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Rotational Thromboelastometry in Neonates Admitted to a Neonatal Intensive Care Unit: A Large Cross-sectional Study.

Semin Thromb Hemost 2021 Jun 15. Epub 2021 Jun 15.

Laboratory of Haematology and Blood Bank Unit, "Attikon" Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.

The aim of the present study was to assess the coagulation profile in neonatal critical illness using rotational thromboelastometry (ROTEM), and to investigate its association with disease severity and its potential prognostic role in this clinical setting. Over a period of 67 months (July 2014-February 2020) 423 critically ill neonates with confirmed or suspected sepsis, perinatal hypoxia, or respiratory distress syndrome, hospitalized in our neonatal intensive care unit were included in the study. Demographic, clinical, and laboratory data were recorded on admission day and arterial blood was analyzed on ROTEM analyzer using the standard extrinsically activated rotational thromboelastometry assay (EXTEM). Read More

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Treatment for grade 4 peripheral intravenous infiltration with type 3 skin tears: A case report and literature review.

Int Wound J 2021 Jun 15. Epub 2021 Jun 15.

Ottawa Hospital Research Institute Clinical Epidemiology Program, Ottawa, Ontario, Canada.

Grade 4 peripheral intravenous infiltration with skin tears has seldom been reported. On 4 August 2020, a 35-year-old female patient was admitted to the emergency department of our hospital because of postprandial abdominal pain for 2 hours. She was diagnosed with a severe acute pancreatitis with type II diabetes mellitus. Read More

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Systematic review: Incidence and prevalence of mucous membrane pressure injury in adults admitted to acute hospital settings.

Int Wound J 2021 Jun 14. Epub 2021 Jun 14.

College of Dentistry, Hawler Medical University, Erbil, Iraq.

Mucous membrane pressure injury (MMPI) is associated with a history of medical device use at the site of injury. The current international guideline recommends they should be reported in incidence and prevalence studies. The aim of this systematic review was to analyse the incidence and prevalence of hospital-acquired MMPI in adults admitted to acute hospital settings. Read More

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The impact of fluid resuscitation via colon on patients with severe acute pancreatitis.

Sci Rep 2021 Jun 14;11(1):12488. Epub 2021 Jun 14.

Department of Emergency, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197, Ruijin er Road, Huangpu District, Shanghai, 200025, China.

Severe acute pancreatitis (SAP) is a life-threatening disease. Fluid Resuscitation Via Colon (FRVC) may be a complementary therapy for early controlled fluid resuscitation. But its clinical application has not been reported. Read More

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Nutrition in acute pancreatitis.

Curr Opin Clin Nutr Metab Care 2021 Jun 14. Epub 2021 Jun 14.

Department of Gastroenterology, Hepatopancreatology and Digestive Oncology, Erasme Hospital, Université Libre de Bruxelles (ULB), Brussels, Belgium.

Purpose Of Review: This review aims to discuss recent developments in different topics regarding nutrition and acute pancreatitis (AP), including oral refeeding, nutritional therapy, and implications of gut microbiota.

Recent Findings: Obesity increases the risk for severe AP and mortality. Considering the worldwide obesity rates, this finding could have major implications in the global outcomes of patients admitted with AP. Read More

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Diet Quality as Measured by the Healthy Eating Index 2015 and Oral and Pharyngeal Cancer Risk.

J Acad Nutr Diet 2021 Jun 11. Epub 2021 Jun 11.

Background: Alcohol and tobacco are the major risk factors for oral and pharyngeal cancer, but diet is likely to have a role, too.

Objective: The objective was to analyze the relationship between adherence to the 2015-2020 Dietary Guidelines for Americans (DGA), as measured by the Healthy Eating Index 2015 (HEI-2015), and oral and pharyngeal cancer risk. Moreover, this work aimed to quantify the number of avoidable cases under different scenarios of increased adherence to the DGA, with the use of the potential impact fraction. Read More

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Effect of Location on Treatment and Outcomes of Cardiac Arrest Complicating Acute Myocardial Infarction in England & Wales.

Am J Cardiol 2021 Jun 11. Epub 2021 Jun 11.

