526,242 results match your criteria clinical outcomes


Ultra-Low Energy Cycled Burst Spinal Cord Stimulation Yields Robust Outcomes in Pain, Function, and Affective Domains: A Subanalysis From Two Prospective, Multicenter, International Clinical Trials.

Neuromodulation 2021 Jul 27. Epub 2021 Jul 27.

University of Chicago Medical Center, Chicago, IL, USA.

Introduction: DeRidder's burst stimulation design has become a key spinal cord stimulation (SCS) waveform because it reduces the intensity of pain as well as its associated emotional distress. The brain pathways underlying these outcomes may also allow for the effects of stimulation to carry over after stimulation is turned off, making it amenable to intermittent application. Here, the utility of intermittently cycled burst was evaluated using data from two large real-world prospective studies (TRIUMPH, REALITY). Read More

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The Risk Factors and Clinical Outcomes Associated with Acute Kidney Injury in Patients with COVID-19: Data from a Large Cohort in Iran.

Kidney Blood Press Res 2021 Jul 27:1-9. Epub 2021 Jul 27.

Department of Nephrology Diseases, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Introduction: Kidney involvement, ranging from mild hematuria and proteinuria to acute kidney injury (AKI) in patients with coronavirus disease-2019 (COVID-19), is a recent finding with various incidence rates reported among hospitalized patients with COVID-19. Given the various AKI rates and their associated risk factors, lack of AKI recovery in the majority of patients hospitalized with COVID-19, and limited data regarding AKI in patients with COVID-19 in Iran, we aim to investigate the potential risk factors for AKI development and its incidence in patients hospitalized with COVID-19.

Methods: In this retrospective cohort study, we enrolled adult patients referred to the Sina Hospital, Iran, from February 20 to May 14, 2020, with either a positive PCR test or a highly susceptible chest computed tomography features consistent with COVID-19 diagnosis. Read More

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Evolution of Evidence-Based Medicine in Stroke.

Authors:
Graeme J Hankey

Cerebrovasc Dis 2021 Jul 27:1-12. Epub 2021 Jul 27.

Medical School, Faculty of Health and Medical Sciences, The University of Western Australia, Perth, Washington, Australia.

The introduction and evolution of evidence-based stroke medicine has realized major advances in our knowledge about stroke, methods of medical research, and patient outcomes that continue to complement traditional individual patient care. It is humbling to recall the state of knowledge and scientific endeavour of our forebears who were unaware of what we know now and yet pursued the highest standards for evaluating and delivering effective stroke care. The science of stroke medicine has evolved from pathophysiological theory to empirical testing. Read More

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Current state of knowledge on immunotherapy in ECOG PS 2 patients. A systematic review.

Adv Med Sci 2021 Jul 24;66(2):381-387. Epub 2021 Jul 24.

2nd Department of Lung Diseases and Tuberculosis, Medical University of Bialystok, Bialystok, Poland.

Background: Patients with Eastern Cooperative Oncology Group Performance Status 2 (ECOG PS 2) are not included in most randomized clinical trials and registry studies. Nevertheless, immune checkpoint inhibitors are registered in the USA and Europe regardless of the performance status. Evidence regarding the effectiveness and safety of such treatment in this cohort is sparse. Read More

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INR and COVID-19 severity and mortality: A systematic review with meta-analysis and meta-regression.

Adv Med Sci 2021 Jul 21;66(2):372-380. Epub 2021 Jul 21.

Discipline of Clinical Pharmacology, College of Medicine and Public Health, Flinders University, Adelaide, Australia; Department of Clinical Pharmacology, Flinders Medical Centre, Southern Adelaide Local Health Network, Adelaide, Australia. Electronic address:

Objectives: D-dimer elevations, suggesting a pro-thrombotic state and coagulopathy, predict adverse outcomes in coronavirus disease 2019 (COVID-19). However, the clinical significance of other coagulation markers, particularly the international normalized ratio (INR), is not well established. We conducted a systematic review and meta-analysis of the INR in COVID-19. Read More

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Psychosocial functioning in integrated treatment of co-occurring posttraumatic stress disorder and alcohol use disorder.

