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Development of a community outreach project: An interprofessional partnership for thalassemia families guided by nursing students.

Nurse Educ Pract 2021 May 2;53:103075. Epub 2021 May 2.

Rady Children's Hospital San Diego and University of California San Diego, USA.

Children with chronic illnesses have improved physiological and psychosocial outcomes when they are able to identify and converse with others who experience the same challenges. Support groups are one way to enhance this interaction. To facilitate this process, student nurses worked with an interprofessional healthcare team, thalassemia patients, and their families to determine their support needs. Read More

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Use of a machine learning-based smartphone app to detect the sunscreen features in a photograph and provide feature-based recommendation.

J Cosmet Dermatol 2021 May 15. Epub 2021 May 15.

College of Medical Sciences, Department of Dermatology.

Sunscreens have been used as photoprotective agents to prevent photoaging, photocarcinogenesis and photodermatoses. However, a recent study found that a significant proportion of patients are uneducated about proper sunscreen use, with about 40% of the patients unaware about the minimum sun protection factor (SPF) requirement set by the American Academy of Dermatology (AAD). Another study based on consumer reviews on Amazon. Read More

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Predictors of 30-Day Readmissions for Adrenal Insufficiency: A Retrospective National Database Study.

Clin Endocrinol (Oxf) 2021 May 15. Epub 2021 May 15.

Department of Endocrinology, South Shore University Hospital, Bay Shore, NY, USA.

Objective: The aim of this study is to describe rates and characteristics of non-elective 30-day readmission among patients hospitalized for adrenal insufficiency and to assess predictors of readmission.

Design: We analyzed the 2018 National Readmission Database. Adrenal insufficiency hospitalizations were identified using the International Classification of Diseases, Tenth Revisions, Clinical Modification diagnosis codes for principal diagnostic codes of primary adrenal insufficiency, Addisonian crisis, drug-induced adrenocortical insufficiency, and other and unspecified adrenocortical insufficiency. Read More

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Early secondary repair of obstetric anal sphincter injuries (OASIs): experience and a review of the literature.

Int Urogynecol J 2021 May 15. Epub 2021 May 15.

Croydon University Hospital, Thornton Heath, CR7 7YE, UK.

Introduction And Hypothesis: Secondary anal sphincter repair for a dehisced obstetric anal sphincter injury (OASI) is required following 2.6% of primary repairs. There is growing evidence that instead of delaying repair for 3-6 months, early secondary repair of the anal sphincter can be completed within 14 days. Read More

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Epidemiology and risk factors for ureteral stent-associated urinary tract infections in non-transplanted renal patients: a systematic review of the literature.

World J Urol 2021 May 15. Epub 2021 May 15.

Service D'Urologie, CHRU Bretonneau, Tours, France.

Purpose: Pathophysiology and risk factors for Ureteral Stent-Associated Urinary Tract Infection (USAUTI) have been poorly investigated. This situation results in highly diverse practices regarding USAUTI prevention, diagnosis and treatment. The aim of the present study was to describe the epidemiology and risk factors for USAUTI in non-transplanted patients. Read More

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Response to crizotinib in a patient with MET-amplified hepatocellular carcinoma.

Hepatol Res 2021 May 15. Epub 2021 May 15.

Department of Hepatobiliary Surgery, the First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China.

Aims: Molecular profiling of hepatocellular carcinoma (HCC) has helped identify actionable genomic alterations that may guide therapeutic decision-making and clinical trial enrollment. However, in clinical practice, next-generation sequencing (NGS) is not extensively used in routine clinical care to identify patients with HCC who are likely to benefit from genome-directed targeted therapies.

Methods: Here, we describe the case of a 66-year-old man with advanced HCC. Read More

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A practice-based model to guide nursing science and improve the health and well-being of patients and caregivers.

J Clin Nurs 2021 May 15. Epub 2021 May 15.

Nursing Research Division, Mayo Clinic, Rochester, MN, USA.

Aims And Objectives: The purpose of this paper is to describe a model to guide nursing science in a clinical practice-based setting. Exemplars are provided to highlight the application of this nursing research model, which can be applied to other clinical settings that aim to fill evidence gaps in the literature.

Background: Nurse scientists are well positioned to develop new knowledge aimed at identifying global health solutions to multiple disparities. Read More

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Real life Study on the Pharmacokinetic of Remdesivir in ICU patients admitted for Severe COVID-19 Pneumonia.

