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Venetoclax combinations induce high response rates in newly diagnosed Acute Myeloid Leukemia patients ineligible for intensive chemotherapy in routine practice.

Am J Hematol 2021 Apr 9. Epub 2021 Apr 9.

Department of Hematology, Shamir Medical Center (formerly Assaf Harofe Medical Center), Zerifin, Israel, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Combinations of the BCL-2 inhibitor, venetoclax, with either hypomethylating agents (HMA), or low dose cytarabine (LDAC), have shown promising results in clinical trials of AML patients unfit for intensive therapy. We report on the efficacy and safety of AML patients that were treated with venetoclax combinations outside of clinical trials. Data on 133 patients with a mean age of 77 years is included. Read More

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Comprehensive Review of Cardiovascular Involvement in COVID-19.

AACN Adv Crit Care 2021 Apr 15:e1-e19. Epub 2021 Apr 15.

Ruff Joseph Macale Cajanding is Charge Nurse, Adult Critical Care Unit, 6th Floor, King George V Building, St. Bartholomew's Hospital, Barts Health NHS Trust, 2 King Edward Street, London EC1A 1HQ, United Kingdom

COVID-19 has emerged as one of the most devastating and clinically significant infectious diseases of the last decade. It has reached global pandemic status at an unprecedented pace and has placed significant demands on health care systems worldwide. Although COVID-19 primarily affects the lungs, epidemiologic reports have shown that the disease affects other vital organs of the body, including the heart, vasculature, kidneys, brain, and the hematopoietic system. Read More

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An exploratory focus group study on experiences with snakebites: health-seeking behaviour and challenges in rural communities of Kenya.

Trans R Soc Trop Med Hyg 2021 Apr 9. Epub 2021 Apr 9.

Health Action International, Overtoom 60 (2), 1054 HK Amsterdam, the Netherlands.

Background: Snakebite envenoming is a long-hidden public health threat in the rural communities of Kenya. This study aimed to shed light on the health-seeking behaviour of people bitten by snakes, views on prevention measures and community needs and the consequences for snakebite patients in these areas.

Methods: Six focus group interviews were conducted in communities in the Kajiado (n=3) and Kilifi (n=3) counties. Read More

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Individualized blood pressure targets in the postoperative care of patients with intracerebral hemorrhage.

J Neurosurg 2021 Apr 9:1-10. Epub 2021 Apr 9.

1Neurological Intensive Care Unit, Department of Neurology, and.

Objective: Recent guidelines recommend targeting a systolic blood pressure (SBP) < 140 mm Hg in the early management of patients with spontaneous intracerebral hemorrhage (ICH). The optimal SBP targets for ICH patients after hematoma evacuation (HE) remain unclear. Here, the authors aimed to define the optimal SBP range based on multimodal neuromonitoring data. Read More

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Effectiveness and safety of direct oral anticoagulants in patients with cancer associated venous thromboembolism.

Thromb Res 2021 Mar 29;202:128-133. Epub 2021 Mar 29.

Department of Medicine, McGill University, Montreal, QC, Canada; Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, QC, Canada; Division of General Internal Medicine, Jewish General Hospital, Montreal, QC, Canada. Electronic address:

Introduction: Real-world evidence on the effects of direct oral anticoagulants (DOACs) in patients with cancer associated venous thromboembolism (VTE) is limited. Thus, our population-based cohort study aimed to assess the effectiveness and safety of DOACs compared to the standard of care low-molecular-weight heparin (LMWH) in this vulnerable population.

Materials And Methods: Using linked administrative healthcare databases from the province of Québec, Canada, we identified patients with incident VTE from 2012 to 2015 and a cancer diagnosis in the year before the VTE, who initiated treatment with anticoagulants within 30 days after the VTE. Read More

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Predicting the duration of supplemental home oxygen in prematurely-born infants at discharge from neonatal care.

Early Hum Dev 2021 Mar 17;157:105353. Epub 2021 Mar 17.

Neonatal Intensive Care Centre, King's College Hospital NHS Foundation Trust, London, United Kingdom; Department of Women and Children's Health, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom. Electronic address:

Background: Discharge home of preterm infants on supplemental oxygen has significant healthcare, parental psychological and financial implications, but the potential ability of clinical parameters at discharge to predict the duration of home oxygen has not been previously examined.

