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Pituitary metastasis unveiling a lung adenocarcinoma.

Endocrinol Diabetes Metab Case Rep 2021 Feb 26;2021. Epub 2021 Feb 26.

Endocrinology Department, Centro Hospitalar e Universitário do Porto, EPE, Porto, Portugal.

Summary: Pituitary metastasis (PM) can be the initial presentation of an otherwise unknown malignancy. As PM has no clinical or radiological pathognomonic features, diagnosis is challenging. The authors describe the case of a symptomatic PM that revealed a primary lung adenocarcinoma. Read More

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February 2021

Characteristics of clinically node negative breast cancer patients needing preoperative MRI.

Surg Oncol 2021 Mar 31;38:101552. Epub 2021 Mar 31.

Department of Oncology, Turku University Hospital, Finland; University of Turku, Turku, Finland; Finnish Nuclear and Radiation Safety, Helsinki, Finland.

Background: International guidelines do not recommend magnetic resonance imaging (MRI) for all breast cancer patients at primary diagnostics. This study aimed to understand which patient or tumor characteristics are associated with the use of MRI. The role of MRI among other preoperative imaging methods in clinically node negative breast cancer was studied. Read More

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Comparing respiratory polygraphy with pulse transit time analysis versus overnight polysomnography in the diagnosis of obstructive sleep apnoea in children.

Sleep Med 2021 Mar 1;81:457-462. Epub 2021 Mar 1.

FHKAM(Otolaryngology), Department of Otolaryngology, Tuen Mun Hospital, Hong Kong.

Objective: Obstructive sleep apnea syndrome in children is associated with significant morbidity. Polysomnography is the main diagnostic tool but is time consuming and requires skilled manpower to supervise the patient overnight and hence long referral to diagnosis time. However, there are limitations and underestimation of the apnoea hyponea index (AHI) with alternative home sleep apnoea testing (HSAT), such as type 3 respiratory polygraphy (RP). Read More

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Molecular diagnosis of childhood immune dysregulation, polyendocrinopathy and enteropathy, and implications for clinical management.

J Allergy Clin Immunol 2021 Apr 14. Epub 2021 Apr 14.

Department of Medicine (Medical Genetics) and Department of Genome Sciences, University of Washington, Seattle WA. Electronic address:

Background: Most patients with childhood-onset immune dysregulation, polyendocrinopathy and enteropathy have no genetic diagnosis for their illness. These patients may undergo empirical immunosuppressive treatment with highly variable outcomes.

Objective: To determine the genetic basis of disease in patients referred with "IPEX-like" disease, but with no mutation in FOXP3; then to assess consequences of genetic diagnoses for clinical management. Read More

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Comparative Sensitivity Study of Primary Cells, Vero, OA3.Tsand ESH-L cell lines to Lumpy Skin Disease, Sheeppox, and Goatpox viruses Detection and Growth.

J Virol Methods 2021 Apr 14:114164. Epub 2021 Apr 14.

Laboratory of Research and Development virology, MCI Animal Health, Lot. 157, Zone Industrielle Sud-Ouest (ERAC) B.P: 278, Mohammedia, 28810, Morocco.

Lumpy skin disease virus (LSDV), sheeppox virus (SPPV) and goatpox (GTPV) virus have been usually grown on primary cells for diagnosis, production and titration purposes. The use of primary cells present several inconvenient, heavy preparation, heterogeneous cell population, non-reproducible viral titration and presence of potential endogenous contaminants. Therefore investigating sensitivity of candidate continuous cell lines is needed. Read More

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Brain Metastases: An Update on Multi-disciplinary Approach of Clinical Management.

Neurochirurgie 2021 Apr 14. Epub 2021 Apr 14.

Department of Neurosurgery, University of Wisconsin School of Medicine & Public Health, UW Carbone Cancer Center, Madison, WI, USA. Electronic address:

Importance: Brain metastasis (BM) is the most common malignant intracranial neoplasm in adults with over 100,000 new cases annually in the United States and outnumbering primary brain tumors 10:1.

Observations:  The incidence of BM in adult cancer patients ranges from 10-40%, and is increasing with improved surveillance, effective systemic therapy, and an aging population. The overall prognosis of cancer patients is largely dependent on the presence or absence of brain metastasis, and therefore, a timely and accurate diagnosis is crucial for improving long-term outcomes, especially in the current era of significantly improved systemic therapy for many common cancers. Read More

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Temporal trends and patient characteristics associated with 30-day hospital readmission rates after a first acute myocardial infarction.

