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Impact of a pharmacist-led substance use disorder transitions of care clinic on postdischarge medication treatment retention.

J Subst Abuse Treat 2021 Apr 28;130:108440. Epub 2021 Apr 28.

VA Tennessee Valley Healthcare System, 1310 24th Avenue South, Nashville, TN 37212, United States.

Background: The Veterans Health Administration (VHA) has made significant improvements in increasing prescribing of medication treatment for opioid use disorder (MOUD) and medication treatment for alcohol use disorder (MAUD); however, several barriers to treatment retention remain. In an effort to improve MOUD/MAUD retention, a Veterans Affairs (VA) facility established a pharmacist-led substance use disorder (SUD) transitions of care telephone clinic for patients discharged from an inpatient hospitalization on MOUD/MAUD, including buprenorphine/naloxone (BUP/NAL) and extended-release (ER) naltrexone injections. Pharmacists within the clinic assess aspects of treatment retention such as medication tolerability, perceived barriers to continuing treatment, status of current prescriptions, and appointment coordination. Read More

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Impact of a personalized mHealth program for type 2 diabetes mellitus during the COVID-19 pandemic: single-group pre-post retrospective analysis.

JMIR Diabetes 2021 Jun 6. Epub 2021 Jun 6.

NOVI Health, Singapore, SG.

Background: With increasing type 2 diabetes mellitus (T2DM) prevalence, there is a need for effective programs that support diabetes management and improve T2DM outcomes. Mobile health (mHealth) interventions have shown promising results. With advances in wearable sensors and improved integration, mHealth programs could become more accessible and personalized. Read More

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American martens use vigilance and short-term avoidance to navigate a landscape of fear from fishers at artificial scavenging sites.

Sci Rep 2021 Jun 9;11(1):12146. Epub 2021 Jun 9.

Global Wildlife Conservation Center, State University of New York, College of Environmental Science and Forestry, 1 Forestry Drive, Syracuse, NY, 13210, USA.

Where two sympatric species compete for the same resource and one species is dominant, there is potential for the subordinate species to be affected through interference competition or energetic costs of avoiding predation. Fishers (Pekania pennanti) and American martens (Martes americana) often have high niche overlap, but fishers are considered dominant and potentially limiting to martens. We observed presence and vigilance of fishers and martens at winter carcass sites using remote cameras in Michigan, USA, to test the hypothesis that interference competition from fishers creates a landscape of fear for martens. Read More

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A musculoskeletal ultrasound program as an intervention to improve disease modifying anti-rheumatic drugs adherence in rheumatoid arthritis: a randomized controlled trial.

Scand J Rheumatol 2021 Jun 10:1-9. Epub 2021 Jun 10.

Department of Rheumatology and Immunology, Singapore General Hospital, Singapore.

: To evaluate the effect of a musculoskeletal ultrasound programme (MUSP) applying real-time ultrasonography with reinforcement of findings by a rheumatologist on improving disease-modifying anti-rheumatic drugs (DMARDs) adherence in rheumatoid arthritis (RA).: Eligible RA patients with low adherence score (< 6) on the 8-item Morisky Medication Adherence Scale (MMAS-8) were randomized to either an intervention group (receiving MUSP at baseline) or a control group (no MUSP), and followed up for 6 months. Adherence measures (patient-reported and pharmacy dispensing records) and clinical efficacy data were collected. Read More

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Standing at the edge of mortality; Five-year audit of an emergency department of a tertiary care hospital in a low resource setup.

Pak J Med Sci 2021 May-Jun;37(3):633-638

Anna Q Yaffee, MD, MPH. Consultant EM, Grady Memorial Hospital, Emory University, Atlanta, USA.

Background & Objective: Understanding the demographics of mortality and its burden in the emergency department of a tertiary care setup can lead to better planning and allocation of resources to streamline process flow. This can be achieved systematically through mortality audit that can identify the loopholes and areas of improvement. Our objective was to characterize the epidemiology of ED mortality in a tertiary care hospital of Karachi, Pakistan. Read More

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Longitudinal Risk Management for Patients with Increased Risk for Breast Cancer.

J Surg Res 2021 Jun 5;266:421-429. Epub 2021 Jun 5.

Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, Colorado. Electronic address:

Introduction: This study aims to characterize longitudinal care management and evaluate the relationship between various patient factors and the likelihood of choosing risk-reducing behaviors in women with increased risk of developing breast cancer.

