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[The Bavarian Midwives Bonus - A Contribution to Monitoring Freelance Midwifery Care in Bavaria].

Gesundheitswesen 2021 Sep 24. Epub 2021 Sep 24.

Bundesministerium für Ernährung und Landwirtschaft, Abteilung Lebensmittelsicherheit, Tiergesundheit, Berlin, Deutschland.

Background: Supply bottlenecks in midwifery care could intensify due to increasing birth rates in Bavaria. Midwives are already fully booked and can only take care of pregnant women by increasing their working hours. The situation of self-employed midwives is particularly precarious. Read More

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September 2021

Healthcare Resource Utilization After Living Liver Donation: A Retrospective Case-control Study.

Transplantation 2021 Sep 23. Epub 2021 Sep 23.

Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea. Department of Information Statistics, Andong National University, Andong, South Korea. Department of Statistics, Kyungpook National University, Daegu, South Korea. Department of Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea.

Background: Living liver donation is generally considered safe, but donors may experience short or long-term complications. The purpose of this study was to assess healthcare resource utilization after liver donation in living liver donors in comparison to the general population.

Methods: Outpatient or emergency department visits and hospital admissions were compared between living liver donors who underwent hepatic resection for living liver donation between 2004 and 2018 and the matched general population. Read More

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September 2021

The diagnostic accuracy of MRI and nonenhanced CT for high-risk vertebral artery anatomy for subaxial anterior cervical spine surgery safety.

J Neurosurg Spine 2021 Sep 24:1-8. Epub 2021 Sep 24.

1Spine Care Institute, Hospital for Special Surgery, New York, New York.

Objective: Medial migration of the vertebral artery (VA) can be a risk factor for injury during anterior procedures. CT angiography (CTA) has been considered the gold standard for the evaluation of various areas of the arterial anatomy. MRI and nonenhanced CT are more commonly used as routine preoperative imaging studies, but it is unclear if these modalities can safely exclude the anomalous course of the VA. Read More

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September 2021

Obstructive sleep apnea in surgical patients and its relationship with difficult intubation: two years of experience from a single center.

Braz J Anesthesiol 2021 Sep 21. Epub 2021 Sep 21.

Demiroglu Bilim University Florence Nightingale Hospital School of Nursing, Istanbul, Turkey.

Background And Objectives: In this study, we aimed to determine the risk of obstructive sleep apnea (OSA) in patients undergoing elective surgery and its relationship with difficult intubation (DI).

Methods: This prospective, descriptive cross-sectional study was conducted between December 2018 and February 2020 in the anesthesiology and reanimation service of a training and research hospital. The study included patients who were ASA I-II, 18 years of age and older who underwent elective surgery under general anesthesia. Read More

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September 2021

Spine Surgeons Burnout and Quality of Life: Results of a Worldwide Survey.

Spine (Phila Pa 1976) 2021 Oct;46(20):1418-1927

Department of Neurosurgery, University of Caxias do Sul, Caxias do Sul, Rio Grande do Sul, Brazil.

Study Design: Cross-sectional survey study.

Objective: To evaluate the prevalence of burnout, assess the personal and professional characteristics associated with burnout in spine surgeons and determine their quality of life.

Summary Of Background Data: Burnout is a syndrome characterized by emotional exhaustion, depersonalization, and decreased sense of accomplishment that leads to decreased effectiveness at work. Read More

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October 2021

Reconstruction of Massive Segmental Distal Femoral Metaphyseal Bone Defects After Open Injury: A Study of 20 Patients Managed with Intercalary Gamma-Irradiated Structural Allografts and Autologous Cancellous Grafts.

J Bone Joint Surg Am 2021 Sep 24. Epub 2021 Sep 24.

Department of Orthopaedics & Trauma Surgery, Ganga Medical Centre & Hospitals Private Limited, Coimbatore, India.

Background: Our aim was to examine the outcome of gamma-irradiated intercalary structural allografts combined with autologous cancellous grafts in treating large metaphyseal bone defects of the distal femur following open injuries.

Methods: We prospectively included 20 consecutive patients with large metaphyseal bone defects of >4 cm located in the region of the distal femur following open injuries treated between 2010 and 2018, with a mean follow-up of 2 years (range, 2 to 10 years). Of these patients,18 were men and 2 were women. Read More

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September 2021

Association of Sagittal Spinopelvic Realignment with Correction in Lower Lumbar Lordosis after Surgical Treatment in Degenerative Lumbar Scoliosis.

