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Development of emodepside as a possible adulticidal treatment for human onchocerciasis-The fruit of a successful industrial-academic collaboration.

PLoS Pathog 2021 Jul 22;17(7):e1009682. Epub 2021 Jul 22.

Department of Biomedical Sciences, Iowa State University, Ames, Iowa, United States of America.

Current mass drug administration (MDA) programs for the treatment of human river blindness (onchocerciasis) caused by the filarial worm Onchocerca volvulus rely on ivermectin, an anthelmintic originally developed for animal health. These treatments are primarily directed against migrating microfilariae and also suppress fecundity for several months, but fail to eliminate adult O. volvulus. Read More

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Protocol for the economic evaluation of the China Salt Substitute and Stroke Study (SSaSS).

BMJ Open 2021 Jul 20;11(7):e045929. Epub 2021 Jul 20.

The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia.

Introduction: Cardiovascular diseases (CVDs) are the leading causes of death and disability worldwide. Reducing dietary salt consumption is a potentially cost-effective way to reduce blood pressure and the burden of CVD. To date, economic evidence has focused on sodium reduction in food industry or processed food with blood pressure as the primary outcome. Read More

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Cost-Effectiveness of Therapeutic Drug Monitoring-Guided Adalimumab Therapy in Rheumatic Diseases: A Prospective, Pragmatic Trial.

Rheumatol Ther 2021 Jul 18. Epub 2021 Jul 18.

R&D Department, Progenika Biopharma S.A., A Grifols Company, 504 Parque Tecnológico Bizkaia, 48160, Derio, Spain.

Introduction: To assess the clinical and cost-effectiveness of therapeutic drug monitoring (TDM) based on serum adalimumab levels compared to standard of care in patients with rheumatoid arthritis, psoriatic arthritis and ankylosing spondylitis.

Methods: This was a non-inferiority, multicentric, non-randomized, pragmatic trial including adult patients diagnosed with moderate-to-severe, clinically stable rheumatic diseases treated with adalimumab. Consecutive patients were assigned 1:2 to the control (CG) or the intervention group (IG), based on the site of inclusion, and followed up for 18 months. Read More

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Adverse Reactions and Clinical Outcomes for Leukocyte-Poor Versus Leukocyte-Rich Platelet-Rich Plasma in Knee Osteoarthritis: A Systematic Review and Meta-analysis.

Orthop J Sports Med 2021 Jun 30;9(6):23259671211011948. Epub 2021 Jun 30.

Department of Orthopedic Surgery, Madisesang Hospital, Seoul, Republic of Korea.

Background: Platelet-rich plasma (PRP) has gained attention as a therapeutic option for knee osteoarthritis; however, its efficacy varies widely. Leukocytes in PRP raise the concern of aggravating proinflammatory activity. To date, PRP has rarely been investigated with regard to leukocyte concentration. Read More

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Intensive multidisciplinary treatment strategies and patient resilience to challenge long-term survival in metastatic colorectal cancer: a case report in real life and clinical practice.

Ann Transl Med 2021 Jun;9(12):1027

Oncology Territorial Care, S. Salvatore Hospital, Oncology Network ASL1 Abruzzo, University of L'Aquila, L'Aquila, Italy.

In fit metastatic colorectal cancer (MCRC), multidisciplinary treatment strategy integrating intensive FIr-B/FOx triplet chemotherapy associated to bevacizumab and secondary metastasectomies significantly improved clinical outcomes up to progression-free survival (PFS) 17 months and overall survival (OS) 44 months. A non-elderly woman affected by rectal cancer, lymph nodes involvement, synchronous unresectable liver metastases, was treated with first-line FIr-B/FOx integrated with two-stage liver resections, short course radiotherapy, anterior rectal resection, with a PFS 9 months and progression-free interval (PFI) 4 months off-treatment. After progression characterized by single liver and lymph node inferior mesenteric axis metastases, FIr-B/FOx was re-introduced, liver and lymph node resections were performed, with a PFS 8 months and PFI 3 months. Read More

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Reliability of the fMRI-based assessment of self-evaluation in individuals with internet gaming disorder.

Eur Arch Psychiatry Clin Neurosci 2021 Jul 17. Epub 2021 Jul 17.

Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany.