J Psychiatr Res 2021 Jul 22;142:40-47. Epub 2021 Jul 22.

V.A. San Diego Healthcare System, 3350 La Jolla Village Dr, San Diego, CA, 92161, USA; Department of Psychiatry, University of California, San Diego, 9500 Gilman Drive #9116B, La Jolla, CA, 92093, USA; Center of Excellence for Stress and Mental Health/VA San Diego Healthcare System, 3350 La Jolla Village Dr, San Diego, CA, 92161, USA; National Center for PTSD, 215 North Main St, White River Junction, VT, 05009, USA. Electronic address:

Co-occurring posttraumatic stress disorder and alcohol use disorder (PTSD/AUD) is associated with poorer psychosocial functioning than either disorder alone; however, it is unclear if psychosocial functioning improves in treatment for PTSD/AUD. This study examined if psychosocial functioning improved in integrated treatments for PTSD/AUD, and if changes in PTSD severity and percentage heavy drinking days (PHDD) during treatment were associated with functioning outcomes. 119 veterans with PTSD/AUD randomized to receive either Concurrent Treatment of PTSD and Substance Use Disorders using Prolonged Exposure or Seeking Safety completed measures of functioning (Medical Outcomes Survey SF-36), PTSD (Clinician Administered PTSD Scale for DSM-5), and alcohol use (Timeline Follow-Back) at baseline, posttreatment, 3- and 6-month follow-ups. Read More

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Endovascular Therapy for Acute Ischemic Stroke in Patients with Large-Vessel Occlusion due to Atherosclerotic Stenosis.

J Stroke Cerebrovasc Dis 2021 Jul 24;30(10):105960. Epub 2021 Jul 24.

Department of Neurosurgery, Hyogo College of Medicine, Nishinomiya, Japan.

Objectives: Endovascular therapy (EVT) is safe and effective for acute ischemic stroke (AIS) due to large-vessel occlusion (LVO). However, the influence of the AIS subtype (large-artery atherosclerosis [LAA] or cardioembolism [CE]) on clinical outcome in patients treated with EVT remains unclear. This study aimed to evaluate the differences in clinical results between the two subtypes using data from a multicenter prospective registry (RESCUE-Japan Registry 2). Read More

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Adrenal adenoma as a cause of atypical psychosis: Presentation, diagnosis, surgical technique and outcome (case report with a brief literature review).

Int J Surg Case Rep 2021 Jul 8;85:106187. Epub 2021 Jul 8.

Department of Cardiology, Mohammed VI University Hospital of Oujda, Mohammed First University of Oujda, Morocco; Laboratory of Epidemiology, Clinical Research and Public Health, Faculty of Medicine and Pharmacy, Mohammed the First University of Oujda, Morocco.

Introduction And Importance: Psychiatric symptoms may be a mode of the revelation of several endocrinopathies, but rarely in primary hyperaldosteronism, which can increase psychiatric comorbidity, as well as cardiovascular risk.

Case Presentation: We report a case of a 26-year-old engineer, who suffered from atypical psychosis before being hospitalized for a state of agitation, he presented with high blood pressure and severe hypokalemia. An etiological assessment revealed a right adrenal adenoma, which was afterward resected, with a very good evolution. Read More

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Intensive clinical trauma treatment for children and adolescents with mild intellectual disability or borderline intellectual functioning: A pilot study.

Res Dev Disabil 2021 Jul 24;117:104030. Epub 2021 Jul 24.

Trajectum, Zwolle, the Netherlands; Behavioural Science Institute, Radboud University, Nijmegen, the Netherlands.

