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Mechanical Thrombectomy of Carotid Terminus Occlusion Using Direct Aspiration Technique-Video Illustration: 2-Dimensional Operative Video.

Oper Neurosurg (Hagerstown) 2021 Jul 31. Epub 2021 Jul 31.

Department of Neurosurgery, Medical University of South Carolina, Charleston, South Carolina, USA.

Acute carotid terminus occlusion (CTO) is responsible for up to 5% of acute ischemic strokes secondary to emergent large vessel occlusion (ELVO) and up to 20% of acute internal carotid artery (ICA) occlusions.1 The term "CTO" has also been used to describe occlusions in the supra-clinoid segment or at the bifurcation of the ICA. Compared to other ELVOs, patients with CTO present with higher stroke severity and larger infarct volume, likely to be a result of disruption of direct Circle of Willis collaterals across the anterior communicating artery (AComA) and posterior communicating artery (PComA). Read More

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Transcervical approach for carotid artery stenting with transitory reversal flow: Case report.

Int J Surg Case Rep 2021 Jul 17;85:106206. Epub 2021 Jul 17.

Vascular Surgery Unit, AOUP Policlinico 'P. Giaccone', Palermo, Italy; Department of Surgical, Oncological and Oral Sciences, University of Palermo, Italy.

Introduction: Carotid artery stenting (CAS) has been indicated as an alternative to carotid endarterectomy in high risk patients. Sometimes, an aortic arch can be anatomically unfavourable for CAS. Herein we report our experience in a case of CAS with transcervical approach. Read More

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Post-embolization outcomes of splenic artery pseudoaneurysms: A single-center experience.

Clin Imaging 2021 Jul 26;80:160-166. Epub 2021 Jul 26.

Department of Radiology, Section of Interventional Radiology, Northwestern University, Chicago, IL, USA. Electronic address:

Purpose: Splenic artery pseudoaneurysms (PSA) are relatively rare but associated with high mortality/morbidity when presenting acutely. Embolization has emerged as the treatment of choice. We aim to evaluate the outcomes of embolization for the treatment of splenic artery PSAs. Read More

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Added burden of major depressive disorder on cardiovascular morbidity and mortality among patients with cardiovascular disease and the modifying effects of antidepressants: A national retrospective cohort study.

J Affect Disord 2021 Jul 22;294:580-585. Epub 2021 Jul 22.

Department of Healthcare Administration, Asia University, Taiwan; Department of Psychology, Asia University, Taiwan. Electronic address:

Background: To evaluate the likelihood of a future cardiovascular event (i.e., in-hospital mortality or cardiovascular disease [CVD] complications/interventions) among patients with CVD and major depressive disorder (MDD) compared to those without MDD, and the antidepressant use on future cardiovascular events between the two groups. Read More

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Nursing students first experience on high fidelity simulation: A phenomenological research study.

Nurse Educ Pract 2021 Jul 23;55:103162. Epub 2021 Jul 23.

Universitat Autònoma de Barcelona, Nursing Department, Faculty of Medicine, Av. Can Domènech s/n, 08193 Bellaterra, Spain. Electronic address:

Aim/objective: This study aimed to explore the perceptions of nursing students towards their first experience with high-fidelity simulation (HFS) in a Spanish university.

Background: Simulation experiences are becoming more popular in nursing education, allowing students to practice clinical skills before encountering actual patients.

Methods: A phenomenological approach was used. Read More

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Functional and oncological outcomes of renal surgery for hilar tumors: informing the decisions in risk-adapted management.

Urology 2021 Jul 28. Epub 2021 Jul 28.

Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY. Electronic address:

Objective: No consensus exists on whether renal hilar tumors should be considered for radical (RN) or partial nephrectomy (PN). In this study we aim to describe the safety and efficacy of PN for surgically managed renal hilar tumors MATERIALS AND METHODS: : we retrospectively reviewed institutional records of patients with a small (<5 cm) solitary renal (hilar or non-hilar) mass who underwent PN or RN between 2008 and 2018. Hilar tumors were defined as those at medial position, abutting the renal vessels. Read More

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Fibrin Glue and Partial Capitonnage in Giant Hydatid Cyst in a Pediatric Patient.

Ann Thorac Surg 2021 Jul 28. Epub 2021 Jul 28.

Health Science University, Sureyyapasa Chest Disease and Thoracic Surgery, Reseacrh and Training Hospital, Thoracic Surgery Clinics.

