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Association of venous thromboembolism following pediatric traumatic spinal injuries with injury severity and longer hospital stays.

J Neurosurg Spine 2021 Sep 17:1-7. Epub 2021 Sep 17.

1Computational Neurosciences Outcomes Center, Department of Neurosurgery, Harvard Medical School, Brigham and Women's Hospital; and.

Objective: Venous thromboembolism (VTE) can cause significant morbidity and mortality in hospitalized patients, and may disproportionately occur in patients with limited mobility following spinal trauma. The authors aimed to characterize the epidemiology and clinical predictors of VTE in pediatric patients following traumatic spinal injuries (TSIs).

Methods: The authors conducted a retrospective cohort analysis of children who experienced TSI, including spinal fractures and spinal cord injuries, encoded within the National Trauma Data Bank from 2011 to 2014. Read More

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September 2021

The Clinical Implications of Aspergillus Fumigatus Sensitization in Difficult-To-Treat Asthma Patients.

J Allergy Clin Immunol Pract 2021 Sep 14. Epub 2021 Sep 14.

Clinical and Experimental Sciences Department, Faculty of Medicine, University of Southampton, Southampton, SO16 6YD, UK; National Institute for Health Research (NIHR) Southampton Biomedical Research Centre at University Hospital Southampton NHS Foundation Trust, Southampton, UK; Asthma, Allergy and Clinical Immunology Department, University Hospital Southampton NHS Foundation Trust, Southampton, UK; The David Hide Asthma & Allergy Research Centre, St Mary's Hospital, Newport, Isle of Wight, UK. Electronic address:

Background: Fungal sensitivity has been associated with severe asthma outcomes. However, the clinical implication of Aspergillus fumigatus (A.fumigatus) sensitization in difficult-to-treat (or difficult) asthma is unclear. Read More

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September 2021

Dynamics of the Upper Respiratory Tract Microbiota and its Association with Mortality in COVID-19.

Am J Respir Crit Care Med 2021 Sep 17. Epub 2021 Sep 17.

Beijing Institute of Genomics, Chinese Academy of Sciences, Beijing, China;

Rationale: Alteration of human respiratory microbiota had been observed in COVID-19. How the microbiota is associated with the prognosis in COVID-19 is unclear.

Objectives: To characterize the feature and dynamics of the respiratory microbiota and its associations with clinical features in COVID-19 patients. Read More

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September 2021

Characterizing Adverse Events Reporting for an Over-the-Counter Disposable Intravaginal Support Device for Stress Urinary Incontinence.

Female Pelvic Med Reconstr Surg 2021 Sep 15. Epub 2021 Sep 15.

From the Department of Urology Department of Obstetrics and Gynecology Department of Healthcare Policy and Research, Weill Cornell Medical College-New York Presbyterian, New York, NY.

Objectives: In recent years, new intravaginal support devices for stress urinary incontinence have been introduced to the market. Although studies have demonstrated their safety and efficacy, few studies have examined adverse events attributed to their use. The objective of this study was to characterize reported adverse events for an over-the-counter intravaginal support device and determine whether further medical treatment was necessary to manage the adverse event. Read More

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September 2021

A Retrospective Study of Hearing Loss in Patients Diagnosed with Peroxisome Biogenesis Disorders in the Zellweger Spectrum.

Ear Hear 2021 Sep 15. Epub 2021 Sep 15.

Department of Otolaryngology, Boston Children's Hospital, Center for Life Sciences, Boston, Massachusetts, USA Department of Human Genetics/Department of Pediatrics, McGill University, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada.

Objectives: Peroxisome Biogenesis Disorders in the Zellweger Spectrum (PBD-ZSD) are autosomal recessive disorders characterized by defects in peroxisome function, biosynthesis, and/or assembly. Despite its frequent documentation, hearing loss associated with PBD-ZSD has not been extensively characterized. The purpose of this retrospective natural history study was to better characterize the hearing loss associated with PBD-ZSD and to provide additional insight into the evaluation and management of PBD-ZSD patients with hearing loss. Read More

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September 2021

Assessment of Allergic and Anaphylactic Reactions to mRNA COVID-19 Vaccines With Confirmatory Testing in a US Regional Health System.

JAMA Netw Open 2021 Sep 1;4(9):e2125524. Epub 2021 Sep 1.

