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Clinical Frailty Scale is a useful tool for predicting postoperative complications following elective colon cancer surgery in the age of 80 years and older: A prospective, multicentre observational study.

Colorectal Dis 2021 Apr 29. Epub 2021 Apr 29.

Finland, Centre of Geriatrics, Tampere University Hospital, Tampere, Finland.

Background: Identifying risks of postoperative complications may be challenging in older patients with heterogeneous physical and cognitive status. The aim of this multicentre, observational study was to identify variables that affect colon cancer surgery outcomes and, especially to find tools to quantify the risks related to surgery.

Methods: Patients aged ≥80 years with electively operated stage I-III colon cancer were recruited. Read More

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Mechanical and oral antibiotic bowel preparation versus no bowel preparation in right and left colectomy: subgroup analysis of MOBILE trial.

BJS Open 2021 Mar;5(2)

Department of Gastroenterological Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.

Background: In retrospective series, mechanical and oral antibiotic bowel preparation (MOABP) has been reported to reduce surgical-site infections (SSIs) after colectomy compared with no bowel preparation (NBP).

Method: This was a subgroup analysis of a multicentre randomized trial that included patients scheduled for elective colectomy. The MOABP group underwent mechanical bowel preparation, and took 2 g neomycin and 2 g metronidazole orally during the day before surgery. Read More

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Cut-off value to identify a flare using the Flare Assessment in Rheumatoid Arthritis (FLARE-RA) questionnaire: analysis of the TOSCA study.

Rheumatology (Oxford) 2021 Mar 31. Epub 2021 Mar 31.

Rheumatology Department, Pitié Salpêtrière hospital, Sorbonne Université - Assistance Publique Hôpitaux de Paris, Paris, France.

Objective: The Flare Assessment in Rheumatoid Arthritis (FLARE-RA) self-administered questionnaire aims to identify patients who had flare in the interval between 2 consultations. This study aimed to establish a threshold for FLARE-RA score to identify RA flare.

Methods: The Tocilizumab SubCutAneous (TOSCA) study evaluated the efficacy and safety of subcutaneous Tocilizumab (TCZ) to patients with active RA. Read More

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GOECP/SEOR radiotherapy guidelines for small-cell lung cancer.

World J Clin Oncol 2021 Mar;12(3):115-143

Department of Radiation Oncology, Thoracic Unit, Hospital Clinic, Barcelona 08036, Spain.

Small cell lung cancer (SCLC) accounts for approximately 20% of all lung cancers. The main treatment is chemotherapy (Ch). However, the addition of radiotherapy significantly improves overall survival (OS) in patients with non-metastatic SCLC and in those with metastatic SCLC who respond to Ch. Read More

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Regret and Quality of Life After Mastectomy With or Without Reconstruction.

Clin Breast Cancer 2020 Oct 14. Epub 2020 Oct 14.

Breast Center, Department of Surgery, San Giovanni-Addolorata Hospital Rome, Rome, Italy.

Background: Mastectomy represents a deep burden for women with breast cancer. Very little is known about the psychological consequences over time and the quality of life (QoL) of women so treated, with or without breast reconstruction (BR).

Patients And Methods: A total of 709 patients underwent mastectomy with or without BR between 2002 and 2012 at one institution. Read More

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October 2020

Personalizing Cancer Pain Therapy: Insights from the Rational Use of Analgesics (RUA) Group.

Pain Ther 2021 Jun 17;10(1):605-617. Epub 2021 Mar 17.

University of Florence, Pain and Palliative Care Clinic, Careggi Hospital, 50139, Florence, Italy.

Introduction: A previous Delphi survey from the Rational Use of Analgesics (RUA) project involving Italian palliative care specialists revealed some discrepancies between current guidelines and clinical practice with a lack of consensus on items regarding the use of strong opioids in treating cancer pain. Those results represented the basis for a new Delphi study addressing a better approach to pain treatment in patients with cancer.

Methods: The study consisted of a two-round multidisciplinary Delphi study. Read More

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Radiomics in lung cancer for oncologists.

J Clin Transl Res 2020 Oct 2;6(4):127-134. Epub 2020 Sep 2.

Department of Medical Physics, Ramón y Cajal Hospital, Madrid, Spain.