Orthop Surg 2021 Sep 24. Epub 2021 Sep 24.

The Spine Surgery, The First Medical Center of the Chinese PLA General Hospital, Beijing, China.

Objective: To assess the effect that correction of lower lumbar lordosis (3L) has on global spine realignment due to the key role of 3L for scoliosis surgery in patients with degenerative lumbar scoliosis (DLS).

Methods: This study is a retrospective review performed between June 2018 and January 2020, including consecutive patients with DLS. Only patients age ≥ 45 years who had already undergone a selective root block operation and had the procedure of long-fusion extending to pelvis and posterior lumbar interbody fusion (PLIF) at lower lumbar spine (L -S ) were retained for analysis. Read More

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September 2021

Different management of adrenocortical carcinoma in children compared to adults: is it time to share guidelines?

Endocrine 2021 Sep 24. Epub 2021 Sep 24.

Medical Oncology Unit, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia at ASST Spedali Civili, Brescia, Italy.

Pediatric and adult adrenocortical carcinomas differ in many respects but treatment is often similar in both age groups. The Journal of Clinical Oncology recently published the results of a risk-stratified single-arm interventional trial conducted by the Children's Oncology Group in which 77 patients were treated in three different interventional cohorts. In this Point of View paper we comment on the treatment strategies adopted within the ARAR0332 trial in terms of surgery approach, duration of adjuvant therapies, and palliative chemotherapy. Read More

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September 2021

Early Post-operative Feeding: An Investigation of Early Functional Outcomes for Oral Cancer Patients Treated with Surgical Resection and Free Flap Reconstruction.

Dysphagia 2021 Sep 24. Epub 2021 Sep 24.

Therapies Department, The Royal Marsden NHS Foundation Trust, London, UK.

Traditionally patients can remain nil by mouth (NBM) for up to 12 days after oral tumour resection with free flap reconstruction to reduce the risk of flap dehiscence, poor healing and fistulae. The literature reports that patients could on average remain an inpatient for up to 20 days post-surgery. An evaluation of the impact of a defined early oral feeding protocol was undertaken investigating functional outcomes and complications rates. Read More

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September 2021

Association of Cardiovascular Outcomes and Mortality With Sustained Long-Acting Insulin Only vs Long-Acting Plus Short-Acting Insulin Treatment.

JAMA Netw Open 2021 Sep 1;4(9):e2126605. Epub 2021 Sep 1.

HealthPartners Institute, Minneapolis, Minnesota.

Importance: Cardiovascular events and mortality are the principal causes of excess mortality and health care costs for people with type 2 diabetes. No large studies have specifically compared long-acting insulin alone with long-acting plus short-acting insulin with regard to cardiovascular outcomes.

Objective: To compare cardiovascular events and mortality in adults with type 2 diabetes receiving long-acting insulin who do or do not add short-acting insulin. Read More

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September 2021

Association of Public Reporting of Medicare Dialysis Facility Quality Ratings With Access to Kidney Transplantation.

JAMA Netw Open 2021 Sep 1;4(9):e2126719. Epub 2021 Sep 1.

Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts.

Importance: Improving the quality of dialysis care and access to kidney transplantation for patients with end-stage kidney disease is a national clinical and policy priority. The role of dialysis facility quality in increasing access to kidney transplantation is not known.

Objective: To determine whether patient, facility, and kidney transplant waitlisting characteristics are associated with variations in dialysis center quality. Read More

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September 2021

Real-world efficacy and safety of switching to bictegravir/emtricitabine/tenofovir alafenamide in older people living with HIV.

Medicine (Baltimore) 2021 Sep;100(38):e27330

Orlando Immunology Center, Orlando, FL.

Abstract: Approximately 50% of people living with HIV (PLWH) in the United States are ≥50 years old. Clinical trials of bictegravir/emtricitabine/tenofovir alafenamide (B/F/TAF) demonstrated potent efficacy and favorable safety in older PLWH; however, real-world data would be useful to validate these results.Retrospective cohort study. Read More

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September 2021

Risk factors and management of pulmonary infection in elderly patients with heart failure: A retrospective analysis.