Sean N. Parker Center for Allergy and Asthma Research at Stanford University, Stanford, California.

Importance: As of May 2021, more than 32 million cases of COVID-19 have been confirmed in the United States, resulting in more than 615 000 deaths. Anaphylactic reactions associated with the Food and Drug Administration (FDA)-authorized mRNA COVID-19 vaccines have been reported.

Objective: To characterize the immunologic mechanisms underlying allergic reactions to these vaccines. Read More

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September 2021

International Changes in COVID-19 Clinical Trajectories Across 315 Hospitals and 6 Countries: a 4CE Consortium Study.

J Med Internet Res 2021 Sep 2. Epub 2021 Sep 2.

Institute for Biomedical Informatics, University of Kentucky, Lexington, US.

Background: Many countries have experienced two predominant waves of COVID-19-related hospitalizations. Comparing the clinical trajectories of patients hospitalized in separate waves of the pandemic enables further understanding of the evolving epidemiology, pathophysiology, and healthcare dynamics of the COVID-19 pandemic.

Objective: In this retrospective cohort study, we analyzed electronic health record (EHR) data from patients with SARS-CoV-2 infections hospitalized in participating healthcare systems representing 315 hospitals across six countries. Read More

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September 2021

Risk Assessment of the Door-In-Door-Out Process at Primary Stroke Centers for Patients With Acute Stroke Requiring Transfer to Comprehensive Stroke Centers.

J Am Heart Assoc 2021 Sep 17:e021803. Epub 2021 Sep 17.

Department of Neurology Biological Sciences Division University of Chicago Chicago IL.

Background Patients with acute stroke at non- or primary stroke centers (PSCs) are transferred to comprehensive stroke centers for advanced treatments that reduce disability but experience significant delays in treatment and increased adjusted mortality. This study reports the results of a proactive, systematic, risk assessment of the door-in-door-out process and its application to solution design. Methods and Results A learning collaborative (clinicians, patients, and caregivers) at 2 PSCs and 3 comprehensive stroke centers in Chicago, Illinois participated in a failure modes, effects, and criticality analysis to identify steps in the process; failures of each step, underlying causes; and to characterize each failure's frequency, impact, and safeguards using standardized scores to calculate risk priority and criticality numbers for ranking. Read More

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September 2021

Coagulation profiles and viscoelastic testing in multisystem inflammatory syndrome in children.

Pediatr Blood Cancer 2021 Sep 17:e29355. Epub 2021 Sep 17.

Department of Cardiology, Boston Children's Hospital, Boston, Massachusetts, USA.

Objective: To characterize viscoelastic testing profiles of children with multisystem inflammatory syndrome in children (MIS-C).

Methods: This single-center retrospective review included 30 patients diagnosed with MIS-C from March 1 to September 1, 2020. Thromboelastography (TEG) with platelet mapping was performed in 19 (63%) patients and compared to age- and sex-matched controls prior to cardiac surgery. Read More

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September 2021

Systematic Review: Cardiac Metastasis of Lingual Squamous Cell Carcinoma.

Spartan Med Res J 2021 30;6(2):27297. Epub 2021 Aug 30.

Metro Health Hospital-University of Michigan, Wyoming, Michigan, USA.

Introduction: Lingual squamous cell carcinoma (LSCC) is an aggressive malignancy that carries significant mortality risk and the potential for cardiac metastasis. The authors performed a systematic review designed to characterize disease progression of LSCC cardiac metastasis by evaluating patient demographics, characteristics, management, and clinical outcomes.

Methods: Two authors independently screened articles in Embase, PubMed, and Cochrane Database of Systematic Reviews up until December 2019 for study eligibility. Read More

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Assessment of atrial septal defect using 2D or real-time 3D transesophageal echocardiography and outcomes following transcatheter closure.

Ann Transl Med 2021 Aug;9(16):1309

Cardiovascular Department, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.

Background: The assessment of interatrial septum (IAS) requires a standardized, systematic approach, including two-dimensional transthoracic echocardiography (2D TTE), 2D transesophageal echocardiography (2D TEE), and three-dimensional (3D) TEE. Although 2D TEE has been widely used for the preoperative assessment of atrial septal defect (ASD), its ability to provide reliable information is often limited due to the structural characteristics of IAS. The introduction of 3D TEE provides a unique "en face" view of IAS, which allows the visualization and accurate measurements of diameters, area, and rims of ASD. Read More

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Comprehensive Analysis of circRNA Expression Profiles During Cervical Carcinogenesis.