Keele Cardiovascular Research Group, School of Medicine, Keele University, Stoke-on-Trent, United Kingdom; Department of cardiology, Royal Stoke University Hospital, Stoke-on-Trent, United Kingdom; Department of Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania. Electronic address:

We investigated the incidence, management, and outcomes of acute myocardial infarction (AMI) patients according to cardiac arrest location. Patients admitted with a diagnosis of AMI between January 1, 2010 to March 31, 2017 from the Myocardial Ischaemia National Audit Project (MINAP) were studied. We used logistic regression models to evaluate predictors of the clinical outcomes and treatment strategy. Read More

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A new approach for interpretability and reliability in clinical risk prediction: Acute coronary syndrome scenario.

Artif Intell Med 2021 Jul 13;117:102113. Epub 2021 May 13.

Cardiology Department, Leiria Hospital Centre, Leiria, Portugal. Electronic address:

Introduction: The risk prediction of the occurrence of a clinical event is often based on conventional statistical procedures, through the implementation of risk score models. Recently, approaches based on more complex machine learning (ML) methods have been developed. Despite the latter usually have a better predictive performance, they obtain little approval from the physicians, as they lack interpretability and, therefore, clinical confidence. Read More

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Methylphenidate-Induced Chorea Due to Possible Cytochrome P450 Metabolism Heterogeneity - A Rare Case.

CNS Spectr 2021 Apr;26(2):176-177

University of Colorado, Department of Neurosurgery, Aurora, CO, USA.

Background: Chorea is defined as a hyperactive movement disorder associated with involuntary, quick, and unpredictable muscle contractions of the limbs, face, and trunk. The unpredictable nature of these movements includes variation in speed, timing, and direction of movement. A wide variety of medications, medical conditions and illicit drugs have been associated with movement disorders. Read More

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Long-term prognosis in patients with acute myocardial infarction and newly detected glucose abnormalities: predictive value of oral glucose tolerance test and HbA1c.

Cardiovasc Diabetol 2021 Jun 14;20(1):122. Epub 2021 Jun 14.

Department of Clinical Sciences, Karolinska Institutet, Danderyd Hospital, SE-182 88, Stockholm, Sweden.

Background: Disturbances of glucose metabolism can be diagnosed by an oral glucose tolerance test (OGTT) and by glycated haemoglobin (HbA1c). The aim of this study was to investigate the association between newly detected disturbances of glucose metabolism and long-term prognosis after acute myocardial infarction (AMI) and to compare the predictive value of an OGTT and HbA1c.

Methods: Patients under the age of 80 years with no known history of diabetes admitted for AMI at the Department of Cardiology, Danderyd University Hospital, Stockholm, Sweden, from January 1st, 2006 until December 31st, 2013, were investigated with an OGTT and a HbA1c before discharge and were classified as having normal glucose tolerance (NGT), prediabetes or diabetes according to American Diabetes Association (ADA) criteria. Read More

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Anti-neutrophil cytoplasmic antibody-associated vasculitis accompanied by type II heparin-induced thrombocytopenia resulting in asymptomatic cerebral infarction: a case report.

BMC Nephrol 2021 Jun 14;22(1):220. Epub 2021 Jun 14.

Department of Hypertension and Nephrology, NTT Medical Centre, 5-9-22, Higasi- Gotanda, Shinagawa-ku, 141-8625, Tokyo, Japan.

Background: Heparin-induced thrombocytopenia (HIT) involves platelet activation and aggregation caused by heparin or HIT antibodies associated with poor survival outcomes. We report a case of HIT that occurred after hemodialysis was started for rapidly progressive glomerulonephritis (RPGN), which was caused by anti-neutrophil cytoplasmic antibody-associated vasculitis (AAV), and ultimately resulted in asymptomatic cerebral infarction.

Case Presentation: A 76-year-old Japanese man was urgently admitted to our hospital for weight loss and acute kidney injury (serum creatinine: 12 mg/dL). Read More

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Outcome Prediction for Patients With Ischemic Stroke in Acute Care: New Three-Level Model by Eating and Bladder Functions.

Ann Rehabil Med 2021 Jun 14. Epub 2021 Jun 14.