Radiomics has revolutionized the world of medical imaging. The aim of this review is to guide oncologists in radiomics and its applications in diagnosis, prediction of response and damage, prediction of survival, and prognosis in lung cancer. In this review, we analyzed published literature on PubMed and MEDLINE with papers published in the last 10 years. Read More

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October 2020

Effect of Oral Moxifloxacin vs Intravenous Ertapenem Plus Oral Levofloxacin for Treatment of Uncomplicated Acute Appendicitis: The APPAC II Randomized Clinical Trial.

JAMA 2021 01;325(4):353-362

Division of Digestive Surgery and Urology, Turku University Hospital, Turku, Finland.

Importance: Antibiotics are an effective and safe alternative to appendectomy for managing uncomplicated acute appendicitis, but the optimal antibiotic regimen is not known.

Objective: To compare oral antibiotics with combined intravenous followed by oral antibiotics in the management of computed tomography-confirmed uncomplicated acute appendicitis.

Design, Setting, And Participants: The Appendicitis Acuta (APPAC) II multicenter, open-label, noninferiority randomized clinical trial was conducted from April 2017 until November 2018 in 9 Finnish hospitals. Read More

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January 2021

SBRT in non-spine bone metastases: a literature review.

Med Oncol 2020 Nov 21;37(12):119. Epub 2020 Nov 21.

Radiation Oncology, Ramon y Cajal Hospital, Madrid, Spain.

Stereotactic Body Radiotherapy (SBRT) is a technique for delivering high doses of radiation to tumors while preserving the normal tissues located around this area. Bone metastases are frequent in cancer patients. They can be distressingly painful or may cause pathological fractures. Read More

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November 2020

Comparing Laparoscopic Elective Sigmoid Resection With Conservative Treatment in Improving Quality of Life of Patients With Diverticulitis: The Laparoscopic Elective Sigmoid Resection Following Diverticulitis (LASER) Randomized Clinical Trial.

JAMA Surg 2021 Feb;156(2):129-136

Gastroenterological Surgery, University of Helsinki, Helsinki University Hospital, Helsinki, Finland.

Importance: Diverticulitis has a tendency to recur and affect quality of life.

Objective: To assess whether sigmoid resection is superior to conservative treatment in improving quality of life of patients with recurrent, complicated, or persistent painful diverticulitis.

Design, Setting, And Participants: This open-label randomized clinical trial assessed for eligibility 128 patients with recurrent, complicated, or persistent painful diverticulitis in 6 Finnish hospitals from September 29, 2014, to October 10, 2018. Read More

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February 2021

Mal de Pinta, first autochthonous case from South of Brazil.

Int J Dermatol 2021 Jan 5;60(1):e19-e21. Epub 2020 Nov 5.

Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil.

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January 2021

Long-Term Outcomes of Once-Daily Accelerated Partial-Breast Irradiation With Tomotherapy: Results of a Phase 2 Trial.

Int J Radiat Oncol Biol Phys 2021 Mar 21;109(3):678-687. Epub 2020 Oct 21.

Chirurgia Senologica Ospedale San Giovanni Addolorata, Rome, Italy.

Purpose: We report long-term outcomes of phase 2 trial on patients with invasive breast cancer treated with accelerated partial-breast irradiation (APBI) using tomotherapy after breast conservative surgery.

Methods And Materials: From December 2010 to December 2018, we treated 338 women with APBI-tomotherapy: 38.5 Gy in 10 once-daily fractions. Read More

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Clinical Characteristics and Prognostic Factors for Intensive Care Unit Admission of Patients With COVID-19: Retrospective Study Using Machine Learning and Natural Language Processing.

J Med Internet Res 2020 10 28;22(10):e21801. Epub 2020 Oct 28.

Hospital Universitario de La Princesa, Madrid, Spain.

Background: Many factors involved in the onset and clinical course of the ongoing COVID-19 pandemic are still unknown. Although big data analytics and artificial intelligence are widely used in the realms of health and medicine, researchers are only beginning to use these tools to explore the clinical characteristics and predictive factors of patients with COVID-19.

Objective: Our primary objectives are to describe the clinical characteristics and determine the factors that predict intensive care unit (ICU) admission of patients with COVID-19. Read More

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October 2020

Immediate Breast Reconstruction after mastectomy with polyurethane implants versus textured implants: A retrospective study with focus on capsular contracture.

