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Multi-omics subtyping pipeline for chronic obstructive pulmonary disease.

PLoS One 2021 25;16(8):e0255337. Epub 2021 Aug 25.

Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, United States of America.

Chronic Obstructive Pulmonary Disease (COPD) is the third leading cause of mortality in the United States; however, COPD has heterogeneous clinical phenotypes. This is the first large scale attempt which uses transcriptomics, proteomics, and metabolomics (multi-omics) to determine whether there are molecularly defined clusters with distinct clinical phenotypes that may underlie the clinical heterogeneity. Subjects included 3,278 subjects from the COPDGene cohort with at least one of the following profiles: whole blood transcriptomes (2,650 subjects); plasma proteomes (1,013 subjects); and plasma metabolomes (1,136 subjects). Read More

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Utilisation of remote capillary blood testing in an outpatient clinic setting to improve shared decision making and patient and clinician experience: a validation and pilot study.

BMJ Open Qual 2021 08;10(3)

Department of Respiratory Medicine, Royal Brompton and Harefield NHS Foundation Trust, London, UK.

Background: In a tertiary respiratory centre, large cohorts of patients are managed in an outpatient setting and require blood tests to monitor disease activity and organ toxicity. This requires either visits to tertiary centres for phlebotomy and physician review or utilisation of primary care services.

Objectives: This study aims to validate remote capillary blood testing in an outpatient setting and analyse impact on clinical pathways. Read More

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Risk factor control across the spectrum of cardiovascular risk: Findings from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL).

Am J Prev Cardiol 2021 Mar 13;5:100147. Epub 2021 Jan 13.

Department of Hospital Medicine, San Francisco VA Medical Center, San Francisco, CA, USA.

Background: Presence of cardiovascular disease (CVD) risk factors (RFs) should prompt patients and their providers to work aggressively towards controlling those that are modifiable. The extent to which a greater CVD RF burden is related to CVD RF control in a contemporary and diverse Hispanic/Latino population is not well-understood.

Methods: Using multicenter community-based data from the Hispanic Community Health Study/Study of Latinos, we assessed the self-reported prevalence of hypertension, hypercholesterolemia, diabetes, and prevalent CVD (ischemic heart disease or stroke). Read More

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Neutralizing activity of Sputnik V vaccine sera against SARS-CoV-2 variants.

Nat Commun 2021 07 26;12(1):4598. Epub 2021 Jul 26.

Department of Microbiology at the Icahn School of Medicine at Mount Sinai, New York, NY, USA.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has infected at least 180 million people since its identification as the cause of the current COVID-19 pandemic. The rapid pace of vaccine development has resulted in multiple vaccines already in use worldwide. The contemporaneous emergence of SARS-CoV-2 'variants of concern' (VOC) across diverse geographic locales underscores the need to monitor the efficacy of vaccines being administered globally. Read More

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Blood transcriptional biomarkers of acute viral infection for detection of pre-symptomatic SARS-CoV-2 infection: a nested, case-control diagnostic accuracy study.

Lancet Microbe 2021 Jul 6. Epub 2021 Jul 6.

Division of Infection and Immunity, University College London, London, UK.

Background: We hypothesised that host-response biomarkers of viral infections might contribute to early identification of individuals infected with SARS-CoV-2, which is critical to breaking the chains of transmission. We aimed to evaluate the diagnostic accuracy of existing candidate whole-blood transcriptomic signatures for viral infection to predict positivity of nasopharyngeal SARS-CoV-2 PCR testing.

Methods: We did a nested case-control diagnostic accuracy study among a prospective cohort of health-care workers (aged ≥18 years) at St Bartholomew's Hospital (London, UK) undergoing weekly blood and nasopharyngeal swab sampling for whole-blood RNA sequencing and SARS-CoV-2 PCR testing, when fit to attend work. Read More

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May Bacterial Infections Trigger Bullous Pemphigoid? Case Report and Review of Literature.

Microorganisms 2021 Jun 7;9(6). Epub 2021 Jun 7.

Dipartimento di Medicina Clinica e Molecolare, Sapienza, Università di Roma, AOU S. Andrea, 00189 Roma, Italy.

Bullous pemphigoid (BP) is an autoimmune blistering skin disease, mainly observed in the elderly. Infections have been suggested as possible disease triggers. However, infections may even heavily influence the disease clinical course and mortality. Read More

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A phase 2 trial of the somatostatin analog pasireotide to prevent GI toxicity and acute GVHD in allogeneic hematopoietic stem cell transplant.

