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Association of Acute Kidney Injury with Outcomes in Patients Undergoing Transcatheter Mitral Valve Repair.

Cardiology 2021 Jun 15:1-7. Epub 2021 Jun 15.

Division of Cardiology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA.

Introduction: Although transcatheter mitral valve repair (TMVr) is a contrast-free procedure, prior single-center studies have demonstrated a high incidence of acute kidney injury (AKI) following TMVr. The main objective of this study was to examine risk factors for AKI, and its association with outcomes in patients undergoing TMVr.

Methods: We queried the National Readmission Database to identify TMVr procedures performed between January 2014 and December 2017. Read More

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Early lung ultrasound assessment for the prognosis of patients hospitalized for COVID-19 pneumonia. A pilot study.

Respir Med Res 2021 Jun 4;80:100832. Epub 2021 Jun 4.

Department of Respiratory Diseases, University Hospitals KU Leuven, Herestraat 49, 3000 Leuven, Belgium.

Objective: SARS CoV-2 is an epidemic viral infection that can cause mild to severe lung involvement. Newly apprehended knowledge on thoracic imaging abnormalities and the growing clinical experience on the evolution of this disease make the radiographic follow-up of hospitalized patients relevant. The value of consecutive bedside lung ultrasonography in the follow-up of hospitalized patients with SARS CoV-2 pneumonia and its correlation with other clinical and laboratory markers needs to be evaluated. Read More

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Clinical characteristics and outcomes of community-acquired pneumonia in western Saudi Arabia: A four-year retrospective analysis of medical records.

J Infect Public Health 2021 May 27;14(7):960-966. Epub 2021 May 27.

Infection Prevention and Control, King Abdulaziz Medical City, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia; King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.

Background: Community-acquired pneumonia (CAP) is a significant cause of morbidity and mortality, especially for the elderly and people who suffer from chronic conditions. This study was conducted to assess the clinical and microbiological characteristics and disease outcomes associated with the occurrence of CAP.

Methods: This retrospective chart review was conducted at King Abdulaziz Medical City, Jeddah, Saudi Arabia. Read More

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Stroke Mechanism in COVID-19 Infection: A Prospective Case-Control Study.

J Stroke Cerebrovasc Dis 2021 Jun 1;30(8):105919. Epub 2021 Jun 1.

Department of Neurology, Hacettepe University Hospitals Turkey.

Background: The characteristics and pathophysiological mechanisms involved in acute ischemic stroke in patients with COVID-19 infection have not been fully clarified. We prospectively studied the phenotypic and etiological features of acute stroke occurring in COVID-19 infection.

Patients & Methods: Within nine months starting from April-2020, the presence of COVID-19 infection was determined by thoracic CT and SARS-CoV-2 PCR in all acute stroke cases managed in a single tertiary center. Read More

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Frequency and factors associated with post-stroke seizures in a large multicenter study in West Africa.

J Neurol Sci 2021 Jun 9;427:117535. Epub 2021 Jun 9.

Federal Medical Centre, Abeokuta, Nigeria; Center for Genomic and Precision Medicine, College of Medicine, University of Ibadan, Nigeria.

Background: Post-stroke seizures (PSS) are associated with significant morbidity and mortality across the globe. There is a paucity of data on PSS in Africa.

Purpose: To assess the frequency and factors associated with PSS by stroke types across 15 hospitals in Nigeria and Ghana. Read More

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Echocardiographic predictors of cardioembolic stroke due to underlying atrial fibrillation: Reliable left atrial remodeling signs in acute stroke.

J Neurol Sci 2021 Jun 1;427:117514. Epub 2021 Jun 1.

Department of Neurology, National Cerebral and Cardiovascular Center, Japan.

Introduction: Atrial remodeling due to high-burden atrial fibrillation (AF) is associated with cardioembolic stroke (CES). As not all CESs is caused by AF, we analyzed the diagnostic values of each echocardiographic parameter to distinguish likely AF-related CES in acute stroke patients while in non-AF rhythm.

Methods: The data of consecutive patients with acute ischemic stroke in sinus rhythm between 2012 and 2015 were obtained. Read More

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Nutritional Risk at intensive care unit admission and outcomes in survivors of critical illness.

