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Early everolimus-facilitated reduced tacrolimus in liver transplantation: Results from the randomized HEPHAISTOS trial.

Liver Transpl 2021 Sep 15. Epub 2021 Sep 15.

Novartis Pharma GmbH, Nürnberg, Germany.

Background: Everolimus-facilitated reduced tacrolimus exposure (EVR+rTAC) at 30 days post-liver transplantation (LT) has shown advantages in renal preservation. This study evaluated the effects of early initiation of EVR+rTAC in de novo liver transplant recipients (LTR).

Methods: In HEPHAISTOS (NCT01551212, EudraCT 2011-003118-17), a 12-month (M), multicenter, controlled study, LTR were randomized at 7-21 days post-LT to receive EVR+rTAC or standard tacrolimus (sTAC), with steroids. Read More

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September 2021

Caudad Insertion of Pedicle Screws Facilitates Interbody Distraction During Spondylolisthetic Vertebrae Restoration: A Retrospective Study.

Pain Ther 2021 Sep 15. Epub 2021 Sep 15.

Department of Spine Surgery, Tongji Hospital, Tongji University School of Medicine, Shanghai, 200065, China.

Introduction: Based on the results of long-term clinical and radiological follow-up studies of decompression and fusion with internal fixation for degenerative lumbar spondylolisthesis (DLS), we recognized that the direction of the pedicle screw affects the stability of the fixation. However, few studies have analyzed the role of pedicle screw insertion trajectory in disc height recovery after fusion. We therefore analyzed patients' general information, clinical efficacy and sagittal, coronal and implant parameters to determine whether there is a correlation between the insertion trajectory of screws and the recovery of intervertebral space height, with the ultimate aim to provide a basis for improving the clinical efficacy and radiological outcomes of patients with DLS and to identify an optimal technique for spine surgeons that would benefit patients with spondylolisthesis. Read More

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September 2021

The use of patient-reported outcomes in routine cancer care: preliminary insights from a multinational scoping survey of oncology practitioners.

Support Care Cancer 2021 Sep 15. Epub 2021 Sep 15.

Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Bedford Park, South Australia, 5042, Australia.

Background: There exists scant evidence on the optimal approaches to integrating patient-reported outcomes (PROs) in clinical practice. This study gathered oncology practitioners' experiences with implementing PROs in cancer care.

Methods: Between December 2019 and June 2020, we surveyed practitioners who reported spending > 5% of their time providing clinical care to cancer patients. Read More

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September 2021

T1 relaxation times and MR elastography-derived stiffness: new potential imaging biomarkers for the assessment of chronic pancreatitis.

Abdom Radiol (NY) 2021 Sep 15. Epub 2021 Sep 15.

Mech-Sense, Department of Radiology, Aalborg University Hospital, Hobrovej 18-22, PO. Box 365, 9000, Aalborg, Denmark.

Purpose: Non-invasive imaging methods to detect morphological changes of the pancreas in patients with mild chronic pancreatitis (CP) are needed. This study aimed to compare magnetic resonance imaging-based parameters, pancreatic volume, T1 mapping, magnetic resonance elastography (MRE), and proton density fat fraction between CP patients and controls, and determine the diagnostic performance for diagnosing different stages of CP.

Methods: Nineteen patients with mild CP (Cambridge grade 2 or less or recurring acute pancreatitis; n = 19), 30 with moderate/severe CP (Cambridge grade 3 and 4), and 35 healthy controls underwent pancreatic magnetic resonance imaging to assess the above mentioned magnetic resonance imaging-based parameters. Read More

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September 2021

Vestibular mapping assessment in idiopathic sudden sensorineural hearing loss.

Ear Hear 2021 Sep 14. Epub 2021 Sep 14.

Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Hanyang University, Seoul, Republic of Korea.

Objective: The aim of this study was to investigate patterns of semicircular canal (SCC) and otolith organ dysfunction by vestibular mapping, and to determine the clinical implications of treatment outcomes in idiopathic sudden sensorineural hearing loss (ISSNHL).