Aims: To use clinical and epidemiological parameters available at discharge to predict the duration of home oxygen therapy.

Study Design: Retrospective observational cohort study with a primary and a validation cohort. Read More

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Pharmacologic and hormonal treatments for menopausal sleep disturbances: A network meta-analysis of 43 randomized controlled trials and 32,271 menopausal women.

Sleep Med Rev 2021 Mar 11;57:101469. Epub 2021 Mar 11.

Institute of Biomedical Sciences, National Sun Yat-sen University, Kaohsiung, Taiwan. Electronic address:

This network meta-analysis aimed at investigating efficacy/tolerability of pharmacologic/hormonal interventions for menopausal sleep disturbances. Major databases were searched for randomized controlled trials (RCTs) examining pharmacologic or hormonal interventions with either placebo or active controlled designs. Primary outcomes were improvements in sleep disturbance severity/tolerability (i. Read More

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The effects of maintenance cardiac rehabilitation: A systematic review and Meta-analysis, with a focus on sex.

Heart Lung 2021 Apr 6;50(4):504-524. Epub 2021 Apr 6.

Faculty of Health, York University, Toronto, ON, Canada; KITE-Toronto Rehabilitation Institute & Peter Munk Cardiac Centre, University Health Network, University of Toronto, ON, Canada. Electronic address:

Phase III/IV cardiac rehabilitation (CR) is recommended to promote maintenance of benefits achieved during Phase II; there has been no meta-analysis to test this to date. This study determined the effects of maintenance CR on any outcome, with consideration of sex. Seven databases were searched from inception-January 2020. Read More

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Association between extreme ambient temperatures and general indistinct and work-related road crashes. A nationwide study in Italy.

Accid Anal Prev 2021 Apr 6;155:106110. Epub 2021 Apr 6.

Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Italian Workers' Compensation Authority (INAIL), Monte Porzio Catone, RM, Italy.

Despite the relevance of road crashes and their impact on social and health care costs, the effects of extreme temperatures on road crashes risk have been scarcely investigated, particularly for those occurring in occupational activities. A nationwide epidemiological study was carried out to estimate the risk of general indistinct and work-related road crashes related with extreme temperatures and to identify crash and occupation parameters mostly involved. Data about road crashes, resulting in death or injury, occurring during years 2013-2015 in Italy, were collected from the National Institute of Statistics, for general indistinct road crashes, and from the compensation claim applications registered by the national workers' compensation authority, for work-related ones. Read More

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Renal replacement therapy modality in critically ill patients with acute kidney injury - A network meta-analysis of randomized controlled trials.

J Crit Care 2021 Mar 25;64:82-90. Epub 2021 Mar 25.

Department of Intensive Care Medicine, HwaMei Hospital, University of Chinese Academy of Sciences, Ningbo, Zhejiang 315000, China; Ningbo Institute of Life and Health Industry, University of Chinese Academy of Sciences, Ningbo, Zhejiang 315000, China. Electronic address:

Purpose: This network meta-analysis aims to compare the efficacy and safety of various renal replacement therapy (RRT) modalities in critically ill patients with acute kidney injury (AKI).

Materials And Methods: We searched the electronic databases for randomized controlled trials (RCTs) comparing different RRT modalities, including continuous RRT, intermittent RRT, hybrid RRT, and peritoneal dialysis (PD), in critically ill patients with AKI through July 26, 2020. The primary outcomes were renal recovery and short-term mortality. Read More

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Impacts and challenges of the COVID-19 pandemic on emergency medicine physicians in the United States.

Am J Emerg Med 2021 Apr 2;48:38-47. Epub 2021 Apr 2.

Department of Surgery, Division of Trauma and Surgical Critical Care, Kendall Regional Medical Center, Miami, FL, USA. Electronic address:

Background: Emergency medicine (EM) physicians have been on the front line of the COVID-19 pandemic. This study aims to determine the impact of COVID-19 pandemic and other related factors such as resource availability and institutional support on well-being, burnout and job-satisfaction of EM physicians in the United States.

Methods: A cross-sectional survey study of EM physicians was conducted through the Emergency Medicine Practice Research Network of the ACEP. Read More

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Determinants of phthalate exposure among a U.S.-based group of Latino workers.

Int J Hyg Environ Health 2021 Apr 6;234:113739. Epub 2021 Apr 6.

