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Case fatality of hospital-treated intracerebral hemorrhage in Finland - A nationwide population-based registry study.

J Neurol Sci 2021 Apr 13;425:117446. Epub 2021 Apr 13.

Heart Center, Turku University Hospital, Turku, Finland; Research Center of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland; Center for Population Health Research, Turku University Hospital and University of Turku, Turku, Finland; Administrative Center, Hospital District of Southwest Finland, Turku, Finland. Electronic address:

Background: Case-fatality of Intracerebral hemorrhage (ICH) has been reported to have improved in some areas recently. Previous reports have shown that in Finland ICH survival has improved already from the 1980s. We aimed to investigate if this trend has continued and to assess possible predictors for death. Read More

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Central line-associated blood stream infection during COVID-19 pandemic.

J Infect Public Health 2021 Feb 9;14(5):668-669. Epub 2021 Feb 9.

Department of Infection Control and Prevention, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia. Electronic address:

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February 2021

Imported scrub typhus in Europe: report of three cases and a literature review.

Travel Med Infect Dis 2021 Apr 13:102062. Epub 2021 Apr 13.

Department of Infectious/Tropical Diseases and Microbiology (DITM), IRCCS Sacro Cuore Don Calabria Hospital, Negrar, Verona, Italy. Electronic address:

Background: Scrub typhus is a vector-borne rickettsial infection, which can cause relevant morbidity and mortality. While the number of cases is around a million per year globally, the infection is seldom diagnosed in travellers from Europe.

Methods: We herein report three cases diagnosed in Italian travellers and review the literature about imported cases in Europe in the last 60 years. Read More

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Septic Shock Caused by Rahnella aquatilis Bacteremia in an Immunocompetent Adult.

Am J Case Rep 2021 Apr 16;22:e930888. Epub 2021 Apr 16.

Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, CO, USA.

BACKGROUND Rahnella aquatilis is a facultatively anaerobic, gram-negative rod bacterium commonly found in freshwater. There are few cases of bacteremia caused by Rahnella aquatilis in the literature and even fewer cases reported of it causing sepsis in immunocompetent individuals. In this case report, we present a rare case of an immunocompetent individual who developed sepsis secondary to bacteremia caused by Rahnella aquatilis. Read More

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Inertial Cavitation Behaviors Induced by Nonlinear Focused Ultrasound Pulses.

IEEE Trans Ultrason Ferroelectr Freq Control 2021 Apr 16;PP. Epub 2021 Apr 16.

Inertial cavitation induced by pulsed high intensity focused ultrasound (pHIFU) has previously been shown to successfully permeabilize tumor tissue and enhance chemotherapeutic drug uptake. In addition to HIFU frequency, peak rarefactional pressure (p-), and pulse duration, the threshold for cavitation-induced bioeffects has recently been correlated with asymmetric distortion caused by nonlinear propagation, diffraction and formation of shocks in the focal waveform, and therefore with the transducer F-number. To connect previously observed bioeffects with bubble dynamics and their attendant physical mechanisms, the dependence of inertial cavitation behavior on shock formation was investigated in transparent agarose gel phantoms using high-speed photography and passive cavitation detection (PCD). Read More

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Extended thromboprophylaxis for medically ill patients with cancer: a systemic review and meta-analysis.

Blood Adv 2021 Apr;5(8):2055-2062

Division of Hemostasis and Thrombosis, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.

Hospitalized medically ill patients with cancer are at increased risk of both venous thromboembolism and bleeding. The safety and efficacy of extended thromboprophylaxis in patients with cancer are unclear. We conducted a systematic review and meta-analysis of the literature using of MEDLINE, EMBASE, and the Cochrane CENTRAL databases to identify cancer subgroups enrolled in randomized controlled trials evaluating extended thromboprophylaxis following hospitalization. Read More

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Modeling and mapping the habitat suitability and the potential distribution of Arboviruses vectors in Morocco.

Parasite 2021 14;28:37. Epub 2021 Apr 14.

Laboratory of Microbiology and Virology, Department of Medical Biology, Faculty of Medicine and Pharmacy, Cadi Ayyad University, PO Box 7010, 40000 Marrakech, Morocco.

Mosquitoes transmit several agents of diseases and the presence of different species represents a threat to animal and public health. Aedes and Culex mosquitoes are of particular concern giving their potential vector competence for Arbovirus transmission. In Morocco, the lack of detailed information related to their spatial distribution raises major concerns and hampers effective vector surveillance and control. Read More

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Acta Med Port 2021 Apr 16. Epub 2021 Apr 16.

Serviço de Medicina Interna. Hospital São Francisco Xavier. Centro Hospitalar de Lisboa Ocidental. Lisboa. Portugal.