Department of Rehabilitation Medicine, Nishinomiya Kyoritsu Neurosurgical Hospital, Nishinomiya, Japan.

Objective: To develop a new prediction model by combining independence in eating and bladder management functions, and to assess its utility in an acute care setting.

Methods: Patients with ischemic stroke who were admitted in our acute stroke care unit (n=250) were enrolled in this study. Functional Independence Measure (FIM) scores for eating and bladder management on the initial day of rehabilitative treatment (median, 3 days) were collected as predictive variables. Read More

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Extracorporeal Blood Purification in Moderate and Severe COVID-19 Patients: A Prospective Cohort Study.

Blood Purif 2021 Jun 14:1-10. Epub 2021 Jun 14.

Zan Mitrev Clinic, Skopje, North Macedonia.

Introduction: Coronavirus disease 2019 (COVID-19) is characterized by hyperinflammation and coagulopathy. Severe cases often develop respiratory distress, requiring mechanical ventilation and with critical cases progressing to acute respiratory distress syndrome. Control of hyperinflammation has been proposed as a possible therapeutic avenue for COVID-19; extracorporeal blood purification (EBP) modalities offer an attractive mean to ameliorate maladaptive inflammation. Read More

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Timing of Coronary Artery Bypass Grafting in Acute Coronary Syndrome: A National Analysis.

Ann Thorac Surg 2021 Jun 11. Epub 2021 Jun 11.

Cardiovascular Outcomes Research Laboratories, Division of Cardiac Surgery, Department of Surgery, University of California, Los Angeles, Los Angeles, California. Electronic address:

Background: Timing of surgical revascularization for acute coronary syndrome (ACS) remains debated. We assessed the impact of timing to CABG on mortality and resource utilization in a national cohort.

Methods: Adults admitted for ACS in the 2009-2018 National Inpatient Sample were grouped by time from coronary angiography to CABG (Δt): 0, 1-3, 4-7, and >7 days. Read More

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Postmortem detection of COL gene family variants in two aortic dissection cases.

Int J Legal Med 2021 Jun 14. Epub 2021 Jun 14.

Department of Forensic Medicine, Tongji Medical College of Huazhong University of Science and Technology, 13 Hangkong Road, Hankou, Wuhan, 430030, Hubei, People's Republic of China.

Aortic dissection (AD) usually remains undiagnosed, but its manifestation is abrupt and is associated with high morbidity and poor prognosis, leading to sudden cardiac death. Variants in COL family genes are associated with AD. In case 1, a 32-year-old Chinese man was admitted to the hospital with complaints of abdominal pain and died on the next day. Read More

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Postprandial Hypotension in the Intensive Care Unit Due To Portal Hypertension and Coronavirus Disease 2019: A Case Report.

A A Pract 2021 Jun 14;15(6):e01485. Epub 2021 Jun 14.

Anesthesiology, University of Wisconsin Hospitals and Clinics, Madison, Wisconsin.

A 49-year-old man with cirrhosis and portal hypertension was admitted for acute respiratory distress syndrome secondary to coronavirus disease 2019 (COVID-19) pneumonia. His course was complicated by postprandial hypotension (PPH)-episodic hemodynamic collapse that occurred minutes after enteral administration of medications or fluids. Octreotide, which reduces splanchnic pooling and can treat PPH, successfully prevented ongoing events. Read More

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Persistent COVID-19 symptoms are highly prevalent 6 months after hospitalization: results from a large prospective cohort.

Clin Microbiol Infect 2021 Apr 30. Epub 2021 Apr 30.

Université de Paris, INSERM, IAME UMR 1137, Paris, France; INSERM, Centre d'Investigation clinique-Epidémiologie Clinique 1425, Hôpital Bichat, Paris, France; Departement of Epidemiology Biostatistics and Clinical Research, AP-HP, Hôpital Bichat, Paris, France. Electronic address:

Objectives: Persistent COVID-19 symptoms have been reported up to 3 months after hospital discharge. Little is known on the frequency and the nature of persistent symptoms beyond 3 months. Here we have assessed, in the longitudinal prospective French COVID-19 cohort, symptoms that persisted 6 months after admission for COVID-19. Read More

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Performance of Emergency Heart Failure Mortality Risk Grade in the Emergency Department.

