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IDENTIFICATION OF OPTIMAL THERAPEUTIC WINDOW FOR STEROID USE IN SEVERE ALCOHOL-ASSOCIATED HEPATITIS: A WORLDWIDE STUDY.

J Hepatol 2021 Jun 21. Epub 2021 Jun 21.

Department of Gastroenterology, Hospital de la Santa Creu i Sant Pau, CIBERehd, Barcelona, Spain.

Background: Corticosteroids are the only effective therapy for severe alcohol-associated hepatitis (AH), defined as MELD score >20. However, there are patients who may be too sick to benefit from therapy.

Aim: To identify the range of MELD score within which steroids are effective treatment for AH. Read More

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CAR-HEMATOTOX: A model for CAR T-cell related hematological toxicity in relapsed/refractory large B-cell lymphoma.

Blood 2021 Jun 24. Epub 2021 Jun 24.

University Hospital of the LMU Munich, Munich, Germany.

Hematotoxicity represents a frequent chimeric antigen receptor (CAR) T-cell related adverse event and remains poorly understood. In this multicenter analysis, we studied patterns of hematopoietic reconstitution and evaluated potential predictive markers in 258 patients receiving Axicabtagene ciloleucel (Axi-cel) or Tisagenlecleucel (Tisa-cel) for relapsed/refractory large B-cell lymphoma. We observed profound (ANC<100/µl) and prolonged (≥day 21) neutropenia in 72 and 64% of patients respectively. Read More

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Diagnostic usefulness of the spot urine sodium/potassium ratio in cirrhotic patients with ascites.

PLoS One 2021 24;16(6):e0253886. Epub 2021 Jun 24.

Department of Internal Medicine, Keimyung University School of Medicine, Daegu, South Korea.

Background And Aims: The low-salt diet is considered important for control of ascites in cirrhotic patients. To validate whether the spot urine sodium (Na)/potassium (K) ratio could replace 24-h urine Na (uNa) excretion in assessing low-salt diet compliance.

Methods: We prospectively studied 175 patients. Read More

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Capacity building of healthcare workers: Key step towards elimination of viral hepatitis in developing countries.

PLoS One 2021 24;16(6):e0253539. Epub 2021 Jun 24.

Project ECHO & PRAKASH, Institute of Liver and Biliary Sciences, New Delhi, Delhi, India.

Background: Lack of awareness about viral hepatitis (VH) potentially predisposes the healthcare workers (HCWs) to a higher risk of infection and may in turn increase the risk of transmission of the infection to their families and in the community. Thus, combating VH, requires adequate and updated training to the HCWs. With this objective, Project PRAKASH designed a meticulously planned training program, aimed to assess the effect of a one-day training on VH among in-service nurses. Read More

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Impact of Anti-anaerobic Antibiotic Activity on Graft-versus-Host Disease in Allogeneic Hematopoietic Stem Cell Transplant (HSCT) Recipients at an Institution that Utilizes Antibiotic Cycling.

Transpl Infect Dis 2021 Jun 24:e13676. Epub 2021 Jun 24.

+Department of Pharmacy, West Virginia University Hospital.

Background: At our institution, antibiotic cycling for febrile neutropenia is utilized to increase heterogeneity of antibiotic exposure in patients who have undergone an allogeneic hematopoietic stem cell transplantation (allo-HSCT). Development of acute graft-versus-host disease (aGVHD) has been associated with low diversity within stool microbiota. To date, discordant outcomes have been reported implicating anti-anaerobic antibiotic use with the development of aGVHD, and there is currently a lack of published data available in an antibiotic cycled environment. Read More

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An observational study on the relationship between zinc concentrations in bulk tank milk and in serum and farmer-reported zinc supplementation of dairy cattle for facial eczema prophylaxis.

N Z Vet J 2021 Jun 24:1-15. Epub 2021 Jun 24.

Fonterra Co-operative Group Limited, 80 London St, Hamilton, New Zealand.

