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Contemporary Clinical Use of Aspirin: Mechanisms of Action, Current Concepts, Unresolved Questions, and Future Perspectives.

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

Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark.

The ability of aspirin to inhibit platelet aggregation has positioned this agent within the most frequently used drugs worldwide. The aim of this article is to review the contemporary clinical use of aspirin and also to discuss unresolved issues not yet translated into clinical practice. Results from several clinical trials have led to strong guideline recommendations for aspirin use in the acute management and secondary prevention of cardiovascular disease. 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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Treatment Guideline for Patients with Native Culture-negative Pyogenic Vertebral Osteomyelitis.

Clin Orthop Relat Res 2021 Jun 15. Epub 2021 Jun 15.

Spine Center, Department of Orthopedics, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea.

Background: With the development of evidence-based guidelines for the diagnosis and antibiotic treatment of patients with pyogenic vertebral osteomyelitis, various nonsurgical and surgical treatment strategies have achieved favorable results. However, sufficient administration of appropriate antibiotics is a prerequisite for treatment success, which cannot be guaranteed in patients with culture-negative pyogenic vertebral osteomyelitis. Unfortunately, previous studies on culture-negative pyogenic vertebral osteomyelitis were limited by small patient groups, short follow-up periods, varied treatment protocols, and inconsistently defined clinical endpoints. Read More

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Irritable Bowel Syndrome: Questions and Answers for Effective Care.

Am Fam Physician 2021 Jun;103(12):727-736

Mayo Clinic College of Medicine and Science, Rochester, MN, USA.

Irritable bowel syndrome (IBS) is a heterogeneous group of conditions related to specific biologic and cellular abnormalities that are not fully understood. Psychological factors do not cause IBS, but many people with IBS also have anxiety or depressed mood, a history of adverse life events, or psychosocial stressors. Physicians must understand the fears and expectations of patients and how they think about their symptoms and should also respond empathetically to psychosocial cues. Read More

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Global data analysis supports smoking as the fundamental element associated with geographic gender disparities in hidradenitis suppurativa.

Br J Dermatol 2021 Jun 15. Epub 2021 Jun 15.

Institute of Basic Medical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan.

Hidradenitis suppurativa (HS), or acne inversa, is a painful and recurrent inflammatory cutaneous disorder involving the terminal hair follicles of intertriginous and gluteal areas. Epidemiological studies have revealed geographic differences regarding the demographic and clinical characteristics of HS. The gender distribution of HS patients is diverse among different countries. Read More

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Brain networks in patients with isolated or recurrent transient global amnesia.

Acta Neurol Scand 2021 Jun 15. Epub 2021 Jun 15.

Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea.

Objectives: The aim of this study was to investigate differences in cerebral blood flow (CBF) and functional networks between transient global amnesia (TGA) patients with a single event and those with recurrent events using arterial spin labeling (ASL) MRI.

Methods: We enrolled patients with TGA and classified them into two groups according to the number of TGA events: TGA patients with a single event and those with recurrent events. MRI scans were performed within 24 h after TGA ictal onset in all patients. Read More

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Carcinomatous meningitis from recurrent glassy cell carcinoma of the uterine cervix-A case report.

J Obstet Gynaecol Res 2021 Jun 14. Epub 2021 Jun 14.

Department of Obstetrics and Gynecology, St. Mary's Hospital, Kurume, Japan.

Carcinomatous meningitis presents with a variety of neurological symptoms and has a poor prognosis. We encountered a case of carcinomatous meningitis from cervical cancer. A 30-year-old patient was diagnosed with cervical cancer (glassy cell carcinoma), stage IIB. Read More

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Recurrent acute pericarditis diagnosed by extra-cellular volume maps.

Eur Heart J 2021 Jun 13. Epub 2021 Jun 13.

King's College Hospital NHS Foundation Trust, Denmark Hill, London SE5 9RS, UK.

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Simultaneous imputation and classification using Multigraph Geometric Matrix Completion (MGMC): Application to neurodegenerative disease classification.

Artif Intell Med 2021 Jul 8;117:102097. Epub 2021 May 8.

Department of Computer Aided Medical Procedures (CAMP), Technical University of Munich (TUM), Boltzmannstr. 3, 85748 Garching, Germany; German Center for Vertigo and Balance Disorders (DSGZ), Ludwig-Maximilians University (LMU), Fraunhoferstr. 20, 82152, Planegg, Germany. Electronic address:

Large-scale population-based studies in medicine are a key resource towards better diagnosis, monitoring, and treatment of diseases. They also serve as enablers of clinical decision support systems, in particular computer-aided diagnosis (CADx) using machine learning (ML). Numerous ML approaches for CADx have been proposed in literature. Read More

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Mood symptoms Associated with CADASIL Syndrome: A Case Report.