Br J Clin Pharmacol 2021 May 14. Epub 2021 May 14.

Laboratory of Clinical Pharmacology and Pharmacogenetics, Amedeo di Savoia Hospital, Department of Medical Sciences, University of Turin, Italy.

Remdesivir is one of the most encouraging treatments against SARS-CoV-2 infection. After intravenous infusion, RDV is rapidly metabolized (T 1h) within the cells to its active adenosine triphosphate analogue form (GS-443902) and, then, it can be found in plasma in its nucleoside analogue form (GS-441524). In this real life study we describe the Remdesivir and GS-441524 concentrations at 3 time points in nine ICU patients, through a validated UHPLC-MS/MS method. Read More

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Fibrosis in hypertrophic cardiomyopathy: role of novel echo techniques and multi-modality imaging assessment.

Heart Fail Rev 2021 May 15. Epub 2021 May 15.

Cardiomyopathy & Neuromuscular Disease Unit, Third Cardiology Department, Hippokrateion University Hospital, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece.

Hypertrophic cardiomyopathy (HCM) represents one of the primary cardiomyopathies and may lead to heart failure and sudden cardiac death. Among various histologic features of the disease examined, assessment of myocardial fibrosis may offer valuable information, since it may be considered the common nominator for all HCM connected complications. Late gadolinium-enhanced cardiac magnetic resonance (LGE-CMR) has emerged as the reference noninvasive method for visualizing and quantifying myocardial fibrosis in patients with HCM. Read More

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Incidence and trends of ophthalmic cancer in Singapore: Data from Singapore Cancer Registry.

Ann Acad Med Singap 2021 Apr;50(4):297-305

Department of Ophthalmology, National University Hospital, Singapore.

Introduction: Limited data are available on the incidence of primary ophthalmic cancers worldwide. We describe the incidence and trends of primary ophthalmic cancers in Singapore.

Methods: Data on ophthalmic cancers diagnosed in Singapore from 1996 to 2016 were retrieved from the Singapore Cancer Registry for analysis. Read More

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Umbilical cord blood transplants facilitated by the French cord blood banks network. On behalf of the Agency of Biomedicine, Eurocord and the French society of bone marrow transplant and cell therapy (SFGM-TC).

Bone Marrow Transplant 2021 May 14. Epub 2021 May 14.

Eurocord, Hopital Saint-Louis, AP-HP, Institut de Recherche de Saint-Louis (IRSL) EA3518, Université de Paris, Paris, France.

The public French Cord Blood Banks Network was established in 1999 with the objective of standardizing the practices governing umbilical cord blood (UCB) banking in France. The Network adopted a strategy to optimize its inventory and improve the quality of its banked units based on a quality improvement process using outcome data regularly provided by Eurocord. This study aimed to describe the results, over 10 years, of UCBT facilitated by a national network that used the same criteria of UCB collection and banking and to assess how modifications of banking criteria and unit selection might influence transplant outcomes. Read More

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Deep learning for diagnosis of acute promyelocytic leukemia via recognition of genomically imprinted morphologic features.

NPJ Precis Oncol 2021 May 14;5(1):38. Epub 2021 May 14.

Bloomberg Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

Acute promyelocytic leukemia (APL) is a subtype of acute myeloid leukemia (AML), classified by a translocation between chromosomes 15 and 17 [t(15;17)], that is considered a true oncologic emergency though appropriate therapy is considered curative. Therapy is often initiated on clinical suspicion, informed by both clinical presentation as well as direct visualization of the peripheral smear. We hypothesized that genomic imprinting of morphologic features learned by deep learning pattern recognition would have greater discriminatory power and consistency compared to humans, thereby facilitating identification of t(15;17) positive APL. Read More

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Epidemiology of Pediatric Meningitis in South Korea From 2010 to 2018: A Population-based Retrospective Cohort Study.

Pediatr Infect Dis J 2021 May 7. Epub 2021 May 7.

From the Department of Pediatrics, Hallym University College of Medicine, Kangdong Sacred Heart Hospital, Gangdong-gu, Seoul, Republic of Korea.

Background: Studies evaluating the epidemiology of pediatric meningitis are limited in our region. This study aimed to describe recent trends in the incidence of pediatric meningitis.