Method: Multiple BTM samples (n=3330) collected during milk pick-up by the milk tanker driver were stored and tested for 121 farms in Northland (n=50), Waikato (n=51) and Southland (n=20) from February to April 2017. Enrolled farms provided retrospective information on the type of Zn supplementation (if any) used for the prevention of facial eczema and the timeframe over which supplementation occurred. In addition, the concentration of Zn in serum was measured in blood samples collected from ≥15 cattle per farm for 22 farms from Northland (n=11) and Waikato (n=11) and compared against the concentrations of Zn in BTM on the day of blood sampling. Read More

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Burden of illness and costs associated with eosinophilic granulomatosis with polyangiitis: evidence from a managed care database in the United States.

J Manag Care Spec Pharm 2021 Jun 24:1-11. Epub 2021 Jun 24.

Optum, Eden Prairie, MN.

Data on the clinical and economic burden of eosinophilic granulomatosis with polyangiitis (EGPA) are limited. To assess the real-world clinical and economic outcomes of patients diagnosed with EGPA vs patients with asthma (present in > 90% of EGPA cases) receiving treatment in the United States. This retrospective cohort study (HO-17-17742) used administrative claims data (July 1, 2007-May 31, 2017) from the Optum Research Database. Read More

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Vitamin D Status and Clinical Outcomes in Acute Respiratory Distress Syndrome: A Secondary Analysis From the Assessment of Low Tidal Volume and Elevated End-Expiratory Volume to Obviate Lung Injury (ALVEOLI) Trial.

J Intensive Care Med 2021 Jun 24:8850666211028139. Epub 2021 Jun 24.

Department of Medicine, Massachusetts General Hospital, Boston, MA, USA.

Background: Acute respiratory distress syndrome (ARDS) is a highly morbid condition that has limited therapeutic options. Optimal vitamin D status has been linked to immunological effects that may benefit critically ill patients. Therefore, we investigated whether admission 25-hydroxyvitamin D levels (25OHD) are associated with clinical outcomes in ARDS patients. Read More

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Amelioration of anxiety, depression, and chemotherapy related toxicity after crocin administration during chemotherapy of breast cancer: A double blind, randomized clinical trial.

Phytother Res 2021 Jun 24. Epub 2021 Jun 24.

Cellular and Molecular Research Center, Sabzevar University of Medical Sciences, Sabzevar, Iran.

The effects of saffron (Crocus sativus L.) on mood disorders have already been established. More recently, its anti-neoplastic effects have provoked a great attention. Read More

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Prognostic Utility of Daily Changes in Glasgow Coma Scale and the Full Outline of Unresponsiveness Score Measurement in Patients with Metabolic Encephalopathy, Central Nervous System Infections and Stroke in Uganda.

Neurocrit Care 2021 Jun 23. Epub 2021 Jun 23.

Department of Neurology, Mayo Clinic, Phoenix, AZ, USA.

Background: Metabolic encephalopathy (ME), central nervous system (CNS) infections, and stroke are common causes of reduced level of consciousness in Uganda. However, the prognostic utility of changes in the daily measurements of the Full Outline of Unresponsiveness (FOUR) score and Glasgow Coma Scale (GCS) score in these specific disorders is not known.

Methods: We conducted secondary analyses of data from patients who presented with reduced level of consciousness due to CNS infections, stroke, or ME to a tertiary hospital in Uganda. Read More

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Randomised controlled trial of the effects of increased energy intake on menstrual recovery in exercising women with menstrual disturbances: the 'REFUEL' study.

Hum Reprod 2021 Jun 24. Epub 2021 Jun 24.

Department of Kinesiology, Pennsylvania State University, University Park, PA, USA.

Study Question: Does increased daily energy intake lead to menstrual recovery in exercising women with oligomenorrhoea (Oligo) or amenorrhoea (Amen)?

Summary Answer: A modest increase in daily energy intake (330 ± 65 kcal/day; 18 ± 4%) is sufficient to induce menstrual recovery in exercising women with Oligo/Amen.