Clin Nutr 2021 May 11;40(6):3868-3874. Epub 2021 May 11.

Critical Illness, Brain Dysfunction, and Survivorship (CIBS) Center, Nashville, TN, USA; Division of Pulmonary, Critical Care, and Sleep Medicine, The Ohio State University College of Medicine, Columbus OH, USA; Davis Heart and Lung Research Institute, The Ohio State University Wexner Medical Center, Columbus, OH, USA. Electronic address:

Background And Aims: Risk factors for poor outcomes after critical illness are incompletely understood. While nutritional risk is associated with mortality in critically ill patients, its association with disability, cognitive, and health-related quality of life is unclear in survivors of critical illness. This study's objective was to determine whether greater nutritional risk at ICU admission is associated with greater disability, worse cognition, and worse HRQOL at 3 and 12-month follow-up. Read More

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Micronutrient deficiencies in critical illness.

Clin Nutr 2021 May 11;40(6):3780-3786. Epub 2021 May 11.

Department of Intensive Care Medicine, Gelderse Vallei Hospital, Willy Brandtlaan 10, 6716 RP, Ede, the Netherlands; Division of Human Nutrition and Health, Wageningen University & Research, HELIX (Building 124), Stippeneng 4, 6708 WE, Wageningen, the Netherlands. Electronic address:

Background & Aims: Low micronutrient levels in critical illness have been reported in multiple studies. Because of the antioxidant properties of various micronutrients, micronutrient deficiency may augment oxidative stress in critical illness. However, it remains unclear whether micronutrient concentrations in ICU patients are different from those in healthy age-matched controls. Read More

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Influence of outpatient total knee arthroplasty compared to inpatient surgery on medical and economic outcomes.

Acta Orthop Belg 2021 Mar;87(1):103-109

Firstly, this study compared the rate of readmission after a total knee arthroplasty between selected out- patients (no hospitalization, directly sent home after surgery) and inpatients (3 days hospitalization) at 6 weeks. Secondly, it examined the mobility and the complications in the two groups after the same period of time. The rate of readmission, complications and knee mobility of 32 outpatients (M-age : 61 years ± 10 ; 10 females), were compared against those of 32 birth- matched inpatients (M-age : 64 years ± 8. Read More

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Stressful life events can predict post stroke fatigue in patients with ischemic stroke.

Eur J Neurol 2021 Jun 15. Epub 2021 Jun 15.

Stroke Center & Department of Neurology, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China.

Objective: To investigate whether stressful life events (SLEs) can predict poststroke fatigue (PSF) in patients with acute ischemic stroke (AIS).

Methods: This prospective cohort study included data from patients with AIS who were followed up to 2-year interview. PSF was assessed at admission and at 6 (n=916), 12 (n=880), and 24 (n=857) months with the fatigue severity scale (FSS). Read More

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The discrepancy between admission and discharge diagnoses: Underlying factors and potential clinical outcomes in a low socioeconomic country.

PLoS One 2021 15;16(6):e0253316. Epub 2021 Jun 15.

Department of Medicine, Section of Internal Medicine, Aga Khan University Hospital, Karachi, Pakistan.

Objective: The discrepancy between admission and discharge diagnosis can lead to possible adverse patient outcomes. There are gaps in integrated studies, and less is understood about its characteristics and effects. Therefore, this study was conducted to determine the frequency, characteristics, and outcomes of diagnostic discrepancies at admission and discharge. Read More

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A Knowledge Distillation Ensemble Framework for Predicting Short and Long-term Hospitalisation Outcomes from Electronic Health Records Data.

IEEE J Biomed Health Inform 2021 Jun 15;PP. Epub 2021 Jun 15.

The ability to perform accurate prognosis of patients is crucial for proactive clinical decision making, informed resource management and personalised care. Existing outcome prediction models suffer from a low recall of infrequent positive outcomes. We present a highly-scalable and robust machine learning framework to automatically predict adversity represented by mortality and ICU admission from time-series vital signs and laboratory results obtained within the first 24 hours of hospital admission. Read More

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Morning Discharges and Patient Length of Stay in Inpatient General Internal Medicine.