Front Oncol 2021 31;11:676609. Epub 2021 Aug 31.

Department of Obstetrics and Gynecology, The Second Hospital of Shanxi Medical University, Taiyuan, China.

Circular RNAs (circRNAs) are regulatory molecules that participate in the occurrence, development and progression of tumors. To obtain a complete blueprint of cervical carcinogenesis, we analyzed the temporal transcriptomic landscapes of mRNAs and circRNAs. Microarrays were performed to identify the circRNA and mRNA expression profiles of cervical squamous cell carcinoma (CSCC) and high-grade squamous intraepithelial lesion (HSIL) patients compared with normal controls (NC). Read More

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Neuroinflammatory gene expression in chronic prostatitis/chronic pelvic pain syndrome patients: insights into etiology and phenotype biology.

Transl Androl Urol 2021 Aug;10(8):3340-3347

Glickman Urological and Kidney Institute, The Cleveland Clinic, Cleveland, OH, USA.

Background: Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) has diverse clinical phenotypes and its etiology is multifactorial. Studies to date of gene expression in humans have been limited to small numbers of target genes. NanoString can simultaneously measure hundreds of genes. Read More

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Disparities and survival in newly diagnosed gastric cancer in Hispanic patients in the United States: a propensity score matched analysis.

J Gastrointest Oncol 2021 Aug;12(4):1308-1325

Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA.

Background: The burden of gastric cancer involving Hispanic patients in the United States is growing as both the population and the incidence of gastric cancer in this group increases. This burden is compounded by presentation with advanced disease and socioeconomic challenges shaping cancer care. We sought to describe the demographics, socioeconomic factors, treatment, and survival experience of Hispanic patients with gastric adenocarcinoma. Read More

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Causes of mortality associated with autoimmune rheumatic disease in a referral hospital.

Reumatol Clin (Engl Ed) 2021 Sep 13. Epub 2021 Sep 13.

Unidad de Reumatología, Departamento de Medicina Interna, Hospital Roosevelt, Ciudad de Guatemala, Guatemala; Facultad de Ciencias Médicas, Escuela de Estudios de Postgrado, Universidad de San Carlos de Guatemala, Ciudad de Guatemala, Guatemala. Electronic address:

The causes of mortality among rheumatic diseases vary widely between geographic areas and cannot be generalized, however, they are frequently associated with the aggressiveness of the clinical presentation and the secondary effects of the therapy used. The main purpose of this study was to characterize the causes of death in a group of patients with autoimmune rheumatic disease. For this purpose, a retrospective study was carried out over a period of 10 years (2009-2019), deceased patients were included from a referral centre in Guatemala City, the records were reviewed in search of demographic and clinical variables. Read More

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September 2021

Analysis of Brush Cutter-Related Accidents: Describing an Extraordinary Kind of Agricultural Injury.

J Emerg Med 2021 Sep 13. Epub 2021 Sep 13.

Department of Emergency Medicine, Recep Tayyip Erdoğan University Training and Research Hospital, Rize, Turkey. Electronic address:

Background: Brush cutter (BC)-related penetrating trauma, similar to other types of power saws, can cause serious injuries, especially to the extremities. Studies of this particular injury are limited.

Objective: The objective of this study was to characterize injury patterns and patient demographic characteristics for BC-related injuries. Read More

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September 2021

Hospital outcomes in pediatric patients with Prader-Willi syndrome (PWS) undergoing orthopedic surgery: A 12-year analysis of national trends in surgical management and inpatient hospital outcomes.

J Orthop Sci 2021 Sep 13. Epub 2021 Sep 13.

Department of Orthopedics, Phoenix Children Hospital, Phoenix, 1919 E Thomas Rd, Phoenix, AZ, 85016, USA.

Background: The incidence of orthopedic disorders amongst patients with Prader-Willi Syndrome (PWS) is high when compared to the general pediatric population. The purpose of this retrospective study was to define the most commonly performed orthopedic procedures in pediatric patients with PWS and to characterize the peri-operative outcomes of these patients.

Methods: The Kids Inpatient Database (KID) was queried to collect data and identify all pediatric patients with PWS who underwent orthopedic procedures from 2001 to 2012. Read More

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September 2021

Predictors for early readmission in patients hospitalized with new onset pediatric lupus nephritis.

