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The Subarachnoid Hemorrhage Early Brain Edema Score (SEBES) as radiographic marker of clinically relevant intracranial hypertension and unfavorable outcome after subarachnoid hemorrhage.

Eur J Neurol 2021 Jul 22. Epub 2021 Jul 22.

Department of Neurosurgery and Spine Surgery, University Hospital of Essen, Germany.

Objective: The severity of early brain edema after aneurysm rupture was reported to be strongly associated with the risk of poor outcome after aneurysmal subarachnoid hemorrhage (SAH). Using the recently developed SEBES (Subarachnoid Hemorrhage Early Brain Edema Score), we analyzed the predictors of early brain edema and its impact on the complications related to intracranial pressure (ICP) increase after SAH and poor outcome.

Methods: All consecutive SAH cases treated between January 2003 and June 2016 with assessable SEBES were included (n=745). Read More

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Self-reported reasons for colonoscopy among adults aged 45-49 versus 50 years and older from 2010-2018.

Cancer Epidemiol 2021 Jul 19;74:101984. Epub 2021 Jul 19.

Department of Radiation Oncology, University of Texas Southwestern, Dallas, TX, USA. Electronic address:

Background: In May of 2018, the American Cancer Society lowered the age of colorectal cancer (CRC) screening initiation from 50 to 45 years and in October 2020, United States Preventive Services Task Force published draft guidelines also lowering age of screening initiation to 45 years. Evaluating guideline adherence is needed; however, the majority of prior research on cancer screening do not distinguish whether colonoscopy was performed for true screening purposes or for post-symptomatic diagnosis.

Methods: Using data from the National Health Interview Survey between 2010 to mid-2018, we assessed response to the question "What was the MAIN reason you had [last] colonoscopy?" stratified by age (45-49 versus 50+ years). Read More

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Blood volatile organic aromatic compounds concentrations across adulthood in relation to total and cause specific mortality: A prospective cohort study.

Chemosphere 2021 Jul 16;286(Pt 1):131590. Epub 2021 Jul 16.

Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China. Electronic address:

Objective: We aimed to evaluate the relationship between blood volatile organic aromatic compounds (VOACs) across adulthood and mortality.

Methods: A total of 16,968 participants from the National health and Nutrition Examination Surveys (NHANES 1988-1994 and 1999-2014) were included in the present study. Cox proportional hazards models were used to explore the associations between VOACs and total or cause-specific mortality. Read More

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Elevated levels of perfluoroalkyl substances in breast cancer patients within the Greater Manila Area.

Chemosphere 2021 Jul 12;286(Pt 1):131545. Epub 2021 Jul 12.

Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco, San Francisco, CA, USA.

Several studies have reported exposure of humans to various endocrine disrupting chemicals (EDCs) worldwide. However, there is a lack of data regarding EDC exposures in humans living in Southeast Asian countries, such as the Philippines. Hence, this study measured levels of 41 EDCs in women residing in the Greater Manila Area, home to the second largest city in Southeast Asia. Read More

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Clinical benefits of a Bayesian model for plasma-derived factor VIII/VWF after one year of pharmacokinetic-guided prophylaxis in severe/moderate hemophilia A patients.

Thromb Res 2021 Jul 15;205:99-105. Epub 2021 Jul 15.

Hospital Universitari i Politècnic La Fe, Pharmacy Department, Valencia, Spain.

Introduction: Individual pharmacokinetic (PK) profiling in hemophilia A (HA) helps to individualize prophylaxis using population PK models (popPK). A specific popPK model for plasma-derived factor VIII containing von-Willebrand Factor (pdFVIII/VWF) was developed.

Aim: To compare standard versus PK-driven prophylaxis, using a generic or a specific popPK model for pdFVIII/VWF. Read More

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Establishing amoxicillin allergy in children through direct graded oral challenge (GOC): evaluating risk factors for positive challenges, safety, and risk of cross reactivity to cephalosporines.

J Allergy Clin Immunol Pract 2021 Jul 19. Epub 2021 Jul 19.