CNS Spectr 2021 Apr;26(2):144

Resident.

Objective: To discuss the psychiatric symptoms that are associated with CADASIL syndrome Abstract Cerebral:Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL) is a rare type of hereditary disease involving the small cerebral vessels. The clinical symptoms are various and include recurrent ischemic strokes, migraine with aura, seizures with epilepsy, psychiatric problems such as mood disturbances, and progressive cognitive decline leading to dementia. This disease needs awareness amongst the psychiatrists even though it is discussed much more in neurology literature. Read More

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Post-mortem diagnosis of imported malaria in France: a case report.

Malar J 2021 Jun 14;20(1):271. Epub 2021 Jun 14.

Service de Parasitologie-Mycologie, Hôpital L'Archet, Centre Hospitalier Universitaire de Nice, UCA, 151 route de Saint Antoine de Giestière, 06000, Nice, France.

Background: Malaria is a potentially lethal parasitic disease due to infection by Plasmodium parasites, transmitted by Anopheles mosquito vectors. Various preventative measures may be recommended for travellers who visit endemic areas. The diagnosis is generally evoked in the context of a febrile patient returning from an endemic zone. Read More

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[Radiofrequency catheter ablation of ventricular tachycardia in patients post surgical repair of tetralogy of Fallot].

Zhonghua Xin Xue Guan Bing Za Zhi 2021 Jun;49(6):615-620

Cardiac Arrhythmia Center, National Center of Cardiovascular Disease, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.

To investigate the clinical and electrophysiological features of ventricular tachycardia (VT) in tetralogy of Fallot (TOF) patients post surgical repair (rTOF) and to analyze the therapeutic effect and prognosis of radiofrequency ablation of rTOF-VT. This is a retrospective study. Consecutive patients with rTOF-VT, who were treated in Fuwai Hospital from January 2015 to March 2020, were enrolled. Read More

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Photodynamic Therapy for Recurrent Early Central Lung Cancer of Great Longitudinal Extent Following Two Surgical Lung Resections: A Case Report.

Photodiagnosis Photodyn Ther 2021 Jun 11:102400. Epub 2021 Jun 11.

Department of Pulmonary and Critical Care Medicine, Peking University First Hospital, Beijing, Beijing 100034, China. Electronic address:

Photodynamic therapy (PDT) is an endobronchial treatment requiring a photosensitizer activated by a specific wavelength light to kill tumor cells, which is effective in treating early central lung cancer (ECLC) especially for lesions <1.0 cm in length. We present a patient with history of two lung resections for squamous cell carcinoma, who had unresectable ECLC lesions (4. Read More

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Decline in COPD Admissions During the COVID-19 Pandemic Associated with Lower Burden of Community Respiratory Viral Infections.

Am J Med 2021 Jun 11. Epub 2021 Jun 11.

Division of Pulmonary and Critical Care, University of Maryland School of Medicine. Electronic address:

Background: The COVID-19 pandemic has led to widespread implementation of public health measures, such as stay-at-home orders, social distancing, and masking mandates. In addition to decreasing spread of SARS-CoV2, these measures also impact the transmission of seasonal viral pathogens, which are common triggers of COPD exacerbations. Whether reduced viral prevalence mediates reduction in COPD exacerbation rates is unknown. Read More

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Intravesical gemcitabine for non-muscle invasive bladder cancer.

Cochrane Database Syst Rev 2021 Jun 14;6:CD009294. Epub 2021 Jun 14.

Urology Section, Minneapolis VA Health Care System, Minneapolis, Minnesota, USA.

Background: It remains unclear whether people with non-muscle invasive bladder cancer (NMIBC) benefit from intravesical gemcitabine compared to other agents in the primary or recurrent setting following transurethral resection of a bladder tumor. This is an update of a Cochrane Review first published in 2012. Since that time, several randomized controlled trials (RCTs) have been reported, making this update relevant. Read More

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Operational tolerance after pediatric composite liver-pancreas-intestine transplantation following severe graft-versus-host disease.

Pediatr Transplant 2021 Jun 14:e14069. Epub 2021 Jun 14.

Division of Gastroenterology, Hepatology and Nutrition, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.

Background: While operational tolerance has been previously described in isolated intestinal transplant, reports of this phenomenon in combined liver-intestine transplant are lacking.

Case Description: We detail a unique case of a patient who received a composite allograft including liver, pancreas, and small bowel due to short gut syndrome secondary to gastroschisis complicated by volvulus. The indication for transplantation was permanent dependence on total parenteral nutrition, end-stage liver disease, recurrent sepsis, and persistent stomal variceal hemorrhage. Read More

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Vulvar Melanoma: Molecular Characteristics, Diagnosis, Surgical Management, and Medical Treatment.

Am J Clin Dermatol 2021 Jun 14. Epub 2021 Jun 14.

