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The Characteristics of Women with Subsequent Distal Radius Fracture after Initial Distal Radius Fracture.

J Bone Metab 2021 May 31;28(2):123-129. Epub 2021 May 31.

Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Background: The purpose of this study was to investigate the characteristics of women with subsequent distal radius fracture (DRF) and to compare bone fragility variables in women with initial and subsequent DRF.

Methods: We enrolled 227 women who experienced DRF (203 women with initial DRF and 24 women with subsequent DRF) between September 2016 and April 2019. We compared demographic characteristics and bone fragility variables, including bone mineral density, trabecular bone score, hip geometry, bicortical thickness of the distal radius, and fracture risk assessment tool (FRAX) scores between the 2 groups. Read More

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Type 2A and 2M von Willebrand Disease: Differences in Phenotypic Parameters According to the Affected Domain by Disease-Causing Variants and Assessment of Pathophysiological Mechanisms.

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

Laboratorio de Hemostasia y Trombosis, IMEX-CONICET-Academia Nacional de Medicina de Buenos Aires. CABA, Argentina.

Type 2A and 2M von Willebrand disease (VWD) broadly show similar phenotypic parameters, but involve different pathophysiological mechanisms. This report presents the clinical and laboratory profiles of type 2A and type 2M patients genotypically diagnosed at one large center. Higher bleeding score values and a higher incidence of major bleeding episodes were observed in type 2A compared with type 2M, potentially reflective of the absence of large and intermediate von Willebrand factor (VWF) multimers in 2A. Read More

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Abdominal Panniculectomy Can Simplify Kidney Transplantation in Obese Patients.

Urol Int 2021 Jun 15:1-8. Epub 2021 Jun 15.

Department of Plastic and Hand Surgery and Laboratory for Tissue Engineering and Regenerative Medicine, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany.

Background: Obesity is frequently present in patients suffering from end-stage renal disease (ESRD). However, overweight kidney transplant candidates are a challenge for the transplant surgeon. Obese patients tend to develop a large abdominal panniculus after weight loss creating an area predisposed to wound-healing disorders. Read More

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Development of a Management Algorithm for Acute and Chronic Radiation Urethritis and Cystitis.

Urol Int 2021 Jun 15:1-12. Epub 2021 Jun 15.

Department of Urology, St. Antonius Hospital, Gronau, Germany.

Objective: The purpose of this review was to summarize the current literature on the assessment and treatment of radiation urethritis and cystitis (RUC) for the development of an evidenced-based management algorithm.

Material And Methods: The PubMed/MEDLINE database was searched by a multidisciplinary group of experts in January 2021.

Results: In total, 48 publications were identified. Read More

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Overhydration May Be the Missing Link between Peritoneal Protein Clearance and Mortality.

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

Division of Nephrology, Department of Medicine, Amsterdam University Medical Centre, Amsterdam, The Netherlands.

Introduction: Peritoneal protein loss (PPL) has been associated with mortality. Inflammation was assumed a putative cause with malnutrition as a consequence. Hydrostatic convection is a major drive for microvascular protein transport, but most studies in peritoneal dialysis (PD) patients overlooked this mechanism. Read More

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Validation of the German Day-to-Day Impact of Vaginal Aging (DIVA) Questionnaire in Peri- and Postmenopausal Women.

Sex Med 2021 Jun 12;9(4):100382. Epub 2021 Jun 12.

Institute of Social Medicine and Health Systems Research, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany.

Background: The Day-to-Day Impact of Vaginal Aging (DIVA) questionnaire is a validated patient-reported outcome measure (PROM) capturing the impacts of vaginal symptoms in postmenopausal women.

Aim: We aimed to psychometrically validate the German version of the DIVA questionnaire.

Methods: Data was collected online and by paper-pencil. 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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Early detection of cognitive decline in mild cognitive impairment and Alzheimer's disease with a novel eye tracking test.

J Neurol Sci 2021 Jun 3;427:117529. Epub 2021 Jun 3.

Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan. Electronic address:

Due to an increasing number of dementia patients, the development of a rapid and sensitive method for cognitive assessment is awaited. Here, we examined the usefulness of a novel and short (3 min) eye tracking device to evaluate the cognitive function of normal control (NC, n = 52), mild cognitive impairment (MCI, n = 52), and Alzheimer's disease (AD, n = 70) subjects. Eye tracking total score declined significantly in MCI (**p < 0. Read More

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Autonomy and consent assessment for electroconvulsive therapy (ECT). A retrospective study of medical records.

