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Rotational Thromboelastometry in Neonates Admitted to a Neonatal Intensive Care Unit: A Large Cross-sectional Study.

Semin Thromb Hemost 2021 Jun 15. Epub 2021 Jun 15.

Laboratory of Haematology and Blood Bank Unit, "Attikon" Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.

The aim of the present study was to assess the coagulation profile in neonatal critical illness using rotational thromboelastometry (ROTEM), and to investigate its association with disease severity and its potential prognostic role in this clinical setting. Over a period of 67 months (July 2014-February 2020) 423 critically ill neonates with confirmed or suspected sepsis, perinatal hypoxia, or respiratory distress syndrome, hospitalized in our neonatal intensive care unit were included in the study. Demographic, clinical, and laboratory data were recorded on admission day and arterial blood was analyzed on ROTEM analyzer using the standard extrinsically activated rotational thromboelastometry assay (EXTEM). Read More

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ECMO induces early alterations in coagulation and fibrinolysis profiles in COVID-19 patients with acute respiratory distress syndrome.

Thromb Haemost 2021 Jun 15. Epub 2021 Jun 15.

Department of haematology, Assistance Publique - Hopitaux de Paris, Paris, France.

Hemostatic changes induced by extracorporeal membrane oxygenation (ECMO) support have been yet poorly documented in COVID-19 patients who have a baseline complex hypercoagulable state. In this prospective monocentric study of patients with severe acute respiratory distress syndrome (ARDS) rescued by ECMO, we performed longitudinal measurements of coagulation and fibrinolysis markers throughout the course of ECMO support in 20 COVID-19 and 10 non-COVID-19 patients. Blood was sampled before and then 24 hours, 7 and 14 days after ECMO implantation. Read More

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Impact of Confinement in Patients under Long-Term Noninvasive Ventilation during the First Wave of the SARS-CoV-2 Pandemic: A Remarkable Resilience.

Respiration 2021 Jun 15:1-9. Epub 2021 Jun 15.

Division of Pulmonary Diseases, Geneva University Hospitals, Geneva, Switzerland.

Background: During the first wave of the SARS-CoV-2 pandemic in Switzerland, confinement was imposed to limit transmission and protect vulnerable persons. These measures may have had a negative impact on perceived quality of care and symptoms in patients with chronic disorders.

Objectives: To determine whether patients under long-term home noninvasive ventilation (LTHNIV) for chronic respiratory failure (CRF) were negatively affected by the 56-day confinement (March-April 2020). Read More

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Early lung ultrasound assessment for the prognosis of patients hospitalized for COVID-19 pneumonia. A pilot study.

Respir Med Res 2021 Jun 4;80:100832. Epub 2021 Jun 4.

Department of Respiratory Diseases, University Hospitals KU Leuven, Herestraat 49, 3000 Leuven, Belgium.

Objective: SARS CoV-2 is an epidemic viral infection that can cause mild to severe lung involvement. Newly apprehended knowledge on thoracic imaging abnormalities and the growing clinical experience on the evolution of this disease make the radiographic follow-up of hospitalized patients relevant. The value of consecutive bedside lung ultrasonography in the follow-up of hospitalized patients with SARS CoV-2 pneumonia and its correlation with other clinical and laboratory markers needs to be evaluated. Read More

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Refeeding syndrome occurs among older adults regardless of refeeding rates: A systematic review.

Nutr Res 2021 May 21;91:1-12. Epub 2021 May 21.

Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo 0130, Norway; Regional Advisory Unit for Palliative Care, Department of Oncology, Oslo University Hospital, Oslo 0424, Norway. Electronic address:

Refeeding syndrome is a life-threatening clinical disorder that can occur when treating malnutrition. The aim was to examine the current knowledge of refeeding syndrome in patients ≥ 65 + years with special focus on the incidence of hypophosphatemia (HP) in relation to refeeding rate (kcal/kg/day), number of days until the lowest level of phosphate occurs (day of nadir), refeeding rates and adverse events, and death. Specifically, we hypothesized that higher energy provision would cause a higher incidence of HP. Read More

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Early multidrug treatment of SARS-CoV-2 infection (COVID-19) and reduced mortality among nursing home (or outpatient/ambulatory) residents.

