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Shorter outpatient wait-times for buprenorphine are associated with linkage to care post-hospital discharge.

Drug Alcohol Depend 2021 Apr 20;224:108703. Epub 2021 Apr 20.

Department of Medicine, Boston University School of Medicine, 801 Massachusetts Ave, Boston, MA, 02118, USA.

Background: Inpatient addiction consult services (ACS) lower barriers to accessing medications for opioid use disorder (MOUD), however not every patient recommended for MOUD links to outpatient care. We hypothesized that fewer days between discharge date and outpatient appointment date was associated with improved linkage to buprenorphine treatment among patients evaluated by an ACS.

Methods: We extracted appointment and demographic data from electronic medical records and conducted retrospective chart review of adults diagnosed with opioid use disorder (OUD) evaluated by an ACS in Boston, MA between July 2015 and August 2017. Read More

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Is Outpatient Management of Mandibular Fractures Associated With Inflammatory Complications? An ACS-NSQIP Study.

J Oral Maxillofac Surg 2021 Mar 26. Epub 2021 Mar 26.

Assistant Professor, Oral & Maxillofacial Surgery, Massachusetts General Hospital and Harvard School of Dental Medicine, Boston, MA. Electronic address:

Purpose: Timing of mandibular fracture repair has long been debated. The purpose of the present study was to assess the incidence of postoperative inflammatory complications (POICs) following open repair of mandibular fractures managed non-urgently in the outpatient setting versus urgently in the inpatient setting.

Methods: The authors utilized the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database to enroll a sample of patients with mandibular fractures who underwent open repair. Read More

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Extracorporeal photopheresis vs standard therapies for steroid-refractory chronic graft-vs-host disease: Pharmacoeconomic assessment of hospital resource use in Spain.

J Clin Apher 2021 May 8. Epub 2021 May 8.

Haematology Department, Hospital Universitari i Politècnic La Fe, Valencia, Spain.

Background: This study assessed pharmacoeconomic costs associated with extracorporeal photopheresis (ECP) compared with other available second-line therapies for chronic graft-vs-host disease (cGvHD) in a tertiary Spanish institution.

Methods: Patients (≥18 years) diagnosed with steroid-refractory cGvHD were eligible. Data were collected retrospectively from index date until 1 year or relapse. Read More

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Opioid and non-opioid analgesic prescribing before and after the CDC's 2016 opioid guideline.

Int J Health Econ Manag 2021 May 8. Epub 2021 May 8.

Division of Research and Modeling, Center for Financing, Access, and Cost Trends, Agency for Healthcare Research and Quality, and the McCourt School of Public Policy, Georgetown University, Rockville, MD, USA.

The U.S. has addressed the opioid crisis using a two-front approach: state regulations limiting opioid prescriptions for acute pain patients, and voluntary federal CDC guidelines on shifting chronic pain patients to lower opioid doses and non-opioids. Read More

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Gastrointestinal and oncologic outcomes of pediatric gastrointestinal lymphoma following upfront resection or biopsy of bowel masses.

Pediatr Surg Int 2021 May 8. Epub 2021 May 8.

Department of Paediatric Surgery, KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore, 229899, Singapore.

Purpose: Complete upfront resection of pediatric gastrointestinal lymphomas is recommended over biopsy whenever feasible, but either approach may have adverse sequelae. We sought to compare gastrointestinal and oncological outcomes of pediatric gastrointestinal lymphomas who underwent attempted upfront resection or biopsy of the presenting bowel mass.

Methods: We retrospectively reviewed charts of children with gastrointestinal lymphomas treated on LMB89 and LMB96 protocols from 2000 to 2019 who underwent upfront gastrointestinal surgery, and compared resection and biopsy groups. Read More

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Orthogeriatric co-management reduces incidence of delirium in hip fracture patients.

Osteoporos Int 2021 May 8. Epub 2021 May 8.

Oslo Delirium Research Group, Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway.

Hip fracture patients often display an acute confusional state (delirium) which is associated with worse outcomes. In this observational study, we found that co-management of hip fracture patients by a multidisciplinary team including a geriatrician and an orthopaedic surgeon could reduce the incidence of delirium.