Lupus 2021 Sep 16:9612033211044648. Epub 2021 Sep 16.

Department of Pediatrics, Division of Pediatric Rheumatology, 12239Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, GA, USA.

Objective: The objective is to determine the 30-day hospital readmission rate following a hospitalization due to pediatric lupus nephritis of recent onset and characterize the risk factors associated with these early readmissions.

Methods: The study included 76 children hospitalized from 01/01/2008 to 4/30/2017 due to a new diagnosis of lupus nephritis. We calculated the 30-day hospital readmission rate and compared the characteristics of the patients that were readmitted to patients that were not readmitted using univariable and multivariable analysis. Read More

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September 2021

Postoperative Pain and Opioid Use after Facial Feminization Surgery.

Facial Plast Surg 2021 Sep 16. Epub 2021 Sep 16.

Department of Head and Neck Surgery, Kaiser Permanente Oakland Medical Center, Oakland, California.

The objective of this study is to characterize surgical pain after facial feminization surgery (FFS) and delineate postoperative opioid usage. It is a retrospective cohort study. It was performed in a multicenter integrated health care system. Read More

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September 2021

Highly multiplexed image analysis of intestinal tissue sections in patients with inflammatory bowel disease.

Gastroenterology 2021 Sep 13. Epub 2021 Sep 13.

Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. Electronic address:

Background Aims: Significant progress has been made since the first report of inflammatory bowel disease (IBD) in 1859, following decades of research that contributed to the understanding of the genetic and environmental factors involved in IBD pathogenesis. Today, a range of treatments is available for directed therapy, mostly targeting the overactive immune response. However, the mechanisms by which the immune system contributes to disease pathogenesis and progression are not fully understood. Read More

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September 2021

Blood Product Administration During Transport Throughout the US Africa Command Theater of Operation.

J Spec Oper Med 2021 ;21(3):66-70

Background: United States Africa Command (US AFRICOM) is one of six US Defense Department's geographic combatant commands and is responsible to the Secretary of Defense for military relations with African nations, the African Union, and African regional security organizations. A full-spectrum combatant command, US AFRICOM is responsible for all US Department of Defense operations, exercises, and security cooperation on the African continent, its island nations, and surrounding waters. We seek to characterize blood product administration within AFRICOM using the in-transit visibility tracking tool known as TRAC2ES (TRANSCOM Regulating and Command & Control Evacuation System). Read More

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January 2021

Genotypic HIV-1 tropism determination might help to identify people with exhausted treatment options and advanced disease.

J Antimicrob Chemother 2021 Sep 16. Epub 2021 Sep 16.

Department of Experimental Medicine, University of Rome 'Tor Vergata', Rome, Italy.

Objectives: To evaluate HIV-1 tropism in 1382 combined antiretroviral therapy (cART)-experienced patients failing therapy to characterize those with exhausted therapeutic options.

Methods: HIV-1 genotypic tropism was inferred through Geno2Pheno by estimating the false-positive-rate (FPR) values. Cumulative resistance and drug activity were evaluated by Stanford algorithm. Read More

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September 2021

Pharmacokinetics and safety of high-dose rifampicin in children with TB: the Opti-Rif trial.

J Antimicrob Chemother 2021 Sep 16. Epub 2021 Sep 16.

Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, PO Box 241, Cape Town 8000, South Africa.

Background: Rifampicin doses of 40 mg/kg in adults are safe and well tolerated, may shorten anti-TB treatment and improve outcomes, but have not been evaluated in children.

Objectives: To characterize the pharmacokinetics and safety of high rifampicin doses in children with drug-susceptible TB.

Patients And Methods: The Opti-Rif trial enrolled dosing cohorts of 20 children aged 0-12 years, with incremental dose escalation with each subsequent cohort, until achievement of target exposures or safety concerns. Read More

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September 2021

Clinical and molecular characterization of patients fulfilling Chompret criteria for Li-Fraumeni syndrome in Southern Brazil.

PLoS One 2021 16;16(9):e0251639. Epub 2021 Sep 16.

Programa de Pós-Graduação em Genética e Biologia Molecular (PPGBM), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil.

