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How representative is a point-of-care randomized trial? Clinical outcomes of patients excluded from a point-of-care randomized controlled trial evaluating antibiotic duration for Gram-negative bacteremia: a multicenter prospective observational cohort study.

Clin Microbiol Infect 2021 Jun 8. Epub 2021 Jun 8.

Division of Infectious Diseases, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland; Center for Clinical Research, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland.

Objectives: Patients included in randomized controlled trials (RCT) are poorly representative of the general population. We compared outcomes of patients excluded from the PIRATE trial, a point-of-care RCT evaluating antibiotic durations for Gram-negative bacteremia, to those of enrolled patients.

Methods: A prospective observational cohort study, "EPCO" (Excluded Patients' Clinical Outcomes) included patients excluded from the PIRATE trial. Read More

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Predicting overall survival and resection in patients with locally advanced pancreatic cancer treated with FOLFIRINOX: Development and internal validation of two nomograms.

J Surg Oncol 2021 Jun 11. Epub 2021 Jun 11.

Department of Surgery, UMC Utrecht Cancer Center, St Antonius Hospital Nieuwegein and Meander Medical Center, Utrecht, The Netherlands.

Background And Objectives: Patients with locally advanced pancreatic cancer (LAPC) are increasingly treated with FOLFIRINOX, resulting in improved survival and resection of tumors that were initially unresectable. It remains unclear, however, which specific patients benefit from FOLFIRINOX. Two nomograms were developed predicting overall survival (OS) and resection at the start of FOLFIRINOX for LAPC. Read More

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The Effects of Limosilactobacillus reuteri LR-99 Supplementation on Body Mass Index, Social Communication, Fine Motor Function, and Gut Microbiome Composition in Individuals with Prader-Willi Syndrome: a Randomized Double-Blinded Placebo-Controlled Trial.

Probiotics Antimicrob Proteins 2021 Jun 11. Epub 2021 Jun 11.

The Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China.

Prader-Willi syndrome (PWS) is a rare genetic disorder associated with developmental delay, obesity, and neuropsychiatric comorbidities. Limosilactobacillus reuteri (Lactobacillus reuteri, Lact. reuteri) has demonstrated anti-obesity and anti-inflammatory effects in previous studies. Read More

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Do patients who have newly identified prediabetes lose weight in the following year?

Fam Pract 2021 Jun 11. Epub 2021 Jun 11.

Cleveland Clinic Community Care, Center for Value Based Care, Cleveland Clinic, Cleveland, OH, USA.

Background: Identifying a window of opportunity when patients are motivated to lose weight might improve the effectiveness of weight loss counseling. The onset of chronic disease could create such a window.

Objective: To determine whether identifying prediabetes was associated with subsequent weight loss. Read More

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Characterization of COPD Admissions During the First COVID-19 Outbreak.

Int J Chron Obstruct Pulmon Dis 2021 3;16:1549-1554. Epub 2021 Jun 3.

Respiratory medicine, Hospital Arnau de Vilanova-CIBERES, Valencia, Spain.

Purpose: Exacerbations of COPD (ECOPD) are a frequent cause of hospitalization that seemed to ameliorate during the COVID outbreak. We aimed to evaluate the clinical characteristics of COPD-related hospital admissions and mortality in relation to the presence of COVID-19.

Patients And Methods: We conducted a case-control study of patients admitted in four teaching hospitals throughout Spain between March 15 and April 30, 2020. Read More

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Stroke care and case fatality in people with and without schizophrenia: a retrospective cohort study.

BMJ Open 2021 Jun 10;11(6):e044766. Epub 2021 Jun 10.

Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.

Background: Schizophrenia is associated with an increased risk of death following stroke; however, the magnitude and underlying reasons for this are not well understood.

Objective: To determine the association between schizophrenia and stroke case fatality, adjusting for baseline characteristics, stroke severity and processes of care.