The patient in shock represents a common clinical challenge in the emergency room, and potentially represents an immediate lifethreatening situation that requires the intervention of different medical specialties in order for hemodynamic stabilization to be achieved. This paper reports a non-systematic review of the initial approach to the patient in shock, highlighting the adaptation of the instituted measures to the particularities of the emergency room environment. This review is structured according to a proposed protocol of action based on the early diagnosis of shock, the identification of the type of shock and the most likely cause, and the institution of supportive therapy. Read More

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Time-dependent association between selective serotonin reuptake inhibitors and hospitalization due to hyponatremia.

J Psychopharmacol 2021 Apr 16:2698811211001082. Epub 2021 Apr 16.

Department of Laboratory Medicine, Division of Clinical Pharmacology, Karolinska University Hospital Huddinge, Karolinska Institutet, Stockholm, Sweden.

Background: Selective serotonin reuptake inhibitors (SSRIs) have a wide and increasing use for the treatment of depression and anxiety. Previous studies have indicated an increased risk of hyponatremia during the first months of treatment. We aimed to investigate the detailed time-course of SSRI-associated hyponatremia with a high temporal resolution, using registry data encompassing the total Swedish population. Read More

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Primary rectal squamous cell carcinoma resembling a submucosal tumor.

JGH Open 2021 Apr 26;5(4):517-519. Epub 2021 Feb 26.

Department of Endoscopy Mie University Hospital Tsu Japan.

Primary rectal squamous cell carcinoma is an extremely rare tumor and, in most cases, detected at an advanced stage. In our case, the tumor was at an early stage and had a submucosal appearance. Thus, the tumor was difficult to differentiate from other rectal submucosal tumors and, it was removed by endoscopic submucosal dissection for excisional biopsy. Read More

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Wuhan to World: The COVID-19 Pandemic.

Front Cell Infect Microbiol 2021 30;11:596201. Epub 2021 Mar 30.

Translational Health Science and Technology Institute (THSTI), Faridabad, India.

COVID-19 is a Severe Acute Respiratory Syndrome (SARS), caused by SARS-CoV-2, a novel virus which belongs to the family . It was first reported in December 2019 in the Wuhan city of China and soon after, the virus and hence the disease got spread to the entire world. As of February 26, 2021, SARS-CoV-2 has infected ~112. Read More

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Bronchoscopic Management of Endobronchial Atypical Carcinoid With Argon Plasma Coagulation and Laser: A Rare Case With Literature Review.

Cureus 2021 Mar 12;13(3):e13862. Epub 2021 Mar 12.

Interventional Pulmonology, Norton Thoracic Institute, St. Joseph's Hospital and Medical Center, Phoenix, USA.

Atypical carcinoid belongs to a spectrum of neuroendocrine tumors that can present as central airway obstruction. We treated a 58-year-old female who presented with recurrent pneumonia. Flexible bronchoscopy showed complete obstruction of the tumor in the right lower lobe. Read More

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Multiple Evanescent White Dot Syndrome Presenting After Initiation of Empagliflozin, a Sodium-Glucose Cotransporter-2 Inhibitor.

Cureus 2021 Mar 12;13(3):e13853. Epub 2021 Mar 12.

Ophthalmology, University of Texas Medical Branch Galveston, Galveston, USA.

Multiple evanescent white dot syndrome (MEWDS) is an inflammatory condition of the retina that typically presents unilaterally with multiple gray-white spots in the outer retina or retinal pigmented epithelium and granular changes within the fovea. We report a case of new-onset MEWDS in a patient closely after the initiation of empagliflozin, a sodium-glucose cotransporter inhibitor medicine for his type II diabetes mellitus. Read More

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Recurrent Hematemesis From Downhill Esophageal Varices: A Therapeutic Challenge for Gastroenterologists.

Cureus 2021 Mar 11;13(3):e13840. Epub 2021 Mar 11.

Internal Medicine, Federal Medical and Dental College, Islamabad, PAK.

Downhill or upper esophageal varices have an etiology that differs from that of the "uphill" varices secondary to portal hypertension. Approximately 0.1% of all cases of variceal hemorrhage are due to downhill varices. Read More

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A Patient with an Ileocecal MiNEN and a Synchronous Squamous Non-Small-Cell Lung Cancer: Case Report and Review of the Literature.

Case Rep Oncol Med 2021 31;2021:8896254. Epub 2021 Mar 31.

Medical Oncology Department, Hospital Universitario 12 de Octubre, Madrid, Spain.

Mixed neuroendocrine non-neuroendocrine neoplasms (MiNENs) are rare tumors composed of two different histological components, one of which is of a neuroendocrine origin. Given its suggested underdiagnosis and consequent low prevalence, no clear diagnostic and treatment guidelines are available, and treatment usually follows regimens similar to that of the most aggressive component. On the other hand, multiple primary tumors (MPTs) are also rare neoplastic entities that usually confer a challenge regarding treatment options, for a regimen that comprises both the primary and the synchronous/metachronous malignancy should be used. Read More

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Hepatic encephalopathy induced by Lenvatinib and anti-PD-1 mAb in a patient with advanced hepatocellular carcinoma: A case report.

