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Drug-Induced Vanishing Bile Duct Syndrome: From Pathogenesis to Diagnosis and Therapeutics.

Semin Liver Dis 2021 Jun 15. Epub 2021 Jun 15.

Instituto de Fisiología Experimental (CONICET-UNR), Facultad de Ciencias Bioquímicas y Farmacéuticas, Universidad Nacional de Rosario, Rosario, Argentina.

The most concerned issue in the context of drug/herb-induced chronic cholestasis is vanishing bile duct syndrome. The progressive destruction of intrahepatic bile ducts leading to ductopenia is usually not dose dependent, and has a delayed onset that should be suspected when abnormal serum cholestasis enzyme levels persist despite drug withdrawal. Immune-mediated cholangiocyte injury, direct cholangiocyte damage by drugs or their metabolites once in bile, and sustained exposure to toxic bile salts when biliary epithelium protective defenses are impaired are the main mechanisms of cholangiolar damage. Read More

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Neurological Complications of Cardiac Procedures.

Semin Neurol 2021 Jun 15. Epub 2021 Jun 15.

Department of Neurology, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, Massachusetts.

Neurological complications after cardiac surgery and percutaneous cardiac interventions are not uncommon. These include periprocedural stroke, postoperative cognitive dysfunction after cardiac surgery, contrast-induced encephalopathy after percutaneous interventions, and seizures. In this article, we review the incidence, pathophysiology, diagnosis, and management of these complications. Read More

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From Proteinuria to Fibrosis: An Update on Pathophysiology and Treatment Options.

Kidney Blood Press Res 2021 Jun 15:1-10. Epub 2021 Jun 15.

Department of Renal Medicine, St. George Hospital, Sydney, New South Wales, Australia.

Background: Proteinuria is a key biomarker in nephrology. It is central to diagnosis and risk assessment and the primary target of many important therapies. Etiologies resulting in pathological proteinuria include congenital and acquired disorders, as well as both glomerular (immune/non-immune mediated) and tubular defects. Read More

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Risk Factors Associated with Preterm Prelabor Rupture of Membranes after Cord Occlusion in Monochorionic Diamniotic Twins.

Fetal Diagn Ther 2021 Jun 15:1-7. Epub 2021 Jun 15.

BCNatal Fetal Medicine Research Center, Hospital Clínic and Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain.

Introduction: Preterm prelabor rupture of membranes (PPROM) is a common complication after fetal surgeries. The aim of this study was to assess risk factors for and outcomes after PPROM following cord occlusion (CO) in monochorionic diamniotic (MCDA) pregnancies.

Methods: This was a retrospective cohort study of 188 consecutive MCDA pregnancies treated by bipolar or laser CO, either primarily because of discordant malformation (dMF) or severe selective fetal growth restriction (sFGR), or secondarily when complete bichorionization was not possible in case of twin-to-twin transfusion syndrome (TTTS) or sFGR. Read More

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Association of Acute Kidney Injury with Outcomes in Patients Undergoing Transcatheter Mitral Valve Repair.

Cardiology 2021 Jun 15:1-7. Epub 2021 Jun 15.

Division of Cardiology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA.

Introduction: Although transcatheter mitral valve repair (TMVr) is a contrast-free procedure, prior single-center studies have demonstrated a high incidence of acute kidney injury (AKI) following TMVr. The main objective of this study was to examine risk factors for AKI, and its association with outcomes in patients undergoing TMVr.

Methods: We queried the National Readmission Database to identify TMVr procedures performed between January 2014 and December 2017. Read More

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Deriving reference values for nerve conduction studies from existing data using mixture model clustering.

Clin Neurophysiol 2021 May 21;132(8):1820-1829. Epub 2021 May 21.

Department of Neurology, Leiden University Medical Center, Leiden, the Netherlands. Electronic address:

Objective: to obtain locally valid reference values (RVs) from existing nerve conduction study (NCS) data.

Methods: we used age, sex, height and limb temperature-based mixture model clustering (MMC) to identify normal and abnormal measurements on NCS data from two university hospitals. We compared MMC-derived RVs to published data; examined the effect of using different variables; validated MMC-derived RVs using independent data from 26 healthy control subjects and investigated their clinical applicability for the diagnosis of polyneuropathy. Read More

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Radiological findings of e-cigarette or vaping product use associated lung injury: A systematic review.

Heart Lung 2021 Jun 12;50(5):736-741. Epub 2021 Jun 12.