Design: Retrospective cohort study used linked clinical and administrative databases. Read More

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Suboptimal Completion Rates, Adverse Events, Costs, Resource Utilization, and Cost Impact of Noncompletion in Oral Adjuvant Capecitabine-Based Chemotherapy in Patients With Early-Stage Colon Cancer.

Clin Colorectal Cancer 2021 May 12. Epub 2021 May 12.

Albert Einstein Cancer Center, Albert Einstein College of Medicine, 1300 Morris Park Ave, Bronx, NY 10461.

Background: Suboptimal completion of chemotherapy, which may involve reduced patient adherence, remains a serious issue and leads to reduced treatment efficacy. This study assessed the completion rates, risk factors for noncompletion, and cost impact for noncompletion in patients on capecitabine monotherapy (Cape) or capecitabine with oxaliplatin (CAPOX) for the adjuvant treatment of early-stage colon cancer.

Methods: Patients with a diagnosis of early-stage colon cancer between April 2013 and March 2017 were retrospectively identified. Read More

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Demographic, multi-morbidity and genetic impact on myocardial involvement and its recovery from COVID-19: protocol design of COVID-HEART-a UK, multicentre, observational study.

J Cardiovasc Magn Reson 2021 Jun 10;23(1):77. Epub 2021 Jun 10.

Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, LS2 9JT, UK.

Background: Although coronavirus disease 2019 (COVID-19) is primarily a respiratory illness, myocardial injury is increasingly reported and associated with adverse outcomes. However, the pathophysiology, extent of myocardial injury and clinical significance remains unclear.

Methods: COVID-HEART is a UK, multicentre, prospective, observational, longitudinal cohort study of patients with confirmed COVID-19 and elevated troponin (sex-specific > 99th centile). Read More

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Understanding Factors That Cause Tinnitus: A Mendelian Randomization Study in the UK Biobank.

Ear Hear 2021 Jun 8. Epub 2021 Jun 8.

Royal Devon and Exeter NHS Foundation Trust, Barrack Road, Exeter, United Kingdom Genetics of Complex Traits, University of Exeter Medical School, RILD building, Royal Devon and Exeter Hospital, Exeter, United Kingdom Torbay and South Devon NHS Foundation Trust, Newton Road, Torquay, United Kingdom.

Objectives: To investigate the causal role of established risk factors and associated conditions to tinnitus and tinnitus severity in the UK Biobank.

Design: The prospective cohort study with large dataset of >500,000 individuals. The analytical sample of 129,731 individuals in the UK Biobank of European descent. Read More

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Increased risk factors associated with lower BMD in antiretroviral-therapy-naïve HIV-infected adult male.

BMC Infect Dis 2021 Jun 9;21(1):542. Epub 2021 Jun 9.

Infectious Diseases Division, Fundación Jiménez Díaz University Hospital, Universidad Autónoma de Madrid, 28040, Madrid, Spain.

Background: Low BMD (bone mineral density) has been described as a non-AIDS (Acquired Immune Deficiency Syndrome)-related event in HIV (human immunodeficiency virus)-patients but it is poorly studied in young HIV-infected men who have received no previous antiretroviral therapy.

Methods: A cross-sectional study of 245 naïve-HIV-infected men over 21 and under 50 years old who voluntary attended the Infectious Disease Division appointment in Hospital Fundación Jimenez Díaz in Madrid, from January 1st, 2014 to September 30th, 2017. All subjects underwent a baseline DXA scan (dual energy x-ray absorptiometry) performed prior to start antiretroviral treatment. Read More

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Endoscopic Retrograde Cholangiopancreatography (ERCP) in Patients With Liver Cirrhosis: Analysis of Trends and Outcomes From the National Inpatient Sample Database.

J Clin Gastroenterol 2021 Jun 9. Epub 2021 Jun 9.

Department of Medicine, Geisinger Commonwealth School of Medicine, Scranton Hospitalist Department Department of Gastroenterology, Guthrie Robert Packer Hospital, Sayre, PA Departments of Medicine Family Medicine, Samaritan Medical Center, Watertown, NY Department of Medicine, Central Michigan University College of Medicine, Saginaw Department of Gastroenterology, Henry Ford Hospital, Detroit, MI Department of Public Health, Rutgers University, New Brunswick, NJ.