Background: Children and adolescents with mild intellectual disability (MID) or borderline intellectual functioning (BIF) are at increased risk for posttraumatic stress disorder (PTSD) or trauma-related symptoms due to adverse childhood experiences (ACEs). Weekly provided treatment sessions and/or outpatient treatment may not be effective enough.

Aims: Investigate feasibility, safety and potential effectiveness of an intensive clinical trauma treatment in children and adolescents with MID-BIF and trauma-related symptoms as a result of ACEs or PTSD. Read More

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Ultraviolet-A light reduces cellular cytokine release from human endotracheal cells infected with Coronavirus.

Photodiagnosis Photodyn Ther 2021 Jul 24:102457. Epub 2021 Jul 24.

Medically Associated Science and Technology (MAST) Program, Cedars-Sinai, Los Angeles, CA, USA; Karsh Division of Gastroenterology and Hepatology, Cedars-Sinai, Los Angeles, CA, USA. Electronic address:

Background: An important clinical feature of coronavirus disease 2019 (COVID-19) is hypercytokinemia (cytokine storm). We previously showed that narrow band ultraviolet-A (NB-UVA) treatment salvages coronavirus (CoV)-229E-infected human tracheal cells, and that daily endotracheal NB-UVA therapy reduced severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) levels in human subjects, with improved clinical outcomes. Here, we examined NB-UVA effects on cytokine release during CoV-229E infection. Read More

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THE USE OF BIOLOGICAL AGENTS IN PREGNANT WOMEN AFFECTED BY AUTOIMMUNE DISORDERS: WHY WE NEED MORE RESEARCH OF THIS NEGLECTED AREA.

Pharmacol Res 2021 Jul 24:105786. Epub 2021 Jul 24.

Department of Woman, Mother and Neonate, 'V. Buzzi' Children Hospital, ASST Fatebenefratelli Sacco, 20141 Milan, Italy; Department of Biomedical and Clinical Sciences, "Luigi Sacco", University of Milan, 20157 Milan, Italy.

Women of childbearing age are largely affected by several autoimmune disorders (the estimates range between 1.5 and 10 per 10,000). The increasing number of effective biological agents has dramatically revolutionized the treatment of these clinical conditions, ameliorating the patient's quality of life. Read More

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Examining the influence of mental stress on balance perturbation responses in older adults.

Exp Gerontol 2021 Jul 24;153:111495. Epub 2021 Jul 24.

University of Maryland School of Medicine, Department of Physical Therapy and Rehabilitation Science, Baltimore, MD 21201, USA. Electronic address:

Background: Reach-to-grasp responses following balance perturbations are important to fall prevention but are often ineffective in older adults. The ability to shift attention from an ongoing cognitive task to balance related processes has been shown to influence reach-to-grasp effectiveness in older adults. However, the added influence of stress and anxiety - known to negatively affect attention shifting ability - has not yet been explored in relation to recovery from balance perturbations. Read More

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Prospective associations of chronic and intrusive pain with sarcopenia and physical disability amongst older Australian men: The Concord Health and Ageing in Men Project.

Exp Gerontol 2021 Jul 24:111501. Epub 2021 Jul 24.

School of Public Health, University of Sydney, New South Wales, Sydney, Australia; The ARC Centre of Excellence in Population Ageing Research, University of Sydney, New South Wales, Sydney, Australia.

Background: Associations of chronic and intrusive pain with sarcopenia and disability in older men are unclear.

Methods: 1452 community-dwelling men aged ≥70 years self-reported chronic pain (pain every day for ≥3 months) and intrusive pain (pain interfering with normal activities in the last 4 weeks) at baseline and five years later, and were classified as having no, prevalent (baseline only), incident (follow-up only) or persistent (both baseline and follow-up) pain. Appendicular lean mass (ALM), hand grip strength and gait speed were assessed. Read More

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Multicenter European Real-World Utilization of VasQ™ Anastomotic External Support Device for Arteriovenous Fistulae.

J Vasc Surg 2021 Jul 24. Epub 2021 Jul 24.