Med Hypotheses 2021 Jun 5;153:110622. Epub 2021 Jun 5.

Concerned Ontario Doctors, Toronto, ON, Canada. Electronic address:

The outbreak of COVID-19 from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread all over the world with tremendous morbidity and mortality in the elderly. In-hospital treatment addresses the multifaceted nature of the illness including initial viral replication, cytokine storm, and endothelial injury with thrombosis. We identified nine reports of early treatment outcomes in COVID-19 nursing home patients. Read More

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Cerebrovascular disease, neurodegeneration, and clinical phenotype in dementia with Lewy bodies.

Neurobiol Aging 2021 May 14;105:252-261. Epub 2021 May 14.

Department of Radiology, Mayo Clinic, Rochester, MN, USA. Electronic address:

We investigated whether cerebrovascular disease contributes to neurodegeneration and clinical phenotype in dementia with Lewy bodies (DLB). Regional cortical thickness and subcortical gray matter volumes were estimated from structural magnetic resonance imaging (MRI) in 165 DLB patients. Cortical and subcortical infarcts were recorded and white matter hyperintensities (WMHs) were assessed. Read More

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Measured energy expenditure in mildly hypothermic critically ill patients with traumatic brain injury: A sub-study of a randomized controlled trial.

Clin Nutr 2021 May 24;40(6):3875-3882. Epub 2021 May 24.

Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventative Medicine, Monash University, St Kilda Road, Melbourne, 3004, Australia; Intensive Care Unit, The Alfred Hospital, Commercial Road, Melbourne, 3004, Australia.

Background & Aims: Prophylactic hypothermia, often used in critically ill patients with traumatic brain injury, reduces energy expenditure and may affect energy delivered by nutrition therapy. The primary objective of this study was to measure energy expenditure in hypothermic patients over the first 3 days after traumatic brain injury (TBI). Secondary objectives included comparison of measured energy expenditure and nutrition delivery to day 7. Read More

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Magnitude of gluconeogenesis and endogenous glucose production: are they predictable in clinical settings?

Clin Nutr 2021 Jun 3;40(6):3807-3814. Epub 2021 Jun 3.

Service of Adult Intensive Care, Lausanne University Hospital (CHUV), Lausanne, Switzerland.

Introduction: Regulation of endogenous glucose production (EGP) is essential for glucose homeostasis. It includes gluconeogenesis (GNG) from non-carbohydrate substrates and hepatic glycogenolysis. Both these pathways are dysregulated in acute stress, but the magnitude of this deregulation cannot be assessed in clinical practice. Read More

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Micronutrient deficiencies in critical illness.

Clin Nutr 2021 May 11;40(6):3780-3786. Epub 2021 May 11.

Department of Intensive Care Medicine, Gelderse Vallei Hospital, Willy Brandtlaan 10, 6716 RP, Ede, the Netherlands; Division of Human Nutrition and Health, Wageningen University & Research, HELIX (Building 124), Stippeneng 4, 6708 WE, Wageningen, the Netherlands. Electronic address:

Background & Aims: Low micronutrient levels in critical illness have been reported in multiple studies. Because of the antioxidant properties of various micronutrients, micronutrient deficiency may augment oxidative stress in critical illness. However, it remains unclear whether micronutrient concentrations in ICU patients are different from those in healthy age-matched controls. Read More

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Influence of outpatient total knee arthroplasty compared to inpatient surgery on medical and economic outcomes.

Acta Orthop Belg 2021 Mar;87(1):103-109

Firstly, this study compared the rate of readmission after a total knee arthroplasty between selected out- patients (no hospitalization, directly sent home after surgery) and inpatients (3 days hospitalization) at 6 weeks. Secondly, it examined the mobility and the complications in the two groups after the same period of time. The rate of readmission, complications and knee mobility of 32 outpatients (M-age : 61 years ± 10 ; 10 females), were compared against those of 32 birth- matched inpatients (M-age : 64 years ± 8. Read More

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Sensory wellbeing workshops for inpatient and day-care patients with anorexia nervosa.

Neuropsychiatr 2021 Jun 15. Epub 2021 Jun 15.