The self-concept-defined as the cognitive representation of beliefs about oneself-determines how individuals view themselves, others, and their actions. A negative self-concept can drive gaming use and internet gaming disorder (IGD). The assessment of the neural correlates of self-evaluation gained popularity to assess the self-concept in individuals with IGD. Read More

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Sacral Stress Fracture due to Excess Weight Gain during Pregnancy while Self-Quarantining during the COVID-19 Pandemic.

Authors:
Rıfat Sahin

J Coll Physicians Surg Pak 2021 07;31(7):127-129

Department of Orthopaedia and Traumatology, Recep Tayyip Erdogan University, Rize, Turkey.

Most pregnancy-related sacral stress fractures occur after delivery. This case aims to emphasise that stress fractures can occur before delivery, and since excessive weight gain is a risk factor, pregnant women should avoid gaining excess weight, especially during quarantine. This patient, who gained 20 kgs during first pregnancy, started complaining of severe pain in the left sacral region in the 40th week of pregnancy, without any trauma. Read More

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Impact of patient and family engagement in improving continuous positive airway pressure adherence in patients with obstructive sleep apnea: a randomized controlled trial.

J Clin Sleep Med 2021 Jul 16. Epub 2021 Jul 16.

Department of Medicine, Michigan State University, East Lansing, MI.

Study Objectives: The aim of the Improving CPAP Adherence Program (I-CAP study) was to assess the impact of a multidimensional treatment framework based on shared decision-making, patient activation, and caregiver engagement on improving long-term positive airway pressure (PAP) adherence in patients newly diagnosed with obstructive sleep apnea (OSA).

Methods: In this pilot study, patients aged ≥ 18 years with new OSA diagnosis, who qualified for PAP treatment and lived with a caregiver, were randomly assigned to receive either the multidimensional treatment (intervention, n=28) or unrelated education (control group, n=32). All patients and their caregivers participated in a group visit. Read More

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Functional outcomes following critical illness: epidemiology, current management strategies and the future priorities.

Curr Opin Crit Care 2021 Jul 9. Epub 2021 Jul 9.

NHS Greater Glasgow and Clyde, University of Glasgow, School of Medicine, Dentistry and Nursing, THIS Institute (University of Cambridge), Cambridge, UK Department of Medicine, Division of Allergy, Pulmonary, and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, Tennessee Division of Pulmonary, Allergy, and Critical Care Medicine, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania, USA.

Purpose Of The Review: Intensive care unit (ICU) survivorship has gained significant attention over the course of the COVID-19 pandemic. In this review, we summarize the contemporary literature in relation to the epidemiology and management of post-ICU problems.

Recent Findings: Survivors of critical illness can have complex physical, social, emotional and cognitive needs in the months following hospital discharge. Read More

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Autopsy Study of Calretinin Immunohistochemistry in the Anorectal Canal in Young Infants and Potential Implications for Rectal Biopsy Approach in the Neonatal Period.

Pediatr Dev Pathol 2021 Jul 15:10935266211030172. Epub 2021 Jul 15.

Department of Pathology, Children's Healthcare of Atlanta, Children's Healthcare of Atlanta Inc., Atlanta, Georgia.

Background: Absent submucosal ganglion cells in biopsies 1-3 cm above the pectinate line establishes the pathologic diagnosis of Hirschsprung Disease (HD). Calretinin stains both ganglion cells and their mucosal neurites and has gained importance in HD diagnosis. Absent calretinin positive mucosal neurites in biopsies at the appropriate level above the pectinate line is highly specific for HD. Read More

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Colonoscopic Diagnosis of Postoperative Gastrointestinal Bleeding in Patients With Hirschsprung's Disease.

Front Pediatr 2021 28;9:672767. Epub 2021 Jun 28.

Department of Pediatric Surgery, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China.

Postoperative lower gastrointestinal bleeding in children with Hirschsprung's Disease (HSCR) is a non-specific symptom, which may be caused by various etiologies. Our current study aims to utilize colonoscopy to diagnose the causes of postoperative hematochezia and to analyze its feasibility, accuracy, and safety. Twenty-four patients with HSCR with postoperative lower gastrointestinal bleeding or occult blood in the stool were enrolled in this study. Read More

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Real-World Outcomes in Diabetic Macular Edema for the 0.2 µg/Day Fluocinolone Acetonide Implant: Case Series from the Midlands, UK.

Clin Ophthalmol 2021 7;15:2935-2943. Epub 2021 Jul 7.