Melbourne Medical School, University of Melbourne, Melbourne, VIC, 3010, Australia; Department of Radiology, Royal Melbourne Hospital, Melbourne VIC, 3010, Australia.

Introduction: Chest radiology provides an opportunity to better understand the diagnostic characteristics of e-cigarette or vaping product use associated lung injury (EVALI). This systematic review aimed to summarize the radiological findings associated with EVALI reported in the literature.

Methods: This systematic review was conducted in accordance with PRISMA guidelines. Read More

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Utility of multi-parametric quantitative magnetic resonance imaging of the lacrimal gland for diagnosing and staging Graves' ophthalmopathy.

Eur J Radiol 2021 Jun 8;141:109815. Epub 2021 Jun 8.

Department of Endocrinology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080, Guangdong Province, China. Electronic address:

Purpose: To explore radiological changes of the lacrimal gland (LG) in Graves' ophthalmopathy (GO) based on multi-parametric quantitative MRI and its clinical utility in LG diagnosis and activity in GO.

Methods: We enrolled 99 consecutive patients with GO (198 eyes) and 12 Graves' Disease (GD) patients (24 eyes) from July 2018 to June 2020. Clinical, laboratory, and MRI data were collected at the first visit. Read More

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Direct 3D ultrasound fusion for transesophageal echocardiography.

Comput Biol Med 2021 May 21;134:104502. Epub 2021 May 21.

Division of Cardiology, Department of Medicine and Therapeutics, Prince of Wales Hospital and Laboratory of Cardiac Imaging and 3D Printing, Li Ka Shing Institute of Health Science, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.

Background: Real-time three-dimensional transesophageal echocardiography (3D TEE) has been increasingly used in clinic for fast 3D analysis of cardiac anatomy and function. However, 3D TEE still suffers from the limited field of view (FoV). It is challenging to adopt conventional multi-view fusion methods to 3D TEE images because feature-based registration methods tend to fail in the ultrasound scenario, and conventional intensity-based methods have poor convergence properties and require an iterative coarse-to-fine strategy. Read More

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COVID-19 in Argentine teriflunomide-treated multiple sclerosis patients: First national case series.

Mult Scler Relat Disord 2021 May 30;53:103049. Epub 2021 May 30.

Centro de Esclerosis Múltiple de Buenos Aires, CABA; Argentina; Servicio de Neurología, Hospital Universitario CEMIC, Buenos Aires, Argentina.

We report COVID-19 presentation, course and outcomes in teriflunomide-treated MS patients in Argentina.

Methods: descriptive, retrospective, multicentre, study that included MS patients receiving teriflunomide who developed COVID-19, with clinical follow-up at reference MS centres, also listed in a nationwide registry.

Results: Eighteen MS patients on teriflunomide treatment, from eight MS centres developed COVID-19. Read More

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Clinical characteristics and outcomes of community-acquired pneumonia in western Saudi Arabia: A four-year retrospective analysis of medical records.

J Infect Public Health 2021 May 27;14(7):960-966. Epub 2021 May 27.

Infection Prevention and Control, King Abdulaziz Medical City, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia; King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.

Background: Community-acquired pneumonia (CAP) is a significant cause of morbidity and mortality, especially for the elderly and people who suffer from chronic conditions. This study was conducted to assess the clinical and microbiological characteristics and disease outcomes associated with the occurrence of CAP.

Methods: This retrospective chart review was conducted at King Abdulaziz Medical City, Jeddah, Saudi Arabia. Read More

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Medical image recognition and segmentation of pathological slices of gastric cancer based on Deeplab v3+ neural network.

Comput Methods Programs Biomed 2021 May 29;207:106210. Epub 2021 May 29.

Department of General Surgery Shengjing Hospital of China Medical University, Liaoning 110004, China. Electronic address:

Objective: In order to improve the efficiency of gastric cancer pathological slice image recognition and segmentation of cancerous regions, this paper proposes an automatic gastric cancer segmentation model based on Deeplab v3+ neural network.

Methods: Based on 1240 gastric cancer pathological slice images, this paper proposes a multi-scale input Deeplab v3+ network, _and compares it with SegNet, ICNet in sensitivity, specificity, accuracy, and Dice coefficient.

Results: The sensitivity of Deeplab v3+ is 91. Read More

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Neuroimaging findings in rheumatologic disorders.

J Neurol Sci 2021 Jun 11;427:117531. Epub 2021 Jun 11.