West J Emerg Med 2021 Apr 8;22(3):672-677. Epub 2021 Apr 8.

Northwell Health, Long Island Jewish Medical Center, Department of Emergency Medicine, New Hyde Park, New York.

Introduction: The purpose of this study was to validate and assess the performance of the Emergency Heart Failure Mortality Risk Grade (EHMRG) to predict seven-day mortality in US patients presenting to the emergency department (ED) with acute congestive heart failure (CHF) exacerbation.

Methods: We performed a retrospective chart review on patients presenting to the ED with acute CHF exacerbation between January 2014-January 2016 across eight EDs in New York. We identified patients using codes from the International Classification of Diseases, 9th and 10 Revisions, or who were diagnosed with CHF in the ED. Read More

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SARS-CoV-2 Infection and Associated Rates of Diabetic Ketoacidosis in a New York City Emergency Department.

West J Emerg Med 2021 May 25;22(3):599-602. Epub 2021 May 25.

Icahn School of Medicine at Mount Sinai, Department of Emergency Medicine, New York City.

Introduction: In early March 2020, coronavirus 2019 (COVID-19) spread rapidly in New York City. Shortly thereafter, in response to the shelter-in-place orders and concern for infection, emergency department (ED) volumes decreased. While a connection between severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and hyperglycemia/insulin deficiency is well described, its direct relation to diabetic ketoacidosis (DKA) is not. Read More

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Rate of Decompensation of Normoxic Emergency Department Patients with SARS-CoV-2.

West J Emerg Med 2021 Apr 2;22(3):580-586. Epub 2021 Apr 2.

Lewis Katz School of Medicine at Temple University, Department of Emergency Medicine, Philadelphia, Pennsylvania.

Introduction: As of October 30, 2020, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has infected over 44 million people worldwide and killed over 1.1 million people. In the emergency department (ED), patients who need supplemental oxygen or respiratory support are admitted to the hospital, but the course of normoxic patients with SARS-CoV-2 infection is unknown. Read More

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Sex differences in independence in activities of daily living early in stroke rehabilitation.

Brain Behav 2021 Jun 14. Epub 2021 Jun 14.

Department of Public Health, Section of Biostatistics, University of Copenhagen, Copenhagen, Denmark.

Background: Current stroke research suggests that there are differences between females and males regarding incidence, stroke risk factors, stroke severity, outcome, and mortality. The few studies that have investigated sex differences in rehabilitation 8-12 months poststroke found that males are more independent, compared to females.

Objectives: To investigate if there is a difference in the improvement of independence in activities of daily living (ADL) between females and males in the acute phase (first 2 weeks) of stroke rehabilitation in a Danish population. Read More

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Dysnatremia and 6-Month Functional Outcomes in Critically Ill Patients With Aneurysmal Subarachnoid Hemorrhage: A Prospective Cohort Study.

Crit Care Explor 2021 Jun 8;3(6):e0445. Epub 2021 Jun 8.

The Alfred Hospital, Melbourne, VIC, Australia.

Objectives: To investigate the association between plasma sodium concentrations and 6-month neurologic outcome in critically ill patients with aneurysmal subarachnoid hemorrhage.

Design: Prospective cohort study.

Setting: Eleven ICUs in Australia and New Zealand. Read More

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Interventricular septum mass presenting as a late acute coronary syndrome with ST-segment elevation: a case report.

Eur Heart J Case Rep 2021 May 12;5(5):ytab164. Epub 2021 May 12.

Radiology Department, Hopital Saint-Joseph, 185 Rue Raymond Losserand, 75014 Paris, France.

Background: Intracardiac masses are relatively rare but the diagnosis can be challenging for the cardiologist and the clinical presentation can be misleading. While most of the cardiac masses are benign, malignant masses are mostly metastatic tumours.

Case Summary: An 81-year-old man was admitted to the cardiology department for congestive heart failure with the complaint of recent dyspnoea. Read More

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Fatal myopericarditis complicated with coronary vein perforation under the triple antithrombotic therapy: a case report.

Eur Heart J Case Rep 2021 Apr 24;5(4):ytab098. Epub 2021 Apr 24.

Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan.