Authors:
Qi Peng Qin Yang

Medicine (Baltimore) 2021 Sep;100(38):e27238

Pharmacy Intravenous Admixture Services, The Sixth Hospital of Wuhan, Affiliated Hospital of Jianghan University, Jiangan District, Wuhan, Hubei, China.

Abstract: Pulmonary infection is common in patients with heart failure, yet the risk factors remain unclear. We aimed to evaluate the clinical characteristics and risk factors of pulmonary infection in elderly patients with heart failure, to provide reference to the prevention of pulmonary infection.This study was a retrospective study design. Read More

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September 2021

Prospective Evaluation of Whole-Body MRI versus FDG PET/CT for Lesion Detection in Participants with Myeloma.

Radiol Imaging Cancer 2021 Sep;3(5):e210048

From the Royal Marsden Hospital Foundation NHS Trust, Fulham Rd, London SW3 6JJ, England (C.M., B.S., D.L., D.M.K., K.B., C.P., A.R., K.D., J.C., V.M., S.S., J.W., W.J.G.O., M.F.K.); The Institute of Cancer Research, London, England (C.M., N.P., D.M.K., C.P., J.W., M.B., W.J.G.O., M.F.K.); Epsom and St Helier University Hospitals NHS Trust, Epsom, England (S.S.); Croydon University Hospital, Croydon, England (B.C.); University College London Hospital NHS Foundation Trust, London, England (C.K.); and Surrey and Sussex Healthcare NHS Trust, Redhill, England (P.K.).

Purpose To compare disease detection of myeloma using contemporary whole-body (WB) MRI and fluorine 18 (F) fluorodeoxyglucose (FDG) PET/CT protocols and to correlate imaging with laboratory estimates of disease burden, including molecular characteristics. Materials and Methods In this observational, prospective study, participants were recruited from November 2015 to March 2018 who had a diagnosis of myeloma, who were planned to undergo chemotherapy and autologous stem cell transplantation, and who underwent baseline WB-MRI and FDG PET/CT (ClinicalTrials.gov identifier NCT02403102). Read More

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September 2021

Risk Prediction of Nosocomial and Posthospital Discharge Infections in Alcohol-Associated Hepatitis.

Hepatol Commun 2021 Jul 28. Epub 2021 Jul 28.

Division of Gastroenterology and Hepatology, Mayo Clinic Rochester, Rochester, MN, USA.

Alcohol-associated hepatitis (AAH) is a severe form of liver injury with mortality as high as 30%-40% at 90 days. As a result of altered immune function in AAH, bacterial infections are common and are associated with poor outcomes. However, determining the risk and subsequent development of infection in patients with AAH remain challenging. Read More

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A real-world study of Alemtuzumab in a cohort of Italian patients.

Eur J Neurol 2021 Sep 24. Epub 2021 Sep 24.

Neuro-immunology and Neuromuscolar Diseases Unit, IRCCS Foundation Carlo Besta Neurological Institute, Milano.

Background: Real-world data on Alemtuzumab are limited and do not provide evidence on its effectiveness after different Disease Modifying Therapies (DMTs). Our aim was to provide real-world data on the impact of clinical variables and previous DMTs on clinical response to Alemtuzumab.

Methods: Sixteen Italian MS-centers retrospectively included patients who started Alemtuzumab from January 2015 to December 2018, and recorded demographics, previous therapies, washout duration, relapses, EDSS, and MRI data. Read More

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September 2021

The short-term impact of standardised packaging on smoking and snus use in Norway.

Nicotine Tob Res 2021 Sep 24. Epub 2021 Sep 24.

Department of Alcohol, Tobacco and Drugs, Norwegian Institute of Public Health, PO Box 222 Skøyen, 0213 Oslo, Norway.

Introduction: Standardised packaging on tobacco products was required in Norway July 1, 2018. We report pre-registered analyses of the potential impact on daily smoking and on daily snus use among women and men.

Methods: Interrupted time series (segmented regression) on repeated cross-sectional surveys (2012 to 2019) from two sources: probability samples (Registry Sample, N=46,957) and market research samples (Market Research Sample, N=64,465) of Norwegian adults aged 16 to 79. Read More

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September 2021

Treatment outcomes of patients with tuberculosis and diabetes: A prospective cohort study from India.

Int J Mycobacteriol 2021 Apr-Jun;10(2):111-115

Department of Infectious Diseases, Kasturba Medical College, Manipal Academy of Higher Education; Manipal Center for Infectious Diseases, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, Karnataka, India.

