienza-Molinette Hospital, Turin, Italy.

Background: Helicobacter pylori (H. pylori), main agents of several gastroduodenal diseases, represents a therapeutic challenge. Since the influence of age on the success of bacterial treatment remains uncertain, in this case-control study we assessed the efficacy of a standard H. Read More

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[Recurrent pancreatitis in children: Case series].

Arch Argent Pediatr 2021 Aug;119(4):e222-e325

Servicio de Gastroenterología, Hospital de Pediatría SAMIC "Prof. Dr. Juan P. Garrahan", Ciudad Autónoma de Buenos Aires, Argentina.

Recurrent pancreatitis (RP) occurs in children between 15- 35 % of the cases. To determine the etiology and outcome of RP in children a descriptive, cross-sectional cohort study was conducted in children under 18 years of age with RP seen at Hospital Garrahan between 2008-2016. Of 10 patients with RP, 90 % were girls. Read More

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Improvement in communication during patient handoff between areas from a children's hospital.

Arch Argent Pediatr 2021 Aug;119(4):259-265

Hospital de Pediatría S.A.M.I.C. "Prof. Dr. Juan P. Garrahan", Ciudad Autónoma de Buenos Aires, Argentina.

Introduction: Patient handoff is an interactive process including data communication and responsible transfer in order to safely maintain the continuity of care. Failure in this process may result in inadequate care and favor the occurrence of errors.

Objective: To implement a standardized instrument for patient handoff from the intensive care unit (ICU) to the intermediate-medium care unit (IMCU), and compare communication between health care providers before and after the intervention. Read More

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Introducing SentiMag in a rural setting: A 5-year experience.

ANZ J Surg 2021 Jul 26. Epub 2021 Jul 26.

General Surgical Department, Gisborne Hospital, Gisborne, New Zealand.

Background: The Sentimag device is a probe that contains a sensitive magnetometer which detects either an implantable magnetic marker (MagSeed) or an infectable superparamagnetic ironoxide nanoparticle tracer (MagTrace). MagSeed is used to localise impalpable breast lesions; MagTrace is used to identify sentinel lymph nodes. In Australasia, Sentinel lymph node (SLN) biopsy, using radioactive colloid injection, is a mainstay of prognostication in breast surgery in patients with a clinically negative axilla. Read More

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