Methods: A retrospective study was conducted to evaluate all adult female patients who had at least one clinic visit with a surgical provider for discussion of breast cancer risk assessment between January, 2017 to July, 2020 at an academic center. Patients with prior history of breast cancer were excluded. Read More

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Streamlining Postoperative Care After Pediatric Supracondylar Humerus Fractures: Is Follow-up After Pin Removal Routinely Needed?

J Pediatr Orthop 2021 Jul;41(6):e464-e469

Department of Orthopedic Surgery, University of Connecticut, Connecticut Children's Medical Center, Hartford, CT.

Background: Closed reduction and percutaneous pinning is the standard of care for displaced supracondylar humerus fractures (SCHFs). Although the operative management of SCHFs has achieved good consensus with low complication rates, there remains a paucity of literature on postoperative management. We hypothesized that routine office visits after pin removal can safely be avoided in uncomplicated SCHFs without compromising patient care. Read More

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Factors associated with HIV infection among children in Larkana District, Pakistan: a matched case-control study.

Lancet HIV 2021 Jun;8(6):e342-e352

Department of Paediatrics and Child Health, Aga Khan University, Karachi, Pakistan; Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, UK.

Background: In April, 2019, an HIV outbreak predominantly affecting children occurred in Larkana District, Sindh, Pakistan. By December, 2019, 881 (4·0%) of 21 962 children screened for HIV had tested positive. We aimed to assess factors associated with HIV infection in this outbreak. Read More

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First trimester antenatal care visit reduces the risk of miscarriage among women of reproductive age in Ghana.

Afr J Reprod Health 2021 Feb;25(1):129-137

School of Public Health and Department of Psychiatry, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.

Miscarriage is a common adverse pregnancy outcome in childbearing and an increasing global reproductive health problem. This study explored 1) the national prevalence of the first trimester (≤12 weeks) miscarriage among women (15-49 years) in Ghana, and 2) the influence of first-trimester antenatal care (ANC) visits on miscarriage risk. A cross-sectional study using the Demographic Health Survey (DHS- 2017) on maternal health in Ghana was conducted. Read More

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February 2021

Impact of the Early Phase of the COVID Pandemic on Cancer Treatment Delivery and the Quality of Cancer Care: A Scoping Review and Conceptual Model.

Int J Qual Health Care 2021 Jun 1. Epub 2021 Jun 1.

Cancer Quality Lab (CQuaL), Princess Margaret Cancer Centre, University Health Network; Toronto ON, Canada.

Background: The disruption of health services due coronavirus disease (COVID) is expected to dramatically alter cancer care; however, the implications for care quality and outcomes remain poorly understood. We undertook a scoping review to evaluate what is known in the literature about how cancer treatment has been modified as a result of the COVID pandemic in patients receiving treatment for solid tumours, and what domains of quality of care are most impacted.

Methods: Citations were retrieved from MEDLINE and EMBASE (1 Jan 2019 to 28 Oct 2020), utilizing search terms grouped by key concept (oncology, treatment, treatment modifications and COVID). Read More

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COVID-19: changing the care process for women's health-the patient's perspective.

J Matern Fetal Neonatal Med 2021 May 27:1-5. Epub 2021 May 27.

Department of Obstetrics and Gynecology, University of Florida, Gainesville, FL, USA.

Objective: Assess women's perceptions of the impact of COVID-19 on their health care and well-being, access to and satisfaction with medical care due to the changes in delivery of care triggered by the pandemic.

Methods: An online survey of women having health care appointments in the outpatient facilities across all divisions of a Department of Obstetrics and Gynecology at a tertiary care referral center in North Central Florida. Patients had outpatient appointments that were scheduled, canceled or rescheduled, in person or by telemedicine, between 11 March 2020 and 11 May 2020, a time during which a COVID-19 stay-at-home order was enacted across our state. Read More

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Does the Use of Sanders Staging and Distal Radius and Ulna Classification Avoid Mismatches in Growth Assessment with Risser Staging Alone?

Clin Orthop Relat Res 2021 05 26. Epub 2021 May 26.

P. W. H. Cheung, J. P. Y. Cheung, Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong SAR, China.

Background: Although Risser stages are visible on the same radiograph of the spine, Risser staging is criticized for its insensitivity in estimating the remaining growth potential and its weak correlation with curve progression in patients with adolescent idiopathic scoliosis. Risser staging is frequently accompanied by other skeletal maturity indices to increase its precision for assessing pubertal growth. However, it remains unknown whether there is any discrepancy between various maturity parameters and the extent of this discrepancy when these indices are used concurrently to assess pubertal growth landmarks, which are important for the timing of brace initiation and weaning. Read More

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Patient outcomes and costs after isolated flexor tendon repairs of the hand.

J Hand Ther 2021 Apr 14. Epub 2021 Apr 14.