Department of Dermatology and Allergology, Paracelsus Medical University, Salzburg, Austria.

Ten percent of all women have pigmented vulvar lesions. Fortunately, most of these are benign but 1% of all melanomas in women affect the vulva. While the mortality rate of cutaneous melanoma has dropped by 7% annually during the last 5 years, the prognosis of vulvar melanoma remains dismal: the 5-year overall survival rate is 47% compared with 92% for cutaneous melanoma. Read More

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[Neurolaryngology].

HNO 2021 Jun 14. Epub 2021 Jun 14.

Klinik für HNO-Heilkunde/Plastische Operationen, SRH Wald-Klinikum Gera, Straße des Friedens 122, 07548, Gera, Deutschland.

Neurological and neurophysiological knowledge of neuromuscular diseases is combined in neurolaryngology with experience from laryngology. Laryngeal electromyography (LEMG) is the most important diagnostic and prognostic tool in neurolaryngology. It can be combined with diagnostic electrostimulation. Read More

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Brain functional changes in patients with Crohn's disease: A resting-state fMRI study.

Brain Behav 2021 Jun 14. Epub 2021 Jun 14.

Department of Radiology, Jing'an District Centre Hospital of Shanghai, Fudan University, Shanghai, China.

Background: Crohn's disease (CD) is a chronic recurrent intestinal inflammatory disease, often accompanied by poor adaptation and excessive stress response. However, the potential neurological mechanisms of these symptoms have not yet been studied in-depth.

Objective: To investigate alterations in brain activity in patients with Crohn's disease and study the relationship between altered regions and clinical indices. Read More

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"Post Coronavirus Disease (COVID-19) Reactivation of a Quiescent Unilateral Anterior Uveitis".

SN Compr Clin Med 2021 Jun 7:1-5. Epub 2021 Jun 7.

Department of Neuro-ophthalmology, Cornea and Refractive Surgery, Narayana Nethralaya, Bangalore, India.

Coronavirus disease (COVID-19) can be associated with ophthalmic manifestations like conjunctivitis, retinal haemorrhages, retinal vascular occlusions, papillophlebitis, and Adie's syndrome. We herein report for a case of a unilateral acute anterior uveitis which was quiescent for 13 years and was reactivated post COVID-19 infection in a 43-year-old Asian Indian male. He had a past history of recurrent unilateral granulomatous anterior and intermediate uveitis in the right eye (RE), and all the investigations done 14 years ago were negative and had been on treatment with topical and oral steroids. Read More

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A case report reappraising the usefulness of Valsalva manoeuvre in drug-refractory ventricular tachycardia.

Eur Heart J Case Rep 2021 May 5;5(5):ytab171. Epub 2021 May 5.

Department of Cardiology, Glenfield Hospital, University of Leicester NHS Trust, Groby Road, Leicester, LE3 9QP, UK.

Background: Ventricular tachycardia (VT) is often misdiagnosed as supraventricular tachycardia with aberrancy. Twelve-lead electrocardiogram remains a key diagnostic tool to differentiate them while providing insights to aid localization of VT. The use of Valsalva manoeuvre (VM) in terminating VT is not conventionally recommended due to lack of robust evidence of its effectiveness and poor understanding of its mechanism in terminating VT. Read More

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Development and Validation of a Risk Score for Predicting Post-acute Myocardial Infarction Infection in Patients Undergoing Percutaneous Coronary Intervention: Study Protocol for an Observational Study.

Front Cardiovasc Med 2021 28;8:675142. Epub 2021 May 28.

Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.

Post-acute myocardial infarction (post-AMI) infection is an infrequent but important and serious complication in patients with ST-segment elevation myocardial infarction (STEMI) treated with percutaneous coronary intervention (PCI). Predicting its occurrence is essential for future prevention. However, little is known about the prediction of post-AMI infection in such patients to date. Read More

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Early vs. Late Onset Cardiac Injury and Mortality in Hospitalized COVID-19 Patients in Wuhan.

Front Cardiovasc Med 2021 28;8:645587. Epub 2021 May 28.

Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

Increasing evidence points to cardiac injury (CI) as a common coronavirus disease 2019 (COVID-19) related complication. The characteristics of early CI (occurred within 72 h of admission) and late CI (occurred after 72 h of admission) and its association with mortality in COVID-19 patients is unknown. This retrospective study analyzed patients confirmed with COVID-19 in Union Hospital (Wuhan, China) from Jan 29th to Mar 15th, 2020. Read More

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Sphingomyelin and Medullary Sponge Kidney Disease: A Biological Link Identified by Omics Approach.

Front Med (Lausanne) 2021 26;8:671798. Epub 2021 May 26.

Renal Unit, Department of Medicine, University-Hospital of Verona, Verona, Italy.