Methods: We estimated national trends in hospitalization rates for pediatric meningitis (<18 years) by analyzing data from the Health Insurance Review and Assessment database between 2010 and 2018. Read More

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Global Trends in Telehealth Among Clinicians in Developmental-Behavioral Pediatric Practice: A COVID-19 Snapshot.

J Dev Behav Pediatr 2021 May 12. Epub 2021 May 12.

Ummeed Child Development Center, Mumbai, India; Division of Developmental and Behavioral Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA; Division of Developmental-Behavioral Pediatrics, Department of Pediatric and Adolescent Medicine, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI.

Objective: This study aims to describe the extent of telehealth use by global developmental-behavioral pediatrics (DBP) clinicians and barriers (if any) in adopting telehealth during the coronavirus disease 2019 (COVID-19) pandemic.

Methods: A survey was disseminated to DBP clinicians through contact with international professional organizations to determine the use of telehealth in DBP care, before and since the beginning of the COVID-19 pandemic. Descriptive statistics and χ2 tests were used for analysis. Read More

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Using Registry Data to Support National Quality Forum Endorsement of Quality Measures for Home-Based Medical Care.

Am J Med Qual 2021 May 12. Epub 2021 May 12.

PCPI Foundation, Chicago, IL US Medical Management, Troy, MI Division of Palliative Care and Geriatric Medicine, Mongan Institute Center for Aging and Serious Illness, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA Department of Medicine, Division of Geriatric Medicine, Center for Transformative Geriatric Research, Johns Hopkins University School of Medicine, Baltimore, MD.

Homebound older adults receiving home-based medical care (HBMC) are high-need, high-cost patients. National Quality Forum (NQF)-endorsed quality measures for this population are lacking. The objective is to describe the reliability and validity testing of 2 new quality measures for such patients to support NQF endorsement. Read More

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Liver enzyme elevation after Lu-PSMA radioligand therapy for metastasized castration-resistant prostate cancer.

J Nucl Med 2021 May 14. Epub 2021 May 14.

Department of Urology, University Medicine Goettingen, Germany.

Lu-PSMA radioligand therapy (Lu-PSMA-RLT) is a promising new therapeutic option for patients with metastasized castration-resistant prostate cancer (mCRPC). The spectrum of adverse events with this treatment has to be evaluated. Here, we describe the case of a mCRPC patient with M1c disease (mediastinum, lungs, bones and liver) who presented with elevated liver enzyme levels after Lu-PSMA-RLT administration. Read More

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Off-label postpartum use of domperidone in Canada: a multidatabase cohort study.

CMAJ Open 2021 Apr-Jun;9(2):E500-E509. Epub 2021 May 14.

Centre for Clinical Epidemiology (Moriello, Reynier, Aibibula, Filion), Lady Davis Institute, Jewish General Hospital, McGill University, Montréal, Que; ICES (Paterson); Institute of Health Policy, Management and Evaluation (Paterson), University of Toronto, Toronto, Ont.; Manitoba Centre for Health Policy, Department of Community Health Sciences (Dahl, Kuo), Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man.; Department of Anesthesiology, Pharmacology and Therapeutics (Fisher), University of British Columbia, Vancouver BC; School of Pharmacy (Gamble), University of Waterloo, Kitchener, Ont.; Department of Community Health Sciences (Ronksley), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Saskatchewan Health Quality Council (Winquist); Department of Community Health and Epidemiology (Winquist), College of Medicine, University of Saskatchewan, Saskatoon Sask.; Departments of Medicine and of Epidemiology, Biostatistics, and Occupational Health (Filion), McGill University, Montréal, Que.

Background: Trends in off-label postpartum use of domperidone and the impact of safety advisories on its use remain unknown. Our objectives were to describe postpartum use of domperidone in Canada, to evaluate the impact of Health Canada advisories on prescribing patterns, and to describe the association between domperidone use and a composite end point of sudden cardiac death or ventricular tachycardia (VT) among postpartum patients.

Methods: We conducted a multidatabase cohort study involving pregnant patients with live births between 2004 and 2017 using administrative health databases from 5 Canadian provinces (British Columbia, Alberta, Saskatchewan, Manitoba and Ontario). Read More

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Quality of care for tuberculosis and HIV in the private health sector: a cross-sectional, standardised patient study in South Africa.