Methods: We retrospectively reviewed 135 consecutive patients diagnosed with ISSNHL from January 2016 to December 2020. Patients underwent video-head impulse tests (vHIT) for each SCC, cervical vestibular-evoked myogenic potential test for the saccules, ocular vestibular-evoked myogenic potential test for the utricles, and hearing tests. Read More

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September 2021

Utility and Outcomes of Pre-Operative Screening Breast MRI for Planned Bilateral Prophylactic Mastectomy in High-Risk Patients.

AJR Am J Roentgenol 2021 Sep 15. Epub 2021 Sep 15.

Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA.

There is a paucity of data and consensus guidelines on the utility of preoperative MRI for planned bilateral prophylactic mastectomy. To evaluate the utility of breast MRI performed in high-risk patients for the indication of planned bilateral prophylactic mastectomy, with attention to diagnostic performance for breast cancer detection. A secondary aim was to assess the potential impact of breast MRI findings on the decision to perform sentinel lymph node biopsy at the time of prophylactic mastectomy. Read More

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September 2021

Prediction of Early Treatment Response in Multiple Myeloma Using MY-RADS Total Burden Score, ADC, and Fat Fraction From Whole-Body MRI: Impact of Anemia on Predictive Performance.

AJR Am J Roentgenol 2021 Sep 15. Epub 2021 Sep 15.

Department of lymphoma, Chinese Academy of Medical Sciences Institute of Hematology and Blood Diseases Hospital, Tianjin, Tianjin, CN 300020.

The recently released Myeloma Response Assessment and Diagnosis System (MY-RADS) for multiple myeloma (MM) evaluation by whole-body MRI (WB-MRI) describes the total burden score. However, assessment is confounded by red bone marrow hyperplasia in anemia. To assess utility of the MY-RADS total burden score, ADC, and fat fraction (FF) from WB-MRI in predicting early treatment response in patients with newly diagnosed MM and to compare these measures' utility between patients with and without anemia. Read More

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September 2021

Provisional posttraumatic stress disorder is associated with greater severity of eating disorder and comorbid symptoms in adolescents treated in residential care.

Eur Eat Disord Rev 2021 Sep 14. Epub 2021 Sep 14.

Monte Nido and Affiliates, Miami, Florida, USA.

Objective: Past traumatic events, subsequent posttraumatic stress disorder (PTSD) and related psychiatric comorbidities are commonly associated with eating disorders (EDs) in adults but remain understudied in adolescents.

Methods: Adolescent participants (mean [SD] age = 15.1 ± 1. Read More

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September 2021

Good subjective outcome and low risk of revision surgery with a novel customized metal implant for focal femoral chondral lesions at a follow-up after a minimum of 5 years.

Arch Orthop Trauma Surg 2021 Sep 14. Epub 2021 Sep 14.

MMK, Stockholm Sports Trauma Research Center, Karolinska Institutet, Solna, Sweden.

Background And Purpose: Patients with focal cartilage lesions experience functional impairment. Results for biological treatments in the middle-aged patient is poor. Previous studies with focal prosthetic inlay resurfacing have shown a higher risk of conversion to total knee replacement at mid-term follow-up. Read More

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September 2021

Assessment of Functional Pain Score by Comparing to Traditional Pain Scores.

Cureus 2021 Aug 3;13(8):e16847. Epub 2021 Aug 3.

Anesthesiology/Pain Management, Guthrie Clinic and Robert Packer Hospital, Sayre, USA.

Background: Pain assessments, such as the Numerical Pain Scale (NPS) and Wong-Baker FACEs (FACEs), offer methods to quantify pain with simplistic descriptions on a scale of 0-10 or facial expressions. These tools have limitations and deliver insufficient information to the provider developing a pain management plan. A new Functional Pain Scale (FPS) assesses other scopes of pain, including the loss of function in activities of daily living, sleep habits, and communication. Read More

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Efficacy of Thiamine and Medical Management in Treating Hyperuricemia in AUD Patients with ALD: Role of Hyperuricemia in Liver Injury, Gut-Barrier Dysfunction, and Inflammation.