Introduction: Delirium after hip fracture is common and is associated with negative outcomes. Read More

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Influence of childhood asthma on dental caries: A longitudinal study.

Clin Exp Dent Res 2021 May 8. Epub 2021 May 8.

Department of Dental Diseases and Endodontology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.

Objectives: The study investigated the influence of childhood asthma on dental caries development and caries risk factors among children with asthma in Slovenia.

Material And Methods: The study population consisted of 2-17 years old children (n = 138), who had used anti-asthmatic medicines for at least 1 year. Controls were their non-asthmatic siblings (n = 140). Read More

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Prevalence of Venous Thromboembolism Following Acute Spinal Cord Injury in an Urban Inner City Hospital.

Int J Spine Surg 2021 May 7. Epub 2021 May 7.

Temple University Department of Orthopedic Surgery and Sports Medicine, Philadelphia, Pennsylvania.

Background: Venous thromboembolism (VTE) is known to occur at high rates in patients who suffer spinal cord injury (SCI). Large population studies in the United States have shown a prevalence of approximately 4-5%, with some studies suggesting higher prevalence. While the specific mechanism behind increased VTE incidence in the SCI population is unknown, it is likely tied to immobility and functional decline. Read More

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How can we optimise the pharmaceutical analysis of radiopharmaceutical pediatric prescriptions?

Eur J Hosp Pharm 2021 May 7. Epub 2021 May 7.

Radio-Pharmacology, Institut Curie, PSL Research University, Paris, France

Objectives: In France, dispensation is defined by the validation of a prescription associated with a pharmaceutical analysis, preparation of medication and provision of information necessary for proper use. There are very few data available in the literature that describe prescription analysis modality in radiopharmacy. The aim was to secure a place for paediatric prescription analysis in radiopharmacy by designing a flow chart validated by experts. Read More

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Real-World Effectiveness of Mepolizumab in Severe Eosinophilic Asthma: A Systematic Review and Meta-analysis.

Clin Ther 2021 May 4. Epub 2021 May 4.

Department of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital, Beijing, China. Electronic address:

Purpose: Mepolizumab is a human monoclonal antibody against interleukin 5 (IL-5) used to treat severe eosinophilic asthma. Several studies have evaluated the effectiveness of mepolizumab in the real world. We conducted a systematic review and meta-analysis in the context of heterogeneity among patients, clinicians, and treatment regimens to study the effectiveness of mepolizumab in the real world. Read More

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Migration-associated malaria from Africa in southern Spain.

Parasit Vectors 2021 May 7;14(1):240. Epub 2021 May 7.

Tropical Medicine Unit. Hospital de Poniente, El Ejido, Almería, Spain.

Background: The western area of the province of Almeria, sited in southern Spain, has one of the highest immigrant population rates in Spain, mainly dedicated to agricultural work. In recent years, there has been a significant increase in the number of cases of imported malaria associated with migrants from countries belonging to sub-Saharan Africa. The objective of our study is to describe the epidemiological, clinical and analytical characteristics of malaria patients treated in a specialized tropical unit, paying special attention to the differences between VFR and non-VFR migrants and also to the peculiarities of microscopic malaria cases compared to submicroscopic ones. Read More

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Dental practice closure during the first wave of COVID-19 and associated professional, practice and structural determinants: a multi-country survey.

BMC Oral Health 2021 May 7;21(1):243. Epub 2021 May 7.

Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Champlion St., Azarita, Alexandria, 21527, Egypt.

Background: The coronavirus outbreak (COVID-19) in China has influenced every aspect of life worldwide. Given the unique characteristics of the dental setting, the risk of cross-infection between dental practitioners and patients is high in the absence of adequate protective measures, and dentists may develop severe anxiety in relation to the current pandemic. The limited provision of services and widespread closure of dental practices have raised concerns among dental professionals about the financial impact. Read More

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Identifying patients at risk for nonroutine discharge after surgery for cervical myelopathy: an analysis from the Quality Outcomes Database.

J Neurosurg Spine 2021 May 7:1-9. Epub 2021 May 7.

15Department of Neurological Surgery, University of Utah, Salt Lake City, Utah.