Surgery is still used as the first choice in the treatment of pulmonary hydatid cysts. Video-assisted thoracoscopic surgery (VATS) has started to be performed as a minimally invasive surgical option in recent years for lung hydatid cyst, few cases have been reported in the literature, especially in children. Thoracoscopic surgery experience is limited in pulmonary hydatid cyst for both adult and child patients. Read More

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Using social security number to identify sub-populations vulnerable to the health impacts from extreme heat in Florida, U.S.

Environ Res 2021 Jul 28;202:111738. Epub 2021 Jul 28.

Bureau of Environmental and Occupational Epidemiology, New York State Department of Health, Albany, NY, USA; School of Public Health, University at Albany, Rensselaer, NY, USA.

Background: Some socioeconomically vulnerable groups may experience disproportionately higher risk of extreme heat illness than other groups, but no study has utilized the presence/absence of a social security number (SSN) as a proxy for vulnerable sub-populations.

Methods: This study focused on the warm season from 2008 to 2012 in Florida, U.S. Read More

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A Review of the Evidence and Recommendations on Communication Skills and the Patient-Provider Relationship (PPR): A Rome Foundation Working Team Report.

Gastroenterology 2021 Jul 28. Epub 2021 Jul 28.

Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.

Background And Aims: Over several decades, changes in health care have negatively impacted meaningful communication between the patient and provider and adversely affected their relationship. Under increasing time pressure, physicians rely more on technology than face-to-face time gathering data to make clinical decisions. As a result, they find it more challenging to understand the illness context and fully address patient needs. Read More

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Sialendoscopy: A 4-Year Single Center Experience.

J Oral Maxillofac Surg 2021 Jun 22. Epub 2021 Jun 22.

OMFS IMPATH research group, Faculty of Medicine, Clinical intern, Department of Imaging & Pathology, KU Leuven, Leuven, Belgium; Professor and Chairperson, Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium.

Purpose: Sialendoscopy is a relatively new technique designed to diagnose and treat benign obstructive salivary gland disease using a minimally invasive approach. The purpose of this study is to present our experiences regarding the use of sialendoscopy in the form of a 4-year, single center experience and to demonstrate its usefulness in oral and maxillofacial practice.

Methods: We collected data on patients who underwent sialendoscopy at the Oral-Maxillofacial Surgery Department of UZ Leuven between November 2015 and August 2019, including age, gender, sex, initial clinical presentation and symptoms, gland involvement, type of diagnostic investigations, diagnosis, localization of the obstruction, therapeutic intervention, surgeon, type of anesthesia, materials used, complications, secondary treatment, duration of follow-up, and outcome. Read More

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Frequent Users of Emergency Departments in the United States by Sexual Orientation.

Acad Emerg Med 2021 Jul 31. Epub 2021 Jul 31.

Department of Medicine, Health & Society, Department of Health Policy, Vanderbilt University, Nashville, TN, USA.

Disparities in health outcomes and access to care are well documented among lesbian, gay, and bisexual (LGB) populations. An ample body of research suggests that LGB people are more likely to report worse health outcomes as a result of minority stress, which is the additional stress that they endure as a result of discrimination and stigma. LGB patients also continue to experience barriers to care, including challenges with securing LGB-affirming providers that are informed on their unique health needs. Read More

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Religion and Spirituality in Oncology: An Exploratory Study of the Communication Experiences of Clinicians in Poland.

J Relig Health 2021 Jul 31. Epub 2021 Jul 31.

Department of Tissue Engineering Chair of Urology and Andrology, Ludwik Rydygier Collegium Medicum in Bydgoszcz Nicolaus Copernicus University in Torun, Karlowicza St. 24, 85-092, Bydgoszcz, Poland.

Communication with patients regarding oncology-related aspects is a challenging experience and requires a high level of skill from the interlocutors. The aim of this study was to verify the influence of religion/spirituality in oncological settings from the health professionals' perspectives in Poland. It assessed the role of religion/spirituality in patient-clinician communication, death or stress self-management, empathy, and breaking bad news skills. Read More

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Ten-year experience of an outpatient clinic for CKD-5 patients with multidisciplinary team and educational support.

Int Urol Nephrol 2021 Jul 31. Epub 2021 Jul 31.

Operative Unit of Nephrology, ASST Spedali Civili Brescia, Piazzale Spedali Civili, 1, 25123, Brescia, Italy.