Am J Med 2021 Apr 14. Epub 2021 Apr 14.

Meyers Primary Care Institute, Worcester, MA 01655; Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, 01655.

Background: Limited data exists about relatively recent trends in the magnitude and characteristics of patients who are re-hospitalized after hospital admission for an acute myocardial infarction (AMI). This study examined trends in the frequency and socio-demographic and clinical characteristics of patients readmitted to the hospital within 30 days after an initial acute myocardial infarction.

Methods: We reviewed the medical records of 3,116 individuals who were hospitalized for a validated first acute myocardial infarction in six study periods between 2003 and 2015 at the three major medical centers in central Massachusetts. Read More

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Intravenous high-dose methotrexate based systemic therapy in the treatment of isolated primary vitreoretinal lymphoma: an LOC network study.

Am J Hematol 2021 Apr 17. Epub 2021 Apr 17.

Neurology, APHP, Sorbonne Université, Paris, France.

The treatment of primary vitreoretinal lymphoma (PVRL) remains controversial regarding the use of local, systemic, or combined treatments. The aim of this study was to analyze the efficacy and toxicity of intravenous high-dose methotrexate (IV HD-MTX) based systemic therapy in a uniformly treated population of PVRL patients. From a nationwide French database, we retrospectively selected 59 patients (median age: 70 years, median Karnofsky Performance Status: 90%) with isolated PVRL at diagnosis who received first-line treatment with HD-MTX between 2011-2018. Read More

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[Combination of tumors of different histogenesis in pediatric neurosurgery].

Zh Vopr Neirokhir Im N N Burdenko 2021 ;85(2):80-90

Almazov National Medical Research Center, St. Petersburg, Russia.

Multiple gliomas are determined by synchronous two or more tumors located in different brain regions. It is important to distinguish multiple primary tumors and metastatic brain lesion. In the first case, tumor spread can`t be explained by dissemination along the cerebrospinal fluid pathways, commissural fibers or local metastases. Read More

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January 2021

Low absolute lymphocyte count is a poor prognostic factor for untreated advanced follicular lymphoma treated with rituximab plus bendamustine: results of the prospective phase 2 CONVERT trial.

Int J Hematol 2021 Apr 17. Epub 2021 Apr 17.

Department of Hematology and Rheumatology, Faculty of Medicine, Kindai University, 377-2, Ohno-higashi, Osaka-sayama, Osaka, 589-8511, Japan.

The aim of this trial is to evaluate the utility of rituximab-bendamustine (R-B) for untreated advanced follicular lymphoma (FL) showing non-optimal response (nOR) to R-CHOP, and to identify clinical prognostic factors for FL patients receiving R-B. Patients who failed to achieve complete response/complete response unconfirmed (CR/CRu) [nOR-group] after 2 cycles of R-CHOP subsequently received 6 cycles of R-B. The primary endpoint was the 3-year progression-free survival (PFS) rate. Read More

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Recognising Colorectal Cancer in Primary Care.

Adv Ther 2021 Apr 17. Epub 2021 Apr 17.

Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, CB1 8RN, UK.

Colorectal cancer (CRC) is the third most common cancer worldwide. Primary care professionals can play an important role in both prevention and early detection of CRC. Most CRCs are attributed to modifiable lifestyle factors, which can be addressed within primary care, and promotion of population-based screening programmes can aid early cancer detection in asymptomatic patients. Read More

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Persistence with oral bisphosphonates and denosumab among older adults in primary care in Ireland.

Arch Osteoporos 2021 Apr 17;16(1):71. Epub 2021 Apr 17.

HRB Centre for Primary Care Research, Department of General Practice, Royal College of Surgeons in Ireland, Dublin, Ireland.

Gaps in pharmacological treatment for osteoporosis can reduce effectiveness. Among older adults, we found about half of new users of oral bisphosphonate and denosumab persisted with their treatment at 2 years, with few switching to alternative therapy. Persistence is suboptimal and warrants evaluation of interventions to improve this. Read More

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Correlations of typical pain patterns with SPECT/CT findings in unhappy patients after total knee arthroplasty.