Background : Acute pericarditis generally follows a mild clinical course and is rarely fatal. Coronary vein involvement is rarely reported.

Case Summary : We report an autopsy case of cardiac tamponade from idiopathic myopericarditis due to coronary venous perforation under the triple antithrombotic therapy. Read More

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Platypnea and orthodeoxia syndrome as an uncommon clinical indication for a challenging percutaneous patent foramen ovale closure: a case report.

Eur Heart J Case Rep 2021 Apr 17;5(4):ytab029. Epub 2021 Apr 17.

Department of Cardiovascular Sciences, O.U. of Interventional Cardiology, San Camillo Hospital, Rome, Italy.

Background: Platypnea and Orthodeoxia Syndrome (POS) is a rare clinical condition characterized by positional dyspnoea and arterial desaturation. Various mechanisms are related to this syndrome. The simultaneous presence of abnormal anatomical findings [aortic root dilatation, atrial septal aneurysm (ASA), Lipomatous septum, and patent foramen ovale (PFO)] and an occurring ventilation/perfusion mismatch can modify intracardiac haemodynamics leading to POS in elderly patients. Read More

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Importance of duration of acute kidney injury after severe trauma: a cohort study.

Trauma Surg Acute Care Open 2021 27;6(1):e000689. Epub 2021 May 27.

Surgery, University of Texas McGovern Medical School, Houston, Texas, USA.

Background: Acute kidney injury (AKI) is common after severe trauma. AKI incidence and AKI stage have previously been shown to be associated with poor outcomes after trauma. However, AKI duration may also be important for outcomes after trauma, given that it is associated with long-term morbidity and mortality in general intensive care unit (ICU) and hospitalized patients. Read More

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Score for Predicting Active Cancer in Patients with Ischemic Stroke: A Retrospective Study.

Biomed Res Int 2021 25;2021:5585206. Epub 2021 May 25.

Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.

Background: We aimed to examine the differences of clinical characteristics between patients with ischemic stroke with active cancer and those without cancer to develop a clinical score for predicting the presence of occult cancer in patients with ischemic stroke.

Methods: This retrospective study enrolled consecutive adult patients with acute ischemic stroke who were admitted to our department between December 2017 and January 2019. The demographic, clinical, laboratory, and neuroimaging characteristics were compared between patients with ischemic stroke with active cancer and those without cancer. Read More

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Importance of KIM-1 and MCP-1 in Determining the Leptospirosis-Associated AKI: A Sri Lankan Study.

Biomed Res Int 2021 2;2021:1752904. Epub 2021 Jun 2.

Department of Microbiology, Faculty of Medical Sciences, University of Sri Jayewardenepura, Sri Lanka.

Background: Acute kidney injury (AKI) is one of most prevalent and serious complications of leptospirosis, a prevalent zoonotic disease in tropical countries. Prompt diagnosis of the leptospirosis-associated AKI is a challenge as there are no proper diagnostic tools that can identify patients in the early stage. Kidney injury molecule-1 (KIM-1) and monocyte chemoattractant protein-1 (MCP-1) are widely used novel AKI biomarkers that are studied in various disease conditions with AKI, but not in leptospirosis. Read More

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Decreased Low-Density Lipoprotein Cholesterol Level Indicates Poor Prognosis of Severe and Critical COVID-19 Patients: A Retrospective, Single-Center Study.

Front Med (Lausanne) 2021 26;8:585851. Epub 2021 May 26.

Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China.

Coronavirus disease 2019 (COVID-19) has become a global public health crisis. Reduced low-density lipoprotein cholesterol (LDL-C) levels were observed in COVID-19 patients. The present study aimed to explore the relationship between LDL-C levels and the prognosis of severe and critical COVID-19 patients. Read More

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Pantoprazole: An Unusual Suspect in a Patient with Fever.

Eur J Case Rep Intern Med 2021 28;8(5):002571. Epub 2021 May 28.

Internal Medicine Department, Centro Hospitalar e Universitário de São João, Porto, Portugal.

Drugs can cause fever of unknown origin. Drug fever is a diagnosis of exclusion and can lead to unnecessary investigations and prolonged hospitalization. Any drug can be responsible. Read More

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