What Is Known Already: Optimal energy availability is critical for normal reproductive function, but the magnitude of increased energy intake necessary for menstrual recovery in exercising women, along with the associated metabolic changes, is not known.

Study Design, Size, Duration: The REFUEL study (trial # NCT00392873) is the first randomised controlled trial to assess the effectiveness of 12 months of increased energy intake on menstrual function in 76 exercising women with menstrual disturbances. Read More

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ReVibe: A Context-assisted Evening Recall Approach to Improve Self-report Adherence.

Proc ACM Interact Mob Wearable Ubiquitous Technol 2019 Dec 11;3(4):1-27. Epub 2019 Dec 11.

Harvard University, Cambridge, MA, USA.

Besides passive sensing, ecological momentary assessments (EMAs) are one of the primary methods to collect in-the-moment data in ubiquitous computing and mobile health. While EMAs have the advantage of low recall bias, a disadvantage is that they frequently interrupt the user and thus long-term adherence is generally poor. In this paper, we propose a less-disruptive self-reporting method, "assisted recall," in which in the evening individuals are asked to answer questions concerning a moment from earlier in the day assisted by contextual information such as location, physical activity, and ambient sounds collected around the moment to be recalled. Read More

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December 2019

Evaluating the Combination of Human Chorionic Gonadotropin and Clomiphene Citrate in Treatment of Male Hypogonadotropic Hypogonadism: A Prospective Study.

Res Rep Urol 2021 15;13:357-366. Epub 2021 Jun 15.

Department of Epidemiology, Vietnam Military Medical University, Hanoi, Vietnam.

Background: In this study, we evaluated MHH patients who wished to preserve fertility, assessing the efficacy of a short course (12 months) of a combined hCG +clomiphene citrate.

Materials And Methods: The cross-sectional study included 19 patients with hypogonadotropic hypogonadism who were admitted to the Andrology and Fertility Hospital of Hanoi between March 2016 and March 2018. Using hCG every three days in combination with clomiphene citrate 25mg per day until normal testosterone levels are reached, maintain the dose until spermatozoa are present. Read More

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Nutritional and Hematological Status of Sudanese Women of Childbearing Age with Steady-state Sickle Cell Anemia.

Oman Med J 2021 May 31;36(3):e270. Epub 2021 May 31.

Lipidomics and Nutrition Research Centre, School of Human Sciences, London Metropolitan University, London, UK.

Objectives: We sought to investigate the nutritional and hematological status of Sudanese women of childbearing age with sickle cell anemia (SCA). Anthropometry and hematology were used to assess nutritional status and health and disease conditions, respectively.

Methods: Women with steady-state (HbSS, n = 39; age = 19. Read More

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Comparison of the Efficacy and Safety of Dinalbuphine Sebacate, Patient-Controlled Analgesia, and Conventional Analgesia After Laparotomy for Gynecologic Cancers: A Retrospective Study.

J Pain Res 2021 15;14:1763-1771. Epub 2021 Jun 15.

Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital Linkou Medical Center, Taoyuan, Taiwan.

Objective: We aimed to investigate the effects of dinalbuphine sebacate (DNS), fentanyl-based patient-controlled analgesia (PCA), and conventional analgesia (CA) for pain management after laparotomy for gynecologic cancers.

Methods: A total of 137 eligible patients who underwent laparotomy through a midline incision wound for gynecologic cancer between July 2019 and June 2020 were retrospectively evaluated. The patients were divided into three groups as follows: the intramuscular DNS, intravenous PCA, and CA groups. Read More

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Diurnal rhythms of urine volume and electrolyte excretion in healthy young men under differing intensities of daytime light exposure.

Sci Rep 2021 Jun 23;11(1):13097. Epub 2021 Jun 23.

Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 kawahara-cho, shogoin, sakyo-ku, Kyoto, 606-8507, Japan.