Division of Allergy and Clinical Immunology, Department of Pediatrics, Montreal Children's Hospital, Montreal, Quebec, Canada; Infectious Diseases and Immunity in Global Health Program, The Research Institute of the McGill University Health Centre, McGill University, Montreal, Quebec, Canada.

Background: Data on the diagnostic properties of direct oral challenges without the use of skin tests in children with suspected amoxicillin allergy is sparse.

Objective: Assess the use of direct oral challenges.

Methods: A cohort study was conducted between March 2013 and March 2020, in Montreal and Winnipeg. Read More

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Metformin use and risk of asthma exacerbation among asthma patients with glycemic dysfunction.

J Allergy Clin Immunol Pract 2021 Jul 19. Epub 2021 Jul 19.

Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore Maryland. Electronic address:

Background: Diabetes is associated with worse asthma morbidity. Metformin, which treats diabetes, may have a role among patients with asthma and glycemic dysfunction.

Objective: To determine the association between metformin use and asthma exacerbations among patients with diabetes. Read More

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Combining tumor deposits with the number of lymph node metastases to improve the prognostic accuracy in stage III colon cancer: a post hoc analysis of the CALGB/SWOG 80702 phase III study (Alliance).

Ann Oncol 2021 Jul 19. Epub 2021 Jul 19.

Department of Medical Oncology, Dana-Farber/Partners Cancer Care, Boston, MA, USA.

Background: In colon cancer, tumor deposits (TD) are considered in assigning prognosis and staging only in the absence of lymph node metastasis (i.e., stage III pN1c tumors). Read More

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The Association of Service Use and Other Client Factors With the Time to Transition From Home Care to Facility-Based Care.

J Am Med Dir Assoc 2021 Jul 19. Epub 2021 Jul 19.

Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada.

Objectives: People are living longer with complex health needs and wish to remain in their homes as their care needs change. We examined which client factors (sociodemographic, health service use, health, and function) influenced older persons' (≥65 years) time to transition from home living to assisted living (AL) or long-term care (LTC) facilities.

Design: Retrospective cohort study. Read More

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Covid-19 and Risk of Venous Thromboembolism in Ethnically Diverse Populations.

Chest 2021 Jul 19. Epub 2021 Jul 19.

Department of Medicine, University of California, San Francisco, San Francisco, CA USA.

Background: Limited existing data suggest the novel coronavirus disease 2019 (Covid-19) may increase risk for venous thromboembolism (VTE) but information from large, ethnically diverse populations with appropriate controls are lacking.

Research Question: Does the rate of VTE among adults hospitalized with Covid-19 differ from matched hospitalized controls without Covid-19?

Study Design And Methods: We conducted a retrospective study among hospitalized adults with laboratory-confirmed Covid-19 and hospitalized adults without evidence of Covid-19 matched on age, gender, race/ethnicity, acute illness severity, and month of hospitalization between February-August 2020 from two integrated healthcare delivery systems with 36 hospitals. Outcomes included VTE (deep venous thrombosis or pulmonary embolism ascertained using diagnosis codes combined with validated natural language processing algorithms applied to electronic health records) and death from any cause at 30 days. Read More

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Prenatal exposure to per- and polyfluoroalkyl substances (PFAS) and associations with attention-deficit/hyperactivity disorder and autism spectrum disorder in children.

Environ Res 2021 Jul 19:111692. Epub 2021 Jul 19.

Division of Mental and Physical Health, Norwegian Institute of Public Health, PO Box 222, Skøyen, N-0213, Oslo, Norway.

Background: Prenatal exposure to per- and polyfluoroalkyl substances (PFAS) may be a risk factor for neurodevelopmental deficits and disorders, but evidence is inconsistent.

Objectives: We investigated whether prenatal exposure to PFAS were associated with childhood diagnosis of attention-deficit/hyperactivity disorder (ADHD) or autism spectrum disorder (ASD).

Methods: This study was based on the Norwegian Mother, Father and Child Cohort Study and included n = 821 ADHD cases, n = 400 ASD cases and n = 980 controls. Read More

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Anti-microbial antibody response is associated with future onset of Crohn's disease independent of biomarkers of altered gut barrier function, subclinical inflammation, and genetic risk.