BMJ Glob Health 2021 May;6(5)

Dahdaleh Institute of Global Health Research, York University, Toronto, Ontario, Canada

Background: South Africa has high burdens of tuberculosis (TB) and TB-HIV, yet the quality of patient care in the private sector is unknown. We describe quality of TB and TB-HIV care among private general practitioners (GPs) in two South African cities using standardised patients (SPs).

Methods: Sixteen SPs presented one of three cases during unannounced visits to private GPs in selected high-TB burden communities in Durban and Cape Town: case 1, typical TB symptoms, HIV-positive; case 2, TB-specified laboratory report, HIV-negative and case 3, history of incomplete TB treatment, HIV-positive. Read More

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Tumor Immunity and Immunotherapy for HPV-Related Cancers.

Cancer Discov 2021 May 14. Epub 2021 May 14.

Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York.

Human papillomavirus (HPV) infection drives tumorigenesis in the majority of cervical, oropharyngeal, anal, and vulvar cancers. Genetic and epidemiologic evidence has highlighted the role of immunosuppression in the oncogenesis of HPV-related malignancies. Here we review how HPV modulates the immune microenvironment and subsequent therapeutic implications. Read More

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Community distribution of oxygen: a unique COVID-19 intervention.

Trop Med Health 2021 May 14;49(1):39. Epub 2021 May 14.

Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK.

The rapid spread of COVID-19 around the world has exposed some long-standing deficiencies in health systems, particularly in environments with low financial and medical resources. Most patients ill with COVID-19 require oxygen and supportive therapy for survival as there remains no conclusively established curative therapy. Following a number of critical research work and drawing from a millennia-long evolution of medical practice, respiratory support has been identified as a paramount intervention to ensure lives are saved when supportive care is required, and oxygen is an essential commodity to achieve this. Read More

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Elevated sweat chloride test: is it always cystic fibrosis?

Ital J Pediatr 2021 May 14;47(1):112. Epub 2021 May 14.

Department of Translational Medical Sciences, Cystic Fibrosis Center, University Federico II, Naples, Italy.

Background: The sweat chloride test (ST) is the gold standard for cystic fibrosis (CF) diagnosis in symptomatic patients, within the newborn screening and in the follow-up of CF patients during molecular therapies. However, false positives have been reported in patients with different diseases. We describe and discuss 4 cases due to different clinical conditions in which we recorded false positive ST, and the test remained altered for a period of varying length. Read More

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Cancer-Related Venous Thromboembolism: From Pathogenesis to Risk Assessment.

Semin Thromb Hemost 2021 May 14. Epub 2021 May 14.

Department of Medical Oncology, Centro Hospitalar Universitário do Porto, Institute of Biomedical Sciences Abel Salazar, University of Porto, Porto, Portugal.

Cancer-related venous thromboembolism (VTE) remains a major health problem, accounting for at least 18% of all cases of VTE. Cancer patients with VTE have worse prognosis than those without VTE. Prophylaxis reduces VTE risk, but it is not feasible for all outpatients with cancer due to an increased bleeding risk. Read More

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Massive advancing non-exudative type 1 choroidal neovascularization in CTRP5 Late Onset Retinal Degeneration: longitudinal findings on multimodal imaging and implications for age-related macular degeneration.

Retina 2021 May 3. Epub 2021 May 3.

Division of Epidemiology and Clinical Applications, National Eye Institute, National Institutes of Health, Bethesda, MD, USA Center for Ocular Regenerative Therapy, UC Davis Eye Center, University of California Davis, Sacramento, CA, USA.

Purpose: To describe longitudinal multimodal imaging findings of non-exudative choroidal neovascularization (CNV) in CTRP5 late-onset retinal degeneration (CTRP5-LORD).

Methods: Four patients with CTRP5-positive LORD underwent repeated ophthalmoscopic examination and multimodal imaging. All four patients (two siblings and their cousins, from a pedigree described previously) had the heterozygous S163R mutation. Read More

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Use of Circulating Tumor DNA for the Clinical Management of Metastatic Castration-Resistant Prostate Cancer: A Multicenter, Real-World Study.

J Natl Compr Canc Netw 2021 May 14:1-10. Epub 2021 May 14.

1Department of Urology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai.