In humans, most renal functions, including urine volume and electrolyte excretions, have a circadian rhythm. Light is a strong circadian entrainment factor and daytime-light exposure is known to affect the circadian rhythm of rectal temperature (RT). The effects of daytime-light exposure on the diurnal rhythm of urinary excretion have yet to be clarified. Read More

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Developmental intestinal microbiome alterations in canine fading puppy syndrome: a prospective observational study.

NPJ Biofilms Microbiomes 2021 Jun 23;7(1):52. Epub 2021 Jun 23.

The Hebrew University Veterinary Teaching Hospital and Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Rehovot, Israel.

Fading puppy syndrome (FPS) is a fatal condition in neonatal dogs. Intestinal microbial alterations, although never investigated, may be involved in its pathophysiology. The study examined the occurrence of FPS and its associations with dam, puppy, and husbandry characteristics, compared the intestinal microbial diversity of healthy puppies and those with FPS, and examined whether intestinal microbiomes are predictive of FPS. Read More

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Association between comorbid sleep apnoea-hypopnoea syndrome and prognosis of intensive care patients: a retrospective cohort study.

BMJ Open 2021 Jun 23;11(6):e048886. Epub 2021 Jun 23.

Otorhinolaryngology Head and Neck Surgery, The University of Hong Kong - Shenzhen Hospital, Shenzhen, Shenzhen, People's Republic of China.

Objective: In this study, we investigated the association between comorbid sleep apnoea-hypopnoea syndrome (SAHS) and the prognosis of patients in an intensive care unit (ICU) to determine whether this relationship varies between different disease subgroups.

Methods: We conducted a retrospective cohort study using publicly available information from the critical care database Medical Information Mart for Intensive Care III. Adults (≥18 years of age) who attended the ICU for the first time were enrolled. Read More

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Osteoprotective effects of kefir fortified with omega-3 and vitamin C in ovariectomized rats.

Int J Vitam Nutr Res 2021 Jun 24:1-10. Epub 2021 Jun 24.

Department of Epidemiology, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran.

Nutritional interventions can be valuable for the prevention of postmenopausal osteoporosis. This study aimed to investigate the effects of kefir fortified with omega-3 and vitamin C on the bone and uterus parameters of ovariectomized rats. Seventy-seven female Sprague-Dawley rats were ovariectomized or sham-operated. Read More

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Twenty-four-hour serum creatinine variation is associated with poor outcome in the novel coronavirus disease 2019 (COVID-19) patients.

Kidney Res Clin Pract 2021 Jun 26;40(2):231-240. Epub 2021 Apr 26.

Clinic of Infectious Diseases, University Hospital of Modena, Modena, Italy.

Background: The prognostic value of within-day sCr variation serum creatinine variation is unknown in the setting of the novel coronavirus disease 2019 (COVID-19). We evaluated the prognostic significance of 24-hour serum creatinine variation in COVID-19 patients.

Methods: A monocentric retrospective analysis was conducted in COVID-19 patients not admitted to the intensive care unit. Read More

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Financial Implications of Early Hospital Discharge After AML-Like Induction Chemotherapy: A 4-Year Retrospective Analysis.

J Natl Compr Canc Netw 2021 Jun 22:1-10. Epub 2021 Jun 22.

3Department of Medicine, Division of Hematology, University of Washington.

Background: Early hospital discharge (EHD) after intensive acute myeloid leukemia (AML) induction chemotherapy has become routine at the University of Washington/Seattle Cancer Care Alliance over the past several years. We assessed the financial implications of EHD over the first 4 years after its broad adoption for patients with AML and other high-grade myeloid neoplasms undergoing AML-like induction chemotherapy.

Patients And Methods: We retrospectively compared charges between 189 patients with EHD who received all postinduction inpatient/outpatient care within our care system between August 2014 and July 2018 and 139 medically matched control patients who remained hospitalized for logistical reasons. Read More

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Azithromycin or Doxycycline for Asymptomatic Rectal .