Introduction: Tuberculosis (TB) and diabetes mellitus (DM) are significant causes of morbidity and mortality in developing countries. This study aimed to explore the relationship between diabetes and TB.

Methods: This was a prospective cohort study in which all newly diagnosed inpatients with TB above the age of 18 years during the study period (September 2018 to August 2020) were included. Read More

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September 2021

Tuberculosis stigma: Assessing tuberculosis knowledge, attitude and preventive practices in surulere, Lagos, Nigeria.

Ann Afr Med 2021 Jul-Sep;20(3):184-192

Department of Medicine, College of Medicine, University of Lagos, Idiaraba, Lagos, Nigeria.

Context: Tuberculosis (TB), though preventable and curable, remains a global health problem, ranked one of the top causes of death worldwide, despite the World Health Organization's strategies. This may be due to the stigma surrounding the disease.

Aim: This study assesses TB stigma in light of knowledge, attitudes, and preventive practices among individuals in an urban community. Read More

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September 2021

Changing paradigms in endoscopic thyroid surgery: A comparison between scarless-in-the-neck axillo-breast approach and totally scarless transoral approach.

J Minim Access Surg 2021 Oct-Dec;17(4):509-512

Department of Endocrine Surgery, SGPGIMS, Lucknow, Uttar Pradesh, India.

Background: To avoid cervical scar in thyroid surgery, various approaches have been proposed. The commonly used approach is combined axillo-breast approach (ABA). However, trans-orovestibular approach (TOVA) is getting popular. Read More

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September 2021

Prevalence of spp. in symptomatic BaAka Pygmies inhabiting the rural Dzanga Sangha region of the Central African Republic.

Ann Agric Environ Med 2021 Sep 7;28(3):483-490. Epub 2021 Sep 7.

Department of Tropical Parasitology, Institute of Maritime and Tropical Medicine, Medical University, Gdańsk, Poland.

Introduction: Malaria remains a diagnostic and therapeutic challenge in many endemic regions of sub-Saharan Africa. It is one of the most important causes of morbidity and mortality, especially in children <5 years. is responsible for the majority of severe malaria cases in sub-Saharan Africa, but is not the exclusive one. Read More

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September 2021

Correlation of clinical symptoms, endoscopic features and density of oesophageal eosinophilia in children with newly-diagnosed eosinophilic esophagitis.

Ann Agric Environ Med 2021 Sep 14;28(3):404-408. Epub 2020 Sep 14.

Department of Paediatric Gastroenterology and Nutrition, Medical University, Warsaw, Poland.

Introduction And Objective: Eosinophilic esophagitis (EoE) is an inflammatory immune-mediated oesophageal disease of growing prevalence. The aim of this study is to characterise the clinical symptoms, endoscopic features and histological findings, as well as their possible correlations, in newly-diagnosed EoE paediatric patients.

Material And Methods: Between 2009-2018, the clinical records of patients diagnosed with EoE at the Paediatric Hospital in Warsaw, Poland, were retrospectively reviewed. Read More

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September 2021

Physical activity of children and adolescents from the Czech Republic, Hungary, Poland, and Slovakia: A systematic review.

Ann Agric Environ Med 2021 Sep 5;28(3):385-390. Epub 2020 Aug 5.

Poznan University of Physical Education, Poznań, Poland.

Introduction And Objective: Systematic monitoring of physical activity of young populations from different regions may be useful for making international comparisons, better understanding trends in physical activity and designing public health interventions to increase physical activity. Thus, the aim of the study was to comprehensively review studies examining the level of physical activity of children and adolescents from the Visegrád countries, and indicate the percentage of children and adolescents meeting the recommended level of physical activity.

Material And Methods: A systematic search of the published literature was conducted. Read More

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September 2021

Edentulism and select chronic diseases among adults aged ≥45 years in China, 2011-2018: A longitudinal study.

Community Dent Oral Epidemiol 2021 Sep 23. Epub 2021 Sep 23.

Institute of Hospital Management, West China Hospital, Sichuan University, Chengdu, China.

Objectives: Information on the association between edentulism and chronic medical conditions in developing countries is lacking. We investigated such information among adults aged ≥45 years in China.

Methods: A national longitudinal data set from the China Health and Retirement Longitudinal Study (CHARLS) 2011-2018 was analysed. Read More

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September 2021

Pediatric obstructive sleep-disordered breathing is associated with arterial stiffness.