Objective: Optimizing patient discharge after surgery has been shown to impact patient recovery and hospital/physician workflow and to reduce healthcare costs. In the current study, the authors sought to identify risk factors for nonroutine discharge after surgery for cervical myelopathy by using a national spine registry.

Methods: The Quality Outcomes Database cervical module was queried for patients who had undergone surgery for cervical myelopathy between 2016 and 2018. Read More

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Evolutionary algorithms and decision trees for predicting poor outcome after endovascular treatment for acute ischemic stroke.

Comput Biol Med 2021 Apr 21;133:104414. Epub 2021 Apr 21.

Department of Biomedical Engineering and Physics, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands; Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.

Despite the large overall beneficial effects of endovascular treatment in patients with acute ischemic stroke, severe disability or death still occurs in almost one-third of patients. These patients, who might not benefit from treatment, have been previously identified with traditional logistic regression models, which may oversimplify relations between characteristics and outcome, or machine learning techniques, which may be difficult to interpret. We developed and evaluated a novel evolutionary algorithm for fuzzy decision trees to accurately identify patients with poor outcome after endovascular treatment, which was defined as having a modified Rankin Scale score (mRS) higher or equal to 5. Read More

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Extracorporeal support for trauma: A trauma quality improvement project (TQIP) analysis in patients with acute respiratory distress syndrome.

Am J Emerg Med 2021 Apr 30;48:170-176. Epub 2021 Apr 30.

Division of Acute Care Surgery, University of Southern California, Los Angeles, CA, United States of America.

Introduction: The use of extracorporeal membrane oxygenation (ECMO) in trauma patients with severe acute respiratory distress syndrome (ARDS) continues to evolve. The objective of this study was to perform a comparative analysis of trauma patients with ARDS who received ECMO to a propensity matched cohort of patients who underwent conventional management.

Methods: The Trauma Quality Improvement Program (TQIP) database was queried from 2013 to 2016 for all patients with ARDS and those who received ECMO. Read More

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The Risks and Benefits of Myopia Control.

Ophthalmology 2021 May 4. Epub 2021 May 4.

Children's University Hospital, Dublin, Ireland; Technological University Dublin, Dublin, Ireland.

Objective: The prevalence of myopia is increasing around the world, stimulating interest in methods to slow its progression. The primary justification for slowing myopia progression is to reduce the risk of vision loss through sight-threatening ocular pathology in later life. The paper analyzes whether the potential benefits of slowing myopia progression by one diopter justify the potential risks associated with treatments. Read More

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Does systemic anti-tumor therapy increase COVID-19 risk in patients with cancer?

J Oncol Pharm Pract 2021 May 7:10781552211015762. Epub 2021 May 7.

Department of Medical Oncology, Kartal Dr. Lütfi Kirdar City Hospital, Health Science University, İstanbul, Turkey.

Purpose: We aimed to determine the COVID-19 infection rate and determine the factors that affect hospitalization and prognosis in patients receiving systemic chemotherapy (CT), immunotherapy (IT) and molecular-targeted therapies at our hospital within three months after the onset of COVID-19 pandemic.

Materials And Methods: The patients who received systemic treatment at chemotherapy unit with diagnosis of cancer between 11 March 2020 and 11 June 2020 were included. The clinical and demographic characteristics of patients, the systemic treatments that they received (CT, IT, targeted therapies), and the stage of disease were determined. Read More

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Examining the Business Case for Patient Experience: A Systematic Review.

J Healthc Manag 2021 May-Jun 01;66(3):200-224

RAND Corporation, Arlington, Virginia.

Executive Summary: Hospitals, physician groups, and other healthcare providers are investing in improved patient care experiences. Prior reviews have concluded that better patient care experiences are associated with less healthcare utilization and better adherence to recommended prevention and treatment, clinical outcomes, and patient safety within hospitals. No comprehensive review has examined the business case for investing in patient experiences. Read More

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Management and Recommendations for Future Pregnancy in Patients with Early-Stage Endometrial Cancer: A Survey of Gynecologic Oncologists and Reproductive Endocrinology and Infertility Specialists.

J Adolesc Young Adult Oncol 2021 May 6. Epub 2021 May 6.

Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.