Mol Clin Oncol 2021 Jun 1;14(6):110. Epub 2021 Apr 1.

Department of Gastroenterology Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong 250117, P.R. China.

Previous studies have reported that the combinational therapy of Lenvatinib and anti-programmed cell death-1 (PD-1) monoclonal antibody (mAb) produced a longer overall survival in patients with hepatocellular carcinoma (HCC). The current case report presented a a patient with HCC who had hepatic encephalopathy (HE) following treatment with Lenvatinib and anti-PD-1 mAb. The 42-year-old patient was diagnosed with stage IVa HCC accompanied with cirrhosis and Child-Pugh C. Read More

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Risk Factors Associated with Preterm Delivery in Singleton Pregnancy in a Tertiary Care Hospital in South India: A Case Control Study.

Int J Womens Health 2021 9;13:369-377. Epub 2021 Apr 9.

Department of Biostatistics, Amrita Institute of Medical Sciences and Research Centre, Amrita Vishwa Vidyapeetham, Kochi, 682041, Kerala, India.

Background: Preterm delivery is a major obstetric complication and a leading cause of neonatal mortality and morbidity. It is also associated with significant costs in terms of psychological and financial hardship, to the families.

Objective: The primary objective of this study was to determine the risk factors associated with all preterm deliveries in singleton pregnancy in a tertiary care hospital and the secondary objective was to determine the fetal outcomes among women with preterm delivery. Read More

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Paraplegia due to spinal meningioma during the third trimester of pregnancy: case report and literature review.

Spinal Cord Ser Cases 2021 Apr 15;7(1):31. Epub 2021 Apr 15.

Clinical Epidemilogy, Anesthesiolgy, Cúcuta, Norte Santander, Colombia.

Introduction: Spinal meningiomas represent 25-45% of intradural spinal tumors and ~2% of meningiomas of the central nervous system (CNS), and their occurrence during pregnancy is unusual. We present an updated literature review.

Case Report: A 36-year-old woman, at 32. Read More

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Spinal epidural hematoma in a child with hemophilia A with high titer inhibitors and follow-up with prophylactic emicizumab: case report and literature review.

Blood Coagul Fibrinolysis 2021 Apr 14. Epub 2021 Apr 14.

Hematology Service Pediatric Department, Hospital Universitario 'Dr José Eleuterio González', Universidad Autónoma de Nuevo León, Monterrey, México.

Hemorrhage in the central nervous system is the most severe and debilitating manifestation affecting patients with hemophilia A. The spinal epidural space is the most unusual and clinically challenging site of central nervous system hemorrhage in hemophilia A. These patients often show insidious neurological signs and symptoms that delay diagnosis and treatment. Read More

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A rare case of urachal adenocarcinoma with bone marrow metastasis.

Joshua Van Allen

BMJ Case Rep 2021 Apr 15;14(4). Epub 2021 Apr 15.

Department of Medicine, University of Connecticut Health Center, Farmington, Connecticut, USA

Urachal cancer is a rare and aggressive cancer that often presents in advanced stages. Given the rarity of this malignancy, medical case studies provide one of the few sources of literature available through which clinicians can guide medical management. Surgery is widely considered to be the mainstay of therapy when disease is localised and surgically resectable, therefore most current case studies on urachal cancer focus on surgical management, occasionally with adjuvant chemotherapy. Read More

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Development of central precocious puberty following cannabinoid use for paediatric epilepsy: causal or coincidence?

BMJ Case Rep 2021 Apr 15;14(4). Epub 2021 Apr 15.

Department of Paediatrics, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, Birmingham, UK.

Research suggests a role for cannabidiol oil in managing certain forms of paediatric onset epilepsy. However, studies on the impact of cannabis on the hypothalamo-pituitary-gonadal (HPG) axis have conflicting results. Delta-9-tetrahydrocannabinol (Δ9-THC) acutely inhibits gonadotropin-releasing hormone in the hypothalamus, reducing testosterone levels by 65% in rhesus monkeys. Read More

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ECG patterns of typical and atypical advanced interatrial block: prevalence and clinical relevance.

Rev Esp Cardiol (Engl Ed) 2021 Apr 12. Epub 2021 Apr 12.

Fundación Investigación Cardiovascular, Programa Cardiovascular-ICCC, Institut de Recerca del Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau, Barcelona, Spain.

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Application of telemedicine in infectious diseases.

Enferm Infecc Microbiol Clin 2021 Apr 12. Epub 2021 Apr 12.

Capitán médico, Servicio de Medicina Interna, Hospital Central de la Defensa Gómez Ulla, Madrid, España.

