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Implications of Electronic Consultations for Clinician Communication and Relationships: A Qualitative Study.

Med Care 2021 Jun 11. Epub 2021 Jun 11.

Center for Healthcare Organization and Implementation Research, VA Bedford Healthcare System, Bedford Department of Population and Quantitative Health Sciences, Division of Health Informatics and Implementation Science, University of Massachusetts Medical School, Worcester Section of Endocrinology, Diabetes, and Metabolism, Boston University School of Medicine Medical Service, VA Boston Healthcare System Evans Department of Medicine, Boston University School of Medicine Medical Service and Section of Infectious Diseases, VA Boston Healthcare System, Boston Harvard Medical School, Cambridge Department of Population and Quantitative Health Sciences, Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester Section of Pulmonary, Allergy, Sleep, and Critical Care Medicine, Boston University School of Medicine, Boston, MA.

Background: Strong relationships and effective communication between clinicians support care coordination and contribute to care quality. As a new mechanism of clinician communication, electronic consultations (e-consults) may have downstream effects on care provision and coordination.

Objective: The objective of this study was to understand primary care providers' and specialists' perspectives on how e-consults affect communication and relationships between clinicians. Read More

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The effectiveness of natalizumab vs fingolimod-A comparison of international registry studies.

Mult Scler Relat Disord 2021 May 8;53:103012. Epub 2021 May 8.

KTU Medical Faculty Farabi Hospital, Trabzon, Turkey.

Background: Natalizumab and fingolimod were the first preparations recommended for disease breakthrough in priorly treated relapsing-remitting multiple sclerosis. Of three published head-to-head studies two showed that natalizumab is the more effective to prevent relapses and EDSS worsening.

Methods: By re-analyzing original published results from MSBase, France, and Denmark using uniform methodologies, we aimed at identifying the effects of differences in methodology, in the MS-populations, and at re-evaluating the differences in effectiveness between the two drugs. Read More

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Gastroenterology 2021 Jun 8. Epub 2021 Jun 8.

Second Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan.

Background And Aims: Benefit of rapid on-site evaluation (ROSE) on diagnostic accuracy of endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) has never been evaluated in a randomized study. This trial aimed to test the hypothesis that in solid pancreatic lesions (SPLs), diagnostic accuracy of EUS-FNB without ROSE was not inferior to that of EUS-FNB with ROSE.

Methods: Non-inferiority study (non-inferiority margin 5%) conducted at 14 centers in eight countries. Read More

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Erbium, Chromium:Yttrium-Scandium-Gallium-Garnet Laser for Root Conditioning and Reduction of Postoperative Morbidity in the Treatment of Gingival Recession Defects: A Randomized Controlled Clinical Trial.

Photobiomodul Photomed Laser Surg 2021 Jun 11. Epub 2021 Jun 11.

Department of Periodontology, School of Dental Medicine, Stony Brook University, Stony Brook, New York, USA.

This clinical trial evaluates the effect of erbium, chromium:yttrium-scandium-gallium-garnet (Er,Cr:YSGG) root surface biomodification and laser harvesting of de-epithelialized gingival graft (DGG) on root coverage clinical outcomes and postoperative morbidity, and compares this to the conventional blade-harvested DGG method without Er,Cr:YSGG root surface biomodification in treatment of Miller's class I, II gingival recessions (GR). The application of laser technology to enhance tooth root coverage clinical outcomes as well as the impact of laser on postoperative morbidity after harvesting autogenous soft tissue grafts requires further research. This study is a randomized, single-blinded controlled trial, including 24 volunteers with isolated GR defects. Read More

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Preclinical Safety of a 3D-Printed Hydroxyapatite-Demineralized Bone Matrix Scaffold for Spinal Fusion.

Spine (Phila Pa 1976) 2021 Jun 10. Epub 2021 Jun 10.

Department of Orthopaedic Surgery, Northwestern University, Chicago, IL Center for Regenerative Nanomedicine, Simpson Querrey Institute, Chicago, IL Dimension Inx Corp, Chicago, IL Department of Radiology, Northwestern University, Chicago, IL.

Study Design: Prospective, randomized, controlled preclinical study.

Objective: The objective of this study was to compare the host inflammatory response of our previously described hyperelastic, 3D-printed (3DP) hydroxyapatite (HA)-demineralized bone matrix (DBM) composite scaffold to the response elicited with the use of recombinant human bone morphogenetic protein-2 (rhBMP-2) in a preclinical rat posterolateral lumbar fusion model.