UCSF Department of Orthopedic Surgery, San Francisco, CA. Electronic address:

Background: Acute flexor tendon injuries are challenging injuries for patients, surgeons, and therapists alike. There is ongoing debate about the optimal timing and amount of therapy after these injuries.

Purpose: We sought to investigate the relationship between hand therapy utilization and reoperation rates after flexor tendon repair and quantify reoperation rates and costs associated with flexor tendon repair. Read More

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Diagnosis and management of non-clonal erythrocytosis remains challenging: a single centre clinical experience.

Ann Hematol 2021 May 19. Epub 2021 May 19.

Department of Haematology, University Medical Centre Ljubljana, Zaloška 7, 1000, Ljubljana, Slovenia.

Erythrocytosis has a diverse background. While polycythaemia vera has well defined criteria, the diagnostic approach and management of other types of erythrocytosis are more challenging. The aim of study was to retrospectively analyse the aetiology and management of non-clonal erythrocytosis patients referred to a haematology outpatient clinic in an 8-year period using a 3-step algorithm. Read More

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Third-party Reimbursement of Pharmacist-Led Cardiovascular and Diabetes Preventive Health Services for Workplace Health Initiatives: A Narrative Systematic Review.

Innov Pharm 2021 8;12(1). Epub 2021 Jan 8.

Faculty of Pharmaceutical Sciences, The University of British Columbia, 2405 Wesbrook Mall, Vancouver, BC, Canada.

Objective: To summarize available literature describing third-party payer reimbursement models for pharmacist-led preventive health services as part of workplace health initiatives.

Methods: A combination of search terms related to pharmacists, preventive health, and third-party reimbursement were searched in MEDLINE, EMBASE, and PubMed. Included studies described community pharmacist-led cardiovascular and diabetes preventive health service to employees older than 18 years of age as part of a workplace health program with corresponding third-party reimbursement models. Read More

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January 2021

Post-market safety and efficacy profile of subcutaneous testosterone enanthate-autoinjector: a cohort analysis.

Int J Impot Res 2021 May 18. Epub 2021 May 18.

Department of Urology, University of California, Irvine Health, Orange, CA, USA.

A subcutaneous testosterone enanthate-autoinjector (SCTE-AI) was recently approved by the Food and Drug Administration for patient-administered weekly testosterone replacement therapy (TRT). From January 2019 to October 2019, 110 hypogonadal men were treated with SCTE-AI at two institutions. Patients were assessed in a pretherapy visit prior to receiving SCTE-AI and re-assessed 6 weeks after treatment initiation. Read More

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Association of Opioid Consumption Profiles After Hospitalization With Risk of Adverse Health Care Events.

JAMA Netw Open 2021 May 3;4(5):e218782. Epub 2021 May 3.

Department of Epidemiology and Biostatistics, McGill University, Montreal, Quebec, Canada.

Importance: Although better pain management has guided policies for opioid use over the past few decades, evidence is limited regarding how patterns of use are associated with the risk of potentially avoidable opioid-related adverse events.

Objective: To estimate the risk of harms associated with opioid dose and duration of use, and to ascertain whether the risk is modified by treatment indication and age.

Design, Setting, And Participants: This ad hoc cohort study followed up patients who were enrolled in a cluster randomized trial of medication reconciliation between October 1, 2014, and November 30, 2016, 12 months after they were discharged from the McGill University Health Centre in Montreal, Quebec, Canada. Read More

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Impact of visit-to-visit blood pressure variability on hypertensive-mediated target organ damage and future cardiovascular events: the Campania salute network.

J Hypertens 2021 May 17. Epub 2021 May 17.

Hypertension Center & Department of Advanced Biomedical Sciences Department of Neuroscience, Reproductive Science and Odontostomatology, Federico II University of Naples International Translational Research and Medical Education Consortium (ITME), Naples, Italy.

Background: Exaggerated variability of blood pressure (BP) poses additional stress on cardiovascular system independent of BP average value, increasing risk of target organ damage (HMOD) and cardiovascular events. We assessed the impact of visit-to-visit variability (VVV) of BP on development of cardiovascular events and HMOD.

Methods: Standard deviation (SD) and coefficient of variability of mean SBP and DBP were calculated in 3555 patients from the Campania Salute Network registry, with available echocardiogram and more than six visits during follow-up. Read More

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Long-term safety and effectiveness of canakinumab therapy in patients with cryopyrin-associated periodic syndrome: results from the β-Confident Registry.

RMD Open 2021 May;7(2)

Division of Pediatric Rheumatology, Department of Paediatrics and Autoinflammation Reference Center Tuebingen, University Hospital Tuebingen, Tübingen, Germany.