Department of Angiology and Vascular Surgery, Clinica Sagrada Familia, Barcelona, Spain.

Objectives: To evaluate the outcomes of arteriovenous fistulae (AVF), created with VasQ™ external support device under standard clinical practice across three vascular access clinics.

Methods: This was a multi-national, retrospective study to evaluate prospectively collected clinical outcomes of both forearm and upper-arm brachiocephalic AVF (BCAVF) created using the VasQ™ device. 51 AVF patients were pooled from three different vascular access centers in Germany, Italy and Spain. Read More

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Greater efficacy of a combination of conservative therapies for thumb base OA in individuals with lower radial subluxation - a pre-planned subgroup analysis of the COMBO trial.

Osteoarthritis Cartilage 2021 Jul 24. Epub 2021 Jul 24.

Rheumatology Department, Royal North Shore Hospital and Institute of Bone and Joint Research, Kolling Institute, University of Sydney, Sydney, New South Wales, Australia.

Objective: To investigate heterogeneous effects of a combination of conservative therapies compared with an education comparator for thumb base (TB) osteoarthritis (OA) according to clinically relevant characteristics.

Methods: Pre-planned subgroup analysis of the COMBO trial (n=204) which compared a combination of education on self-management and ergonomic principles, a prefabricated neoprene splint, hand exercises, and diclofenac sodium gel, with education alone for radiographic and symptomatic TB OA. Primary outcomes were change in pain (visual analogue scale [VAS], 0-100 mm) and hand function (Functional Index for Hand Osteoarthritis questionnaire, 0-30) from baseline to week-6. Read More

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Development and pilot implementation of a remote monitoring system for acute toxicity using electronic patient-reported outcomes (ePROs) for patients undergoing radiation therapy for breast cancer.

Int J Radiat Oncol Biol Phys 2021 Jul 24. Epub 2021 Jul 24.

Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY; Center for Health Policy and Outcomes, Memorial Sloan Kettering Cancer Center, New York, NY. Electronic address:

Purpose/Objective(s): We aimed to develop and study the implementation of a remote system for toxicity assessment and management of acute breast radiation side effects using electronic patient-reported outcomes (ePROs).

Materials/methods: A response-adapted PRO-CTCAE-based assessment for breast radiation toxicity was administered weekly during and for 8 weeks after radiation from June 2019 to July 2020. The care team received alerts when "severe" symptoms were reported by patients who were then contacted. Read More

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Perioperative Outcomes and Survival after Preoperative Immunotherapy for Non-small-cell Lung Cancer.

Ann Thorac Surg 2021 Jul 24. Epub 2021 Jul 24.

Massachusetts General Hospital, Boston MA. Electronic address:

Background: Although preoperative immunotherapy (IT) is increasingly utilized for non-small-cell lung cancer (NSCLC), there remains a paucity of robust clinical data on its safety and long-term survival. Our objective was to evaluate the perioperative outcomes and survival associated with IT followed by surgery for patients with NSCLC.

Methods: Outcomes of patients with NSCLC who underwent lung resection after preoperative chemotherapy (PC)±radiation or IT (with or without chemotherapy or chemoradiation) in the National Cancer Data Base (2010-2017) were evaluated using Kaplan Meier analysis, multivariable logistic regression, multivariable Cox proportional hazards analysis, and propensity score-matched analysis. Read More

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Empowerment Approaches in Childhood Weight Management: A Systematic Review.

Child Obes 2021 Jul 26. Epub 2021 Jul 26.

School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, Queensland, Australia.

Empowerment interventions facilitate individuals, organizations, and communities to gain better control over their health. They are distinctly different from traditional behavior change models and encourage participants to set their own health priorities and agenda. Current evidence suggests empowerment interventions are efficacious for smoking, sexual, and mental health outcomes. Read More

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Application of Dimethyl Sulfoxide as a Therapeutic Agent and Drug Vehicle for Eye Diseases.