Knee Surg Sports Traumatol Arthrosc 2021 Apr 17. Epub 2021 Apr 17.

University of Basel, 4051, Basel, Switzerland.

Purpose: The diagnostic process in patients after painful total knee arthroplasty (TKA) is challenging. The more clinical and radiological information about a patient with pain after TKA is included in the assessment, the more reliable and sustainable the advice regarding TKA revision can be. The primary aim was to investigate the position of TKA components and evaluate bone tracer uptake (BTU) using pre-revision SPECT/CT and correlate these findings with previously published pain patterns in painful patients after TKA. Read More

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Implementation of the Good Life with osteoArthritis in Denmark (GLA:D) Program across Canada for the Management of Hip and Knee Osteoarthritis.

Healthc Q 2021 Apr;24(1):54-59

A physiotherapist and the executive director of Bone and Joint Canada in Toronto, ON, where she leads system-improvement projects in orthopedics and arthritis. She is the clinical lead for the implementation of the GLA:D program across Canada. She can be contacted at

Good Life with osteoArthritis in Denmark (GLA:D®) is a program for the management of patients with hip and knee osteoarthritis (OA). Adapted for the Canadian population, the GLA:DTM Canada program implements evidence-based strategies to support the prevention, early diagnosis and effective management of hip and knee OA. GLA:D assists local communities in implementing OA strategies across the spectrum of disease severity. Read More

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Para-testicular lesions: Aetiology and Appearances on Ultrasound.

Andrology 2021 Apr 16. Epub 2021 Apr 16.

King's College London, Department of Radiology, King's College Hospital, London, United Kingdom.

Background: Ultrasound (US) is the primary modality for the investigation of scrotal pathology, including both intra- and para-testicular abnormalities.

Objective: To describe the abnormalities of the para-testicular space.

Materials/methods: The para-testicular space contains the epididymis, spermatic cord and the tunica vaginalis cavity and is affected by a variety of inflammatory or tumoral entities. Read More

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Arsenic and Human Health: Genotoxicity, Epigenomic Effects, and Cancer Signaling.

Biol Trace Elem Res 2021 Apr 16. Epub 2021 Apr 16.

Graduate School of Environmental Engineering, The University of Kitakyushu, 1-1 Hibikino, Wakamatsu-ku, Kitakyushu, Fukuoka, 808-0135, Japan.

Arsenic is a well-known element because of its toxicity. Humans as well as plants and animals are negatively affected by its exposure. Some countries suffer from high levels of arsenic in their tap water and soils, which is considered a primary arsenic-linked risk factor for living beings. Read More

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Genetic Mosaicism as a Cause of Inborn Errors of Immunity.

J Clin Immunol 2021 Apr 16. Epub 2021 Apr 16.

Department of Pediatrics, Division of Rheumatology/Immunology, Washington University in St. Louis, 660 S. Euclid Ave. Box 8208, St. Louis, MO, 63110, USA.

Inborn errors of immunity (IEIs) are a heterogeneous group of disorders due to genetic defects in the immune response that have a broad clinical spectrum. Diagnosis of the precise genetic cause of IEI has led to improved care and treatment of patients; however, genetic diagnosis using standard approaches is only successful in ~40% of patients and is particularly challenging in "sporadic" cases without a family history. Standard genetic testing for IEI evaluates for germline changes in genes encoding proteins important for the immune response. Read More

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Diagnostic Accuracy and Clinical Impact of [ 18F]FET PET in Childhood CNS tumors.

Neuro Oncol 2021 Apr 17. Epub 2021 Apr 17.

Department of Clinical Physiology, Nuclear Medicine and PET, Copenhagen University Hospital Rigshospitalet, Denmark.

Background: Central nervous system (CNS) tumors cause the highest death rates among childhood cancers, and survivors frequently have severe late effects. Magnetic resonance imaging (MRI) is the imaging modality of choice, but its specificity can be challenged by treatment-induced signal changes. In adults, O-(2-[ 18F]fluoroethyl)-L-tyrosine ([ 18F]FET) PET can assist in interpreting MRI findings. Read More

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Phenotypic discordance between primary and metastatic breast cancer in the large-scale real-life multicenter French ESME cohort.

NPJ Breast Cancer 2021 Apr 16;7(1):41. Epub 2021 Apr 16.

Gustave Roussy Cancer Campus, Villejuif, France.