Background: This study aimed to describe the aberrations of DNA damage repair genes and other important driving genes in Chinese patients with metastatic castration-resistant prostate cancer (mCRPC) using circulating tumor (ctDNA) sequencing and to evaluate the associations between the clinical outcomes of multiple therapies and key genomic alterations in mCRPC, especially DNA damage repair genes.

Patients And Methods: A total of 292 Chinese patients with mCRPC enrolled from 8 centers. Multigene targeted sequencing was performed on 306 ctDNA samples and 23 matched tumor biopsies. Read More

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Incidence and clinical profile of venous thromboembolism in hospitalized COVID-19 patients from Madrid region.

Thromb Res 2021 May 8;203:93-100. Epub 2021 May 8.

Hematology Department, University Hospital Puerta de Hierro Majadahonda, Madrid, Spain.

Background: COVID-19 related in-hospital venous thromboembolism (VTE) incidence is high but data reported vary significantly. Some studies show that up to half of the events are diagnosed early after admission.

Objectives: To study symptomatic VTE incidence in acute COVID-19 hospitalized patients and to describe timing of VTE diagnosis. Read More

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Disseminated peritoneal leiomyomatosis and malignant transformation: A case series in a single referral center.

Eur J Obstet Gynecol Reprod Biol 2021 May 5;262:21-27. Epub 2021 May 5.

Division of Gynecologic Oncology, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy; Università Cattolica del Sacro Cuore, Rome, Italy.

Objective: The aim of this study was to describe one of the largest series of disseminated peritoneal leiomyomatosis (DPL) and its malignant counterpart, evaluating possible risk factors for both the benign and malignant condition, and highlighting any differences between them in terms of surgical and clinical management.

Study Design: Clinical, surgical and histopathological characteristics of patients diagnosed with DPL (group 1) and malignant-DPL (group 2), between July 2010 and July 2020, were retrospectively retrieved.

Results: A total of 14 benign and 5 malignant cases were selected. Read More

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The complications of subtotal cholecystectomy: A case report.

Int J Surg Case Rep 2021 Apr 30;83:105950. Epub 2021 Apr 30.

Department B of Surgery, Charles Nicolle Hospital, Tunis, Tunisia.

Introduction: Although the symptoms attributed to gall stones resolve in most patients after cholecystectomy, some may have symptoms that persist or recur. It is known as the post-cholecystectomy syndrome (PCS). The aim of this case was to describe the diagnostic difficulties encountered and to discuss the main etiologies of this entity. Read More

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Adjunctive homeopathic treatment of hospitalized COVID-19 patients (COVIHOM): A retrospective case series.

Complement Ther Clin Pract 2021 May 11;44:101415. Epub 2021 May 11.

WissHom: Scientific Society for Homeopathy, Koethen, Germany.

Background: and purpose. COVID-19 is a novel viral disease causing worldwide pandemia. The aim of this study was to describe the effect of adjunctive individualized homeopathic treatment delivered to hospitalized patients with confirmed symptomatic SARS-CoV-2 infection. Read More

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Double Dose Desogestrel: Is it effective in Adolescent Menstrual Dysfunction?

J Pediatr Adolesc Gynecol 2021 May 11. Epub 2021 May 11.

Paediatric and Adolescent Gynaecology Department, Alder Hey Children's Hospital, Liverpool Women's Hospital, Liverpool, UK.

Study Objective: Adolescent menstrual dysfunction (AMD) is a common cause of iron deficiency anaemia and absences from school. The management of AMD with single and double dose desogestrel is largely based on anecdotal evidence. Our aim is to describe the effectiveness and safety of both dosing strategies in our clinic cohort to help guide future management. Read More

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Critical Review of Oncology Clinical Trial Design Under Non-proportional Hazards.

Crit Rev Oncol Hematol 2021 May 11:103350. Epub 2021 May 11.

Department of Biostatistics, Boston University School of Public Health, Boston, MA, 02118, United States.

In trials of novel immuno-oncology drugs, the proportional hazards (PH) assumption often does not hold for the primary time-to-event (TTE) efficacy endpoint, likely due to the unique mechanism of action of these drugs. In practice, when it is anticipated that PH may not hold for the TTE endpoint with respect to treatment, the sample size is often still calculated under the PH assumption, and the hazard ratio (HR) from the Cox model is still reported as the primary measure of the treatment effect. Sensitivity analyses of the TTE data using methods that are suitable under non-proportional hazards (non-PH) are commonly pre-planned. Read More

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