Ophthalmology Department, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.

Aim: To investigate real-world effectiveness and safety of fluocinolone acetonide (FAc) implant over three years of treatment in eyes with diabetic macular edema (DME) in a population with large ethnic diversity.

Methods: This audit of three large treatment centres in the UK involved retrospective collection of outcome data (best recorded visual acuity [BRVA] by Early Treatment Diabetic Retinopathy Study [ETDRS] letters, central retinal thickness [CRT], intraocular pressure [IOP] and use of supplementary treatments) from patients with DME treated with 0.2 µg/day FAc intravitreal implant with three-year follow-up expected. Read More

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Long-term stability of basilar mandible osteotomy: Chin Wing.

J Stomatol Oral Maxillofac Surg 2021 Jul 11. Epub 2021 Jul 11.

Chirurgie Maxillo-Faciale, Hôpital Privé Jean Mermoz, Lyon. Electronic address:

The Chin Wing is a modified genioplasty extended along the basilar border and the angles of the mandible. This technique may be a better choice than standard genioplasty for correction of lip incompetence, retrogenia and high angle position associated with hyperdivergent cases. Our objective was to analyse the overall movement realized during surgery and the long-term stability of this procedure. Read More

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Reassessing the cost-effectiveness of Nivolumab for the treatment of renal cell carcinoma based on mature survival data, updated safety and lower comparator price.

J Med Econ 2021 Jul 14. Epub 2021 Jul 14.

Monash University, Melbourne, Australia.

Aims: The aim of this study was to estimate the cost-effectiveness of nivolumab versus everolimus for 2-line treatment of renal cell carcinoma (RCC) based on mature data, updated safety and decreased everolimus price.

Materials And Methods: A 3-state (pre-progression/progression free disease, progressive disease and death) Markov model was developed from the perspective of the Australian health care system. Two scenarios were tested. Read More

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Nonmetastatic castration-resistant prostate cancer treated with salvage focal brachytherapy after external beam radiotherapy.

IJU Case Rep 2021 Jul 3;4(4):228-230. Epub 2021 May 3.

Department of Urology Tokyo Medical and Dental University Tokyo Japan.

Introduction: The efficacy of salvage local therapy after external beam radiotherapy has recently gained attention. However, a challenge with these therapies is the risk of significant genitourinary and gastrointestinal toxicity. Focal brachytherapy may be a treatment option because of its potential to reduce side effects. Read More

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Skeletal responses to romosozumab after 12 months of denosumab.

JBMR Plus 2021 Jul 3;5(7):e10512. Epub 2021 Jun 3.

Amgen Inc. Thousand Oaks California USA.

Romosozumab, a monoclonal anti-sclerostin antibody that has the dual effect of increasing bone formation and decreasing bone resorption, reduces fracture risk within 12 months. In a post hoc, exploratory analysis, we evaluated the effects of romosozumab after 12 months of denosumab in postmenopausal women with low bone mass who had not received previous osteoporosis therapy. This phase 2 trial (NCT00896532) enrolled postmenopausal women with a lumbar spine, total hip, or femoral neck -score ≤ -2. Read More

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Safety and Efficacy of Radiofrequency Ablation of Thyroid Nodules-Expanding Treatment Options in the United States.

J Endocr Soc 2021 Aug 10;5(8):bvab110. Epub 2021 Jun 10.

The Thyroid Clinic, Salt Lake City, UT 84124, USA.

Context: Radiofrequency ablation (RFA) has only recently gained popularity in the United States for treatment of thyroid nodules (TNs), with a limited number of patients having undergone the procedure in this country.

Objective: To evaluate the safety and efficacy of RFA of TNs performed in an outpatient setting in the United States.

Methods: This is a retrospective, single-center study of 53 patients who underwent RFA of 58 TNs between November 2018 and January 2021. Read More

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[Update 2021: COVID-19 from the perspective of infectious diseases specialty].

Dtsch Med Wochenschr 2021 Jul 13;146(13-14):904-907. Epub 2021 Jul 13.

From an infectious disease perspective, there have been outstanding findings since January 2020 far beyond the knowledge gained about SARS-CoV, which hopefully will help us to manage future pandemics. Positive highlights include the increased public awareness of infectious disease epidemiology, the increase in immunological knowledge, and the successful use of existing vaccine development platforms and technologies. This article presents a personal selection of interesting developments in recent months. Read More

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Durable complete response to pembrolizumab in microsatellite stable colorectal cancer.