Breast 2020 Dec 29;54:127-132. Epub 2020 Sep 29.

Breast Unit, Azienda Ospedaliera San Giovanni-Addolorata, Via Dell'Amba Aradam 8, Rome, Italy.

Background: Capsular contracture (CC) is the most common complication following Immediate Breast Reconstruction (IBR) with breast implants. Different implant surfaces were developed aiming to reduce the incidence of CC. We evaluated the incidence and degree of CC after Direct-to-Implant (DTI) IBR with insertion of textured (TE) or polyurethane (PU) covered implants. Read More

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December 2020

Brain metastases: Single-dose radiosurgery versus hypofractionated stereotactic radiotherapy: A retrospective study.

J Clin Transl Res 2020 Jul 8;6(1):6-13. Epub 2020 Jul 8.

Department of Radiation Oncology, Ramón y Cajal Hospital, Madrid, Spain.

Background: Radiosurgery is employed for the treatment of brain metastases. The aim of this study is to evaluate the efficacy and tolerability of single-dose radiosurgery (SRS) compared to hypofractionated stereotactic radiotherapy (hFSRT).

Materials And Methods: Between 2004 and 2018, we analyzed treatments of 97 patients with 135 brain metastases. Read More

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Superior primary fascial closure rate and lower mortality after open abdomen using negative pressure wound therapy with continuous fascial traction.

J Trauma Acute Care Surg 2020 12;89(6):1136-1142

From the Department of Abdominal Surgery, Abdominal Center (S.R., P.M., A.L.), Helsinki University Hospital and University of Helsinki, Helsinki; Division of Digestive Surgery and Urology, Department of Surgery (P.S., T.S.), Turku University Hospital, University of Turku, Turku, Department of Surgery, Satakunta Central Hospital, Pori; Department of Abdominal Surgery (V.K.), Oulu University Hospital, Oulo; Department of Gastroenterology and Alimentary Tract Surgery (M.H., L-M.M.), Tampere University Hospital, Tampere; Department of Surgery (T.P.), Seinäjoki Central Hospital, Seinäjoki; Department of Surgery (J.H.), Satakunta Central Hospital, Pori; Department of Surgery (J.R.), Lapland Central Hospital, Rovaniemi; and Department of Surgery (T.R.), Kuopio University Hospital, Institute of Clinical Medicine, University of Eastern Finland, Eastern Finland, Finland.

Background: Open abdomen (OA) is a useful option for treatment strategy in many acute abdominal catastrophes. A number of temporary abdominal closure (TAC) methods are used with limited number of comparative studies. The present study was done to examine risk factors for failed delayed primary fascial closure (DPFC) and risk factors for mortality in patients treated with OA. Read More

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December 2020

New optimization algorithms for neural network training using operator splitting techniques.

Neural Netw 2020 Jun 26;126:178-190. Epub 2020 Mar 26.

Tiberiu Popoviciu Institute of Numerical Analysis Romanian Academy, Cluj-Napoca, RO-400320, Romania; Department of Mathematics Babeş-Bolyai University, Cluj-Napoca, RO-400084, Romania. Electronic address:

In the following paper we present a new type of optimization algorithms adapted for neural network training. These algorithms are based upon sequential operator splitting technique for some associated dynamical systems. Furthermore, we investigate through numerical simulations the empirical rate of convergence of these iterative schemes toward a local minimum of the loss function, with some suitable choices of the underlying hyper-parameters. Read More

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Outcomes of sacral neuromodulation for chronic pelvic pain: a Finnish national multicenter study.

Tech Coloproctol 2020 03 21;24(3):215-220. Epub 2020 Jan 21.

Turku University Hospital, Turku, Finland.

Background: The aim of this study was to report the outcomes of sacral neuromodulation (SNM) in chronic pelvic pain (CPP) patients in the Finnish national cohort.

Methods: This was a register-based retrospective study, involving all the centers that provide SNM treatment in Finland. The data of all patients treated with SNM for CPP were gathered from Oulu-, Turku-, Tampere- and Helsinki University Hospitals, as well as Jyväskylä and Seinäjoki Central Hospitals. Read More

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Advancing the understanding of treponemal disease in the past and present.