Summary Of Background Data: Our group previously found that this 3D-printed HA-DBM composite material shows promise as a bone graft substitute in a preclinical rodent model, but its safety profile had yet to be assessed. Read More

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Organ failure, aetiology and 7-day all-cause mortality among acute adult patients on arrival to an emergency department: a hospital-based cohort study.

Eur J Emerg Med 2021 Jun 10. Epub 2021 Jun 10.

Department of Emergency Medicine, Odense University Hospital, Odense Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus Department of Public Health, University of Southern Denmark Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, Odense Department of Regional Health Research, University of Southern Denmark Department of Emergency Medicine, Hospital of South West Jutland, Esbjerg Institute of Clinical Research, University of Southern Denmark.

Background: Organ failure is both a frequent and dangerous condition among adult patients on arrival to an emergency department (ED). The risk of an unfavourable outcome could depend on the underlying aetiology. Knowledge of the relation between aetiology and prognosis could improve the risk stratification at arrival. Read More

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A Pilot Randomized Trial of Polypectomy Techniques for 4 to 6 mm Colonic Polyps.

J Clin Gastroenterol 2021 Jun 11. Epub 2021 Jun 11.

Department of Internal Medicine/Division of Gastroenterology, Indiana University School of Medicine, Indianapolis, IN.

Background And Goals: There is variation in polypectomy techniques for resection of small polyps. Aim was to compare techniques for 4 to 6 mm polyps for recurrent adenoma, efficiency, and adverse events and to establish methodological factors for definitive trial.

Materials And Methods: The study was a randomized controlled trial. Read More

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The system, the resident, and the preceptor: a curricular approach to continuity of care training.

Perspect Med Educ 2021 Jun 11. Epub 2021 Jun 11.

North York General Hospital, Toronto, ON, Canada.

Background: Continuity of care (CoC) is integral to the practice of comprehensive primary care, yet research in the area of CoC training in residency programs is limited. In light of distributed medical education and evolving accreditation standards, a rigorous understanding of the context and enablers contributing to CoC education must be considered in the design and delivery of residency training programs.

Approach: At our preceptor-based community academic site, we developed a system-resident-preceptor (SRP) framework to explore factors that influence a resident's perception regarding CoC, and established variables in each area to enhance learning. Read More

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Investigation of droplets released during digestive endoscopy using a high-speed camera (with video): a pilot study.

Surg Endosc 2021 Jun 11. Epub 2021 Jun 11.

Department of Gastroenterology, Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea.

Background: A large release of droplets is often expected around the periphery of the digestive endoscope insertion site. Therefore, a sense of alarm over infection because of droplets that may be released during digestive endoscopy examination is increasing. This study aimed to investigate the droplets released during digestive endoscopy using a high-speed camera. Read More

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A comparison of the buttonhole and rope-ladder AVF cannulation techniques and infection rates within the SCOPE collaborative.

Pediatr Nephrol 2021 Jun 11. Epub 2021 Jun 11.

Department of Pediatrics, Division of Nephrology, Children's Mercy Kansas City, University of Missouri-Kansas City, Kansas City, MO, USA.

Background: Studies regarding hemodialysis (HD) arteriovenous fistula (AVF) cannulation in adults indicate a higher risk of infection with the buttonhole (BH) technique compared to the rope-ladder (RL) technique. Pediatric data on this issue is sparse.

Methods: We compared infection rates within the Standardizing Care to Improve Outcomes in Pediatric End stage kidney disease (SCOPE) centers performing BH cannulation versus RL cannulation of AVF. Read More

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Applicant factors contributing to interview selection, ranking determination, and judgement of "Fit" among health service psychology internship training programs.

J Clin Psychol 2021 Jun 11. Epub 2021 Jun 11.

Department of Psychological Sciences, Texas Tech University, Lubbock, Texas, USA.

Background: The predoctoral internshipAQ4 training year is the capstone training experience for health service doctoral students. Previous research has explored what applicant characteristics are desired by internship sites and has not thoroughly explored differences between types of sites or criteria importance at different stages of applicant consideration (interview vs. ranking). Read More

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Assembling the Career Firefighter Health Study cohort: A methods overview.

Am J Ind Med 2021 Jun 10. Epub 2021 Jun 10.

Bureau of Health Services, Fire Department of the City of New York, Brooklyn, New York, USA.