J Ocul Pharmacol Ther 2021 Jul 26. Epub 2021 Jul 26.

Department of Oncology, National Children Hospital, Hanoi, Vietnam.

Dimethyl sulfoxide (DMSO) is an amphipathic molecule widely used as a solvent for water-insoluble substances, cryopreserving, and cell-biological therapies. It has known properties as an inducer of cellular differentiation, a free radical scavenger, and a radioprotectant. In addition, DMSO is used for its various therapeutic and pharmaceutical properties, such as anti-inflammatory, local and systemic analgesic, antibacterial, antifungal, antiviral, and membrane penetration enhancement agents. Read More

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Hemorrhoidectomy Versus Rubber Band Ligation in Grade III Hemorrhoidal Disease: A Large Retrospective Cohort Study With Long-term Follow-up.

Ann Coloproctol 2021 Jul 27. Epub 2021 Jul 27.

1Department of Surgery, Proctos Kliniek, Bilthoven, The Netherlands.

Purpose: Standard therapy for grade III hemorrhoids is rubber band ligation (RBL) and hemorrhoidectomy. The long-term clinical and patient-reported outcomes of these treatments in a tertiary referral center for proctology were evaluated.

Methods: A retrospective analysis was performed in all patients with grade III hemorrhoids who were treated between January 2013 and August 2018. Read More

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Rivaroxaban for Extended Thromboprophylaxis in Acutely Ill Medical Patients 75 Years of Age or Older.

J Thromb Haemost 2021 Jul 27. Epub 2021 Jul 27.

The Feinstein Institute for Medical Research and Zucker School of Medicine at Hofstra/Northwell, Department of Medicine, Anticoagulation and Clinical Thrombosis Services Northwell Health at Lenox Hill Hospital, New York, NY, USA.

Background: Although older patients are at increased risk for venous thromboembolism (VTE), thromboprophylaxis is underutilized because of bleeding concerns. The MARINER trial evaluated whether rivaroxaban reduced symptomatic post-discharge VTE in acutely ill medical patients. We hypothesized that rivaroxaban would have a favorable benefit/risk profile in patients ≥75 years of age. Read More

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An umbrella systematic review of drain fluid analysis in colorectal surgery for the detection of anastomotic leak: not yet ready to translate research studies into clinical practice.

Colorectal Dis 2021 Jul 27. Epub 2021 Jul 27.

Faculty of Medicine and Health, Central Clinical School, The University of Sydney, Sydney, Australia.

Aim: Anastomotic leak (AL) is the most important complication of intestinal surgery with an anastomosis. Whilst a number of studies have defined risk factors for AL, frustratingly, low-risk patients still develop AL. Studies have looked at drain fluid analysis for detection of AL, but these findings have failed to translate into routine clinical practice. Read More

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Predicting life with a permanent end colostomy- a prospective study on function, bother and acceptance.

Colorectal Dis 2021 Jul 27. Epub 2021 Jul 27.

Department of Surgery, SSORG - Scandinavian Surgical Outcomes Research Group, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.

Aim: The factors that influence a patient's experience of a colostomy are not known. The aim was to characterise stoma function, stoma-related bother and acceptance among patients operated for rectal cancer and to investigate if there were any preoperative personal factors with predictive impact on long-term stoma-related bother.

Methods: The QoLiRECT (Quality of Life in RECTal cancer) study is a prospective multicentre study of patients with rectal cancer. Read More

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Burden of disease experienced by patients following a watch-and-wait policy for locally advanced rectal cancer: A qualitative study.

Colorectal Dis 2021 Jul 27. Epub 2021 Jul 27.

Department of Surgery, Maastricht University Medical Centre, Maastricht, the Netherlands.

Aim: Patient-reported outcome measures (PROMs) are increasingly used in routine cancer care to evaluate treatment and monitor symptoms, function and other aspects of quality of life (QoL). For rectal cancer patients there is no suitable PROM following a Watch-and-Wait (W&W) programme. Insight into patient experiences with this programme is an essential step of PROM development. Read More

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Adverse COVID-19 Outcomes in Immune Deficiencies; Inequality Exists Between Subclasses.