Am J Phys Anthropol 2020 05 19;171 Suppl 70:5-41. Epub 2020 Jan 19.

School of Human Evolution and Social Change, Arizona State University, Tempe, Arizona.

Syphilis was perceived to be a new disease in Europe in the late 15th century, igniting a debate about its origin that continues today in anthropological, historical, and medical circles. We move beyond this age-old debate using an interdisciplinary approach that tackles broader questions to advance the understanding of treponemal infection (syphilis, yaws, bejel, and pinta). How did the causative organism(s) and humans co-evolve? How did the related diseases caused by Treponema pallidum emerge in different parts of the world and affect people across both time and space? How are T. Read More

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The pan-genome of Treponema pallidum reveals differences in genome plasticity between subspecies related to venereal and non-venereal syphilis.

BMC Genomics 2020 Jan 10;21(1):33. Epub 2020 Jan 10.

Department of Immunology, Microbiology and Parasitology, Institute of Biological Sciences and Natural Sciences, Federal University of Triângulo Mineiro (UFTM), Uberaba, MG, Brazil.

Background: Spirochetal organisms of the Treponema genus are responsible for causing Treponematoses. Pathogenic treponemes is a Gram-negative, motile, spirochete pathogen that causes syphilis in human. Treponema pallidum subsp. Read More

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January 2020

The "Scourge of the Renaissance". A Short Review About infection.

Endocr Metab Immune Disord Drug Targets 2020 ;20(3):335-343

Department of Emergency/Urgent, National Poison Center, Riuniti University Hospital (OO.RR.) of Foggia, Foggia, Italy.

Background: There is not a time in the history when epidemics did not loom large: infectious diseases have always had civilisation and evolution-altering consequences. Throughout history, there have been a number of pandemics: cholera, bubonic plague, influenza, smallpox are some of the most brutal killers in human history. Historical accounts of pandemics clearly demonstrate that war, unhygienic conditions, social and health inequality create conditions for the transmission of infectious diseases, and existing health disparities can contribute to unequal morbidity and mortality. Read More

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January 2021

Controlled-release mitochondrial protonophore (CRMP) reverses dyslipidemia and hepatic steatosis in dysmetabolic nonhuman primates.

Sci Transl Med 2019 10;11(512)

Department of Internal Medicine, Yale School of Medicine, New Haven, CT 06510, USA.

Nonalcoholic fatty liver disease (NAFLD) is estimated to affect up to one-third of the general population, and new therapies are urgently required. Our laboratory previously developed a controlled-release mitochondrial protonophore (CRMP) that is functionally liver-targeted and promotes oxidation of hepatic triglycerides. Although we previously demonstrated that CRMP safely reverses hypertriglyceridemia, fatty liver, hepatic inflammation, and fibrosis in diet-induced rodent models of obesity, there remains a critical need to assess its safety and efficacy in a model highly relevant to humans. Read More

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October 2019

Regulation of hepatic mitochondrial oxidation by glucose-alanine cycling during starvation in humans.

J Clin Invest 2019 11;129(11):4671-4675

Department of Medicine.

In order to determine whether the glucose-alanine cycle regulates rates of hepatic mitochondrial oxidation in humans, we applied positional isotopomer NMR tracer analysis (PINTA) to assess rates of hepatic mitochondrial oxidation and pyruvate carboxylase flux in healthy volunteers following both an overnight (12 hours) and a 60-hour fast. Following the 60-hour fast, rates of endogenous glucose production and mitochondrial oxidation decreased, whereas rates of hepatic pyruvate carboxylase flux remained unchanged. These reductions were associated with reduced rates of alanine turnover, assessed by [3-13C]alanine, in a subgroup of participants under similar fasting conditions. Read More

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November 2019

Efficacy of the adjuvanted recombinant zoster vaccine (RZV) by sex, geographic region, and geographic ancestry/ethnicity: A post-hoc analysis of the ZOE-50 and ZOE-70 randomized trials.

Vaccine 2019 10 16;37(43):6262-6267. Epub 2019 Sep 16.

GSK, 14200 Shady Grove Road, Rockville, MD 20850, USA. Electronic address:

Background: Herpes zoster (HZ) risk appears to vary by sex and geographic ancestry/ethnicity.