Int J Law Psychiatry 2021 Jun 11;77:101716. Epub 2021 Jun 11.

University of Oslo, Faculty of Medicine, Centre for Medical Ethics, Oslo, Norway. Electronic address:

The Norwegian Mental Health Act allows involuntary treatment for patients who lack consent capacity, however it allows only administration of pharmaceutical treatment and nutrition and not ECT. In lack of specific regulations, the legal access to ECT without valid consent has been grounded on the general rule of necessity in the Norwegian Penal code. This restriction and lack of legal regulation has implications for patients' rights and legal security. Read More

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Dynamic stability during stair negotiation after total knee arthroplasty.

Clin Biomech (Bristol, Avon) 2021 Jun 10;87:105410. Epub 2021 Jun 10.

Department of Biomedical Engineering, University of Strathclyde, Glasgow, Scotland, UK.

Background: The assessment of dynamic stability is crucial for the prevention of falls in the elderly and people with functional impairments. Evidence that total knee arthroplasty improves balance in patients with severe osteoarthritis is scarce and no information exists about how the surgery affects dynamic stability during stair negotiation.

Methods: This study aims to investigate if patients before and one year after surgery are less stable compared to asymptomatic controls. 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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The usefulness of ultrasound before induction of labor.

Am J Obstet Gynecol MFM 2021 Jun 12:100423. Epub 2021 Jun 12.

Obstetric Unit, Department of Medical and Surgical Sciences, University of Bologna and IRCCS Azienda Ospedaliero-Universitaria S.Orsola-Malpighi, Bologna, Italy.

The indications for induction of labor have been consistently on the rise. These indications are mainly medical (maternal or fetal), social or indications that are related to convenience or maternal preferences. With the increase in prevalence of these indications, the incidence rates of induction of labor are expected to continue to rise. Read More

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Clinical Utility of Overlap Time for Incomplete Relaxation to Predict Cardiac Events in Heart Failure: Incomplete relaxation in heart failure.

J Card Fail 2021 Jun 12. Epub 2021 Jun 12.

Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, 2-50-1 Kuramoto, Tokushima, Japan.

Background: The overlap time of transmitral flow can be a novel marker of subclinical left ventricular (LV) dysfunction for predicting adverse events in heart failure (HF). We aimed to 1) investigate the role of overlap time of E-A wave in association with clinical parameters, and 2) evaluate whether the overlap time could add prognostic information with respect to other conventional clinical prognosticators in HF.

Methods: We prospectively evaluated 153 patients hospitalized with HF (mean age 68±15 years; 63% male). Read More

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The role of sexual dimorphism in susceptibility to SARS-CoV-2 infection, disease severity, and mortality: facts, controversies and future perspectives.

Microbes Infect 2021 Jun 12:104850. Epub 2021 Jun 12.

Division of Endocrinology and Metabolism and Diabetes Center, First Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA University Hospital, Thessaloniki, Greece. Electronic address:

Former studies have revealed intersex variability in immune response to infectious diseases, including Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Epidemiological surveillance of the ongoing pandemic has demonstrated a male vulnerability to morbidity and mortality, despite similar infection rates between the two sexes. Divergence in the frequency of comorbidities between males and females, differences in hormonal profile, chromosomal composition and gender behavior have all been proposed as potential causative factors. Read More

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Intra operative assessment of the coronal balance in spinal deformity surgery : a technical note and retrospective study.

Acta Orthop Belg 2021 Mar;87(1):175-179

Obtaining a spine that is well balanced after fusion for scoliotic deformity is primordial for the patients' quality of life. A simple T-shaped instrument combined with standard intraoperative fluoroscopy can be of great help to evaluate the coronal alignment quickly. The aim of this study was to evaluate if a T-shaped device could predict the postoperative coronal balance. Read More

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Inter and intra-observer errors for postoperative total hip radiographic assessment using computer aided design.

Acta Orthop Belg 2021 Mar;87(1):65-71

Plain radiographic assessment of primary total hip arthroplasty following surgery remains to be the commonest radiological assessment. The current paper, studies the accuracy and concordance between observers reviewing these radiographs. A prospective radiographic and medical note review of ten patients who underwent total hip replacement for primary osteoarthritis, with a mean age of 69 years. Read More

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Effect of orofacial physiotherapeutic and hygiene interventions on oral health related quality of life in patients with Parkinson's disease. A randomised controlled trial.