Allergy 2021 Jul 27. Epub 2021 Jul 27.

Faculty of Medicine, Division of Pediatric Allergy-Immunology, Marmara University, Istanbul, Turkey.

Background: Genetic deficiencies of immune system, referred to as inborn errors of immunity (IEI), serve as a valuable model to study human immune responses. In a multicenter prospective cohort, we evaluated the outcome of SARS-CoV-2 infection among IEI subjects and analyzed genetic and immune characteristics that determine adverse COVID-19 outcomes.

Materials And Methods: We studied 34 IEI patients (19M/15F, 12 (min:0. Read More

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CAPABLE program improves disability in multiple randomized trials.

J Am Geriatr Soc 2021 Jul 27. Epub 2021 Jul 27.

Johns Hopkins School of Nursing, Baltimore, Maryland, USA.

Background: Programs to reduce disability are crucial to the quality of life for older adults with disabilities. Reducing disability is also important to avert unnecessary and costly hospitalizations, relocation, or nursing home placements. Few programs reduce disability and few have been replicated and scaled beyond initial research settings. Read More

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DrugWAS: Drug-wide association studies for COVID-19 drug repurposing.

Clin Pharmacol Ther 2021 Jul 27. Epub 2021 Jul 27.

Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, USA.

This study aimed to systematically investigate if any of the available drugs in Electronic Health Record (EHR) can be repurposed as potential treatment for COVID-19. Based on a retrospective cohort analysis of EHR data, drug-wide association studies (DrugWAS) were performed on 9,748 COVID-19 patients at Vanderbilt University Medical Center (VUMC). For each drug study, multivariable logistic regression with overlap weighting using propensity score was applied to estimate the effect of drug exposure on COVID-19 disease outcomes. Read More

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Outcomes linked to eligibility for stem cell transplantation trials in diffuse cutaneous systemic sclerosis.

Rheumatology (Oxford) 2021 Jul 26. Epub 2021 Jul 26.

Division of Medicine, Department of Inflammation, Centre for Rheumatology and Connective Tissue Diseases, Royal Free and University College Medical School, University College London, London, UK.

Objectives: The aim of this study was to explore outcomes in a cohort of diffuse cutaneous systemic sclerosis (dcSSc) patients fulfilling eligibility criteria for stem cell transplantation (SCT) studies but receiving standard immunosuppression.

Methods: From a large single-centre dcSSc cohort (n = 636), patients were identified using the published SCT trials' inclusion criteria. Patients meeting the trials' exclusion criteria were excluded. Read More

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A co-designed integrated kidney and diabetes model of care improves mortality, glycaemic control and self-care.

Nephrol Dial Transplant 2021 Jul 26. Epub 2021 Jul 26.

School of Public Health and Preventive Medicine, Monash University, VIC, Australia.

Background: Current health-care models are ill-equipped for managing people with diabetes and chronic kidney disease (CKD). We evaluated the impact of a new diabetes and kidney disease service (DKS) on hospitalisation, mortality, clinical and patient relevant outcomes.

Methods: Longitudinal analyses of adult patients with diabetes and CKD (stages 3a to 5) were performed using outpatient and hospitalisation data from January 2015 to October 2018. Read More

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Hematological abnormalities and comorbidities are associated with COVID-19 severity among hospitalized patients: Experience from Bangladesh.

PLoS One 2021 27;16(7):e0255379. Epub 2021 Jul 27.

Department of Pharmaceutical Sciences, North South University, Bashundhara, Dhaka, Bangladesh.

Background: The hematological abnormalities are assumed to be involved in the disease progression of COVID-19. However, the actual associations between specific blood parameters and COVID-19 are not well understood. Here we aimed to assess the correlations between hematological parameters and the severity of COVID-19. Read More

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