To determine how young patients with early-stage endometrial cancer are counseled regarding fertility preserving therapy and pregnancy options by gynecologic oncology and reproductive endocrinology and infertility (REI) providers. Anonymous online survey of Society of Gynecology Oncology (SGO) and the Society for Reproductive Endocrinology and Infertility (SREI) members; data were analyzed using chi-square and -tests. Twelve percent (169/1433) of SGO and 6. Read More

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Associations of Chronic Medication Adherence with Emergency Room Visits and Hospitalizations.

J Gen Intern Med 2021 May 6. Epub 2021 May 6.

Department of Quality Measurements and Research, Clalit Health Services, Tel Aviv, Israel.

Introduction: Good medication adherence is associated with decreased healthcare expenditure; however, adherence is usually assessed for single medication. We aim to explore the associations of adherence levels to 23 chronic medications with emergency room (ER) visits and hospitalizations. The primary endpoints are ER visits and hospitalizations in internal medicine and surgical wards. Read More

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Sex differences in the vascular access of hemodialysis patients: a cohort study.

Clin Kidney J 2021 May 6;14(5):1412-1418. Epub 2020 Sep 6.

Libin Cardiovascular Institute, Department of Cardiac Sciences, University of Calgary, Calgary, AB, Canada.

Background: We describe differences for probability of receiving a fistula attempt, achieving fistula use, remaining catheter-free and the rate of access-related procedures as a function of sex.

Methods: Prospectively collected vascular access data on incident dialysis patients from five Canadian programs using the Dialysis Measurement Analysis and Reporting System to determine differences in fistula-related outcomes between women and men. The probability of receiving a fistula attempt and the probability of fistula use were determined using binary logistic regression. Read More

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Retrospective analysis of complications related to endoscopic retrograde cholangio-pancreatography in patients with cirrhosis patients without cirrhosis.

World J Hepatol 2021 Apr;13(4):472-482

Division of Gastroenterology and Hepatology, SUNY Upstate Medical University and Syracuse VA Medical Center, Syracuse, NY 13210, United States.

Background: There is minimal objective data regarding adverse events related to endoscopic retrograde cholangio-pancreatography (ERCP) in patients with cirrhosis compared to those without cirrhosis and even fewer data comparing complications among cirrhosis patients based on severity of cirrhosis.

Aim: To determine if patients with cirrhosis are at increased risk of adverse events related to ERCP: mainly pancreatitis, bleeding, perforation, cholangitis, and mortality; And to see if higher Child-Pugh (CP) score and Model for End-Stage Liver Disease (MELD) score are associated with higher post-ERCP complications.

Methods: We performed a retrospective analysis of 692 patients who underwent ERCP and analyzed the impact of cirrhosis etiology, gender, type of sedation used during procedure, interventions performed, and co-morbidities on the rate of complications in cirrhosis patients as compared to non-cirrhosis patients. Read More

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Yanyu Decoction for Aged Patients with Stable Coronary Artery Disease: A Systematic Review and Meta-Analysis.

Evid Based Complement Alternat Med 2021 17;2021:6615035. Epub 2021 Apr 17.

Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, China.

Background: There was limited evidence of treatments aiming at aged coronary artery disease (CAD) patients. Yanyu decoction (YD) has been used as adjuvant therapy in aged patients with stable CAD and might be a new treatment worthy of recommendation for CAD patients. This study was to evaluate the combined effects of YD plus conventional pharmaceutical treatment (CPT) on senile patients with stable CAD. Read More

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Aging-Related Concerns of People Living with HIV Referred for Geriatric Consultation.

HIV AIDS (Auckl) 2021 30;13:467-474. Epub 2021 Apr 30.

Division of Infectious Diseases, Weill Cornell Medicine, New York, NY, 10065, USA.

Purpose: People with HIV (PWH) are living longer lives and likely experiencing accentuated aging. Comprehensive geriatric assessment (CGA) has been proposed as a way to identify and help meet each individual patient's needs.

Patients And Methods: We performed a retrospective review of the results of CGA in an HIV clinic in New York City. Read More

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Butorphanol in combination with dexmedetomidine provides efficient pain management in adult burn patients.

Burns 2021 Jan 18. Epub 2021 Jan 18.