Clin Exp Pharmacol 2021 28;11(Suppl 7). Epub 2021 Jul 28.

Department of Medicine, University of Louisville, Louisville, Kentucky.

Background: Hyperuricemia has been reported in liver injury; however its role in the early stage of Alcohol-associated Liver Disease (ALD) has not been examined yet. This study investigated the role of Serum Uric Acid (SUA) in alcohol-related liver disease, gut barrier dysfunction, and inflammation activity. This study also evaluated the efficacy of abstinence, treatment with thiamine and medical management to alleviate hyperuricemia. Read More

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Comparison of short- and long-axis nerve hydrodissection for carpal tunnel syndrome: A prospective randomized, single-blind trial.

Int J Med Sci 2021 13;18(15):3488-3497. Epub 2021 Aug 13.

Department of Physical Medicine and Rehabilitation, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, No. 325, Sec. 2, Cheng-Kung Road, Neihu District, Taipei, Taiwan, Republic of China.

This study is to compare the efficacy of short-axis hydrodissection with long-axis hydrodissection for patients with mild-to-moderate carpal tunnel syndrome (CTS). Forty-seven patients with mild-to-moderate CTS were enrolled in a prospective, randomized, single-blinded, controlled trial (6 months follow-up). With ultrasound guidance, patients in both groups (short-axis or long-axis groups) were injected with normal saline (5 mL per session). Read More

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Automated Reporting of Patient Outcomes in Hand Surgery: A Pilot Study.

Hand (N Y) 2021 Sep 14:15589447211043214. Epub 2021 Sep 14.

University of Cincinnati, OH, USA.

Background: Obtaining patient-reported outcomes (PROs) is becoming a standard component of patient care. For nonacademic practices, this can be challenging. From this perspective, we designed a nearly autonomous patient outcomes reporting system. Read More

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September 2021

Methodological Considerations in the Assessment of Effectiveness of Homeopathic Care: A Critical Review of the EPI3 Study.

Yola Moride

Homeopathy 2021 Sep 14. Epub 2021 Sep 14.

Faculty of Pharmacy, Université de Montréal, Montreal, Quebec, Canada.

Background:   EPI3 is an observational study of a representative sample of general practitioners (GPs) and patients in France, demonstrating that patient characteristics differ according to the prescribing preferences of their GPs for homeopathy. For selected conditions (musculoskeletal disorders, sleep disorders, anxiety/depression, upper respiratory tract infections), progression of symptoms and adverse events over follow-up in the homeopathy preference group did not significantly differ from other practice preferences, but there was a two-fold to four-fold lower usage of conventional medicines. The EPI3 study's validity was challenged due to absence of head-to-head comparison of medicines to conclude on a causal association between homeopathy and outcomes. Read More

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September 2021

Midbrain area and the hummingbird sign from brain MRI in progressive supranuclear palsy and idiopathic normal pressure hydrocephalus.

J Neuroimaging 2021 Sep 14. Epub 2021 Sep 14.

Department of Surgical Sciences, Radiology, Uppsala University, Uppsala, Sweden.

Background And Purpose: The main radiological finding in progressive supranuclear palsy (PSP) is reduced midbrain volume. Both qualitative (e.g. Read More

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September 2021

Adjuvant Priming Repetitive Transcranial Magnetic Stimulation for Treatment-Resistant Obsessive-Compulsive Disorder: In Search of a New Paradigm!

J ECT 2021 Sep 13. Epub 2021 Sep 13.

From the Geriatric Mental Health, King George Medical University, Lucknow, Uttar Pradesh Asha Hospital, Banjara Hills, Hyderabad, Telangana Central Institute of Psychiatry, Kanke, Ranchi, Jharkhand, India.