Background: Studies of World Trade Center (WTC)-exposed rescue/recovery workers report the increased occurrence of health conditions after work at the WTC disaster site. However, the extent to which these associations are due to WTC exposure is unclear, in part due to the lack of suitable comparison groups. Accordingly, we identified a previously assembled National Institute for Occupational Safety and Health (NIOSH) cohort of career firefighters from three US cities (n = 29,992). Read More

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Correlation of Aneurysmal Wall Enhancement of Unruptured Intracranial Aneurysms on High-Resolution Vessel-Wall Imaging With Clinical Indices and Surgical Findings.

Neurosurgery 2021 Jun 10. Epub 2021 Jun 10.

Department of Neurosurgery, Guro Hospital, Korea University, College of Medicine, Seoul, Republic of Korea.

Background: Many physicians consider aneurysmal wall enhancement (AWE) on high resolution-vessel wall imaging (HR-VWI) as an imaging biomarker of unstable unruptured intracranial aneurysms (UIAs).

Objective: To evaluate the clinical value of different AWE signal intensities (SIs) by assessing the correlation between the AWE SIs and surgical findings and rupture risk assessment tools.

Methods: Twenty-six patients with 34 aneurysms who underwent surgical clipping were included. Read More

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Deficiency of PPARγ in Bone Marrow Stromal Cells Does not Prevent High-Fat Diet-Induced Bone Deterioration in Mice.

J Nutr 2021 Jun 10. Epub 2021 Jun 10.

Department of Neuroscience and Regenerative Medicine, Augusta University, Augusta, GA, USA.

Background: Bone marrow osteoblasts and adipocytes are derived from a common mesenchymal stem cell and have a reciprocal relationship. Peroxisome proliferator-activated receptor gamma (PPARγ), a regulator for adipocyte differentiation, may be a potential target for reducing obesity and increasing bone mass.

Objectives: This study tested the hypothesis that bone-specific Pparg conditional knockout (cKO), via deletion of Pparg from bone marrow stromal cells (BMSC) using Osterix 1 (Osx1)-Cre, would prevent high-fat (HF) diet-induced bone deterioration in mice. Read More

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Assessing the perforation site of cardiac tamponade during radiofrequency catheter ablation using gas analysis of pericardial effusion.

Heart Rhythm O2 2020 Oct 24;1(4):268-274. Epub 2020 Jun 24.

Department of Cardiovascular Medicine, Kyorin University Hospital, Tokyo, Japan.

Background: The incidence of pericardial effusion (PE) during radiofrequency catheter ablation (CA) for atrial fibrillation is approximately 1%. PE is a major complication during CA, but there has been limited literature about the perforation site responsible.

Objective: This study aimed to retrospectively investigate the characteristics of the procedure and the patients in whom PE developed during CA. Read More

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October 2020

Introducing a novel catheter-tissue contact feedback feature in robotic navigated catheter ablation: Utility, feasibility, and safety.

Heart Rhythm O2 2020 Jun 11;1(2):103-110. Epub 2020 May 11.

Department of Cardiology, Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands.

Background: The quality of catheter-tissue contact is one of the most important determinants of catheter ablation (CA) success. The absence of catheter-tissue contact feedback has been regarded a major limitation of remote magnetic navigation (RMN)-guided CA. The e-Contact module (ECM) is a novel feature designed for RMN that measures the quality of catheter-tissue contact. Read More

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Aortic Valve Calcification Is Associated with Future Cognitive Impairment.

J Alzheimers Dis Rep 2021 Apr 29;5(1):337-343. Epub 2021 Apr 29.

Department of Internal Medicine (Section of Cardiovascular Medicine), Providence VA Medical Center, Providence, RI, USA.

Background: While an association between atherosclerosis and dementia has been identified, few studies have assessed the longitudinal relationship between aortic valve calcification (AVC) and cognitive impairment (CI).

Objective: We sought to determine whether AVC derived from lung cancer screening CT (LCSCT) was associated with CI in a moderate-to-high atherosclerotic risk cohort.

Methods: This was a single site, retrospective analysis of 1401 U. Read More

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Phase II (NAVIGATE-AD study) Results of LY3202626 Effects on Patients with Mild Alzheimer's Disease Dementia.

J Alzheimers Dis Rep 2021 Apr 29;5(1):321-336. Epub 2021 Apr 29.

Eli Lilly and Company, Indianapolis, IN, USA.

Background: LY3202626 is a small molecule inhibitor of β-site amyloid precursor protein cleaving enzyme (BACE)1 shown to reduce amyloid-β (Aβ) and Aβ concentrations in plasma and cerebrospinal fluid developed for the treatment of Alzheimer's disease (AD).