Johns Hopkins University, Bloomberg School of Public Health, Department of Environmental Health & Engineering, Baltimore, MD, USA; Maryland Institute of Applied Environmental Health, School of Public Health, University of Maryland, College Park, MD, USA. Electronic address:

Background: Phthalates are endocrine disrupting compounds linked to various adverse health effects. U.S. Read More

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Nutritional determinants and COVID-19 outcomes of older patients with COVID-19: A systematic review.

Arch Gerontol Geriatr 2021 Mar 31;95:104411. Epub 2021 Mar 31.

Department of Nursing, Faculty of Allied Health Sciences, University of Peradeniya, Sri Lanka.

Background: Malnutrition among older people is one of the serious public health problem worldwide. Nutritional status and levels of nutrients of older patients with COVID-19 effect on COVID-19 outcomes. The purpose of this systematic review was to identify the prevalence of malnutrition and levels of nutrients associated with outcomes of the older patients with COVID-19. Read More

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Influences on emergency department attendance among frail older people with deteriorating health: a multicentre prospective cohort study.

Public Health 2021 Apr 6;194:4-10. Epub 2021 Apr 6.

Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King's College, London, United Kingdom. Electronic address: https://twitter.com/ij_higginson.

Objectives: To examine the patterns and influences on repeated emergency department attendance among frail older people with deteriorating health.

Study Design: Multicentre prospective cohort study (International Access Rights and Empowerment II study) with convergent mixed methods design.

Methods: Eligible patients were aged ≥65 years, with Clinical Frailty Score ≥5, and ≥1 hospital admission or ≥2 acute attendances in the previous 6 months. Read More

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National Institutes of Health Consensus Development Project on Criteria for Clinical Trials in Chronic Graft-versus-Host Disease: IIb. The 2020 Preemptive Therapy Working Group Report.

Transplant Cell Ther 2021 Apr 6. Epub 2021 Apr 6.

Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA.

Background: Chronic graft-versus-host disease (GVHD) commonly occurs after allogeneic hematopoietic cell transplantation (HCT) despite standard prophylactic immune suppression. Intensified universal prophylaxis approaches are effective but risk possible over-treatment and may interfere with the graft-vs-malignancy immune response.

Objectives: We summarize conceptual and practical considerations regarding preemptive therapy of chronic GVHD, namely interventions applied after HCT based on evidence that the risk of developing chronic GVHD is higher than previously appreciated. Read More

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Deep Venous Thrombosis and Pulmonary Embolism Among Hospitalized Coronavirus Disease 2019 (COVID-19) Positive Patients Predict Higher Mortality, Prolonged Intensive Care Unit and Hospital Stays in A Multi-Site Healthcare System.

J Vasc Surg Venous Lymphat Disord 2021 Apr 6. Epub 2021 Apr 6.

Department of Neurology, Mayo Clinic, Jacksonville, FL.

Objective: To assess the incidence of deep venous thrombosis (DVT) and pulmonary embolism (PE) in hospitalized patients with coronavirus disease 2019 (COVID-19) in comparison with a matched cohort with similar cardiovascular risk factors, as well as the impact of DVT/PE on hospital course.

Methods: A retrospective review of prospectively collected data on COVID-19 patients hospitalized from 03/11/2020 to 09/04/2020 was performed. Patients were randomly matched in a 1:1 ratio by age, sex, hospital of admission, smoking history, diabetes mellitus and coronary artery disease with a cohort of non-COVID-19 patients. Read More

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Evaluation of the PRADO Home Discharge Support Programme for Orthopaedic Surgery in 2018.

Orthop Traumatol Surg Res 2021 Apr 6. Epub 2021 Apr 6.

EY Consulting, Tour First, 1 place des Saisons, TSA 14444 92037 Paris-La Défense Cedex, France. Electronic address:

Background: Between 2015 and 2017, nearly 80 000 hospital stays in orthopaedic surgery were entered into a home discharge support programme (PRADO) offered by the statutory health insurance system. The objective of this study was to assess the impact of the PRADO programme on enrolled stays in orthopaedic surgery over the last three years.

Hypothesis: The home discharge support programme used in orthopaedic surgery shortens hospital stays and decreases the rate of re-admission within 30 days. Read More

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Internal-external cross-validation helped to evaluate the generalizability of prediction models in large clustered datasets.

J Clin Epidemiol 2021 Apr 6. Epub 2021 Apr 6.

Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Universiteitsweg 100, 3584 CG, Utrecht, The Netherlands; Health Data Research UK and Institute of Health Informatics, University College London, Gibbs Building, 215 Euston Road, London, NW1 2BE, United Kingdom. Electronic address:

Objective: To illustrate how to evaluate the need of complex strategies for developing generalizable prediction models in large clustered datasets.

Study Design And Setting: We developed eight Cox regression models to estimate the risk of heart failure using a large population-level dataset. These models differed in the number of predictors, the functional form of the predictor effects (non-linear effects and interaction) and the estimation method (maximum likelihood and penalization). Read More

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The K7 modulator, retigabine, is an efficacious antiseizure drug for delayed treatment of organophosphate-induced status epilepticus.

Neuroscience 2021 Apr 6. Epub 2021 Apr 6.

United States Army Medical Research Institute of Chemical Defense, Medical Toxicology Research Division, Neuroscience Department, 2900 Ricketts Point Rd, Aberdeen Proving Ground, MD 21010, USA.

Benzodiazepines are the primary treatment option for organophosphate (OP)-induced status epilepticus (SE), but these antiseizure drugs (ASDs) lose efficacy as treatment is delayed. In the event of a mass civilian or military exposure, significant treatment delays are likely. New ASDs that combat benzodiazepine-resistant, OP-induced SE are critically needed, particularly if they can be efficacious after a long treatment delay. Read More

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Progression of changes in vascular surgery practices during the novel corona virus SARS-CoV-2 pandemic.

Ann Vasc Surg 2021 Apr 6. Epub 2021 Apr 6.

Division of Vascular and Endovscular Surgery, Department of Surgery, Saint Louis University. Electronic address:

Introduction: The novel coronavirus SARS-CoV-2 (COVID-19) has spread rapidly since it was identified. We sought to understand its effects on vascular surgery practices stratified by VASCON surgical readiness level and determine how these effects have changed during the course of the pandemic.

Methods: All members of the Vascular and Endovascular Surgery Society were sent electronic surveys questioning the effects of COVID-19 on their practices in the early pandemic in April (EP) and four months later in the pandemic in August (LP) 2020. Read More

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Impact of altering the available food options on selection: potential mediation by social norms.

Appetite 2021 Apr 6:105245. Epub 2021 Apr 6.

Behaviour and Health Research Unit, Institute of Public Health, University of Cambridge, Cambridge, UK.

Increasing the availability of lower-energy foods increases their selection. The current studies examine the extent to which this effect could be mediated by social norms - assessed by perceived popularity of foods - which may be implied by their relative availability. Study 1 (Online): 2340 UK adults estimated the perceived popularity of products. Read More

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Clinical prediction of iron deficiency at age 2: a national cross-sectional study in France.

J Pediatr 2021 Apr 6. Epub 2021 Apr 6.

Centre of Research in Epidemiology and Statistics, Obstetrical, Perinatal and Pediatric Epidemiology Research team (EPOPé), INSERM UMR 1153, Université de Paris, 75004 Paris, France; Department of General Pediatrics and Pediatric Infectious Diseases, AP-HP, Necker-Enfants malades hospital, Université de Paris, 75015 Paris, France.

Objective: To assess the diagnostic accuracy and to develop prediction tools for iron deficiency in 2-year-old children.

Study Design: In a national cross-sectional study conducted in primary care pediatricians' practices throughout France, 2-year-old children were consecutively included (2016-2017). Multivariable logistic regression modeling and bootstrapping were used to develop several clinical models to predict ID (serum ferritin <12 μg/L). Read More

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TOP1 inhibition therapy protects against SARS-CoV-2-induced lethal inflammation.

Cell 2021 Mar 30. Epub 2021 Mar 30.

Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Global Health and Emerging Pathogens Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA. Electronic address:

The ongoing pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is currently affecting millions of lives worldwide. Large retrospective studies indicate that an elevated level of inflammatory cytokines and pro-inflammatory factors are associated with both increased disease severity and mortality. Here, using multidimensional epigenetic, transcriptional, in vitro, and in vivo analyses, we report that topoisomerase 1 (TOP1) inhibition suppresses lethal inflammation induced by SARS-CoV-2. Read More

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Efficacy and safety of pembrolizumab in patients with advanced mesothelioma in the open-label, single-arm, phase 2 KEYNOTE-158 study.