Purpose: To analyze the results of an outpatient clinic with a multidisciplinary team and educational support for patients with late-stage CKD (lsCKD), to check its possible effect on their outcomes.

Methods: Longitudinal cohort study on patients followed up in the MaReA (Malattia Renale Avanzata = CKD5) outpatient clinic at ASST Spedali Civili of Brescia from 2005 to 2015 for at least six months. Trajectory of renal function over time has been evaluated only in those patients with at least four estimations of eGFR before referring to MaReA. Read More

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Optimisation of CT protocols in PET-CT across different scanner models using different automatic exposure control methods and iterative reconstruction algorithms.

EJNMMI Phys 2021 Jul 31;8(1):58. Epub 2021 Jul 31.

King's College London & Guy's and St Thomas' PET Centre, School of Biomedical Engineering and Imaging Sciences, King's College London, St Thomas' Hospital, Westminster Bridge Road, London, SE1 7EH, UK.

Background: A significant proportion of the radiation dose from a PET-CT examination is dependent on the CT protocol, which should be optimised for clinical purposes. Matching protocols on different scanners within an imaging centre is important for the consistency of image quality and dose. This paper describes our experience translating low-dose CT protocols between scanner models utilising different automatic exposure control (AEC) methods and reconstruction algorithms. Read More

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Influence of inguinal hernia repair on sperm autoimmunity: The largest single center experience.

Andrology 2021 Jul 31. Epub 2021 Jul 31.

Department of Gynecology- Division of Gynecology and Reproductive Medicine- Fertility Center, Humanitas Clinical and Research Center IRCCS, via Manzoni 56, Rozzano, Milan, 20089, Italy.

Background: Studies on immunological infertility after inguinal hernia correction are few and not very representative. Anti-sperm antibodies (ASA) have been shown to reduce male fertility. Although the extent of infertility due to ASAs alone is not very clear, data indicates that about 8-10% of infertile patients have immunological infertility DESIGN: This retrospective study includes all infertile male patients (n = 2,258) who underwent MAR (Mixed Antiglobulin Reaction) test and urologic examination from 2000 to 2020. Read More

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Reducing sedated lumbar punctures in pediatric patients with acute lymphoblastic leukemia.

Pediatr Blood Cancer 2021 Jul 31:e29272. Epub 2021 Jul 31.

Division of Pediatric Hematology/Oncology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA.

Background: Sedation for lumbar punctures (LPs) in pediatric acute lymphoblastic leukemia (ALL) patients has been the standard for decades to reduce pain and anxiety. Recent studies on the potential long-term neurocognitive effects of cumulative propofol exposure have raised concerns about this practice. The recent pandemic introduced additional burdens to patients, with the requirement of a negative COVID-19 test prior to each sedated procedure. Read More

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Three-Dimensional (3D) Breath-Hold Zoomed MR Cholangiopancreatography (MRCP): Evaluation of Additive Value to Conventional 3D Navigator Triggering MRCP in Patients With Branch Duct Intraductal Papillary Mucinous Neoplasms.

J Magn Reson Imaging 2021 Jul 31. Epub 2021 Jul 31.

Department of Radiology, Yamaguchi University Graduate School of Medicine, Ube, Japan.

Background: To resolve drawbacks of navigator triggering (NT) three-dimensional (3D) magnetic resonance cholangiopancreatography (MRCP), several approaches were proposed to obtain 3D MRCP within a single breath-hold (BH). However, reduced field-of-view technique in the phase-encoding direction combined with two-dimensional spatially selective radiofrequency excitation pulses has not yet been applied to 3D BH MRCP.

Purpose: To investigate the feasibility and the complementary value of 3D BH zoomed MRCP to conventional 3D NT MRCP in patients with branch duct intraductal papillary mucinous neoplasms (BD-IPMNs) of the pancreas. Read More

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Patient reported outcomes after minimally invasive retroperitoneal pancreatic necrosectomy to treat acute pancreatitis - an exploratory study.

J Dig Dis 2021 Jul 30. Epub 2021 Jul 30.

Cambridge HPB and Transplant Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.

Aim: A minimally invasive retroperitoneal pancreatic necrosectomy (MIRPN) decreases morbidity and mortality from necrotizing acute pancreatitis. However, the impact of MIRPN on patient reported outcomes (PRO) was not investigated yet.