Daru 2021 Jul 12. Epub 2021 Jul 12.

Stem Cell and Regenerative Medicine Research Center, Iran University of Medical Sciences, Tehran, Iran.

Introduction: Immunotherapy by checkpoint inhibitors, i.e., anti-programmed death-1(PD-1) or anti-programmed death-ligand 1 (PD-L1) antibodies, has gained more attention managing solid tumors. Read More

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A heart-team hybrid approach for atrial fibrillation: a single-centre long-term clinical outcome cohort study.

Eur J Cardiothorac Surg 2021 Jul 13. Epub 2021 Jul 13.

Department of Cardiothoracic Surgery, Adventist Health-Saint Helena, Saint Helena, CA, USA.

Objectives: The Cox-maze IV is the gold standard for surgical ablation of atrial fibrillation (AF). A heart-team hybrid approach using selected epicardial thoracoscopic surgical ablations and completion endocardial ablations to replicate the Cox-maze IV lesion set has gained popularity and early results have been promising. We herein report our single-centre long-term clinical outcomes using the heart-team hybrid approach with 455 patients. Read More

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Gene therapy for aromatic L-amino acid decarboxylase deficiency by MR-guided direct delivery of AAV2-AADC to midbrain dopaminergic neurons.

Nat Commun 2021 07 12;12(1):4251. Epub 2021 Jul 12.

Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA.

Aromatic L-amino acid decarboxylase (AADC) deficiency is a rare genetic disorder characterized by deficient synthesis of dopamine and serotonin. It presents in early infancy, and causes severe developmental disability and lifelong motor, behavioral, and autonomic symptoms including oculogyric crises (OGC), sleep disorder, and mood disturbance. We investigated the safety and efficacy of delivery of a viral vector expressing AADC (AAV2-hAADC) to the midbrain in children with AADC deficiency (ClinicalTrials. Read More

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Use of 5-mm Staple in Neonatal Intestinal Surgery.

J Laparoendosc Adv Surg Tech A 2021 Jul 12. Epub 2021 Jul 12.

Paediatric Surgery Department, Hospital Universitario Doce de Octubre, Madrid, Spain.

The use of staples to perform intestinal anastomosis in children has gained popularity in the past years. The aim of this study is to evaluate the outcomes of pediatric patients who underwent intestinal anastomosis with a 5-mm staple in a tertiary health care center. From April 2017 to November 2019, the records of all pediatric patients who underwent intestinal anastomosis with a 5-mm staple were retrospectively revised. Read More

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COVID-19 Self-quarantine and Weight Gain Risk Factors in Adults.

Authors:
Zachary Zeigler

Curr Obes Rep 2021 Jul 12. Epub 2021 Jul 12.

College of Science Engineering and Technology, Grand Canyon University, 19013 W Solano Dr. Litchfield Park, Phoenix, AZ, 85340, USA.

Purpose Of Review: The COVID-19 pandemic is associated with weight gain in certain individuals. This review highlights the risk factors for weight gain during COVID-19 self-quarantine in adults.

Recent Findings: Among those who have gained weight during COVID-19 self-quarantine, self-reported body weight has increased between . Read More

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Results of patients with neovascular age-related macular degeneration managed by a treat-extend-stop protocol without recurrence.

Graefes Arch Clin Exp Ophthalmol 2021 Jul 12. Epub 2021 Jul 12.

Retina Consultants of Orange County, 301 W. Bastanchury Ave #285, Fullerton, CA, 92835, USA.

Purpose: To assess vision, injection quantity, initial lesion size, and final anatomic status in patients with nAMD completing the treat-extend-stop (TES) protocol.

Methods: Patients with nAMD received ≥ 3 monthly anti-VEGF injections followed by 1-2 week injection interval extensions, with intra/subretinal fluid resolution on SD-OCT, to 12 weeks. With quiescent disease, and 2 quarterly injections, patients were monitored alone beginning at 4 weeks extending by 1-2 week intervals until quarterly monitoring. Read More

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Developing Pretend Play in Autistic Children Using the Playboxes Joint Play Approach as Part of Ongoing Practice.

J Autism Dev Disord 2021 Jul 9. Epub 2021 Jul 9.

NHS Lothian, Edinburgh, UK.