Gastroenterology 2021 Jul 19. Epub 2021 Jul 19.

Zane Cohen Centre for Digestive Diseases, Mount Sinai Hospital, Toronto, Ontario, Canada; Division of Gastroenterology & Hepatology, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada. Electronic address:

Background: /Aim: Altered host immune reactivity to microbial antigens is hypothesized to trigger the onset of Crohn's disease (CD). We aimed to assess whether increased serum anti-microbial antibody response in asymptomatic first-degree relatives (FDR) of CD patients is an independent risk factor for future CD development.

Methods: We measured host serum antibody response to six microbial antigens at enrollment (Prometheus ELISA test: ASCA IgA/IgG, anti-OmpC, anti-A4-Fla2, anti-FlaX, anti-CBir1) and derived the sum of positive antibodies (AS). Read More

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Development and outcomes of hyperkalemia in hospitalized patients: potential implications for care.

Am Heart J 2021 Jul 19. Epub 2021 Jul 19.

Chronic Disease Research Group, Hennepin Healthcare Research Institute, Minneapolis, Minnesota; Department of Internal Medicine, Hennepin Healthcare, and University of Minnesota, Minneapolis, Minnesota. Electronic address:

Introduction: While severe hyperkalemia is commonly encountered, its manifestation in hospitalized patients and related outcomes are unclear. We aimed to examine development of hyperkalemia in hospitalized patients and associated outcomes.

Methods: Data from a county hospital electronic health record were used to assess all inpatient admissions, 2012-2016, for non-dialysis-dependent patients with ≥1 K value for development of hyperkalemia. Read More

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Randomized crossover trial to compare driving pressures in a closed-loop and a conventional mechanical ventilation mode in pediatric patients.

Pediatr Pulmonol 2021 Jul 22. Epub 2021 Jul 22.

Department of Pediatric Intensive Care Unit, Dr Behcet Uz Children's Disease and Surgery Training and Research Hospital, Health Sciences University, Izmir, Turkey.

Introduction: In mechanically ventilated patients, driving pressure (ΔP) represents the dynamic stress applied to the respiratory system and is related to ICU mortality. An evolution of the Adaptive Support Ventilation algorithm (ASV® 1.1) minimizes inspiratory pressure in addition to minimizing the work of breathing. Read More

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Longitudinal analysis of client appointment adherence under Universal Test and Treat strategy: A stepped-wedge trial.

HIV Med 2021 Jul 22. Epub 2021 Jul 22.

Harvard T.H. Chan School of Public Health, Boston, MA, USA.

Objectives: Universal Test and Treat (UTT) strategies are being adopted across sub-Saharan Africa based on clinical benefits to morbidity and mortality and to attain targets of the Joint United Nations Programme on HIV/AIDS (UNAIDS). Universal Test and Treat is expected to change the client population at clinics, due to more asymptomatic HIV clients initiating antiretroviral therapy (ART). We assessed the impact of UTT on client appointment adherence at 14 government-managed health facilities in Eswatini's public sector health system. Read More

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Factors associated with the use and composition of two-drug regimens in a large single-centre HIV cohort.

J Antimicrob Chemother 2021 Jul 22. Epub 2021 Jul 22.

Hospital Clínic-IDIBAPS, University of Barcelona, Barcelona, Spain.

Objectives: We aimed to assess the clinical characteristics associated with the use of two-drug regimens (2DRs) and the factors associated with specific antiretrovirals in 2DRs in a large single-centre HIV cohort.

Methods: Retrospective analysis of demographics, HIV characteristics and AIDS events, antiretroviral prescription, virological failure and genotypic resistance testing, and laboratory results from all adult people with HIV (PWH) prospectively followed at the Hospital Clinic of Barcelona who were receiving a 3DR or a 2DR in January 2020. We assessed factors associated with the probability of receiving 2DRs relative to three-drug regimens (3DRs) using a logistic regression model, controlling for age, sex and year of HIV diagnosis. Read More

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Antibody status and cumulative incidence of SARS-CoV-2 infection among adults in three regions of France following the first lockdown and associated risk factors: a multicohort study.