Goals: We aimed to assess outcomes of patients with liver cirrhosis who underwent therapeutic or diagnostic endoscopic retrograde cholangiopancreatography (ERCP) to determine whether these patients had different outcomes relative to patients without cirrhosis.

Background: ERCP is an important procedure for treatment of biliary and pancreatic disease. However, ERCP is relatively technically difficult to perform when compared with procedures such as esophagogastroduodenoscopy or colonoscopy. Read More

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Association between risk of VTE and mortality in patients with COVID-19.

Int J Infect Dis 2021 Jun 6. Epub 2021 Jun 6.

Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital, Fudan University, Shanghai, China. Electronic address:

Objectives: To investigate the association between risk of VTE with 30-day mortality in COVID-19 patients.

Methods: 1030 COVID-19 patients were retrospective collected, with baseline data on demographics, Sequential Organ Failure Assessment (SOFA) score, and VTE risk assessment models (RAMs) including Padua Prediction Score (PPS), International Medical Prevention Registry (IMPROVE) and Caprini RAM.

Results: Thirty-day mortality increased progressively from 2% in patients at low risk of VTE to 63% in those at high risk defined by PPS. Read More

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Treatment outcomes in HIV infected patients older than 50 years attending an HIV clinic in Harare, Zimbabwe: A cohort study.

PLoS One 2021 9;16(6):e0253000. Epub 2021 Jun 9.

Newlands Clinic, Newlands, Harare, Zimbabwe.

There is a growing number of older people living with HIV (OPLHIV). While a significant proportion of this population are adults growing into old age with HIV, there are also new infections among OPLHIV. There is a lack of data describing the outcomes of OPLHIV who commenced antiretroviral therapy (ART) after the age of 50 years in sub-Saharan Africa. Read More

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Transfusion timing relative to surgery does not impact outcomes in hip fracture patients.

Eur J Orthop Surg Traumatol 2021 Jun 9. Epub 2021 Jun 9.

Department of Orthopedic Surgery, NYU Langone Orthopedic Hospital, New York, NY, USA.

Purpose: The purpose of this study is to determine the effects of blood transfusion timing in hip fracture patients.

Methods: A consecutive series of hip fracture patients 55 years and older who required a blood transfusion during hospitalization were reviewed for demographic, injury, clinical outcome, and cost information. A validated risk predictive score (STTGMA) was calculated for each patient. Read More

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Efinaconazole topical solution (10%) for the treatment of onychomycosis in adult and pediatric patients.

Expert Rev Anti Infect Ther 2021 Jun 9. Epub 2021 Jun 9.

Mediprobe Research Inc., London, ON, CAN.

Introduction: Onychomycosis, a common nail disorder caused by fungal infection, can be managed pharmaceutically with oral or topical treatments. While oral treatments are often used first-line to treat nail infections, these systemic antifungals are not appropriate for all patients, and no oral treatments are approved for use in children in the USA. Given this need, topical antifungals were developed, which can be used as monotherapy or in combination with oral drugs. Read More

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Dihydroergotamine infusion for pediatric refractory headache: A retrospective chart review.

Headache 2021 May;61(5):777-789

Neuroscience Programs, Boston Children's Hospital, Boston, MA, USA.

Background: Headaches are a common symptom in children. Children with refractory headaches may be admitted for inpatient treatment with intravenous dihydroergotamine mesylate (DHE). However, very few studies have characterized these patients and their treatment outcomes using validated, self-reported, pain scales. Read More

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Survival of Patients with Lung Cancer in the Setting of Liver Cirrhosis: A Multicenter Propensity Score Matching Study.

Cancer Manag Res 2021 1;13:4373-4381. Epub 2021 Jun 1.

Department of Radiation Oncology, Chiayi Chang Gung Memorial Hospital, Puzi, Chiayi County, Taiwan.