Li-Fraumeni syndrome (LFS) is an autosomal dominant cancer predisposition syndrome caused by pathogenic germline variants in the TP53 gene, characterized by a predisposition to the development of a broad spectrum of tumors at an early age. The core tumors related to LFS are bone and soft tissue sarcomas, premenopausal breast cancer, brain tumors, adrenocortical carcinomas (ACC), and leukemias. The revised Chompret criteria has been widely used to establish clinical suspicion and support TP53 germline variant testing and LFS diagnosis. Read More

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September 2021

Patient Recovery and Satisfaction with Perioperative Care After Rhinoplasty.

Facial Plast Surg Aesthet Med 2021 Sep 16. Epub 2021 Sep 16.

Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear, Boston, Massachusetts, USA.

Recovery after rhinoplasty is not well characterized in the literature. To quantify key aspects of patient recovery after rhinoplasty and characterize factors that may impact recovery and overall satisfaction with perioperative care. Prospective cohort study of rhinoplasty patients undergoing surgery at a tertiary referral center between January 2018 and January 2020, and completed a patient experience questionnaire at first postoperative visit. Read More

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September 2021

Early platelet dysfunction in patients receiving extracorporeal membrane oxygenation is associated with mortality.

J Thromb Thrombolysis 2021 Sep 16. Epub 2021 Sep 16.

Department of Cardiology and Angiology I, University Heart Center Freiburg - Bad Krozingen, Faculty of Medicine, University of Freiburg, Freiburg, Germany.

Extracorporeal membrane oxygenation (ECMO) is used for patients with cardiopulmonary failure and is associated with severe bleeding and poor outcome. Platelet dysfunction may be a contributing factor. The aim of this prospective observational study was to characterize platelet dysfunction and its relation to outcome in ECMO patients. Read More

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September 2021

Gold Nanobiosensor Based on the Localized Surface Plasmon Resonance is Able to Diagnose Human Brucellosis, Introducing a Rapid and Affordable Method.

Nanoscale Res Lett 2021 Sep 16;16(1):144. Epub 2021 Sep 16.

Department of Biochemistry, Fasa University of Medical Sciences, Fasa, Iran.

Brucellosis is considered as the most common bacterial zoonosis in the world. Although the laboratory findings are the most reliable diagnosis today, the current laboratory methods have many limitations. This research aimed to design and evaluate the performance of a novel technique based on the localized surface plasmon resonance (LSPR) to eliminate or reduce existing shortcomings. Read More

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September 2021

Circulating miR-122 in patients with non-toxic acute acetaminophen ingestions.

Clin Toxicol (Phila) 2021 Sep 16:1-3. Epub 2021 Sep 16.

Department of Emergency Medicine, University of California, San Francisco, CA, USA.

MicroRNA-122 (miR-122) is a novel biomarker of liver injury and has been proposed as an early predictor of acetaminophen-associated hepatotoxicity. However, there is little data on miR-122 in patients with nontoxic acute acetaminophen ingestions. This was an observational study of patients with a history of acute acetaminophen ingestion and measured acetaminophen concentrations below the treatment nomogram and who did not receive antidotal treatment. Read More

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September 2021

Indolent B-Lineage Precursor Populations Identified by Flow Cytometry and Immunohistochemistry in Benign Lymph Nodes.

Am J Clin Pathol 2021 Sep 16. Epub 2021 Sep 16.

Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, USA.

Objectives: In this retrospective study, we report a series of benign lymph nodes showing small populations of normal B-cell precursors characterized by flow cytometry and immunohistochemistry.

Methods: Ten cases identified during clinical flow cytometry practice were retrospectively reanalyzed with particular attention to hematogone categorization and enumeration. Immunohistochemical staining was performed on five excisional lymph node biopsy specimens to characterize the morphologic correlate. Read More

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September 2021

Levocarnitine supplementation for management of hypertriglyceridemia in patients receiving parenteral nutrition.

Nutr Clin Pract 2021 Sep 16. Epub 2021 Sep 16.

Department of Pharmacy, The Johns Hopkins Hospital, Baltimore, Maryland, USA.

Background: Levocarnitine deficiency has been observed in patients receiving parenteral nutrition (PN) and can cause or worsen hypertriglyceridemia. The objective was to characterize use of levocarnitine supplementation in PN and evaluate its effect on triglyceride levels in hospitalized adults.

Methods: This retrospective, single-center study included patients with triglyceride levels ≥175 mg/dl while receiving PN who had a subsequent reduction in lipid injectable emulsion dose. Read More

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September 2021