Methods: In 2 randomized clinical trials, participants received 2 doses of adjuvanted recombinant zoster vaccine (RZV) or placebo intramuscularly, 2 months apart. In this post-hoc analysis, we investigate efficacy of RZV against HZ and postherpetic neuralgia (PHN) by sex, geographic region, and geographic ancestry/ethnicity in ≥50-year-olds (ZOE-50: NCT01165177) and ≥70-year-olds (pooled data from ZOE-50 and ZOE-70: NCT01165229). Read More

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October 2019

Prospective multicentre cohort trial on acute appendicitis and microbiota, aetiology and effects of antimicrobial treatment: study protocol for the MAPPAC (Microbiology APPendicitis ACuta) trial.

BMJ Open 2019 09 6;9(9):e031137. Epub 2019 Sep 6.

Division of Digestive Surgery and Urology, Turku University Hospital, Turku, Finland

Introduction: Based on the epidemiological and clinical data, acute appendicitis can present either as uncomplicated or complicated. The aetiology of these different appendicitis forms remains unknown. Antibiotic therapy has been shown to be safe, efficient and cost-effective for CT-confirmed uncomplicated acute appendicitis. Read More

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September 2019

Mechanical and oral antibiotic bowel preparation versus no bowel preparation for elective colectomy (MOBILE): a multicentre, randomised, parallel, single-blinded trial.

Lancet 2019 09 8;394(10201):840-848. Epub 2019 Aug 8.

Department of Gastroenterological Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.

Background: Decreased surgical site infections (SSIs) and morbidity have been reported with mechanical and oral antibiotic bowel preparation (MOABP) compared with no bowel preparation (NBP) in colonic surgery. Several societies have recommended routine use of MOABP in patients undergoing colon resection on the basis of these data. Our aim was to investigate this recommendation in a prospective randomised context. Read More

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September 2019

Cost-effectiveness of pirfenidone compared to all available strategies for the treatment of idiopathic pulmonary fibrosis in France.

J Mark Access Health Policy 2019 24;7(1):1626171. Epub 2019 Jun 24.

Pulmonology Department, National Coordinating Reference Center for Rare Pulmonary Diseases, Louis Pradel Hospital, University Claude Bernard Lyon 1, Lyon, France.

: To update the health economic evaluation of pirfenidone in the treatment of idiopathic pulmonary fibrosis (IPF) compared to all available alternatives strategies (Best supportive care - BSC and nintedanib), based on a cost-utility model previously validated by the CEESP's (French Committee for Economic Evaluation) in 2014. : A standard Markov cohort model, adapted to French methodology guidelines, was used to simulate the therapeutic management and the course of IPF patients (including potential adverse events) using the collective perspective. Cost-effectiveness was evaluated regarding life years (LY); quality-adjusted life-years (QALY); average cumulative costs; the incremental cost-effectiveness ratio (ICER) expressed in cost per QALY gained. Read More

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Laparoscopic versus hybrid approach for treatment of incisional ventral hernia: a prospective randomised multicentre study, 1-year results.

Surg Endosc 2020 01 2;34(1):88-95. Epub 2019 Apr 2.

Department of Surgery, Oulu University Hospital, Oulu, Finland.

Purpose: Laparoscopic incisional ventral hernia repair (LIVHR) is often followed by seroma formation, bulging and failure to restore abdominal wall function. These outcomes are risk factors for hernia recurrence, chronic pain and poor quality of life (QoL). We aimed to evaluate whether LIVHR combined with defect closure (hybrid) follows as a diminished seroma formation and thereby has a lower rate of hernia recurrence and chronic pain compared to standard LIVHR. Read More

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January 2020

Safety profile of the adjuvanted recombinant zoster vaccine: Pooled analysis of two large randomised phase 3 trials.

Vaccine 2019 04 29;37(18):2482-2493. Epub 2019 Mar 29.

GSK, Wavre, Belgium. Electronic address:

Background: The ZOE-50 (NCT01165177) and ZOE-70 (NCT01165229) phase 3 clinical trials showed that the adjuvanted recombinant zoster vaccine (RZV) was ≥90% efficacious in preventing herpes zoster in adults. Here we present a comprehensive overview of the safety data from these studies.

Methods: Adults aged ≥50 (ZOE-50) and ≥70 (ZOE-70) years were randomly vaccinated with RZV or placebo. Read More

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