Expression of hormone receptor (HR) for estrogens (ER) and progesterone (PR) and HER2 remains the cornerstone to define the therapeutic strategy for breast cancer patients. We aimed to compare phenotypic profiles between matched primary and metastatic breast cancer (MBC) in the ESME database, a National real-life multicenter cohort of MBC patients. Patients with results available on both primary tumour and metastatic disease within 6 months of MBC diagnosis and before any tumour progression were eligible for the main analysis. Read More

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Ga-DOTA-FAPI-04 PET/MR in the evaluation of gastric carcinomas: comparison with F-FDG PET/CT.

J Nucl Med 2021 Apr 16. Epub 2021 Apr 16.

Union Hospital, Tongji Medical College, Huazhong University of Science & Technology.

We sought to evaluate the performance of Ga-DOTA-FAPI-04 (Ga-FAPI) PET/MR for the diagnosis of primary tumor and metastatic lesions in patients with gastric carcinomas and to compare the results with those of F-FDG PET/CT. Twenty patients with histologically proven gastric carcinomas were recruited, and each patient underwent both F-FDG PET/CT and Ga-FAPI PET/MR. A visual scoring system was established to compare the detectability of primary tumors and metastases in different organs/regions (the peritoneum, abdominal lymph nodes, supradiaphragmatic lymph nodes, liver, ovary, bone, and other tissues). Read More

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Primary angiosarcoma of superior vena cava: an unexpected diagnosis after an oncological emergency.

BMJ Case Rep 2021 Apr 16;14(4). Epub 2021 Apr 16.

Internal Medicine, Centro Hospitalar Universitário de Coimbra EPE, Coimbra, Portugal.

Angiosarcoma (AS) is a rare malignant tumour representing 1%-2% of all sarcomas. Primary AS of superior vena cava (SVC) was reported in two cases worldwide. We report a 69-year-old woman with neck discomfort, headache and dyspnoea for 3 months. Read More

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Subdural haematoma, the great imitator, mimicking acute spinal cord lesion.

BMJ Case Rep 2021 Apr 16;14(4). Epub 2021 Apr 16.

Department of Neurology, Matsushita Memorial Hospital, Moriguchi, Japan.

Acute non-traumatic paraparesis is usually caused by vascular, inflammatory or neoplastic myelopathies; however, it is sometimes caused by non-myelopathic pathologies, including polyradiculoneuropathies, myopathies, psychogenic aetiologies or parasagittal cortical pathologies. A 73-year-old woman reported weakness of the bilateral lower limbs and urinary incontinence. Together with the sensory level at the left T6 dermatome, we initially considered thoracic myelopathy as the most likely diagnosis. Read More

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European Respiratory Society clinical practice guidelines for the diagnosis of asthma in children aged 5-16 years.

Eur Respir J 2021 Apr 16. Epub 2021 Apr 16.

Division of Respiratory Medicine, University Children's Hospital Zuerich and Childhood Research Center, Zuerich, Switzerland.

Diagnosing asthma in children represents an important clinical challenge. There is no single gold standard test to confirm the diagnosis. Consequently, both over-, and under-diagnosis of asthma are frequent in children. Read More

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Social Determinants of Health, Goals and Outcomes in High-Risk Children With Type 1 Diabetes.

Can J Diabetes 2021 Mar 2. Epub 2021 Mar 2.

Division of Endocrinology and Diabetes, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States; Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States; Department of Pediatrics and Child Health, University College Cork, Cork, Ireland. Electronic address:

Objectives: Despite advances in technology and type 1 diabetes (T1D) care, children from low-income families continue to have suboptimal outcomes and increased health-care utilization. In this study, we describe social determinants of health (SDOH) in high-risk children with T1D, as well as their SDOH-related priority goals, and assess the correlation between SDOH, glycemic control and health-care utilization.

Methods: Caregivers of children aged 4 to 18 years with a diagnosis of T1D of >1 year, poor glycemic control (glycated hemoglobin [A1C] ≥9. Read More

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Neuropsychological correlates of prospective memory: A comparison between tremor-dominant Parkinson's disease and cervical dystonia.

J Clin Neurosci 2021 May 23;87:156-161. Epub 2021 Mar 23.