Department of Burn and Plastic Surgery, The Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu Province, PR China. Electronic address:

Objective: This study aimed to compare the sedation and analgesic effects of butorphanol alone and butorphanol in combination with dexmedetomidine on dressing changes in adult burn patients.

Method: From June 2016 to May 2019, 44 adult burn patients from our department were enrolled in this prospective, double-blinded study. Their total burn surface area (TBSA) varied from 10% to 30%; and the depth of burn injury ranged from second degree to third degree. Read More

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January 2021

Long-term Success With Diminished Opioid Prescribing After Implementation of Standardized Postoperative Opioid Prescribing Guidelines: An Interrupted Time Series Analysis.

Mayo Clin Proc 2021 May;96(5):1135-1146

Department of Urology, Mayo Clinic, Rochester, MN. Electronic address:

Objective: To assess longitudinal prescribing patterns for patients undergoing urologic surgery in the nearly 2-year time frame before and after implementation of an evidence-based opioid prescribing guideline to accurately characterize the impact on postoperative departmental practices.

Patients And Methods: Historical prescribing data for adults who underwent 21 urologic procedures at 3 academic institutions were used to derive a 4-tiered guideline for postoperative opioid prescribing. The guideline was implemented on January 16, 2018, and prescribing patterns including quantity of opioids prescribed (in oral morphine equivalents [OMEs]) and refill rates were compared for opioid-naïve patients undergoing urologic surgery before (January 1, 2016, through January 15, 2018; N=10,649) and after (January 16, 2018, through September 30, 2019; N=9422) guideline implementation. Read More

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"New classification of late and delayed complications after dermal filler: Localized or Generalized?"

J Cosmet Laser Ther 2021 May 6:1-9. Epub 2021 May 6.

Department of Dermatology, Hanyang University College of Medicine, Seoul, Korea.

As filler injections have become very common procedures worldwide, the number of complications has increased. However, there is a lack of systematized studies and precise classification of late and delayed complications. This study aimed to suggest new and reliable classifications and to characterize the clinical manifestations of late and delayed complications after filler injections. Read More

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A Peek into Their Mind? An Exploration of Links Between Offense-Supportive Statements and Behaviors among Men Who Sexually Exploit Children and Adolescents Online.

Int J Offender Ther Comp Criminol 2021 May 6:306624X211013523. Epub 2021 May 6.

Université de Montréal, QC, Canada.

While forensic psychologists have some access to their patients' thoughts when deciding on a diagnosis or appraising risk, others, such as police investigators, must rely on physical evidence and behavioral markers to make sense of a crime. Studies showing that offense-supportive cognitions constitute a risk factor for sexual offending, including offenses that take place on the internet, highlight the need for some access to offenders' thoughts. This exploratory study examines the associations between offense-supportive statements about the sexual exploitation of children and adolescents and proxy behaviors. Read More

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Effects of COVID-2019 on plastic surgery emergencies in Korea.

Arch Craniofac Surg 2021 Apr 20;22(2):99-104. Epub 2021 Apr 20.

Department of Plastic and Reconstructive Surgery, Nowon Eulji Medical Center, Eulji University School of Medicine, Seoul, Korea.

Background: To fight the coronavirus disease 2019 (COVID-19) pandemic, many countries have implemented social distancing and lockdowns. We investigated the changes in the trauma patterns of emergency plastic surgeries in the midst of a pandemic.

Methods: A retrospective review of the medical records of all patients treated for emergency plastic surgeries was performed at our hospital in Seoul. Read More

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Direct vs Indirect Revascularization in a North American Cohort of Moyamoya Disease.

Neurosurgery 2021 May 6. Epub 2021 May 6.

Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.

Background: In adults with ischemic moyamoya disease (MMD), the efficacy of direct vs indirect revascularization procedures remains a matter of debate.

Objective: To investigate the outcomes of ischemic MMD in a North American cohort treated by direct and indirect revascularizations.

Methods: We retrospectively reviewed medical records of adult patients with MMD with ischemic presentation from 1984 to 2018 at the Brigham and Women's Hospital and Massachusetts General Hospital who underwent either direct or indirect bypasses. Read More

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