Eating Disorders National Service, South London and Maudsley NHS Foundation Trust, London, UK.

Background: The wellbeing of patients with eating disorders is one of the priorities in the "bigger picture" of treatment for eating disorders. Sensory soothing strategies for sensory sensitivities are supportive tools which could be useful in day-care and inpatient clinical programmes.

Methods: Evaluation of multiple separate sensory wellbeing workshops consisting of psychoeducation and experiential components delivered in inpatient and intensive day-care services was performed. Read More

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Same-day discharge arthroplasty has a higher overall complications rate than fast-track arthroplasty: a systematic review and meta-analysis.

Arch Orthop Trauma Surg 2021 Jun 15. Epub 2021 Jun 15.

Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, 37# Guoxue Road, 610041, Chengdu, Sichuan, People's Republic of China.

Background: Published studies have reported many inconsistent results regarding the comparison of same-day discharge total joint arthroplasty (TJA) and inpatient TJA. More notably, many recent studies comparing same-day discharge TJA with fast-track TJA presented higher rates of complications for same-day discharge TJA, which raises concerns about the safety of same-day discharge TJA.

Methods: We systematically searched the MEDLINE, Embase, and Cochrane Central Register of Controlled Trials databases up to June 2020 for studies comparing mortality, readmission, and complications in same-day discharge and inpatient total hip or knee arthroplasty. Read More

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Is newer always better?: comparing cost and short-term outcomes between laparoscopic and robotic right hemicolectomy.

Surg Endosc 2021 Jun 15. Epub 2021 Jun 15.

Division of General Surgery, Section of Colon & Rectal Surgery, Vanderbilt University Medical Center, Nashville, TN, USA.

Background: Enthusiasm is high for expansion of robotic assisted surgery into right hemicolectomy. But data on outcomes and cost is lacking. Our objective was to determine the association between surgical approach and cost for minimally invasive right hemicolectomy. Read More

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Acute Treatments for Episodic Migraine in Adults: A Systematic Review and Meta-analysis.

JAMA 2021 Jun;325(23):2357-2369

Mayo Clinic Evidence-based Practice Center, Rochester, Minnesota.

Importance: Migraine is common and can be associated with significant morbidity, and several treatment options exist for acute therapy.

Objective: To evaluate the benefits and harms associated with acute treatments for episodic migraine in adults.

Data Sources: Multiple databases from database inception to February 24, 2021. Read More

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Feasibility and safety of rVSV-ZEBOV vaccination of humanitarian health workers against Ebola virus disease: an observational study.

J Travel Med 2021 Jun 15. Epub 2021 Jun 15.

Division of Tropical and Humanitarian Medicine, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 6, Geneva 1205, Switzerland.

Background And Rationale: Geneva University Hospitals were granted a temporary authorization to administer the recombinant live vesicular stomatitis virus rVSV-ZEBOV (Ervebo®) vaccine to expatriate humanitarian frontline workers (FLWs) prior to mission deployment.

Objectives: Our aims were to assess the feasibility of FLW vaccination before deployment and to report adverse events (AEs).

Methods: FLWs received a single injection of rVSV-ZEBOV (>7. Read More

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Evaluation of Long-Lasting Potential of Suprachoroidal Axitinib Suspension Via Ocular and Systemic Disposition in Rabbits.

Transl Vis Sci Technol 2021 Jun;10(7):19

Clearside Biomedical Inc., Alpharetta, GA, USA.

Purpose: Axitinib, a tyrosine kinase inhibitor, is a potent inhibitor of vascular endothelial growth factor (VEGF) receptors -1, -2 and -3. Suprachoroidal (SC) delivery of axitinib, combined with pan-VEGF inhibition activity of axitinib, has the potential to provide additional benefits compared to the current standard of care with intravitreal anti-VEGF-A agents. This study evaluated the ocular pharmacokinetics and systemic disposition of axitinib after SC administration in rabbits. Read More

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[Treatment of locally advanced and metastatic cutaneous squamous cell carcinoma.]

Recenti Prog Med 2021 Jun;112(6):69e-74e

Oncologia Day Hospital, Azienda Ospedaliero-Universitaria di Modena.