Objective: To assess the change from baseline in flortaucipir positron emission tomography (PET) after treatment with LY3202626 compared with placebo in patients with mild AD dementia.

Methods: Patients received daily 3 mg or 12 mg doses of LY3202626 or placebo for 52 weeks. Read More

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A case of Wolff-Parkinson-White syndrome in which two-dimensional speckle-tracking echocardiography was useful for identifying the location of the accessory atrioventricular pathway.

Eur Heart J Case Rep 2021 Mar 4;5(3):ytab078. Epub 2021 Mar 4.

Division of Cardiology, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo 693-8501, Japan.

Background: In Wolff-Parkinson-White (WPW) syndrome, accessory atrioventricular pathways (AP) result in abnormal pre-excitation around the atrioventricular annuli and produce a dyssynchronous contraction of cardiac chambers. Identification of the AP affects the outcome of catheter ablation.

Case Summary: We report a case of WPW syndrome and paroxysmal atrial fibrillation in a 65-year-old man. Read More

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Laparoendoscopic single-site adrenalectomy versus multi-port laparoendoscopic adrenalectomy: A systemic review and meta-analysis.

Ann Med Surg (Lond) 2021 Jun 21;66:102388. Epub 2021 May 21.

Department of Urology, Taipei Medical University Hospital, Taipei, 110, Taiwan.

Background: To investigate the outcomes of laparoendoscopic single-site adrenalectomy (LESS-A) compared to multi-port laparoendoscopic adrenalectomy (m-LA).

Methods: Studies comparing LESS-A with m-LA were identified from PubMed, Embase, and Cochrane Library before June 2020. Post-operative pain, resumption outcomes, and perioperative outcomes were analyzed. Read More

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When the Good Syndrome Goes Bad: A Systematic Literature Review.

Yiyun Shi Chen Wang

Front Immunol 2021 25;12:679556. Epub 2021 May 25.

Department of Internal Medicine, Morsani College of Medicine, University of South Florida, Tampa, FL, United States.

Background: Good syndrome is a rare adult-onset immunodeficiency characterized by thymoma and hypogammaglobulinemia. Its clinical manifestations are highly heterogeneous, ranging from various infections to autoimmunity.

Objective: This study was to summarize patient characteristics, identify prognostic factors and define clinical subgroups of Good syndrome. Read More

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Δ133p53α enhances metabolic and cellular fitness of TCR-engineered T cells and promotes superior antitumor immunity.

J Immunother Cancer 2021 Jun;9(6)

Department of Hematology, Oncology and Pneumology, University Medical Centre of the Johannes Gutenberg University Mainz, Mainz, Germany

Background: Tumor microenvironment-associated T cell senescence is a key limiting factor for durable effective cancer immunotherapy. A few studies have demonstrated the critical role of the tumor suppressor TP53-derived p53 isoforms in cellular senescence process of non-immune cells. However, their role in lymphocytes, in particular tumor-antigen (TA) specific T cells remain largely unexplored. Read More

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Short-Term Clinical Outcomes of Transcatheter Tricuspid Valve Repair With the Third-Generation MitraClip XTR System.

JACC Cardiovasc Interv 2021 Jun;14(11):1231-1240

Department of Cardiology, Heart Valve Center, University Medical Center Mainz, Mainz, Germany.

Objectives: The aim of this study was to assess 30-day outcomes of transcatheter edge-to-edge repair with the MitraClip XTR for significant tricuspid regurgitation (TR), relative to baseline coaptation gap sizes (CGS).

Background: Transcatheter edge-to-edge repair using the MitraClip NT for patients with significant TR is safe and efficacious; the utility of the MitraClip XTR is unknown.

Methods: Patients with significant, symptomatic TR treated at a single site between April 2018 and December 2019, with consent and with complete data, were included (n = 50). Read More

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Risk factors in total hip arthroplasty and hemiarthroplasty: Infection and mortality.

Rev Esp Cir Ortop Traumatol 2021 Jul-Aug;65(4):239-247

Medicina Preventiva y Salud Pública, Hospital Universitario de La Princesa, Madrid, Spain.

Background: Surveillance systems make it possible to analyze the trends of infections associated with hip arthroplasty. The aim of this study is to determine risk factors associated with surgical site infection (SSI) and mortality following total hip arthroplasty (THA) or hemiarthroplasty (HHA).