Purpose: The survival outcome of lung cancer patients with coexisting liver cirrhosis has thus far received limited attention in the literature. In this study, we evaluated whether liver cirrhosis is an independent risk factor for the survival of patients with lung cancer.

Materials And Methods: We conducted a retrospective, multicenter, propensity-matched study of lung cancer patients with and without liver cirrhosis. Read More

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Updated antithrombotic strategies to reduce the burden of cardiovascular recurrences in patients with chronic coronary syndrome.

Biomed Pharmacother 2021 Jun 5;140:111783. Epub 2021 Jun 5.

Department of Clinical and Experimental Medicine, University of Florence, Careggi Hospital, Florence, Italy.

Despite recent achievements in secondary cardiovascular prevention, the risk of further events in patients with chronic coronary syndromes (CCS) remains elevated. Highest risk is seen in patients with recurrent events, comorbidities or multisite atherosclerosis. Optimising antithrombotic strategies in this setting may significantly improve outcomes. Read More

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Prognosis of variceal and non-variceal upper gastrointestinal bleeding in already hospitalised patients: Results from a French prospective cohort.

United European Gastroenterol J 2021 Jun 8. Epub 2021 Jun 8.

Groupe Hospitalier Intercommunal Le Raincy-Montfermeil, Montfermeil, France.

Objectives: Patients who develop upper gastrointestinal bleeding (UGIB) while in hospital appear to have a poor prognosis. Our study aims at analysing the difference in outcome between in-patients (IPs) and out-patients presenting with variceal and non-variceal UGIB.

Methods: We conducted a multicentre prospective study by collecting data about variceal and non-variceal UGIB cases through 46 hospitals in France between November 2017 and October 2018. Read More

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Red cell distribution width predicts residual renal function decline in patients undergoing continuous ambulatory peritoneal dialysis.

Ther Apher Dial 2021 Jun 8. Epub 2021 Jun 8.

Department of Nephrology, Huizhou Municipal Central Hospital, People's Republic of China.

To investigate the relationship between red blood cell distribution width (RDW) and residual renal function (RRF) in patients undergoing continuous ambulatory peritoneal dialysis (CAPD). Seventy-seven CAPD patients were enrolled in this study. According to receiver operator characteristic curve (ROC) analysis, patients were divided into high RDW (RDW > 14. Read More

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Association between exercise habits and stroke, heart failure, and mortality in Korean patients with incident atrial fibrillation: A nationwide population-based cohort study.

PLoS Med 2021 Jun 8;18(6):e1003659. Epub 2021 Jun 8.

Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.

Background: There is a paucity of information about cardiovascular outcomes related to exercise habit change after a new diagnosis of atrial fibrillation (AF). We investigated the association between exercise habits after a new AF diagnosis and ischemic stroke, heart failure (HF), and all-cause death.

Methods And Findings: This is a nationwide population-based cohort study using data from the Korea National Health Insurance Service. Read More

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Alcohol and Other Drug Service Availability, Capacity, and Diversity in Urban and Rural Australia: An Integrated Atlas.

J Stud Alcohol Drugs 2021 May;82(3):401-413

Centre for Mental Health Research, Australian National University, Acton, Australian Capital Territory, Australia.

Objective: Variation exists in the patterns of alcohol and other drug (AOD) use and related impacts across geographic locations and over time. Understanding the existing AOD service system and the local context that it operates within is fundamental to optimize service provision. This article describes and compares the availability, placement capacity, and diversity of AOD services in urban and rural regions in Australia. Read More

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Rapid and sustained decline in CXCL-10 (IP-10) annotates clinical outcomes following TNF-α antagonist therapy in hospitalized patients with severe and critical COVID-19 respiratory failure.

medRxiv 2021 Jun 2. Epub 2021 Jun 2.

Background: A feed-forward pathological signaling loop generated by TNFα and IFN-γ in inflamed lung tissue, driving CXCL-10 (IP-10) and CXCL-9 chemokine-mediated activated T-cell and monocyte/macrophage tissue recruitment, may define, sustain and amplify the inflammatory biology of lethal COVID-19 respiratory failure.