Department of Psychology, University of Campania Luigi Vanvitelli, Caserta, Italy. Electronic address:

Cervical Dystonia (CD) and Parkinson's disease, particularly tremor-dominant motor phenotype (TD-PD), showed a selective deficit of time-based prospective memory (TBPM). The two movement disorders are mainly characterized by dysfunctions of basal-ganglia and prefrontal cortex but it is reported that cerebellum also plays a key role in their pathogenesis. These cerebral structures are specifically involved in TBPM rather than in event-based PM (EBPM), but until now no study directly compared these two components of PM between CD and TD-PD patients. Read More

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Signaling pathways governing breast cancer stem cells behavior.

Stem Cell Res Ther 2021 Apr 16;12(1):245. Epub 2021 Apr 16.

Fertility, Infertility and Perinatology Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

Breast cancer is the second common cancer and the leading cause of malignancy among females overall. Breast cancer stem cells (BCSCs) are a small population of breast cancer cells that play a critical role in the metastasis of breast cancer to other organs in the body. BCSCs have both self-renewal and differentiation capacities, which are thought to contribute to the aggressiveness of metastatic lesions. Read More

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Mapping evidence on the distribution of the costs associated with cancer of prostate, cervix, and female breast in the sub-Saharan Africa: protocol for a scoping review.

Syst Rev 2021 Apr 17;10(1):113. Epub 2021 Apr 17.

Discipline of Public Health, School of Nursing and Public Health, University of KwaZulu-Natal, Mazisi Kunene Road, Durban, 4041, South Africa.

Background: Despite the well-documented information on cancer prevention and management, among noncommunicable diseases (NCDs), globally, cancer continues to be the second leading cause of morbidity and mortality with devastating economic consequences. The burden is disproportionately more among developing countries and the extent of evidence available on the economic consequences (direct and indirect costs) of cancer remains unknown in low-income countries particularly in the sub-Saharan region. Understanding the costs of illness is important to inform decision-making on setting up health care policies and informing economic evaluation of interventions. Read More

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Factors associated with sexually transmitted infections among care-seeking adults in the African Cohort Study.

BMC Public Health 2021 Apr 16;21(1):738. Epub 2021 Apr 16.

U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA.

Objectives: Sexually transmitted infections (STIs) are a major cause of morbidity. Understanding drivers of transmission can inform effective prevention programs. We describe STI prevalence and identify factors associated with STIs in four African countries. Read More

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The Use of Clinical Decision Support in Reducing Readmissions for Patients with Heart Failure: A Quasi-experimental Study.

Contemp Nurse 2021 Apr 16:1-21. Epub 2021 Apr 16.

Assistant Professor Department of Nursing Johns Hopkins University School of Nursing 525 N. Wolfe Street, Baltimore, MD 21205 Email:

Background: Heart failure is a chronic, progressive condition which affects over six million Americans and 26 million people worldwide. Evidence-based guidelines, protocols, and decision-support tools are available to enhance the quality of care delivery but are not implemented consistently.

Aims: To examine the effect of clinical decision-making support during patient discharge on 30-day hospital readmission among patients admitted with a primary diagnosis of heart failure and evaluate provider utilization and satisfaction of clinical decision support tool. Read More

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Cystic cervical lymph nodes of papillary thyroid carcinoma, tuberculosis and human papillomavirus positive oropharyngeal squamous cell carcinoma: utility of deep learning in their differentiation on CT.

Am J Otolaryngol 2021 Apr 9;42(5):103026. Epub 2021 Apr 9.

Departments of Radiology, Boston Medical Center, Boston University School of Medicine, One Boston Medical Center Place, Boston, MA 02118, United States; Department of Otolaryngology-Head and Neck Surgery, Boston Medical Center, Boston University School of Medicine, One Boston Medical Center Place, Boston, MA 02118, United States; Department of Radiation Oncology, Boston Medical Center, Boston University School of Medicine, One Boston Medical Center Place, Boston, MA 02118, United States. Electronic address:

Objectives: Cervical lymph nodes with internal cystic changes are seen with several pathologies, including papillary thyroid carcinoma (PTC), tuberculosis (TB), and HPV-positive oropharyngeal squamous cell carcinoma (HPV+OPSCC). Differentiating these lymph nodes is difficult in the absence of a known primary tumor or reliable medical history. In this study, we assessed the utility of deep learning in differentiating the pathologic lymph nodes of PTC, TB, and HPV+OPSCC on CT. Read More

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