J Hosp Med 2021 Jun;16(6):333-338

Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.

Background: Many initiatives seek to increase the number of morning hospital discharges to improve patient flow, but little evidence supports this practice.

Objective: To determine the association between the number of morning discharges and emergency department (ED) length of stay (LOS) and hospital LOS in general internal medicine (GIM).

Design, Setting, And Participants: Multicenter retrospective cohort study involving all GIM patients discharged between April 1, 2010, and October 31, 2017, at seven hospitals in Ontario, Canada. Read More

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Morbidity and Mortality Trends of Pancreatitis: An Observational Study.

Surg Infect (Larchmt) 2021 Jun 15. Epub 2021 Jun 15.

Department of Medicine, Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, University of Minnesota, Minneapolis, Minnesota, USA.

Pancreatitis accounts for more than $2.5 billion of healthcare costs and remains the most common gastrointestinal (GI) admission. Few contemporary studies have assessed temporal trends of incidence, complications, management, and outcomes for acute pancreatitis in hospitalized patients at the national level. Read More

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Potential Role of Natriuretic Response to Furosemide Stress Test During Acute Heart Failure.

Circ Heart Fail 2021 Jun 15;14(6):e008166. Epub 2021 Jun 15.

Servicio de Cardiología, Hospital Universitario 12 de Octubre, Madrid, Spain (P.C.P., J.N., L.M.F., Z.B.-B., J.C.L.-A., J.d.J.B., M.D.G.-C.C., P.E.S., R.S.-B., F.A.Y., J.F.D.).

Background: Poor natriuresis has been associated with a poorer response to diuretic treatment and worse prognosis in acute heart failure. Recommendations on how and when to measure urinary sodium (UNa) are lacking. We aim to evaluate UNa quantification after a furosemide stress test (FST) capacity to predict appropriate decongestion during acute heart failure hospitalization. Read More

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Role of lactulose for prophylaxis against hepatic encephalopathy in cirrhotic patients with upper gastrointestinal bleeding: A randomized trial.

Indian J Gastroenterol 2021 Jun 15. Epub 2021 Jun 15.

NKC Institute of Gastroenterology and Hepatology, Songklanagarind Hospital, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand.

Background: We aimed to assess the efficacy of lactulose as prophylaxis against hepatic encephalopathy (HE) in cirrhotic patients with acute upper gastrointestinal bleeding (AUGIB).

Methods: We conducted a randomized, double-blinded, placebo-controlled, multicenter study from October 2012 to February 2014. Cirrhotic patients presenting with AUGIB (aged 18-80 years, without HE at the time of admission) were enrolled and randomized to receive blinded medications (both physically indistinguishable), labeled "Lactulose A" and "Lactulose B" for 5 days along with standard treatment depending on the type of bleeding (variceal and nonvariceal). Read More

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Impact of polypharmacy on all-cause mortality and hospitalization in incident hemodialysis patients: a cohort study.

Clin Exp Nephrol 2021 Jun 15. Epub 2021 Jun 15.

Department of Hemovascular Medicine and Artificial Organs, Faculty of Medicine, University of Miyazaki, 5200 Kihara Kiyotake, Miyazaki city, Miyazaki, 889-1692, Japan.

Background: Polypharmacy (PP) is common in end-stage chronic renal disease patients largely due to the presence of multiple comorbid conditions. Although PP is potentially harmful, its relationship with mortality and morbidity in hemodialysis patients currently remains unclear.

Methods: Study design: cohort study. Read More

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Clipping of unruptured cerebral aneurysms : Are older patients at higher risk?

Wien Klin Wochenschr 2021 Jun 15. Epub 2021 Jun 15.

Department of Neurosurgery, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Wien, Austria.

Background: The incidence of aneurysms is steadily increasing in older patients due to the aging population. This study compared radiological parameters as well as clinical outcomes between patients younger than 65 years and those over 65 years of age, with special respect to individual treatment options.