Objectives: Repetitive transcranial magnetic stimulation (rTMS) is used as a therapeutic option for obsessive-compulsive disorder (OCD) in both clinical and research settings. There has been no consensus with regard to target area and other parameters, although 1-Hz rTMS over the supplementary motor area (SMA) is found to be promising. Priming stimulation, which involves high-frequency followed by low-frequency rTMS, has been shown to enhance neural response to low-frequency rTMS. Read More

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September 2021

Stereotactic-EEG-guided radiofrequency multiple hippocampal transection (SEEG-guided-RF-MHT) for the treatment of mesial temporal lobe epilepsy: a minimally invasive method for diagnosis and treatment.

Epileptic Disord 2021 Sep 14. Epub 2021 Sep 14.

Department of Neurology, University Hospitals Cleveland Medical Center, Cleveland, Ohio, Case Western Reserve University, School of Medicine, Cleveland, Ohio.

For the treatment of mesial temporal lobe epilepsy on the language-dominant side in patients at high risk of memory decline, we propose a minimally invasive diagnostic and treatment technique, adopting the principles of multiple hippocampal transections (MHT) using stereo-electroencephalography-guided radiofrequency (SEEG-guided-RF-MHT). This new technique allows targeting of the longitudinal fibers in the hippocampus critical for seizure spreading, while sparing the transverse circuits which are considered important for memory processing and avoiding discomfort and longer post-operatory recovery time associated with craniotomies. We report the efficacy and safety of this procedure in a preliminary observational study of cases. Read More

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September 2021

The Effect of Clozapine on Self-reported Duration of Sleep and Its Interaction With 23 Other Medications: A 5-Year Naturalistic Study.

J Clin Psychopharmacol 2021 Sep-Oct 01;41(5):534-539

From the Cambridgeshire and Peterborough NHS Foundation Trust.

Background: Sedation is a common and incapacitating clozapine adverse effect, but the factors associated with sedation and its pharmacological management remain poorly studied.

Methods: We conducted a retrospective cohort study based on deidentified electronic clinical records of clozapine-treated patients from the secondary mental health care provider for Cambridgeshire and Peterborough, United Kingdom. We first evaluated cross-sectionally the influence of clozapine dose, clozapine, and norclozapine plasma levels on self-reported hours slept, as a proxy for sedation, using bivariate correlation and then the longitudinal effect of changes in clozapine dose and other 23 medications using linear mixed effect models. Read More

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September 2021

Evaluation of lung tumor motion in a large sample: Target-related and clinical factors influencing tumor motion based on four-dimensional CT.

Cancer Med 2021 Sep 14. Epub 2021 Sep 14.

Cheeloo College of Medicine, Shandong University, Jinan, China.

Background And Purpose: We aimed to analyze the influence of target-related and clinical factors on lung tumor motion based on four-dimensional CT (4DCT), and clarify the motion based on subgroups in lung stereotactic body radiation therapy.

Materials And Methods: 4DCT image data of 267 tumors from 246 patients were analyzed. The coordinates in the left-right (LR), anterior-posterior (AP), and cranial-caudal (CC) directions of the center of mass (COM) of the gross tumor volumes in 10 phases of 4DCT were measured. Read More

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September 2021

Assessment of hepatic involvement by two-dimensional shear wave elastography in paediatric patients with cystic fibrosis.

J Paediatr Child Health 2021 Sep 14. Epub 2021 Sep 14.

Department of Pediatric Gastroenterology, Cukurova University Medical Faculty, Adana, Turkey.

Aim: This study aimed to investigate parenchymal changes in the liver in paediatric patients with cystic fibrosis (CF) and to analyse diagnostic performance of two-dimensional shear wave elastography (2D-SWE) for the detection of hepatic involvement.

Methods: Patients with CF treated and followed at our centre were evaluated prospectively. All patients underwent liver tissue stiffness (TS) measurements by 2D-SWE, in addition to routine clinical assessments, laboratory work-up and abdominal ultrasound imaging. Read More

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September 2021

Rate-dependent depression is impaired in amyotrophic lateral sclerosis.