J Oral Rehabil 2021 Jun 15. Epub 2021 Jun 15.

Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.

Background: Parkinson's disease (PD) has a negative effect on oral health and orofacial function, but the subjective experience of orofacial symptoms and their impact on the quality of life is not fully investigated. In addition, knowledge of how to improve the subjective oral symptoms is lacking.

Objectives: To assess the self-reported orofacial function and oral health in patients with PD. Read More

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Assessment of clinical efficacy of lidocaine/tetracaine 7%/7% peel cream in fractional micro-ablative laser procedure-associated pain for facial skin ageing treatment. A randomized, controlled, single-blind trial.

J Cosmet Dermatol 2021 Jun 15. Epub 2021 Jun 15.

R&D Cantabria Labs Difa Cooper.

Background: Lidocaine/tetracaine 7%/7% peel cream (L/T-pC) is very effective in reducing pain in several dermatological procedures, such as hair or tattoo laser removal or conventional photodynamic therapy associated pain. Fractional laser resurfacing (FLR) is an effective treatment strategy for facial skin ageing. The main drawback of FLR is the procedure-associated pain. Read More

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Association Between Primary Headache and Bruxism: An Updated Systematic Review.

J Oral Facial Pain Headache 2021 Spring;35(2):129-138

Aims: To answer the question: among observational studies, is there any association between primary headaches and bruxism in adults?

Materials And Methods: A systematic review of observational studies was performed. The search was performed in seven main databases and three gray literature databases. Studies in which samples were composed of adult patients were included. Read More

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Value of spectral detector computed tomography for the early assessment of technique efficacy after microwave ablation of hepatocellular carcinoma.

PLoS One 2021 15;16(6):e0252678. Epub 2021 Jun 15.

Faculty of Medicine and University Hospital Cologne, Department of Diagnostic and Interventional Radiology, University of Cologne, Cologne, Germany.

Objectives: To investigate whether virtual monoenergetic images (VMI) and iodine maps derived from spectral detector computed tomography (SDCT) improve early assessment of technique efficacy in patients who underwent microwave ablation (MWA) for hepatocellular carcinoma (HCC) in liver cirrhosis.

Methods: This retrospective study comprised 39 patients with 49 HCC lesions treated with MWA. Biphasic SDCT was performed 7. Read More

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Symptom trajectories of non-cancer patients in the last six months of life: Identifying needs in a population-based home care cohort.

PLoS One 2021 15;16(6):e0252814. Epub 2021 Jun 15.

Department of Family Medicine, Division of Palliative Care, McMaster University, Hamilton, Ontario, Canada.

Introduction: The end-of-life symptom prevalence of non-cancer patients have been described mostly in hospital and institutional settings. This study aims to describe the average symptom trajectories among non-cancer patients who are community-dwelling and used home care services at the end of life.

Materials And Methods: This is a retrospective, population-based cohort study of non-cancer patients who used home care services in the last 6 months of life in Ontario, Canada, between 2007 and 2014. Read More

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Factors driving choices between types and brands of influenza vaccines in general practice in Austria, Italy, Spain and the UK.

PLoS One 2021 15;16(6):e0252836. Epub 2021 Jun 15.

Centre for Health Economics Research & Modelling Infectious Diseases, Vaccine & Infectious Disease Institute, University of Antwerp, Antwerp, Belgium.

Influenza vaccine effectiveness (IVE) assessment is increasingly stratified by vaccine type or brand, such as done by the European network of DRIVE. In 2019/2020, eleven influenza vaccines were licensed in Europe. If more than one vaccine type is recommended or if more than one vaccine brand is available for a specific risk group, it is not clear which factors affect the choice of a specific vaccine (type or brand) by a health practitioner for individual patients. Read More

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Disability, pain, and wound-specific concerns self-reported by adults at risk of limb loss: A cross-sectional study using the World Health Organization Disability Assessment Schedule 2.0.

PLoS One 2021 15;16(6):e0253288. Epub 2021 Jun 15.

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

Introduction: There has been limited study of patient-reported outcomes (PROs) in patients at risk of limb loss. Our primary objective was to estimate the prevalence of disability in this patient population using the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2. Read More

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Toe-brachial index is beyond a peripheral issue in patients with type 2 diabetes.