Int J Epidemiol 2021 Jul 19. Epub 2021 Jul 19.

Paris University, Paris, France.

Background: We aimed to estimate the seropositivity to anti-SARS-CoV-2 antibodies in May-June 2020 after the first lockdown period in adults living in three regions in France and to identify the associated risk factors.

Methods: Between 4 May 2020 and 23 June 2020, 16 000 participants in a survey on COVID-19 from an existing consortium of three general adult population cohorts living in the Ile-de-France (IDF) or Grand Est (GE) (two regions with high rate of COVID-19) or in the Nouvelle-Aquitaine (NA) (with a low rate) were randomly selected to take a dried-blood spot for anti-SARS-CoV-2 antibodies assessment with three different serological methods (ClinicalTrial Identifier #NCT04392388). The primary outcome was a positive anti-SARS-CoV-2 ELISA IgG result against the spike protein of the virus (ELISA-S). Read More

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Reproducibility and Validity of Capillary Dried Blood Spot for Diagnosis of Vitamin A Deficiency and Anemia in Children <5 Years Old.

J Nutr 2021 Jul 22. Epub 2021 Jul 22.

Department of Social Nutrition, Nutrition Institute, Rio de Janeiro State University, Rio de Janeiro, Brazil.

Background: Vitamin A deficiency (VAD) and anemia are the most prevalent nutritional deficiency in children globally. The dried blood spot (DBS) method has been used in prevalence studies of VAD and anemia in different age groups. However, it has not yet been validated for children. Read More

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A Low-Sodium DASH Dietary Pattern Affects Serum Markers of Inflammation and Mineral Metabolism in Adults with Elevated Blood Pressure.

J Nutr 2021 Jul 22. Epub 2021 Jul 22.

Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, MD, USA.

Background: The blood pressure-lowering effects of the Dietary Approaches to Stop Hypertension (DASH) dietary pattern and reduced sodium intake are well established. The effects on other biomarkers related to vascular health are of interest and might assist in explaining the effects of the DASH diet and sodium reduction.

Objectives: We hypothesized that a low-sodium DASH diet improves (lowers) biomarkers of inflammation [C-reactive protein (CRP) and soluble urokinase plasminogen activator receptor (suPAR)] and mineral metabolism [phosphorus and fibroblast growth factor-23 (FGF23)]. Read More

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Long-term dietary protein intake and subjective cognitive decline in US men and women.

Am J Clin Nutr 2021 Jul 22. Epub 2021 Jul 22.

Department of Epidemiology, Harvard T. H. Chan School of Public Health, Harvard University, Boston, MA, USA.

Background: Diet is one of the modifiable risk factors for cognitive decline. However, studies on dietary protein intake and cognitive decline have remained limited and inconclusive.

Objectives: In this study, we aimed to investigate the associations between long-term dietary protein intake and subsequent subjective cognitive decline (SCD). Read More

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Fibromyalgianess and glucocorticoid persistence among patients with rheumatoid arthritis.

Rheumatology (Oxford) 2021 Jul 22. Epub 2021 Jul 22.

Internal Medicine/Rheumatology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.

Objectives: Over 1/3 of patients with rheumatoid arthritis (RA) exhibit evidence of fibromyalgianess, which is associated with higher rates of disability and inadequate responsiveness to RA treatment. Patients with RA often remain on glucocorticoids long-term, despite the known risk of dose-dependent morbidity. We undertook this study to examine the relationship between fibromyalgianess and glucocorticoid persistence among RA patients. Read More

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Unrestrained eating behavior and risk of digestive system cancers: a prospective cohort study.

Am J Clin Nutr 2021 Jul 22. Epub 2021 Jul 22.

Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA, USA.

Background: Unrestrained eating behavior, as a potential proxy for diet frequency, timing, and caloric intake, has been questioned as a plausible risk factor for digestive system cancers, but epidemiological evidence remains sparse.

Objectives: We investigated prospectively the associations between unrestrained eating behavior and digestive system cancer risk.