Neurol Sci 2021 Sep 13. Epub 2021 Sep 13.

Department of Neurology, Renji Hospital, Shanghai Jiaotong University School of Medicine, 160 Pujian Road, Pudong, Shanghai, 200127, China.

Objective: We investigated rate-dependent depression (RDD) of the Hoffman reflex (H-reflex) in patients with amyotrophic lateral sclerosis (ALS), a degenerative disease with ventral horn involvement.

Patients And Methods: In this case-control study, we enrolled 27 patients with ALS and 30 matched healthy control subjects. Clinical and electrophysiological assessments, as well as RDD in response to various stimulation frequencies (0. Read More

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September 2021

Impact analysis of virtual ambulatory transplant pharmacists during COVID-19.

J Am Coll Clin Pharm 2021 Aug 4;4(8):978-987. Epub 2021 Jul 4.

Department of Pharmacy, Massachusetts General Hospital Boston Massachusetts USA.

Introduction: During the coronavirus disease 2019 (COVID-19) pandemic, transplant centers were challenged to meet the demand for new telemedicine strategies. The ability of lung transplant providers (LTP) to conduct face-to-face clinic visits for high-risk immunocompromised patients, such as lung transplant recipients (LTR), was limited. Through the implementation of comprehensive medication management visits, pharmacists were able to assist LTP in the transition to telemedicine. Read More

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Clinical prediction models for hospital falls: a scoping review protocol.

BMJ Open 2021 Sep 13;11(9):e051047. Epub 2021 Sep 13.

Australian Centre for Health Services Innovation and Centre for Healthcare Translation, School of Public Health and Social Work, Queensland University of Technology, Kelvin Grove, Queensland, Australia.

Introduction: Falls remain one of the most prevalent adverse events in hospitals and are associated with substantial negative health impacts and costs. Approaches to assess patients' fall risk have been implemented in hospitals internationally, ranging from brief screening questions to multifactorial risk assessments and complex prediction models, despite a lack of clear evidence of effect in reducing falls in acute hospital environments. The increasing digitisation of hospital systems provides new opportunities to understand and predict falls using routinely recorded data, with potential to integrate fall prediction models into real-time or near-real-time computerised decision support for clinical teams seeking to mitigate fall risk. Read More

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September 2021

Connected device and therapeutic patient education to promote physical activity among women with localised breast cancer (DISCO trial): protocol for a multicentre 2×2 factorial randomised controlled trial.

BMJ Open 2021 Sep 13;11(9):e045448. Epub 2021 Sep 13.

Department of Prevention Cancer Environment, Centre Léon Bérard, Lyon, France

Introduction: Despite safety and benefits of physical activity during treatment of localised breast cancer, successful exercise strategies remain to be determined. The primary objective of the 'dispositif connecté', that is, connected device in English trial is to evaluate the efficacy of two 6-month exercise interventions, either single or combined, concomitant to adjuvant treatments, on the physical activity level of patients with breast cancer, compared with usual care: an exercise programme using a connected device (activity tracker, smartphone application, website) and a therapeutic patient education intervention. Secondary objectives are to evaluate adherence to interventions, their impact at 6 and 12 months, representations and acceptability of interventions, and to assess the cost-effectiveness of the interventions using quality-adjusted life-years. Read More

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September 2021

A prospective longitudinal study of chronic abdominal pain and symptoms after sleeve gastrectomy.

Surg Obes Relat Dis 2021 Jul 28. Epub 2021 Jul 28.

Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Hepatic, Gastrointestinal and Pediatric Surgery, Oslo University Hospital, Oslo, Norway.

Background: Sleeve gastrectomy (SG) is widely applied. Few studies have evaluated patient-reported abdominal symptoms after SG.

Objective: To evaluate the prevalence of chronic abdominal pain (CAP) and symptom characteristics after SG. Read More

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Clinicopathologic features between different viral epidemic outbreaks involving the skin.