Objective: To report the long-term safety and effectiveness of canakinumab, a fully human anti-interleukin 1β monoclonal antibody, in patients with cryopyrin-associated periodic syndromes (CAPS), including familial cold autoinflammatory syndrome (FCAS), Muckle-Wells syndrome (MWS) and neonatal-onset multisystem inflammatory disease (NOMID), in a real-world setting.

Methods: From December 2009 to December 2015, the β-Confident Registry prospectively enrolled patients with CAPS and non-CAPS conditions who received canakinumab per routine care and were prospectively followed for up to 6 years. The registry protocol did not mandate specific visits or procedures; however, all observed adverse events (AEs) and serious adverse events (SAEs) had to be recorded. Read More

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Reconvalescent plasma/camostat mesylate in early SARS-CoV-2 Q-PCR positive high-risk individuals (RES-Q-HR): a structured summary of a study protocol for a randomized controlled trial.

Trials 2021 May 17;22(1):343. Epub 2021 May 17.

Department of Gastroenterology, Hepatology and Infectious Diseases, University Hospital Duesseldorf, Medical Faculty Heinrich-Heine-University Duesseldorf, Moorenstr. 5, D-40225, Duesseldorf, Germany.

Objectives: Currently, there are no approved treatments for early disease stages of COVID-19 and few strategies to prevent disease progression after infection with SARS-CoV-2. The objective of this study is to evaluate the safety and efficacy of convalescent plasma (CP) or camostat mesylate administered within 72 h of diagnosis of SARS-CoV-2 infection in adult individuals with pre-existing risk factors at higher risk of getting seriously ill with COVID-19. Camostat mesylate acts as an inhibitor of the host cell serine protease TMPRSS2 and prevents the virus from entering the cell. Read More

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Evaluation of adherence to levothyroxine and out-of-range thyroid-stimulating hormone levels in pregnant women with primary hypothyroidism.

Int J Clin Pract 2021 May 17:e14312. Epub 2021 May 17.

Internal Medicine Clinics, Kocaeli Derince Training and Research Hospital, University of Health Sciences, Kocaeli, Turkey.

Purpose: Adherence to levothyroxine (LT4) and attaining thyroid-stimulating hormone (TSH) goal in pregnancy has not been well-defined yet. We aimed to investigate adherence to LT4, success to reach TSH goal, and association between them in pregnant women with primary hypothyroidism.

Materials And Methods: Eight-item Morisky Medication Adherence Scale (MMAS-8) was applied in third trimester in pregnant women with primary hypothyroidism (Hashimoto's thyroiditis, surgical hypothyroidism or iodine deficiency) whom LT4 was given for at least 3 months. Read More

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Temporal Trends and Factors Associated With Cardiac Rehabilitation Participation Among Medicare Beneficiaries With Heart Failure.

JACC Heart Fail 2021 May 5. Epub 2021 May 5.

Ahmanson-UCLA Cardiomyopathy Center, University of California, Los Angeles, California, USA. Electronic address:

Objectives: The purpose of this study was to assess temporal trends and factors associated with cardiac rehabilitation (CR) enrollment and participation among Medicare beneficiaries after the 2014 Medicare coverage expansion.

Background: CR improves exercise capacity, quality of life, and clinical outcomes in heart failure (HF) with reduced ejection fraction (HFrEF). In 2014, Medicare coverage for CR was expanded to include chronic HFrEF. Read More

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Is the postoperative discomfort after connective tissue harvesting from the palate influenced by the use of a bipolar coagulator? A randomized controlled trial.

Clin Exp Dent Res 2021 May 13. Epub 2021 May 13.

Freelance Statistician, Ferrara, Italy.

Objectives: This study aimed to determine the effect of the use of a bipolar coagulator on postoperative pain and complications when used during connective tissue harvesting from the palate.

Material And Methods: A randomized controlled clinical trial was conducted with 57 sequential patients requiring a connective tissue graft for periodontal or implant surgery. All samples were harvested superficially and de-epithelized outside the mouth. Read More

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Predicting outcome of patients with psychogenic nonepileptic seizures after diagnosis in an epilepsy monitoring unit.

Epilepsy Behav 2021 Jul 10;120:108004. Epub 2021 May 10.

Department of Clinical Neurological Sciences, Western University, London, Ontario, Canada; Psychology, Western University, London, Ontario, Canada.

Objective: To identify predictors of Psychogenic NonEpileptic Seizure (PNES) improvement and anti-seizure medication (ASM) discontinuation in patients with PNES only.