Methods: Retrospective data were obtained for patients with cerebral aneurysms at a single academic institution within a 7-year period. Read More

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β-Adrenergic blockade in patients with dementia and hip fracture is associated with decreased postoperative mortality.

Eur J Trauma Emerg Surg 2021 Jun 15. Epub 2021 Jun 15.

School of Medical Sciences, Orebro University, 702 81, Orebro, Sweden.

Purpose: Dementia, present in 20% of hip fracture patients, is associated with an almost threefold increase in postoperative mortality risk. These patients have a substantially higher incidence of cardiovascular, respiratory, and cerebrovascular mortality after hip fracture surgery compared to patients without dementia. This study aimed to investigate the association between beta-blocker therapy and postoperative mortality in patients with dementia undergoing hip fracture surgery. Read More

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Management of traumatic posterior fossa epidural hematomas in pediatrics: our experience and review of the literature.

Childs Nerv Syst 2021 Jun 15. Epub 2021 Jun 15.

Faculty of Medicine, Jordan University of Science and Technology, Irbid, 22110, Jordan.

Background And Aims: Conservative management of posterior fossa epidural hematoma in the pediatric age group has been increasingly considered in the last decade with good clinical outcomes and comparable results to surgical intervention in carefully selected patients. The purpose of this study is to evaluate the outcome of observation in the management of pediatric patients with posterior fossa epidural hematoma (PFEDH) in our tertiary hospital and present a literature review on PFEDH pediatric patients.

Methods: We conducted a retrospective observational study at King Abdullah University Hospital (KAUH), a tertiary hospital in North Jordan. Read More

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Clinical triage of patients on kidney replacement therapy presenting with COVID-19: an ERACODA registry analysis.

Nephrol Dial Transplant 2021 Jun 15. Epub 2021 Jun 15.

Department Internal Medicine, Division of Nephrology, Maastricht University Medical Center, Maastricht, The Netherlands.

Rationale & Objective: Patients on kidney replacement therapy (KRT) are at a very high risk of COVID-19. Triage pathway for KRT patients presenting with varying severity of COVID-19 illness remains ill-defined. We studied clinical characteristics of patients at initial and subsequent hospital presentations and its impact on patient outcomes. Read More

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The spectrum, prevalence and in-hospital outcomes of cardiovascular diseases in a South African district hospital: a retrospective study.

Cardiovasc J Afr 2021 Jun 10;32:1-6. Epub 2021 Jun 10.

Cardiac Clinic, Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.

Introduction: The increasing prevalence of cardiovascular risk factors in South African rural communities is well reported. However, the prevalence of cardiovascular disease (CVD) leading to hospital admission and related in-hospital mortality in rural and semi-rural hospitals is unknown.

Methods: We conducted a retrospective review of hospital records for patients admitted to the Department of Internal Medicine at Dora Nginza Hospital in Port Elisabeth, South Africa between 1 April and 31 October 2016. Read More

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Sphenoid sinus pseudoaneurysm with carotid cavernous fistula presenting with delayed subarachnoid hemorrhage: A case report.

Medicine (Baltimore) 2021 Jun;100(24):e26383

Department of Radiology.

Rationale: Sphenoid sinus pseudoaneurysm arising from the cavernous segment of the internal carotid artery (ICA) caused by traumatic vessel injury is rare, and rarer is a concomitant carotid-cavernous fistula (CCF). In particular, delayed subarachnoid hemorrhage (SAH) due to pseudoaneurysm rupture has not been reported to-date in literature. Here, we report a case of sphenoid sinus pseudoaneurysm with CCF presenting with delayed SAH. Read More

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Cross-cultural adaptation and psychometric validation of the Korean version of rehabilitation complexity scale for the measurement of complex rehabilitation needs.

Medicine (Baltimore) 2021 Jun;100(24):e26259

TBI Rehabilitation Center, National Traffic Injury Rehabilitation Hospital, Gyeonggi-do.