PLoS One 2021 25;16(6):e0252995. Epub 2021 Jun 25.

Division of Hematologic Malignancies and Cellular Therapy, Duke University School of Medicine, Durham, NC, United States of America.

Background: Allogeneic hematopoietic stem cell transplantation (HCT) is an often curative intent treatment, however it is associated with significant gastrointestinal (GI) toxicity and treatment related mortality. Graft-versus-host disease is a significant contributor to transplant-related mortality. We performed a phase 2 trial of the somatostatin analog pasireotide to prevent gastrointestinal toxicity and GVHD after myeloablative allogeneic HCT. Read More

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Perioperative clinical trials for glioma: Raising the bar.

J Clin Neurosci 2021 Jul 11;89:144-150. Epub 2021 May 11.

Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC 3000, Australia; Cancer Biology and Stem Cells Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC 3052, Australia; Department of Medical Biology, University of Melbourne, Parkville, VIC 3010, Australia. Electronic address:

Gliomas are a heterogeneous group of primary brain cancers with poor survival despite multimodality therapy that includes surgery, radiation and chemotherapy. Numerous clinical trials have investigated systemic therapies in glioma, but have largely been negative. Multiple factors have contributed to the lack of progress including tumour heterogeneity, the tumour micro-environment and presence of the blood-brain barrier, as well as extrinsic factors relating to trial design, such as the lack of a contemporaneous biopsy at the time of treatment. Read More

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Contemporaneous and temporal interrelationships between menstrual fluctuations in sex hormones and DXA estimates of body composition in a premenopausal female: a case study.

J Sports Med Phys Fitness 2021 Jun 10. Epub 2021 Jun 10.

Department of Nutrition Physiology and Dietetics, Institute of Sport-National Research Institute, Warsaw, Poland.

Background: The reliability of dual energy X-ray absorptiometry (DXA) to assess body composition is influenced by factors like hydration status. Hence, any factor affecting total body water (TBW) content, such as menstrual shifts in sex hormones, might influence DXA estimates of lean soft tissue (LST) and fat mass (FM). To address this possibility, interrelationships between menstrual fluctuations in sex hormones, LST and FM were examined in a premenopausal female. Read More

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A narrative review of paracetamol-induced hypotension: Keeping the patient safe.

Authors:
Tricia L Young

Nurs Open 2021 Jun 8. Epub 2021 Jun 8.

Australia and Bairnsdale Regional Health Service, University of New England, Armadale, VIC, Australia.

Aim: To understand the prevalence and epidemiology of paracetamol-induced hypotension and clinical implications for contemporaneous practice.

Design: Narrative review.

Methods: In May and June 2020, an open-date literature search of English publications indexed in ProQuest, PubMed, and EBSCO was conducted with the search terms 'acetaminophen' and 'hypotension' and related search combinations ('paracetamol', 'propacetamol', 'low blood pressure', 'fever', 'sepsis', and 'shock') to identify peer-reviewed publications of blood pressure changes after paracetamol administration in humans. Read More

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Advanced Practice Provider-inclusive Staffing Models and Patient Outcomes in Pediatric Critical Care.

Med Care 2021 Jul;59(7):597-603

Department of Critical Care Medicine, CRISMA Center, University of Pittsburgh School of Medicine, Pittsburgh, PA.

Background: Pediatric intensive care units (PICUs) are increasingly staffed with advanced practice providers (APPs), supplementing traditional physician staffing models.

Objectives: We evaluate the effect of APP-inclusive staffing models on clinical outcomes and resource utilization in US PICUs.

Research Design: Retrospective cohort study of children admitted to PICUs in 9 states in 2016 using the Healthcare Cost and Utilization Project's State Inpatient Databases. Read More

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A Cohort Study of Strabismus Rates Following Correction of the Unicoronal Craniosynostosis Deformity: Conventional Bilateral Fronto-Orbital Advancement Versus Fronto-Orbital Distraction Osteogenesis.

J Craniofac Surg 2021 May 28. Epub 2021 May 28.

Division of Plastic Surgery, The University of Pennsylvania and the Children's Hospital of Philadelphia, Philadelphia, PA.

Background: The purpose of this prospective study is to compare perioperative morbidity and strabismus rates between traditional fronto-orbital advancement reconstruction (FOAR) and fronto-orbital distraction osteogenesis (FODO) in unicoronal craniosynostosis (UCS).