Lancet Respir Med 2021 Apr 6. Epub 2021 Apr 6.

University of Chicago, Chicago, IL, USA.

Background: Malignant pleural mesothelioma (MPM) has few treatment options. Pembrolizumab showed preliminary clinical benefit in programmed death ligand 1 (PD-L1)-positive MPM. We evaluated the efficacy and safety of pembrolizumab monotherapy in patients with previously treated MPM irrespective of PD-L1 status in the KEYNOTE-158 study. Read More

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Older adults in skilled nursing facilities demonstrate low physical activity during and after discharge.

Disabil Rehabil 2021 Apr 9:1-6. Epub 2021 Apr 9.

Physical Therapy Program, Department of Physical Medicine and Rehabilitation, University of Colorado, Aurora, CO, USA.

Purpose: This study sought to quantify physical activity and sedentary time among older adults during a skilled nursing facility (SNF) stay and after the transition home, a critical period when patients are at high risk for adverse events.

Materials And Methods: We performed an observational cohort study of physical activity and sedentary behavior during the last 3-5 days before discharge from SNF and the initial 3-5 days at home using accelerometers. Participants answered questions about perceived physical activity in the SNF and at home. Read More

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Mortality associated with third generation cephalosporin-resistance in infections: a multicenter cohort study in Southern China.

Expert Rev Anti Infect Ther 2021 Apr 9. Epub 2021 Apr 9.

Laboratory of Biostatistics, Division of Social Medicine, School of Medicine, University of Crete, Heraklion, Greece.

Background: Emerging third-generation cephalosporin-resistant (3GCR-EB) pose a global healthcare concern. This study assessed the in-hospital mortality attributed to 3GCR-EB.

Methods: : The study cohort comprised inpatients with a community-onset or healthcare-associated infection caused by in three tertiary-care public hospitals in 2017. Read More

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A sequential guide to identify neonates with low bacterial meningitis risk: a multicenter study.

Ann Clin Transl Neurol 2021 Apr 9. Epub 2021 Apr 9.

Department of Neonatology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.

Objective: To derive and validate a predictive algorithm integrating clinical and laboratory parameters to stratify a full-term neonate's risk level of having bacterial meningitis (BM).

Methods: A multicentered dataset was categorized into derivation (689 full-term neonates aged ≤28 days with a lumbar puncture [LP]) and external validation (383 neonates) datasets. A sequential algorithm with risk stratification for neonatal BM was constructed. Read More

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Seroprevalence of SARS-CoV-2 following the largest initial epidemic wave in the United States: Findings from New York City, May 13-July 21, 2020.

J Infect Dis 2021 Apr 9. Epub 2021 Apr 9.

Division of Disease Control, New York City Department of Health and Mental Hygiene, Queens, NY, USA.

Background: New York City (NYC) was the U.S. epicenter of the Spring 2020 COVID-19 pandemic. Read More

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Disruptive technologies for hemodialysis: medium and high cutoff membranes. Is the future now?

J Bras Nefrol 2021 Apr 9. Epub 2021 Apr 9.

San Bortolo Hospital, International Renal Research Institute of Vicenza, Department of Nephrology, Dialysis and Transplantation, Vicenza, Italy.

In the past decade, a new class of hemodialysis (HD) membranes (high retention onset class) became available for clinical use. The high cutoff (HCO) and the medium cutoff (MCO) membranes have wider pores and more uniformity in pore size, allowing an increased clearance of uremic toxins. Owing to the mechanism of backfiltration/internal filtration, middle molecules are dragged by the convective forces, and no substitution solution is needed. Read More

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Consensus on the standard terminology used in the nutrition care of adult patients with chronic kidney disease.

J Bras Nefrol 2021 Apr 9. Epub 2021 Apr 9.

Associação Brazileira de Nutrição, Curitiba, PR, Brasil.

This nutrition consensus document is the first to coordinate the efforts of three professional organizations - the Brazilian Association of Nutrition (Asbran), the Brazilian Society of Nephrology (SBN), and the Brazilian Society of Parenteral and Enteral Nutrition (Braspen/SBNPE) - to select terminology and international standardized tools used in nutrition care. Its purpose is to improve the training delivered to nutritionists working with adult patients with chronic kidney disease (CKD). Eleven questions were developed concerning patient screening, care, and nutrition outcome management. Read More

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