N Engl J Med 2021 Jun;384(25):2418-2427

From the University of Melbourne (A.L., F.Y.S.K., S.P., E.P.F.C., N.C., J.S.H.), the Melbourne Sexual Health Centre (C.K.F., M.Y.C., C.S.B., E.P.F.C., J.S.H.), and Monash University (C.K.F., M.Y.C., C.S.B., E.P.F.C.), Melbourne, VIC, Macquarie University, Macquarie, NSW (J.A.), Central Clinical School, Faculty of Medicine and Health, University of Sydney (D.J.T.), Sydney Sexual Health Centre (A.M., B.D.), and the School of Population Health (A.M.) and the Kirby Institute (D.J.T., M.L., B.D., D.G.R., J.K., J.A.), University of New South Wales, Sydney, the Department of Sexual Health Medicine and Sexual Assault Medicine, Sydney Local Health District, Camperdown, NSW (D.J.T.), Western Sydney Sexual Health Centre, Parramatta, NSW, and Westmead Clinical School, University of Sydney, Westmead, NSW (D.A.L.), the Adelaide Sexual Health Centre (C.K., M.R.) and the University of Adelaide (M.A.B.), Adelaide, SA, and the University of the Sunshine Coast, Sippy Downs, QLD (P.T.) - all in Australia.

Background: Rectal chlamydia is a common bacterial sexually transmissible infection among men who have sex with men. Data from randomized, controlled trials are needed to guide treatment.

Methods: In this double-blind trial conducted at five sexual health clinics in Australia, we randomly assigned men who have sex with men and who had asymptomatic rectal chlamydia to receive doxycycline (100 mg twice daily for 7 days) or azithromycin (1-g single dose). Read More

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Overexpression of miR-19a and miR-20a in iPS-MSCs preserves renal function of chronic kidney disease with acute ischaemia-reperfusion injury in rat.

J Cell Mol Med 2021 Jun 23. Epub 2021 Jun 23.

Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.

This study tested the hypothesis that therapy with double overexpression of miR-19a-3p and miR-20a-5p (miR ) to human inducible pluripotent stem cell-derived mesenchymal stem cells (iPS-MSCs) was superior to iPS-MSCs alone for preserving renal function in rat with pre-existing chronic kidney disease (CKD), followed by ischaemia-reperfusion (IR) injury. In vitro study demonstrated that the protein expressions of oxidative stress (NOX-1/NOX-2/NOX4/oxidized protein/p22phox), inflammatory downstream signalling (TLR2&4/MyD88/TRAF6/IKK-ß/p-NFκB/IL-1ß/IL-6/MMP-9) and cell apoptosis/death signalling (cleaved caspase-3/mitochondrial Bax/p-ERKs/p-JNK/p-p38) at time-points of 24-hour/48-hour cell cultures were significantly increased in p-Cresol-treated NRK-52E cells than in the control that was significantly reversed by miR-19a-3p-transfected iPS-MSC (all P < .001). Read More

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The impact of the covid-19 pandemic on lifestyle behaviors in U.S. college students.

J Am Coll Health 2021 Jun 23:1-6. Epub 2021 Jun 23.

Division of Endocrinology, Metabolism, and Diabetes, University of Colorado Anschutz Medical Campus, Denver, Colorado, USA.

Objective: To investigate COVID-19's impact on college student health behaviors.

Participants: 189 college students.

Methods: Participants completed an online survey on behaviors relating to sleep, sedentary activities, and physical activity before and during the COVID-19 pandemic. Read More

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Long-term Efficacy of Neoadjuvant Chemoradiotherapy Plus Surgery for the Treatment of Locally Advanced Esophageal Squamous Cell Carcinoma: The NEOCRTEC5010 Randomized Clinical Trial.

JAMA Surg 2021 Jun 23. Epub 2021 Jun 23.

Department of Thoracic Surgery, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Guangdong Esophageal Cancer Institute, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.

Importance: The prognosis of patients with locally advanced esophageal squamous cell carcinoma (ESCC) remains poor after surgery. Neoadjuvant chemoradiotherapy (NCRT) has been shown to potentially improve survival.