Methods: To assess TNFα-antagonist therapy, 18 hospitalized adults with hypoxic respiratory failure and COVID-19 pneumonia received single-dose infliximab-abda therapy 5mg/kg intravenously between April and December 2020. The primary endpoint was time to increase in oxygen saturation to fraction of inspired oxygen ratio (SpO2/FiO2) by ≥ 50 compared to baseline and sustained for 48 hours. Read More

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SARS-CoV-2 infectious virus, viral RNA in nasopharyngeal swabs, and serostatus of symptomatic COVID-19 outpatients in the United States.

medRxiv 2021 Jun 1. Epub 2021 Jun 1.

Background: SARS-CoV-2 infectious virus isolation in the upper airway of COVID-19 patients is associated with higher levels of viral RNA. However, comprehensive evaluation of the relationships between host and disease factors and infectious, replication competent virus is needed.

Methods: Symptomatic COVID-19 outpatients were enrolled from the United States. Read More

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Who benefits most from an evidence-based program to reduce anxiety and depression in children? A latent profile analysis.

Dev Psychopathol 2021 Jun 8:1-9. Epub 2021 Jun 8.

Department of Health Psychology, Miguel Hernández University, Elche, Spain.

Comorbidity between anxiety and depression symptoms is often high in children. Person-oriented statistical approaches are useful to detect heterogeneity of individuals and diverse patterns of response to treatment. This study aimed to explore the different profiles in a sample of Spanish children who received the Super Skills for Life (SSL) transdiagnostic program, to identify which profile of individuals benefited most from the intervention and the likelihood of transition of symptom patterns over time. Read More

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Mepolizumab improves clinical outcomes in patients with severe asthma and comorbid conditions.

Respir Res 2021 Jun 7;22(1):171. Epub 2021 Jun 7.

Amsterdam University Medical Center, Location AMC, University of Amsterdam, Amsterdam, The Netherlands.

Background: Comorbidities can complicate the management of severe asthma; therefore, the presence of comorbid conditions or traits often need to be considered when considering treatment options for patients with severe asthma. The aim of this analysis is to investigate the efficacy of mepolizumab in patients with severe eosinophilic asthma and comorbidities.

Methods: This was a post hoc analysis (GSK ID:209140) of data from the Phase IIb/III studies DREAM, MENSA, SIRIUS, and MUSCA. Read More

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Frailty increases the risk for developing urinary tract infection among 79,887 patients with diabetic mellitus and chronic kidney disease.

BMC Geriatr 2021 Jun 7;21(1):349. Epub 2021 Jun 7.

Nephrology division, Department of Internal Medicine, National Taiwan University Hospital Yunlin branch, Yunlin county, Taiwan.

Background: Patients with diabetic mellitus (DM) and chronic kidney disease (CKD) are at an increased risk of urinary tract infection (UTI) due to their altered immunological integrity. These patients are similarly prone to developing frailty, a state of cumulative health deficits involving multiple domains and leading to adverse outcomes. Whether frailty predisposes affected individuals to UTI among patients with DM and CKD remains unclear. Read More

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Neutrophil-lymphocyte ratio as a predictor of slow gait speed in older adults: The Rugao Longitudinal Aging Study.

Exp Gerontol 2021 Jun 8;152:111439. Epub 2021 Jun 8.

State Key Laboratory of Genetic Engineering, Collaborative Innovation Center for Genetics and Development, School of Life Sciences and Human Phenome Institute, Fudan University, Shanghai, China; National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China. Electronic address:

Background: Few studies have investigated the association of the neutrophil-to-lymphocyte ratio (NLR) with gait speed, but whether the NLR is predictive of slow gait speed in older adults remains unknown. The aim of this study is to examine the association of NLR levels with risk of slow gait speed development in older adults.

Methods: Overall, 1753 participants (53. Read More

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