Abstract: The aim of this study was to translate and cross-culturally adapt the Rehabilitation Complexity Scale-Extended version 13 (RCS-E v13) to develop the Korean version of the Rehabilitation Complexity Scale (KRCS), and to explore its reliability, and concurrent and construct validity.This research was an observational study of a series of consecutive rehabilitation inpatients who were previously assessed with KRCS and grouped with the Korean rehabilitation patient group version 1.1 (KRPG v1. Read More

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Clinicopathological analysis and genomic profiling of a rare histiocyte-rich rhabdomyoblastic tumor: A case report.

Medicine (Baltimore) 2021 Jun;100(24):e26105

Department of General Surgery, Shenzhen University General Hospital & Carson International Cancer Research Centre, Shenzhen, P.R. China.

Rationale: Skeletal muscle tumors are traditionally classified as rhabdomyomas or rhabdomyosarcomas. However, some soft tissue tumors cannot easily be identified as benign or malignant. We report a case of a histiocyte-rich rhabdomyoblastic tumor, with pathologic characteristics distinct from either rhabdomyoma or rhabdomyosarcoma. Read More

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Blood concentrations of proapoptotic sFas and antiapoptotic Bcl2 and COVID-19 patient mortality.

Expert Rev Mol Diagn 2021 Jun 15. Epub 2021 Jun 15.

Research Unit. Hospital Universitario de Canarias. Ofra, s/n. La Laguna 38320. Santa Cruz de Tenerife. Spain.

Background: Cell death by apoptosis is increased in septic patients. However, there are not data about circulating concentrations of sFas (proapoptotic protein of extrinsic pathway) and Bcl2 (antiapoptotic protein of intrinsic pathway) in COVID-19 patients. Thus, our objective study was to determine whether exists an association between serum concentrations of sFas and Bcl2 and COVID-19 patient mortality. Read More

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Development and validation of a prediction model of poor performance status and severe symptoms over time in cancer patients (PROVIEW+).

Palliat Med 2021 Jun 15:2692163211019302. Epub 2021 Jun 15.

Institute for Clinical Evaluative Sciences, Toronto, ON, Canada.

Background: Predictive cancer tools focus on survival; none predict severe symptoms.

Aim: To develop and validate a model that predicts the risk for having low performance status and severe symptoms in cancer patients.

Design: Retrospective, population-based, predictive study. Read More

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Non-Selective Thoracic Computed Tomography in Trauma Patients Results in Injury Severity Score Inflation.

Am Surg 2021 Jun 15:31348211024973. Epub 2021 Jun 15.

Division of Trauma, Burns and Surgical Critical Care, Department of Surgery, University of California, Irvine, Orange, CA, USA.

Introduction: Extensive research relying on Injury Severity Scores (ISS) reports a mortality benefit from routine non-selective thoracic CTs (an integral part of pan-computed tomography (pan-CT)s). Recent research suggests this mortality benefit may be artifact. We hypothesized that the use of pan-CTs inflates ISS categorization in patients, artificially affecting admission rates and apparent mortality benefit. Read More

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A prospective study to establish the minimal clinically important difference of the Mini-BESTest in individuals with stroke.

Clin Rehabil 2021 Jun 15:2692155211025131. Epub 2021 Jun 15.

George & Fay Yee Centre for Healthcare Innovation, University of Manitoba, Winnipeg, MB, Canada.

Objective: To determine the minimal clinically important difference of the Mini-BESTest in individuals' post-stroke.

Design: Prospective cohort study.

Setting: Outpatient stroke rehabilitation. Read More

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Do standards of care and early outcomes of periprosthetic fractures change during the COVID-19 pandemic? A multicentre study.

J Orthop Traumatol 2021 Jun 14;22(1):22. Epub 2021 Jun 14.

Department of Orthopaedic Surgery, ASST Papa Giovanni XXIII, Piazza OMS 1, 24127, Bergamo, Italy.

Background: Periprosthetic fractures (PPFs) are a growing matter for orthopaedic surgeons, and patients with PPFs may represent a frail target in the case of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The purpose of this study is to investigate whether hospital reorganisations during the most severe phase of the SARS-CoV-2 pandemic affected standards of care and early outcomes of patients treated for PPFs in Northern Italy.

Materials And Methods: Data were retrieved from a multicentre retrospective orthopaedics and traumatology database, including 14 hospitals. Read More

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