A repeated measures single subject design was used to examine the effectiveness of a joint play approach embedded in professional practice, in supporting pretend play for autistic children. Seven autistic children, aged 5-8 years, with a placement within a specialist educational provision, and who demonstrated restricted play, participated in weekly sessions using the Playboxes approach over a period of 3 months. Pre- and post-approach pretend play abilities were assessed using the Symbolic Play Test and the Test of Pretend Play. Read More

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Diagnostic and Treatment Challenges in Cerebral Tuberculoma in a Patient with Morbid Obesity.

Am J Case Rep 2021 Jul 10;22:e932852. Epub 2021 Jul 10.

Infectious Disease Unit, Department of Internal Medicine, Sarawak General Hospital, Ministry of Health Malaysia, Kuching, Sarawak, Malaysia.

BACKGROUND Tuberculosis is prevalent, especially in low-income countries. The most devastating manifestation of tuberculosis is central nervous system (CNS) involvement, albeit rare. CASE REPORT We report a rare case of a 26-year-old woman with morbid obesity and hepatitis C who had cerebral tuberculoma and was treated with an extended duration of anti-tuberculosis multi-drug therapy. Read More

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Cost savings associated with nutritional support in medical inpatients: an economic model based on data from a systematic review of randomised trials.

BMJ Open 2021 Jul 9;11(7):e046402. Epub 2021 Jul 9.

Internal Medicine, Kantonsspital Aarau AG, Aarau, Switzerland.

Background And Aims: Nutritional support improves clinical outcomes during hospitalisation as well as after discharge. Recently, a systematic review of 27 randomised, controlled trials showed that nutritional support was associated with lower rates of hospital readmissions and improved survival. In the present economic modelling study, we sought to determine whether in-hospital nutritional support would also return economic benefits. Read More

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The Impact of COVID-19 Lockdown on Metabolic Control and Access to Healthcare in People with Diabetes: the CONFI-DIAB Cross-Sectional Study.

Diabetes Ther 2021 Jul 9. Epub 2021 Jul 9.

Endocrinology, Diabetology and Nutrition, CHRU of Nancy, Brabois Hospital, ILCV Lorraine University, 54500, Vandoeuvre-lès-Nancy, France.

Introduction: The COVID-19 pandemic led to an international health crisis and restrictions. While the phenotype associated with COVID-19 severity in people with diabetes has rapidly been explored, the impact of restrictive measures, including lockdown, and tertiary care disruption on metabolic control and access to healthcare remained unknown. The aim of our study was to provide a comprehensive assessment on the overall management of diabetes during lockdown, including glucose control, weight changes, health care consumption and use of alternative forms of care such as telemedicine services, in a large sample of patients with type 1 (T1DM) or type 2 diabetes mellitus (T2DM). Read More

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Principles of Integrated Cognitive Training for Executive Attention: Application to an Instrumental Skill.

Front Psychol 2021 22;12:647749. Epub 2021 Jun 22.

Department of Intensive and Robotic Neurorehabilitation, Bambino Gesù Children's Hospital Institute of Recovery and Care Caracterized by Research, Rome, Italy.

One effective cognitive treatment is the rehabilitation of working memory (WM) using an integrated approach that targets the "executive attention" system. Recent neuroscientific literature has revealed that treatment efficacy depends on the presence of various features, such as adaptivity, empathy, customization, avoidance of automatism and stereotypies, and alertness activation. Over the last two decades, an Integrated Cognitive Training (ICT) protocol has been proposed and developed; ICT takes the above-mentioned features and existing literature into account, and has been used to promote the development of reading skills. Read More

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Coached, Coordinated, Enhanced Neonatal Transition (CCENT): protocol for a multicentre pragmatic randomised controlled trial of transition-to-home support for parents of high-risk infants.

BMJ Open 2021 Jul 7;11(7):e046706. Epub 2021 Jul 7.

Division of Paediatric Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada.

Introduction: Having an infant admitted to the neonatal intensive care unit (NICU) is associated with increased parental stress, anxiety and depression. Enhanced support for parents may decrease parental stress and improve subsequent parent and child outcomes. The Coached, Coordinated, Enhanced Neonatal Transition (CCENT) programme is a novel bundled intervention of psychosocial support delivered by a nurse navigator that includes Acceptance and Commitment Therapy-based coaching, care coordination and anticipatory education for parents of high-risk infants in the NICU through the first year at home. Read More

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