PLoS One 2021 15;16(6):e0253138. Epub 2021 Jun 15.

Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences (IUMS), Tehran, Iran.

Background: Atherosclerosis is the leading cause of death in patients with diabetes. We aimed to evaluate the association between ankle-brachial index (ABI) and toe-brachial index (TBI) with carotid intima-media thickness (CIMT) in patients with type 2 diabetes (T2DM).

Methods: This cross sectional study included 296 patients with T2DM who met the American Diabetes Association criteria for the assessment of peripheral arterial atherosclerosis. Read More

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Quantification of Motor Function Post-stroke using Novel Combination of Wearable Inertial and Mechanomyographic Sensors.

IEEE Trans Neural Syst Rehabil Eng 2021 Jun 15;PP. Epub 2021 Jun 15.

Subjective clinical rating scales represent the gold-standard diagnosis of motor function following stroke, however in practice they suffer from well-recognized limitations including assessor variance, low inter-rater reliability and low resolution. Automated systems have been proposed for empirical quantification but have not significantly impacted clinical practice. We address translational challenges in this arena through: (1) implementation of a novel sensor suite combining inertial measurement and mechanomyography (MMG) to quantify hand and wrist motor function; and (2) introduction of a new range of signal features extracted from the suite to supplement predicted clinical scores. Read More

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Time-Driven Activity-Based Costing for Cataract Surgery in Canada: The Case of the Kensington Eye Institute.

Healthc Policy 2021 May;16(4):97-108

Director, Health System Strategy, Medtronic ULC, Brampton, ON.

Time-driven activity-based costing (TDABC) has received considerable attention globally as a way to measure value in healthcare systems. This study aimed to apply TDABC for cataract surgery at the Kensington Eye Institute (KEI). During a field evaluation, a detailed process map was created for cataract surgery at KEI. Read More

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The recurrent urinary tract infection health and functional impact questionnaire (RUHFI-Q): design and feasibility assessment of a new evaluation scale.

Can J Urol 2021 Jun;28(3):10729-10732

Department of Urology, University Hospital Limerick, Dooradoyle, Co. Limerick, Ireland.

Introduction: We aim to design a tool to assess the impact of recurrent urinary tract infection (rUTI) on quality of life (QoL) in adult women, given the notable absence of an established instrument for this purpose.

Materials And Methods: Best practice guidelines in health-related survey design were reviewed. A literature review informed creation of an interview guide. Read More

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Cardiac Amyloidosis: Multimodal Imaging of Disease Activity and Response to Treatment.

Circ Cardiovasc Imaging 2021 Jun 15;14(6):e009025. Epub 2021 Jun 15.

Section of Cardiovascular Medicine, Department of Medicine, Amyloidosis Center, Department of Radiology, Boston University School of Medicine, Boston Medical Center, MA (F.L.R.).

Cardiac amyloidosis (CA) is a disease characterized by the deposition of misfolded protein deposits in the myocardial interstitium. Although advanced CA confers significant morbidity and mortality, the magnitude of deposition and ensuing clinical manifestations vary greatly. Thus, an improved understanding of disease pathogenesis at both cellular and functional levels would afford critical insights that may improve outcomes. 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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Kidney outcomes using a sustained ≥40% decline in eGFR: A meta-analysis of SGLT2 inhibitor trials.

Clin Cardiol 2021 Jun 15. Epub 2021 Jun 15.

Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.

Background: A recent meta-analysis of sodium-glucose cotransporter 2 (SGLT2) inhibitor outcome trials reported that SGLT2 inhibitors were associated with reduction in the risk of adverse composite kidney outcomes, with moderate heterogeneity across the trials; however, the endpoints were defined differently across the trials.

Hypothesis: The apparent heterogeneity of the meta-analysis of kidney composite outcomes of SGLT2 inhibitor trials will be substantially reduced by using a consistent assessment of sustained ≥40% decline in eGFR/chronic kidney dialysis/transplantation/renal death across trials.

Methods: We performed a meta-analysis of kidney composite outcomes from the four SGLT2 cardiovascular outcome trial programs conducted in general type 2 diabetes mellitus populations, which included, as a surrogate of progression to kidney failure, a sustained ≥40% decline in eGFR along with kidney replacement therapy and kidney death. Read More

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