Method: A consecutive group of 15 patients undergoing FODO for isolated UCS were compared to a contemporaneous group of 15 patients undergoing traditional FOAR for UCS. Patient age, operative time, blood loss, blood replacement, technical details of the surgery, length of stay, complications, and strabismus rates were documented and compared statistically using chi-square and Student t test with a significance value of 0. Read More

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Community-based molecular and serological surveillance of subclinical malaria in Myanmar.

BMC Med 2021 May 28;19(1):121. Epub 2021 May 28.

Burnet Institute for Medical Research and Public Health, Melbourne, Australia.

Background: In the Greater Mekong Subregion (GMS), current malaria surveillance strategies rely on a network of village health volunteers (VHVs) reporting the results of rapid diagnostic tests (RDTs), known to miss many asymptomatic infections. Integration of more sensitive diagnostic molecular and serological measures into the VHV network may improve surveillance of residual malaria transmission in hard-to-reach areas in the region and inform targeted interventions and elimination responses. However, data on residual malaria transmission that would be captured by these measures in the VHV-led testing and treatment surveillance network in the GMS is unknown. Read More

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Peripheral and lung resident memory T cell responses against SARS-CoV-2.

Nat Commun 2021 05 21;12(1):3010. Epub 2021 May 21.

Infectious Diseases Department, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain.

Resident memory T cells (T) positioned within the respiratory tract are probably required to limit SARS-CoV-2 spread and COVID-19. Importantly, T are mostly non-recirculating, which reduces the window of opportunity to examine these cells in the blood as they move to the lung parenchyma. Here, we identify circulating virus-specific T cell responses during acute infection with functional, migratory and apoptotic patterns modulated by viral proteins and associated with clinical outcome. Read More

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Physiology of Low Blood Pressure During the First Day After Birth Among Extremely Preterm Neonates.

J Pediatr 2021 Sep 18;236:40-46.e3. Epub 2021 May 18.

Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada; Department of Newborn and Developmental Pediatrics, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada. Electronic address:

Objective: To investigate the circulatory physiology of hypotension during the first day after birth among stable extremely preterm neonates.

Study Design: Case-control study of neonates born at ≤27 weeks gestational age with hypotension, defined as mean blood pressure in mmHg less than gestational age in weeks for at least 1 hour during the first 24 hours after birth, who underwent comprehensive echocardiography assessment before commencement of cardiovascular drugs. Neonates with hypotension (n = 14) were matched by gestational age and intensity of respiratory support with normotensive neonates (n = 27) who underwent serial echocardiography during the first day after birth, and relatively contemporaneous echocardiography assessments were used for comparison. Read More

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September 2021

Temporal variations in maternal treatment requirements and early neonatal outcomes in patients with gestational diabetes.

Diabet Med 2021 Sep 19;38(9):e14596. Epub 2021 May 19.

School of Clinical Medicine, Addenbrooke's Hospital, Cambridge, UK.

Aims: There is seasonal variation in the incidence of gestational diabetes (GDM) and delivery outcomes of affected patients. We assessed whether there was also evidence of temporal variation in maternal treatment requirements and early neonatal outcomes.

Methods: We performed a retrospective analysis of women diagnosed with GDM (75 g oral glucose tolerance test, 0 h ≥ 5. Read More

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September 2021

The association of alcohol, cigarette, e-cigarette, and marijuana use with disease severity in adolescents and young adults with pediatric chronic kidney disease.

Pediatr Nephrol 2021 Aug 29;36(8):2493-2497. Epub 2021 Apr 29.

Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.

Background: We investigated the putative associations of alcohol, cigarette, e-cigarette, and marijuana use with kidney function and proteinuria among adolescents and young adults (AYA) with pediatric-onset chronic kidney disease (CKD) enrolled in the Chronic Kidney Disease in Children (CKiD) study.

Methods: Participants responded to questions about past year and 30-day substance use. Associations between each substance and kidney function, proteinuria, nephrotic range proteinuria, and high blood pressure were separately estimated using repeated measures regression models, adjusting for sociodemographic characteristics. Read More

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Clinical Utility of Pegaspargase in Children, Adolescents and Young Adult Patients with Acute Lymphoblastic Leukemia: A Review.

Blood Lymphat Cancer 2021 19;11:25-40. Epub 2021 Apr 19.