Objective: To compare the treatment efficacy of NCRT plus surgery with surgery alone for long-term survival among patients with locally advanced ESCC. Read More

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High-dose statin pretreatment decreases periprocedural myocardial infarction and cardiovascular events in East Asian patients undergoing percutaneous coronary intervention: A meta-analysis of fifteen randomized controlled trials.

Medicine (Baltimore) 2021 Jun;100(25):e26278

Department of Cardiology, Institute of Cardiovascular Disease, Peking University First Hospital, Beijing, China.

Background: Numerous studies have shown that high-dose statin pretreatment may reduce the risk of periprocedural myocardial infarction (PMI) and short-term major adverse cardiac events (MACE) in western people undergoing percutaneous coronary intervention (PCI). However, the effects in East Asian patients are still controversial. The objective was to evaluate the effects of short-term high-dose statin (all types) pretreatment compared with the control (low-dose or no statin) on the reduction of the rate of MACE and PMI in East Asian patients. Read More

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The Influence of Body Mass Index in Obese and Morbidly Obese Patients on Complications and 30- and 90-day Readmissions Following Lumbar Spine Fusion.

Spine (Phila Pa 1976) 2021 Jul;46(14):965-972

Department of Orthopedic Surgery, Keck School of Medicine of USC, Los Angeles, CA.

Study Design: Retrospective cohort study using the 2013-2017 National Readmission Database.

Objective: The aim of this study was to quantify the influence of body mass index (BMI) on complication and readmission rates following lumbar spine fusion.

Summary Of Background Data: Compared to controls, patients with BMI ≥35 had greater odds of readmission, infection, and wound complications following lumbar spine fusion. Read More

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The Five-item Modified Frailty Index is Predictive of 30-day Postoperative Complications in Patients Undergoing Spine Surgery.

Spine (Phila Pa 1976) 2021 Jul;46(14):939-943

Departments of Orthopedic and Neurologic Surgery, NYU Langone Orthopedic Hospital; New York Spine Institute, New York, NY.

Study Design: Retrospective cohort study.

Objective: This study aimed to evaluate the utility of the modified frailty index (mFI-5) in a population of patients undergoing spine surgery.

Summary Of Background Data: The original modified frailty index (mFI-11) published as an American College of Surgeons National Surgical Quality Improvement Program 11-factor index was modified to mFI-5 after variables were removed from recent renditions. Read More

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Effects of altitude and recombinant human erythropoietin on iron metabolism: a randomized controlled trial.

Am J Physiol Regul Integr Comp Physiol 2021 06 23. Epub 2021 Jun 23.

Department of Nutrition, Exercise, and Sports, University of Copenhagen, Denmark.

Current markers of iron deficiency (ID) such as ferritin and hemoglobin have shortcomings, and hepcidin and erythroferrone (ERFE) could be of clinical relevance in relation to early assessment of ID. Here, we evaluate whether exposure to altitude-induced hypoxia (2,320 m) alone, or in combination with recombinant human erythropoietin (rHuEPO) treatment, affects hepcidin and ERFE levels before alterations in routine ID biomarkers and stress erythropoiesis manifest. Two interventions were completed, each comprising a four-week baseline, a four-week intervention at either sea level or altitude, and a four-week follow-up. Read More

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A-lines and B-lines in patients with acute heart failure.

Eur Heart J Acute Cardiovasc Care 2021 Jun 23. Epub 2021 Jun 23.

Cardiovascular Division, Brigham and Women's Hospital, 360 Longwood Ave., 7th Floor, Boston, MA 02115, USA.

Aims: Lung ultrasound (LUS) relies on detecting artefacts, including A-lines and B-lines, when assessing dyspnoeic patients. A-lines are horizontal artefacts and characterize normal lung, whereas multiple vertical B-lines are associated with increased lung density. We sought to assess the prevalence of A-lines and B-lines in patients with acute heart failure (AHF) and examine their clinical correlates and their relationship with outcomes. Read More

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