Methods: Observational study including individuals ≥18 years who underwent THA or HHA between January 2007 and December 2017. Read More

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AntimiR-132 Attenuates Myocardial Hypertrophy in an Animal Model of Percutaneous Aortic Constriction.

J Am Coll Cardiol 2021 Jun;77(23):2923-2935

Klinik und Poliklinik für Innere Medizin I, University Clinic rechts der Isar, Technical University of Munich, Munich, Germany; Deutsches Zentrum für Herz-Kreislauf-Forschung (German Center for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany; Institute for Cardiovascular Prevention, Ludwig-Maximilians-University Munich, Munich, Germany. Electronic address:

Background: Pathological cardiac hypertrophy is a result of afterload-increasing pathologies including untreated hypertension and aortic stenosis. It features progressive adverse cardiac remodeling, myocardial dysfunction, capillary rarefaction, and interstitial fibrosis often leading to heart failure.

Objectives: This study aimed to establish a novel porcine model of pressure-overload-induced heart failure and to determine the effect of inhibition of microribonucleic acid 132 (miR-132) on heart failure development in this model. Read More

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Human endometrium-derived stem cell improves cardiac function after myocardial ischemic injury by enhancing angiogenesis and myocardial metabolism.

Stem Cell Res Ther 2021 Jun 10;12(1):344. Epub 2021 Jun 10.

The Laboratory of Stem Cell Regenerative Medicine Research, Shanxi Key Laboratory of Birth Defect and Cell Regeneration, Key Laboratory of Cell Physiology of Ministry of Education, Shanxi Medical University, Taiyuan, China.

Background: The human endometrium in premenopausal women is an active site of physiological angiogenesis, with regenerative cells present, suggesting that the endometrium contains adult angiogenic stem cells. In the context of cardiac repair after ischemic injury, angiogenesis is a crucial process to rescue cardiomyocytes. We therefore investigated whether human endometrium-derived stem cells (hEMSCs) can be used for cardiac repair after ischemic injury and their possible underlying mechanisms. Read More

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Intra-iliac bone marrow injection as a novel alternative to intra-tibial inoculation in rat model.

Stem Cell Res Ther 2021 Jun 10;12(1):336. Epub 2021 Jun 10.

Department of Pathology, Faculty of Veterinary Medicine, Cairo University, Giza, 12211, Egypt.

Background: Intra-bone marrow injection (IBMI) in rats is adopted in many studies for stem cell and hematopoietic cell transplantation. IBMI in the tibia or the femur results in severe distress to the animal. Therefore, this study aims to evaluate intra-iliac injections as an alternative approach for IBMI. Read More

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Surgical site infection prevention and management in immunocompromised patients: a systematic review of the literature.

World J Emerg Surg 2021 Jun 10;16(1):33. Epub 2021 Jun 10.

General, Emergency and Trauma Surgery Department, Pisa University Hospital, Via Paradisa 1, 56100, Pisa, Italy.

Background: Immunocompromised patients are at higher risk of surgical site infection and wound complications. However, optimal management in the perioperative period is not well established. Present systematic review aims to analyse existing strategies and interventions to prevent and manage surgical site infections and other wound complications in immunocompromised patients. Read More

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European registry of type A aortic dissection (ERTAAD) - rationale, design and definition criteria.

J Cardiothorac Surg 2021 Jun 10;16(1):171. Epub 2021 Jun 10.

Leipzig Heart center, Leipzig, Germany.

Background: Acute Stanford type A aortic dissection (TAAD) is a life-threatening condition. Surgery is usually performed as a salvage procedure and is associated with significant postoperative early mortality and morbidity. Understanding the patient's conditions and treatment strategies which are associated with these adverse events is essential for an appropriate management of acute TAAD. Read More

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Stress hormone level and the welfare of captive European bison (Bison bonasus): the effects of visitor pressure and the social structure of herds.

Acta Vet Scand 2021 Jun 10;63(1):24. Epub 2021 Jun 10.

Department of Animal Genetics and Conservation, Institute of Animal Sciences, Warsaw University of Life Sciences, Ciszewskiego 8, 02-786, Warsaw, Poland.

Background: Captive European bison (Bison bonasus) play an active role in conservation measures for this species; this includes education, which may conflict with these animals' welfare. The effect of the presence of visitors on the welfare of captive animals can be negative, positive or neutral. However, the response of a given species to visitors is difficult to predict, since even closely related species display varying levels of tolerance to captivity. Read More

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