Division of Hematology/Oncology, Department of Pediatrics, University of Utah and Primary Children's Hospital, Salt Lake City, UT, USA.

Acute lymphoblastic leukemia (ALL) is a heterogenous hematological malignancy representing 25% of all cancers in children less than 15 years of age. Significant improvements in survival and cure rates have been made over the past four decades in pediatric ALL treatment. Asparaginases, derived from and , have become a critical component of ALL therapy since the 1960s. Read More

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Anticardiolipin and other antiphospholipid antibodies in critically ill COVID-19 positive and negative patients.

Ann Rheum Dis 2021 09 26;80(9):1236-1240. Epub 2021 Apr 26.

Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada

Background: Reports of severe COVID-19 being associated with thrombosis, antiphospholipid antibodies (APLA), and antiphospholipid syndrome have yielded disparate conclusions. Studies comparing patients with COVID-19 with contemporaneous controls of similar severity are lacking.

Methods: 22 COVID-19 and 20 COVID-19 patients with respiratory failure admitted to intensive care were studied longitudinally. Read More

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September 2021

Glucose-6-phosphate dehydrogenase activity in individuals with and without malaria: Analysis of clinical trial, cross-sectional and case-control data from Bangladesh.

PLoS Med 2021 04 23;18(4):e1003576. Epub 2021 Apr 23.

Global and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, Northern Territory, Australia.

Background: Glucose-6-phosphate dehydrogenase (G6PD) activity is dependent upon G6PD genotype and age of the red blood cell (RBC) population, with younger RBCs having higher activity. Peripheral parasitemia with Plasmodium spp. induces hemolysis, replacing older RBCs with younger cells with higher G6PD activity. Read More

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A Phase II Trial of Melphalan Based Reduced-Intensity Conditioning for Transplantation of T-Replete HLA-Haploidentical Peripheral Blood Stem Cells with Posttransplant Cyclophosphamide in Patients with Hematologic Malignancies.

Adv Hematol 2021 23;2021:8868142. Epub 2021 Mar 23.

Blood and Marrow Transplant Program at Northside Hospital, Atlanta, GA, USA.

T-replete haploidentical donor transplants using posttransplant cyclophosphamide (haplo) have greatly expanded donor availability and are increasingly utilized. Haplo were originally performed using truly nonmyeloablative conditioning and a bone marrow graft. We have also developed myeloablative conditioning and peripheral blood stem cell (PBSC) grafts for use with haplo. Read More

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Neutralization sensitivity of genital tract HIV-1: shift in selective milieu shapes the population available to transmit.

AIDS 2021 07;35(9):1365-1373

Division of Immunology, Department of Pathology, University of Cape Town.

Objective: Previous studies indicate that transmitted/founder HIV-1 isolates are sensitive to neutralization by the transmitting donor's antibodies. This is true in at least a subset of sexual transmissions. We investigated whether this selection for neutralization-sensitive variants begins in the genital tract of the donor, prior to transmission. Read More

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Neurologic Assessment of the Neurocritical Care Patient.

Front Neurol 2021 22;12:588989. Epub 2021 Mar 22.

Department of Neurosurgery, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV, United States.

Sedation is a ubiquitous practice in ICUs and NCCUs. It has the benefit of reducing cerebral energy demands, but also precludes an accurate neurologic assessment. Because of this, sedation is intermittently stopped for the purposes of a neurologic assessment, which is termed a neurologic wake-up test (NWT). Read More

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Machine Learning for Early Lung Cancer Identification Using Routine Clinical and Laboratory Data.

Am J Respir Crit Care Med 2021 08;204(4):445-453

Medial EarlySign, Newton, Massachusetts.

Most lung cancers are diagnosed at an advanced stage. Presymptomatic identification of high-risk individuals can prompt earlier intervention and improve long-term outcomes. To develop a model to predict a future diagnosis of lung cancer on the basis of routine clinical and laboratory data by using machine learning. Read More

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The NIMH Intramural Longitudinal Study of the Endocrine and Neurobiological Events Accompanying Puberty: Protocol and rationale for methods and measures.

Neuroimage 2021 07 24;234:117970. Epub 2021 Mar 24.

Section on Integrative Neuroimaging, Clinical & Translational Neuroscience Branch, National Institute of Mental Health, Bethesda, MD USA.