Clin Dermatol 2021 May-Jun;39(3):405-417. Epub 2021 Apr 25.

Dermatology Clinic, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy; Vita-SaluteS.Raffaele University, Milan, Italy.

The current coronavirus disease 2019 pandemic has exceeded any epidemiologic prevision, but increasing information suggests some analogies with the major viral outbreaks of the last century. A general warning has been issued on the possibility that coinfections can make differential diagnosis and treatment difficult, especially in tropical countries. Some reports have pointed out that the presence of high Dengue antibodies can give a false-negative result for severe acute respiratory syndrome coronavirus 2. Read More

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The novel effectiveness of Tai Chi on cardiopulmonary fitness among stroke patients in the recovery phase: a study protocol for a randomized controlled trial.

Trials 2021 Sep 13;22(1):614. Epub 2021 Sep 13.

Beijing University of Chinese Medicine, Beijing, China.

Background: Stroke is the leading cause of death worldwide. China faces a similar risk of stroke as developed countries because of considerable changes in lifestyle, such as overeating and smoking. Tai Chi is a traditional form of mind-body exercise that has been widely practiced in China for thousands of years. Read More

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September 2021

Early detection of hearing loss for infants in Western Australia: Comparison to international benchmarks.

J Paediatr Child Health 2021 Sep 13. Epub 2021 Sep 13.

Department of Audiology, Perth Children's Hospital, Perth, Western Australia, Australia.

Aim: To assess the degree to which timely audiological assessment of congenital hearing loss is achieved at our institution - Perth Children's Hospital, Western Australia, and to review cases which breached this timeframe in order to address barriers to timely assessment. The benchmark used to determine timely assessment is that set out by The Joint Committee on Infant Hearing (JCIH) in which diagnostic audiological testing occurs by three months of age for those who do not pass newborn hearing screening.

Methods: A retrospective chart review of infants who underwent diagnostic auditory assessment at Perth Children's Hospital between 2016-2019. Read More

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September 2021

Exploring Vestibular/Ocular and Cognitive Dysfunction as Prognostic Factors for Protracted Recovery in Sports-Related Concussion Patients Aged 8 to 12 Years.

Clin J Sport Med 2021 Sep 8. Epub 2021 Sep 8.

Children's Health Andrews Institute for Orthopaedics and Sports Medicine, Plano, Texas; Department of Psychiatry, University of Texas-Southwestern Medical Center, Dallas, Texas; Department of Epidemiology, Human Genetics, and Environmental Sciences, The University of Texas Health Science Center at Houston, Dallas, Texas; Center for Pediatric Population Health, Children's Health/The University of Texas Health Science Center at Houston, Dallas, Texas; and Akron Children's Hospital, Akron, Ohio.

Objective: To explore the prognostic ability of the vestibular/ocular motor screening (VOMS), King-Devick (K-D) Test, and C3 Logix Trails A and B to identify protracted recovery from sports-related concussion (SRC) in patients aged 8 to 12 years.

Design: Retrospective cohort analysis.

Setting: Specialty pediatric sports concussion clinic. Read More

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September 2021

Longitudinal 18F-MK-6240 tau tangles accumulation follows Braak stages.

Brain 2021 Sep 13. Epub 2021 Sep 13.

Translational Neuroimaging Laboratory, The McGill University Research Centre for Studies in Aging, Department of Neurology and Neurosurgery, Faculty of Medicine, McGill University, Montreal, QC, Canada.

Tracking longitudinal tau tangles accumulation across the Alzheimer's disease continuum is crucial to better understand the natural history of tau pathology and for clinical trials. Although the available first-generation tau PET tracers detect tau accumulation in symptomatic individuals, their nanomolar affinity offers limited sensitivity to detect early tau accumulation in asymptomatic subjects. Here, we hypothesized the novel sub-nanomolar affinity tau tangles tracer [18F]MK-6240 can detect longitudinal tau accumulation in asymptomatic and symptomatic subjects. Read More

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September 2021