Molecular biology has recently added new insights into the comprehension of the physiopathology of the medullary sponge kidney disease (MSK), a rare kidney malformation featuring nephrocalcinosis and recurrent renal stones. Pathogenesis and metabolic alterations associated to this disorder have been only partially elucidated. Plasma and urine samples were collected from 15 MSK patients and 15 controls affected by idiopathic calcium nephrolithiasis (ICN). Read More

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Recurrent Urinary Tract Infection: A Mystery in Search of Better Model Systems.

Front Cell Infect Microbiol 2021 26;11:691210. Epub 2021 May 26.

Centre for Urological Biology, Department of Renal Medicine, University College London, London, United Kingdom.

Urinary tract infections (UTIs) are among the most common infectious diseases worldwide but are significantly understudied. Uropathogenic (UPEC) accounts for a significant proportion of UTI, but a large number of other species can infect the urinary tract, each of which will have unique host-pathogen interactions with the bladder environment. Given the substantial economic burden of UTI and its increasing antibiotic resistance, there is an urgent need to better understand UTI pathophysiology - especially its tendency to relapse and recur. Read More

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The Incorporation of Immunotherapy and Targeted Therapy Into Chemoradiation for Cervical Cancer: A Focused Review.

Front Oncol 2021 26;11:663749. Epub 2021 May 26.

Department of Radiation Oncology, SUNY Upstate Medical University, Syracuse, NY, United States.

In 2011 the Food and Drug Administration (FDA) approved anti-vascular endothelial growth factor (VEGF) therapy, bevacizumab, for intractable melanoma. Within the year, immunotherapy modulators inhibiting cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) and programmed cell death protein 1 (PD-1) were approved in addition to programmed death-ligand 1 (PD-L1) antibodies in 2012. Since then, research showing the effectiveness of targeted therapies in a wide range of solid tumors has prompted studies incorporating their inclusion as part of upfront management as well as refractory or relapsed disease. Read More

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High-Resolution CT Following Primary Spontaneous Pneumothorax in Adolescents: Useful Tool or Wasted Radiation?

Cureus 2021 May 10;13(5):e14936. Epub 2021 May 10.

Pediatrics/Hospitalist Medicine, The University of Arizona, Banner-Diamond Children's Medical Center, Tucson, USA.

Background The current trend in management of first-time primary spontaneous pneumothorax (PSP) in children is to obtain a high-resolution chest computerized tomography (HRCT) scan to look for bleb/bullae disease or other forms of structural lung disease. We aimed to evaluate the significance of HRCT findings in relation to initial management strategies, and we hypothesized that these findings do not guide management.  Methods We evaluated patients with first-time PSP in a single-institution, retrospective, longitudinal study. Read More

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Use of Shockwave Lithoplasty for a Patient With Recurrent Angina.

Cureus 2021 May 3;13(5):e14823. Epub 2021 May 3.

Internal Medicine, Maimonides Medical Center, Brooklyn, USA.

Current calcium modification treatments only address the burden of intimal calcium with varying degrees of success and result in an increased risk for adverse events. Here, we describe the use of shockwave intravascular lithoplasty (S-IVL) to effectively treat a severely calcified coronary artery lesion. A 59-year-old male with a history of coronary artery disease with stents presented to our hospital with angina. Read More

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Allogeneic Hematopoietic Cell Transplant for Systemic Juvenile Idiopathic Arthritis and Macrophage Activation Syndrome.

Case Rep Rheumatol 2021 24;2021:9323141. Epub 2021 May 24.

Pediatric Hematology, Oncology, Blood and Marrow Transplant, Nationwide Children's Hospital, Columbus, OH, USA.

Systemic juvenile idiopathic arthritis (sJIA) is characterized by arthritis, fever, rash, lymphadenopathy, hepatosplenomegaly, and serositis. Macrophage activation syndrome is the most feared complication of sJIA with a high risk of mortality. We report a 16-year-old female diagnosed with refractory systemic juvenile idiopathic arthritis (sJIA) complicated by recurrent macrophage activation syndrome (MAS), severe joint disease, and lung involvement requiring prolonged immunosuppressive therapy. Read More

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Tubulointerstitial Nephritis and Uveitis Syndrome: Case Series and Literature Review.

Case Rep Ophthalmol Med 2021 2;2021:1812271. Epub 2021 Jun 2.

Department of Ophthalmology, Beatriz Ângelo Hospital, Loures, Portugal.

Tubulointerstitial nephritis and uveitis syndrome (TINU) is a rare oculorenal inflammatory entity with a probable autoimmune etiology. Interstitial nephritis may be asymptomatic and usually has a benign course with spontaneous resolution. Uveitis, instead, is classically anterior, bilateral, and nongranulomatous, but it can be unilateral and presents as posterior uveitis or panuveitis, sometimes with a chronic or recurrent evolution. Read More

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