Eur J Pediatr 2021 Sep 23. Epub 2021 Sep 23.

Post-Graduate Program in Health Sciences, Faculdade Ciências Médicas de Minas Gerais - FCM-MG, MG, Belo Horizonte, Brazil.

The association between obstructive sleep-disordered breathing (oSDB) and arterial stiffness, an independent predictor of cardiovascular outcomes, is not well established in children. This study compared cardiovascular parameters between healthy and oSDB children and aimed to identify predictors of arterial stiffness indices in children with oSDB. Cross-sectional study realized in a tertiary hospital from June 2018 to January 2020. Read More

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September 2021

Antimicrobial susceptibility of Neisseria gonorrhoeae isolates and syndromic treatment of men with urethral discharge in Kingston, Jamaica, 2018-19.

J Antimicrob Chemother 2021 Sep 24. Epub 2021 Sep 24.

Department of Microbiology, Faculty of Medical Sciences, University of the West Indies, Mona, Kingston, Jamaica.

Objectives: To quantitatively determine the antimicrobial susceptibility of clinical Neisseria gonorrhoeae isolates from men with urethral discharge in Jamaica and to describe the syndromic treatment therapies administered.

Methods: Urethral eSwabs (Copan) were collected from 175 men presenting with urethral discharge to the Comprehensive Health Centre STI Clinic, Kingston, Jamaica. Clinical information was collected and MICs of eight antimicrobials were determined for N. Read More

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September 2021

Socioeconomic inequalities in the incidence of alcohol-related liver disease: A nationwide Danish study.

Lancet Reg Health Eur 2021 Sep 13;8:100172. Epub 2021 Jul 13.

Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark.

Background: There is socio-economic inequality in total alcohol-related harm, but knowledge of inequality in the incidence of specific alcohol-related diseases would be beneficial for prevention. Registry-based studies with nationwide coverage may reveal the full burden of socioeconomic inequality compared to what can be captured in questionnaire-based studies. We examined the incidence of alcohol-related liver disease (ALD) according to socioeconomic status and age. Read More

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September 2021

Age specific trends in mortality disparities by socio-economic deprivation in small geographical areas of England, 2002-2018: A retrospective registry study.

Lancet Reg Health Eur 2021 Aug 7;7:100136. Epub 2021 Jun 7.

Institute for Fiscal Studies, London, UK.

Background: Disparities in mortality rates according to socioeconomic position (SEP) have been rising in England. We describe the association between recent changes in socioeconomic inequality and trends in mortality disparities for different age and sex groups at small-area level in England.

Methods: Vital registration data from the Office for National Statistics on resident population size and number of deaths in each Lower Super Output Area (LSOA) in England from 2002 to 2018 were stratified by sex and 5-year age group. Read More

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Paediatric outpatient prescriptions in France between 2010 and 2019: A nationwide population-based study: Paediatric outpatient prescriptions in France, 2010 to 2019.

Lancet Reg Health Eur 2021 Aug 7;7:100129. Epub 2021 Jun 7.

EPI-PHARE (French National Agency for Medicines and Health Products Safety -ANSM- and French National Health Insurance -CNAM-), Saint-Denis, France.

Background: Paediatric outpatient prescription (POP) monitoring is pivotal to identify inadequate prescriptions and optimize drug use. We aimed at describing recent trends in POPs in France.

Methods: All reimbursed dispensations of outpatient prescribed drugs (excluding vaccines) were prospectively collected for the paediatric population (<18 years old) in the French national health database in 2010-2011 and 2018-2019 (mean 117,356,938/year). Read More

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Peripheral artery disease in Germany (2009-2018): Prevalence, frequency of specialized ambulatory care and use of guideline-recommended therapy - A population-based study.

Lancet Reg Health Eur 2021 Jun 3;5:100113. Epub 2021 May 3.

Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, University of Duisburg-Essen, Hufelandstraße 55, 45147 Essen, Germany.

Background: Peripheral artery disease (PAD) patients have high morbidity and mortality rates, demonstrating a need for improved treatment strategies. While underuse and undertreatment have been reported, there is no clear picture of patterns in population-level disease prevalence, prescription of guideline-recommended pharmacotherapy, or frequency of contact with dedicated specialists. We present population-level data on changes in prevalence, care and treatment of PAD from 2009 to 2018 in Germany. Read More

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