Locally advanced and metastatic cutaneous squamous cell carcinoma (cSCC) of the skin is a rare entity and with a poor prognosis. Although less than 5% of patients with squamous carcinoma develop metastases or relapses locally after surgical removal, cSCC is difficult to treat. It tends to develop especially in elderly, frail or patients with important comorbidities and therefore not suitable for receiving aggressive treatments. Read More

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A case report of prenatal diagnosis of fetal alloimmune thrombocytopenia: A CARE-compliant article.

Medicine (Baltimore) 2021 Jun;100(24):e26092

Department of Obstetrics, Xiangya Hospital, Central South University, Changsha, Hunan, China.

Rationale: Fetal alloimmune thrombocytopenia (FAIT) is a serious life-threatening disease caused by platelet-antigen incompatibility between the mother and fetus. FAIT can lead to fetal thrombocytopenia, intracranial hemorrhage (ICH), fetal death and severe neurological disorders after birth. Noninvasive prenatal diagnosis technology has not been widely used in China, and thus few cases of FAIT can be diagnosed prenatally. Read More

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Doxycycline host-directed therapy in human pulmonary tuberculosis.

J Clin Invest 2021 Jun 15. Epub 2021 Jun 15.

Department of Medicine, Yong Loo Ling School of Medicine, National University of Singapore, Singapore, Singapore.

Background: Matrix metalloproteinases (MMPs) are implicated as key regulators of tissue destruction in tuberculosis (TB) and may be a target for host-directed therapy. Here, we conducted a Phase 2 randomized, double-blind, placebo-controlled trial investigating doxycycline, a licensed broad spectrum MMP inhibitor, in pulmonary TB patients.

Methods: Thirty pulmonary TB patients were enrolled within 7 days of initiating anti-TB treatment and randomly assigned to receive either doxycycline 100 mg or placebo twice a day for 14 days in addition to standard care. Read More

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Effect of Mobile Phone Text Message Reminders on the Completion and Timely Receipt of Routine Childhood Vaccinations: Superiority Randomized Controlled Trial in Northwest Ethiopia.

JMIR Mhealth Uhealth 2021 Jun 15;9(6):e27603. Epub 2021 Jun 15.

Department of Health Informatics, Institute of Public Health, University of Gondar, Gondar, Ethiopia.

Background: Nonattendance at vaccination appointments is a big challenge for health workers as it is difficult to track routine vaccination schedules. In Ethiopia, 3 out of 10 children have incomplete vaccination and the timely receipt of the recommended vaccines is low. Thus, innovative strategies are required to reach the last mile where mobile technology can be effectively utilized to achieve better compliance. Read More

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Adjunctive treatment with high-titre convalescent plasma in severely and critically ill COVID-19 patients - a safe but futile intervention. A comparative cohort study.

Infect Dis (Lond) 2021 Jun 15:1-10. Epub 2021 Jun 15.

Austrian Red Cross, Blood Service for Vienna, Lower Austria and Burgenland, Vienna, Austria.

Background: Convalescent plasma (CP) containing antibodies derived from coronavirus disease 2019 (COVID-19) survivors has been proposed as a promising therapeutic option for severe COVID-19.

Methods: In our intensive care unit (ICU), 55 patients (46 male, median age 61 years) with PCR-confirmed COVID-19 (35 = 63.6% on mechanical ventilation, 7 = 14. Read More

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The PALliative MUlticenter Study in Intensive Care (PalMuSIC). Results From a Multicenter Study Addressing Frailty and Palliative Care Interventions in Intensive Care Units in Portugal.

J Palliat Care 2021 Jun 15:8258597211020964. Epub 2021 Jun 15.

Intensive Care Unit, Hospital Vila Franca Xira, NOVA Medical School, Portugal.

Introduction: Frailty is a clinically recognizable state of increased vulnerability common in critical medicine. When underrecognized, it may lead to invasive treatments that do not serve the patients' best interest. Our aim was to evaluate the use of both palliative care consultation and invasive interventions in frail patients admitted to Intensive Care Units in Portugal. Read More

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Mental health of children with neurodevelopmental disorders during COVID-19: A brief report of family experiences from a low and middle income country.