Introduction: Infectious pathologies can benefit from the application of Telemedicine (TM). This study provides a description of the infectious pathology treated by the Telemedicine Service of the Hospital Central de la Defensa Gómez Ulla (STM-HCDGU).

Methods: Analysis of the e-consultations made by members of the Armed Forces of Spain displaced to the area of operations in the period between 01/1/2015 and 31/12/2018 who developed symptoms of infectious diseases. Read More

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Autophagy and PTEN in DNA damage-induced senescence.

Adv Cancer Res 2021 3;150:249-284. Epub 2021 Mar 3.

Department of Cancer Biology, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, United States; Department of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, United States; Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland, OH, United States. Electronic address:

The use of DNA-damaging agents such as radiotherapy and chemotherapy has been a mainstay treatment protocol for many cancers, including lung and prostate. Recently, FDA approval of inhibitors of DNA repair, and targeting innate immunity to enhance the efficacy of DNA-damaging agents have gained much attention. Yet, inherent or acquired resistance against DNA-damaging therapies persists as a fundamental drawback. Read More

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Central Nervous System Manifestations of COVID-19: A Critical Review and Proposed Research Agenda.

J Int Neuropsychol Soc 2021 Apr 16:1-15. Epub 2021 Apr 16.

University of Florida, Department of Clinical and Health Psychology, Gainesville, FL32610, USA.

Objective: On March 11, 2020, the World Health Organization declared an outbreak of a new viral entity, coronavirus 2019 (COVID-19), to be a worldwide pandemic. The characteristics of this virus, as well as its short- and long-term implications, are not yet well understood. The objective of the current paper was to provide a critical review of the emerging literature on COVID-19 and its implications for neurological, neuropsychiatric, and cognitive functioning. Read More

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Epidemiology of dengue virus infections in Nepal, 2006-2019.

Infect Dis Poverty 2021 Apr 15;10(1):52. Epub 2021 Apr 15.

Central Department of Microbiology, Tribhuvan University, Kirtipur, Kathmandu, Nepal.

Background: Dengue is one of the newest emerging diseases in Nepal with increasing burden and geographic spread over the years. The main objective of this study was to explore the epidemiological patterns of dengue since its first outbreak (2006) to 2019 in Nepal.

Methods: This study is a retrospective analysis that covers the last 14 years (2006-2019) of reported dengue cases from Epidemiology Diseases Control Division (EDCD), Ministry of Health and Population, Government of Nepal. Read More

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Situational analysis of service provision for adolescents with mental and neurological disorders in in two districts of Ghana.

Int J Ment Health Syst 2021 Apr 15;15(1):35. Epub 2021 Apr 15.

Kintampo Health Research Centre, Ghana Health Service, P.O. Box 200, Kintampo, Ghana.

Background: Prevalence among adolescents with mental disorders are about 20% worldwide. In 2012, Ghana enacted the Mental Health Act, Act 846 to regulate mental health care, but did not include specific programmatic details of service provision nor any measurable indicators for adolescent mental health. Currently no service programmes focused on adolescents and no aggregated data exists documenting prevalence of mental and neurological disorders among adolescents. Read More

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Using the autologous innominate vein as a substitute for pulmonary arteries in a patient with pulmonary atresia and absent pulmonary arteries.

J Cardiothorac Surg 2021 Apr 15;16(1):89. Epub 2021 Apr 15.

Shiraz University of Medical Sciences, Shiraz, Iran.

Background: Repair of the absence of the whole or major parts of pulmonary arteries is a challenge, and the choice of conduit material to reconstruct the pulmonary arteries is under dispute. We used the autologous innominate vein to construct pulmonary arteries.

Case Presentation L: We present a novel technique using the autologous innominate vein as a free graft in a 6-month-old infant with pulmonary atresia and absence of central pulmonary arteries. Read More

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Mild Leber hereditary optic neuropathy (LHON) in a Western European family due to the rare Asian m.14502T>C variant in the gene.

Ophthalmic Genet 2021 Apr 16:1-6. Epub 2021 Apr 16.

Department of Ophthalmology, Ghent University Hospital, Ghent, Belgium.

: Leber hereditary optic neuropathy (LHON) is a mitochondrial neurodegenerative disease. The majority (>90%) is related to three primary mitochondrial DNA (mtDNA) variants: m.3460G>A, m. Read More

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Keratoconus in a child with partial trisomy 13.

Ophthalmic Genet 2021 Apr 16:1-4. Epub 2021 Apr 16.

UPMC Eye Center, Pittsburgh, Pennsylvania, USA.

Clinical studies suggest the importance of genetic components in the etiology of keratoconus. However, the contributing genes and variants remain elusive. We present a case of bilateral keratoconus in a child with partial trisomy 13, with a trisomic region spanning loci that have been associated with keratoconus. Read More

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