Methods: Participants in the Nurses' Health Study who were free of cancer and reported dietary information in 1994 were followed for ≤18 y. Read More

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Remnant cholesterol predicts cardiovascular disease beyond LDL and ApoB: a primary prevention study.

Eur Heart J 2021 Jul 19. Epub 2021 Jul 19.

Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Baltimore, MD, USA.

Aims: Emerging evidence suggests that remnant cholesterol (RC) promotes atherosclerotic cardiovascular disease (ASCVD). We aimed to estimate RC-related risk beyond low-density lipoprotein cholesterol (LDL-C) and apolipoprotein B (apoB) in patients without known ASCVD.

Methods And Results: We pooled data from 17 532 ASCVD-free individuals from the Atherosclerosis Risk in Communities study (n = 9748), the Multi-Ethnic Study of Atherosclerosis (n = 3049), and the Coronary Artery Risk Development in Young Adults (n = 4735). Read More

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Relationship between initial self-perceived depressive symptoms and disease severity in working patients with first-onset major depressive disorder.

PLoS One 2021 22;16(7):e0255084. Epub 2021 Jul 22.

Department of Neuropsychiatry, Graduate School of Medicine, Osaka City University, Osaka, Japan.

The severity of major depressive disorder (MDD), which is related to the depressive symptoms, is a predictor of clinical outcomes and may be used to determine the appropriate treatment. However, there is a lack of systematic research on the relationship between early depressive symptoms and MDD severity. This study aimed to clarify the association between initial depressive symptoms and MDD severity in working patients. Read More

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Comparison of lean mass indices as predictors of mortality in incident peritoneal dialysis patients.

PLoS One 2021 22;16(7):e0254942. Epub 2021 Jul 22.

Division of Nephrology, Department of Internal Medicine, Yeungnam University Medical Center, Daegu, Republic of Korea.

Background: Few studies have considered optimal adjusted lean mass indices for prediction of clinical outcomes in peritoneal dialysis (PD) patients. We aimed to evaluate clinical variables using various adjusted indices in PD patients.

Methods: Total 528 incident PD patients were included. Read More

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Long-term effect of botulinum toxin A on the hip and spine in cerebral palsy: A national retrospective cohort study in Taiwan.

PLoS One 2021 22;16(7):e0255143. Epub 2021 Jul 22.

School of Public Health, National Defense Medical Center, Taipei, Taiwan.

Objectives: To investigate the effect of botulinum toxin A (BTA) on the development of hip dislocation and scoliosis, surgical rates for hip and spine, and mortality in cerebral palsy (CP).

Study Design: A cohort study was conducted using CP data from a Taiwan National Insurance Health Research Database. Diagnoses were defined using the International Classification of Diseases codes, 9th revision. Read More

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Clinical outcomes of adults hospitalized for laboratory confirmed respiratory syncytial virus or influenza virus infection.

PLoS One 2021 22;16(7):e0253161. Epub 2021 Jul 22.

Department of Internal Medicine, Cantonal Hospital Muensterlingen, Thurgau Hospital Group, Muensterlingen, Switzerland.

Objectives: Respiratory syncytial virus (RSV) can cause severe disease in adults, but far less is known than for influenza. The aim of our study was to compare the disease course of RSV infections with influenza infections among hospitalized adults.

Methods: We retrieved clinical data from an ongoing surveillance of adults hospitalized with RSV or influenza virus infection in two acute care hospitals in North-Eastern Switzerland during the winter seasons 2017/2018 and 2018/2019. Read More

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Telestroke for acute ischaemic stroke: A systematic review of economic evaluations and a de novo cost-utility analysis for a middle income country.

J Telemed Telecare 2021 Jul 22:1357633X211032407. Epub 2021 Jul 22.

Deakin Health Economics, Institute for Health Transformation, 2104Deakin University, Australia.

Introduction: Telemedicine can alleviate the problems faced in rural settings in providing access to specialist stroke care. The evidence of the cost-effectiveness of this model of care outside high-income countries is limited. This study aimed to conduct: (a) a systematic review of economic evaluations of telestroke and (b) a cost-utility analysis of telestroke, using China as a case study. Read More

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