Methods: This is a retrospective study of a consecutively enrolled cohort of 271 patients diagnosed with PNES by video-EEG (vEEG) telemetry in our Epilepsy Monitoring Unit (EMU) between May 2000 and February 2010. Patients with any possibility of past or present comorbid epilepsy based on clinical, EEG, and neuroimaging, or less than one year of follow-up after discharge were excluded. Read More

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Systematic Review of Bilateral Benign Paroxysmal Positional Vertigo.

Laryngoscope 2021 May 10. Epub 2021 May 10.

Division of Otolaryngology - Head & Neck Surgery, McMaster University, Hamilton, Ontario, Canada.

Objectives: To evaluate the success rates of canalith repositioning maneuvers (CRM) in the treatment of patients diagnosed with bilateral benign paroxysmal positional vertigo (BiBPPV).

Study Design: Systematic review.

Methods: A comprehensive search of only English studies in PubMed, Ovid (1946 to the present), and Embase (1974 to the present) databases was done up until January 1, 2021. Read More

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3-month, 6-month, 9-month, and 12-month respiratory outcomes in patients following COVID-19-related hospitalisation: a prospective study.

Lancet Respir Med 2021 May 5. Epub 2021 May 5.

Biological Sciences, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK; Institute for Life Sciences, University of Southampton, Southampton, UK; NIHR Southampton Biomedical Research Centre, University Hospital Southampton, Southampton, UK. Electronic address:

Background: The consequences of COVID-19 in those who recover from acute infection requiring hospitalisation have yet to be clearly defined. We aimed to describe the temporal trends in respiratory outcomes over 12 months in patients hospitalised for severe COVID-19 and to investigate the associated risk factors.

Methods: In this prospective, longitudinal, cohort study, patients admitted to hospital for severe COVID-19 who did not require mechanical ventilation were prospectively followed up at 3 months, 6 months, 9 months, and 12 months after discharge from Renmin Hospital of Wuhan University, Wuhan, China. Read More

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The Financial Implications of Telehealth Visits Within a Hand and Wrist Surgery Clinical Practice During the COVID-19 Pandemic.

J Hand Surg Am 2021 Apr 6. Epub 2021 Apr 6.

Rothman Orthopaedic Institute, Philadelphia, PA; Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA. Electronic address:

Purpose: Telehealth use is likely to increase as a result of practice changes during the COVID-19 pandemic, although the overall picture surrounding the billing, coding, and continued insurance coverage of these visits remains uncertain. The purpose of this study was to identify potential financial implications of continued telehealth use in hand and wrist surgery clinical practice.

Methods: Two hundred telehealth visits were randomly selected and matched 1:1 based on primary diagnosis code to in-person visits. Read More

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Frequency of Peripheral Nerve Injury in Trauma in Emergency Settings.

Cureus 2021 Mar 30;13(3):e14195. Epub 2021 Mar 30.

Internal Medicine, Jinnah Postgraduate Medical Centre, Karachi, PAK.

Introduction Neurological injuries because of trauma and accidents are common but rarely reported or examined in Pakistan. In this study, we will determine the frequency of neurological deficits reported in the emergency unit in patients presenting with acute trauma. Material This study was conducted in an emergency unit of tertiary care setting in Karachi, Pakistan. Read More

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Combination fixed-dose beta agonist and steroid inhaler as required for adults or children with mild asthma.

Cochrane Database Syst Rev 2021 05 4;5:CD013518. Epub 2021 May 4.

Respiratory Medicine Unit, Nuffield Department of Medicine, University of Oxford, Oxford, UK.

Background: Asthma affects 350 million people worldwide including 45% to 70% with mild disease. Treatment is mainly with inhalers containing beta₂-agonists, typically taken as required to relieve bronchospasm, and inhaled corticosteroids (ICS) as regular preventive therapy. Poor adherence to regular therapy is common and increases the risk of exacerbations, morbidity and mortality. Read More

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Beyond Body Mass Index - Body Composition Assessment by Bioimpedance in Routine Endocrine Practice.

Endocr Pract 2021 May 15;27(5):419-425. Epub 2020 Dec 15.

Pediatric Endocrinology and Diabetes Unit, Dana-Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel, affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.

Objective: To explore the body composition of pediatric patients referred for endocrine evaluation.

Methods: This real-life observational study conducted between January 2018 and January 2020 included 10 001 clinic visits of 3500 children and adolescents; first visits of 5 to 18-year-old patients were included. Anthropometric data, blood pressure levels, pubertal status, and bioelectrical impedance analysis (BIA, Tanita MC-780 MA) were extracted from medical files. Read More

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