Methods: Patients with acute pancreatitis who underwent MIRPN between January 2010 and December 2016 were identified and invited to participate completing the EORTC QLQ-C30 and EORTC PAN-28(CP) questionnaires. Read More

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Post-Identification Approaches to Addressing Health-Related Social Needs in Primary Care: A Qualitative Study.

J Gen Intern Med 2021 Jul 30. Epub 2021 Jul 30.

Division of General Pediatrics and Adolescent Health, Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN, USA.

Background: Social determinants of health play a fundamental role in a patient's health status. In recent years, health systems across the nation have implemented numerous strategies aimed at identifying and addressing the health-related social needs of the patients they serve. Despite the influx of peer-reviewed research highlighting outcomes of specific health-related social needs interventions, the spectrum of practices utilized by primary care clinics has not been established. Read More

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Thoracıc surgery experience from the largest pandemic hospital in Europe.

Ir J Med Sci 2021 Jul 31. Epub 2021 Jul 31.

Department of Thoracic Surgery, University of Health Sciences, Ankara City Hospital, Bilkent, Ankara, Turkey.

Background: SARS-CoV-2 coronavirus disease 19 (COVID-19), which was detected in December 2019, whose first cases were observed in Turkey on 11 March 2020, and which was declared a pandemic by the World Health Organization on the same day, has become a public health problem worldwide and has required the adaptation of medical practices to the current situation. In the current paper, we present our experience and practices regarding thoracic surgery from the largest pandemic hospital in Europe over the 1-year period of the pandemic.

Methods: Patients who were operated by our thoracic surgery clinic in the largest pandemic hospital in Europe between March 2020 and March 2021 in the COVID-19 pandemic in our country and in the world were evaluated retrospectively. Read More

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East meets West: the initial results of laparoscopic gastric cancer resections with Eastern principles in a single Western centre - a propensity score-matched study.

Authors:
Tomaz Jagric

Langenbecks Arch Surg 2021 Jul 31. Epub 2021 Jul 31.

Department for Abdominal and General Surgery, University Clinical Centre Maribor, Ljubljanska ulica 5, 2000, Maribor, Slovenia.

Background: We compared the initial experience of totally laparoscopic gastric cancer surgery with Eastern principles with the results of propensity score-matched counterparts operated with open surgery.

Methods: From 1163 patients stored in our database, 62 PSM patients were selected for this study. The quality control was assured with video documentation and standardisation of the procedures. Read More

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Comparison of Postoperative, In-Hospital Outcomes After Complete Repair of Tetralogy of Fallot Between 22q11.2 Deletion Syndrome and Trisomy 21.

Pediatr Cardiol 2021 Jul 30. Epub 2021 Jul 30.

Division of Cardiology, Department of Pediatrics, University of Arkansas for Medical Sciences and Arkansas Children's Hospital, Little Rock, AR, USA.

22q11.2 deletion syndrome (22q11) and trisomy 21 (T21) are frequently associated with tetralogy of Fallot (TOF). We hypothesized that there are differences in postoperative length of stay (LOS) and occurrence of postoperative interventions after complete repair of TOF when comparing children with 22q11 to those with T21. Read More

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Two centres experience of lung cancer resection in patients with advanced non-small cell lung cancer upon treatment with immune checkpoint inhibitors: safety and clinical outcomes.

Eur J Cardiothorac Surg 2021 Jul 31. Epub 2021 Jul 31.

Department of Thoracic Surgery, Brigham and Women's Hospital, Boston, MA, USA.

Objectives: Recent trials have begun to explore immune checkpoint inhibitors for non-small cell lung cancer in the neoadjuvant setting, but data on tumour response and surgical outcome remain limited.

Methods: Retrospective evaluation of clinical data from patients with non-small cell lung cancer treated with immune checkpoint inhibitors followed by lung resection was performed at 2 large volume institutions (1 North American, 1 European). Data were analysed using Chi-squared, Fisher's and Wilcoxon rank-sum tests where appropriate. Read More

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QUiC Clinics in the Central Texas Market: Value-Based Primary Care in Military Medicine.

Mil Med 2021 Jul 31. Epub 2021 Jul 31.

Carl R. Darnall Army Medical Center, Fort Hood, TX 76544, USA.

Introduction: For the past 16 years, Military Health System primary care providers have been incentivized to pursue work in a fee-for-service (FFS) model. The system values documentation of productivity to earn as many relative value units as possible. The result is densely packed clinic schedules that often lack the space or flexibility to accommodate patients when sick. Read More

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The effect of video-instructed versus audio-instructed dispatcher-assisted cardiopulmonary resuscitation on patient outcomes following out of hospital cardiac arrest in Seoul.