Delineating the relationship between human neurodevelopment and the maturation of the hypothalamic-pituitary-gonadal (HPG) axis during puberty is critical for investigating the increase in vulnerability to neuropsychiatric disorders that is well documented during this period. Preclinical research demonstrates a clear association between gonadal production of sex steroids and neurodevelopment; however, identifying similar associations in humans has been complicated by confounding variables (such as age) and the coactivation of two additional endocrine systems (the adrenal androgenic system and the somatotropic growth axis) and requires further elucidation. In this paper, we present the design of, and preliminary observations from, the ongoing NIMH Intramural Longitudinal Study of the Endocrine and Neurobiological Events Accompanying Puberty. Read More

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Monitoring the Impact of Aggressive Glycemic Intervention during Critical Care after Cardiac Surgery with a Glycemic Expert System for Nurse-Implemented Euglycemia: The MAGIC GENIE Project.

J Diabetes Sci Technol 2021 03;15(2):251-264

Division of Endocrinology, Medicine Service Line, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA.

A novel, multi-dimensional protocol named GENIE has been in use for intensive insulin therapy (IIT, target glucose <140 mg/dL) in the surgical intensive care unit (SICU) after open heart surgery (OHS) at VA Pittsburgh since 2005. Despite concerns over increased mortality from IIT after the publication of the NICE-SUGAR Trial, it remains in use, with ongoing monitoring under the MAGIC GENIE Project showing that GENIE performance over 12 years (2005-2016) aligns with the current consensus that IIT with target blood glucose (BG) <140 mg/dL is advisable only if it does not provoke severe hypoglycemia (SH). Two studies have been conducted to monitor glucometrics and outcomes during GENIE use in the SICU. Read More

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The impact of pulmonary artery catheter use in cardiac surgery.

J Thorac Cardiovasc Surg 2021 Feb 2. Epub 2021 Feb 2.

Division of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pa; Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pa. Electronic address:

Objective: Pulmonary artery catheterization provides continuous monitoring of hemodynamic parameters that may aid in the perioperative management of patients undergoing cardiac surgery. However, prior data suggest that pulmonary artery catheterization has limited benefit in intensive care and surgical settings. Thus, this study sought to determine the impact of pulmonary artery catheter insertion on short-term postoperative outcomes in a large, contemporaneous cohort of patients undergoing open cardiac surgery compared with standard central venous pressure monitoring. Read More

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February 2021

Longitudinal associations of blood pressure with aortic stiffness and pulsatility: the Atherosclerosis Risk in Communities Study.

J Hypertens 2021 05;39(5):987-993

Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.

Objective: To characterize the longitudinal relationships between blood pressure measured over 24 years and arterial stiffness in late life measured as pulse wave velocity (PWV).

Methods: Carotid--femoral (cf) and femoral--ankle (fa) PWV were measured in 4166 adults at the visit 5 Atherosclerosis Risk in Communities study cohort examination (2011-2013). Participants were categorized into tertiles of PWV measurements. Read More

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Impact of Gut and Metabolic Hormones on Feeding Reward.

Compr Physiol 2021 02 12;11(2):1425-1447. Epub 2021 Feb 12.

Faculty of Science and Engineering, University of Waikato, Hamilton, New Zealand.

Ingestion of food activates a cascade of endocrine responses (thereby reflecting a contemporaneous feeding status) that include the release of hormones from the gastrointestinal (GI) tract, such as cholecystokinin (CCK), glucagonlike peptide YY (PYY), peptide PP, and oleoylethanolamide, as well as suppression of ghrelin secretion. The pancreas and adipose tissue, on the other hand, release hormones that serve as a measure of the current metabolic state or the long-term energy stores, that is, insulin, leptin, and adiponectin. It is well known and intuitively understandable that these hormones target either directly (by crossing the blood-brain barrier) or indirectly (e. Read More

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February 2021

Follow-up results of microendoscopic discectomy compared to day surgery using percutaneous endoscopic lumbar discectomy for the treatment of lumbar disc herniation.

BMC Musculoskelet Disord 2021 Feb 9;22(1):160. Epub 2021 Feb 9.

Spine Surgery Department of Suining Central Hospital, Suining, Sichuan, People's Republic of China.

Background: Percutaneous endoscopic lumbar discectomy (PELD) is satisfactory for hospitalized patients with lumbar disc herniation (LDH). Currently, only a few studies have reported about the day surgery patients undergoing PELD.

Methods: A total of 267 patients with LDH underwent PELD during day surgery and were followed up for at least 3 years. Read More

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February 2021