Clin Child Psychol Psychiatry 2021 Jun 15:13591045211026058. Epub 2021 Jun 15.

Center for Advanced Research and Excellence in Autism and Developmental Disorders (CAREADD), St. John's Medical College, Bangalore, Karnataka, India.

COVID-19 has grossly impacted lives of people across the globe. In particular, children have also been affected due to closure of schools, therapy, and day care centers. Families have been challenged with new circumstances, and mental health professionals are coming up with novel ways to help these families who have children with mental health issues. Read More

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Review: Unaccompanied refugee minors' perception of mental health services and professionals: a systematic review of qualitative studies.

Child Adolesc Ment Health 2021 Jun 15. Epub 2021 Jun 15.

Univ. Grenoble-Alpes/CNRS/TIMC-IMAG UMR 5525, Grenoble, France.

Background: Unaccompanied refugee minors (URMs) are a population at risk of mental health problems and a population with whom the therapeutic alliance can be difficult to set up. The therapeutic alliance's quality can impact the result and effectiveness of psychotherapeutic interventions. The aim of the present study was to gather URMs' points of view about mental health services and mental health professionals (MHP) in the host country. Read More

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"Disruptive Technology" in Spine Surgery and Education: Virtual and Augmented Reality.

Oper Neurosurg (Hagerstown) 2021 Jun;21(Supplement_1):S85-S93

Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA.

Background: Technological advancements are the drivers of modern-day spine care. With the growing pressure to deliver faster and better care, surgical-assist technology is needed to harness computing power and enable the surgeon to improve outcomes. Virtual reality (VR) and augmented reality (AR) represent the pinnacle of emerging technology, not only to deliver higher quality education through simulated care, but also to provide valuable intraoperative information to assist in more efficient and more precise surgeries. Read More

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Testosterone is Sufficient to Impart Susceptibility to Isoflurane Neurotoxicity in Female Neonatal Rats.

J Neurosurg Anesthesiol 2021 Jun 15. Epub 2021 Jun 15.

Department of Anesthesia and Perioperative Care, University of California, San Francisco, San Francisco, CA.

Background: Volatile anesthetic exposure during development leads to long-term cognitive deficits in rats which are dependent on age and sex. Female rats are protected relative to male rats for the same exposure on postnatal day 7. Here we test our hypothesis that androgens can modulate chloride cotransporter expression to alter the susceptibility to neurotoxicity from GABAergic drugs using female rats with exogenous testosterone exposure. Read More

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Emtricitabine triphosphate in dried blood spots predicts future viremia in persons with HIV and identifies mismatch with self-reported adherence.

AIDS 2021 Jun 14. Epub 2021 Jun 14.

Department of Biostatistics and Bioinformatics, Colorado School of Public Health, Aurora, Colorado Division of Infectious Diseases, School of Medicine, University of Colorado-AMC, Aurora, Colorado University of Colorado Hospital, Aurora, Colorado Colorado Antiviral Pharmacology Laboratory and Department of Pharmaceutical Sciences, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado-AMC, Aurora, Colorado.

Objective: Emtricitabine triphosphate (FTC-TP) in dried blood spots (DBS), a measure of short-term ART adherence, is associated with viral suppression in persons with HIV (PWH). However, its ability to predict future viremia remains unknown.

Design: Prospective, observational cohort (up to 3 visits in 48 weeks). Read More

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Reversal of residual neuromuscular block with neostigmine or sugammadex and postoperative pulmonary complications: a prospective, randomised, double-blind trial in high-risk older patients.

Br J Anaesth 2021 Jun 11. Epub 2021 Jun 11.

Department of Anaesthesiology and Intensive Care, University of Debrecen, Debrecen, Hungary.

Background: Residual neuromuscular block is associated with an increased risk of postoperative pulmonary complications in retrospective studies. The aim of our study was to investigate prospectively the incidence of postoperative pulmonary complications after reversal with either sugammadex (SUG) or neostigmine (NEO) in high-risk older patients.

Methods: We randomly allocated 180 older patients with significant morbidity (ASA physical status 3) ≥75 yr old to reversal of rocuronium with either SUG or NEO. Read More

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