Sci Rep 2021 Jul 30;11(1):15555. Epub 2021 Jul 30.

EMS Situation Management Center, Seoul Emergency Operation Center, Seoul Metropolitan Fire & Disaster Headquarters, Seoul, South Korea.

We aimed to investigate whether video-instructed dispatcher-assisted (DA)-cardiopulmonary resuscitation (CPR) improved neurologic recovery and survival to discharge compared to audio-instructed DA-CPR in adult out-of-hospital cardiac arrest (OHCA) patients in a metropolitan city with sufficient experience and facilities. A retrospective cohort study was conducted for adult bystander-witnessed OHCA patients administered DA-CPR due to presumed cardiac etiology between January 1, 2018 and October 31, 2019 in Seoul, Korea. The primary and secondary outcomes were the differences in favorable neurologic outcome and survival to discharge rates in adult OHCA patients in the two instruction groups. Read More

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Do chronic heart failure symptoms interact with burden of treatment? Qualitative literature systematic review.

BMJ Open 2021 Jul 30;11(7):e047060. Epub 2021 Jul 30.

Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK.

Objective: Explore the interaction between patient experienced symptoms and burden of treatment (BoT) theory in chronic heart failure (CHF). BoT explains how dynamic patient workload (self-care) and their capacity (elements influencing capability), impacts on patients' experience of illness.

Design: Review of qualitative research studies. Read More

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Establishing Local Diagnostic Reference Level for Bone Scintigraphy in a Nigerian Tertiary Hospital.

J Nucl Med Technol 2021 Jul 30. Epub 2021 Jul 30.

University of Nigeria Enugu Campus, Nigeria.

It is of vital importance to optimize radiation dose to patients undergoing radionuclide bone scintigraphy. This is one of the most common nuclear medicine procedures in many parts of the world, including Nigeria. However, this study was carried out as part of a national survey to establish Diagnostic Reference Levels for common nuclear medicine procedures in Nigeria, to facilitate optimization of medical exposure. Read More

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Androgen deprivation therapy and radiation for prostate cancer-cognitive impairment, sleep, symptom burden: a prospective study.

BMJ Support Palliat Care 2021 Jul 30. Epub 2021 Jul 30.

Department of Psychology, Memorial University, St. John's, Newfoundland and Labrador, Canada

Objectives: This paper (1) sought to compare sleep, mood and physical symptom profiles of men with prostate cancer (PCa) who experienced subjective and objective cancer-related cognitive impairment (CRCI) during the first year of treatment and (2) examine if fluctuations in mood and physical symptoms are associated with change in subjective or objective CRCI.

Methods: This prospective observational cohort study examined 24 new patients with PCa receiving androgen deprivation therapy (ADT) and radiation therapy (RT) during the first 12 months of treatment. Participants completed subjective and objective assessments of cognition, sleep continuity and self-report measures of insomnia, fatigue, depression and anxiety. Read More

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Early onset congenital diarrheas; single center experience.

Pediatr Neonatol 2021 Jul 17. Epub 2021 Jul 17.

Medical University of Innsbruck, Department of Pediatrics I, Anichstrasse 35, 6020, Innsbruck, Austria.

Background: Congenital diarrheal disorders (CDDs) are a rare group of enteropathies that typically present in the early few months of life and pose a diagnostic challenge. We aimed to analyze the clinical findings and outcome of infants with CDDs and share experience about genetic testing.

Methods: Demographic, clinical and genetic findings, and outcome of the patients (n = 24) with CDDs were recorded from hospital files. Read More

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Primary Mediastinal B-Cell Lymphoma: A 2021 Update on Genetics, Diagnosis, and Novel Therapeutics.

Clin Lymphoma Myeloma Leuk 2021 Jun 24. Epub 2021 Jun 24.

Armed Forces Bone Marrow Transplant Centre, Rawalpindi, Pakistan. Electronic address:

Primary mediastinal large B-cell lymphoma (PMBCL) is an aggressive B-cell lymphoma arising from thymic B-cells having clinicopathologic features distinct from systemic diffuse large B-cell lymphoma (DLBCL). PMBCL comprises 2% to 4% of all non-Hodgkin lymphomas (NHL), 7% of DLBCL and seen predominantly in young females with a median age of 35 years at diagnosis. The annual incidence of PMBCL is 0. Read More

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