University of Iowa Hospital and Clinics, Department of Radiology, USA. Electronic address:

Patients with rheumatological diseases may present with neurological manifestations of peripheral and/or central nervous system (CNS). Symptoms may be related to underlying rheumatological disease or CNS effects of immune-modulating drugs. Early diagnosis and therapy may help prevent serious complications. Read More

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Performance of the EarlyCDT® Lung test in detection of lung cancer and pulmonary metastases in a high-risk cohort.

Lung Cancer 2021 Jun 10;158:85-90. Epub 2021 Jun 10.

Institute of Regional Health Research, University of Southern Denmark, J.B. Winsløws Vej 19, 3, 5000 Odense C, Denmark; Department of Internal Medicine, Vejle Hospital, University Hospital of Southern Denmark, Beriderbakken 4, 7100 Vejle, Denmark. Electronic address:

Objectives: Early detection of lung cancer is pivotal for an optimal prognosis. CT screening is currently implemented in USA. To decrease the amount of CT scans, the application of a blood-based biomarker as part of screening criteria is desirable. Read More

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Cross-sectional observational study - Investigation of vitamin D concentration in Caucasian cancer patients. what is the adequate dose of vitamin D for these patients?

Clin Nutr 2021 Apr 22;40(6):3852-3858. Epub 2021 Apr 22.

Department of Clinical Nutrition, Maria Sklodowska-Curie National Research Institute of Oncology, Roentgen Str.5, 02781, Warsaw, Poland. Electronic address:

Background & Aims: Vitamin D impairs tumour-related transformation and supports the anticancer function of the immune system. Currently, there are no guidelines on vitamin D supplementation devoted solely to cancer patients. The primary objective of the study was to evaluate the frequency of vitamin D deficiency in Caucasian cancer patients and to characterize the clinical factors that predispose individuals to decreased vitamin D concentration. Read More

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GLIM vs ESPEN criteria for the diagnosis of early malnutrition in oncological outpatients.

Clin Nutr 2021 Apr 22;40(6):3741-3747. Epub 2021 Apr 22.

Instituto de Investigación Sanitaria (IIS) Aragón, Av. San Juan Bosco, 13, 50009, Zaragoza, Spain; Translational Research Unit, Miguel Servet University Hospital, Instituto Aragonés de Ciencias de La Salud (IACS), Av. Isabel La Católica 1-3, 50009, Zaragoza, Spain; Biomedical Research Center in Physiopathology of Obesity and Nutrition (CIBERObn), Health Institute Carlos III (ISCIII), Av. Monforte de Lemos, 3-5, 28029, Madrid, Spain.

Background & Aims: Malnutrition is one of the most prevalent problems among oncological patients. It reduces the response to treatments and negatively impacts survival. In 2019, a consensus criteria for diagnosing malnutrition (GLIM criteria) were proposed by most scientific nutrition societies. Read More

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Tumefactive demyelination appearing as multiple cystic brain lesions.

World Neurosurg 2021 Jun 12. Epub 2021 Jun 12.

Department of Neurosurgery, St. Vincent's Hospital Melbourne, 41 Victoria Pde, Fitzroy, Victoria 3065, Australia.

Tumefactive demyelinating lesions (TDL) are a rare sequalae of idiopathic inflammatory demyelinating diseases (IIDD) of the central nervous system (CNS). Their propensity to mimic tumor and abscess poses a diagnostic challenge for the clinician. Our case depicts TDL causing right hand focal sensory seizures in an otherwise healthy 35-year-old female. Read More

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Ultrasound-assisted CF-filled PLGA nanobubbles for enhanced FGF21 delivery and improved prophylactic treatment of diabetic cardiomyopathy.

Acta Biomater 2021 Jun 12. Epub 2021 Jun 12.

Department of Ultrasound in Medicine, Shanghai Institute of Ultrasound in Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai 200233, P.R. China.; Department of Ultrasound in Medicine, Shanghai Eighth People's Hospital, 8 Caobao Road, Shanghai 200235, P.R. China.

Diabetic cardiomyopathy (DCM) is a serious cardiac complication of diabetes that currently lacks specific treatment. Fibroblast growth factor 21 (FGF21) has been proved to have cardioprotective effect in DCM. However, the insufficient cardiac delivery effect of FGF21 limits its application in DCM. Read More

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Combining gene expression signature with clinical features for survival stratification of gastric cancer.

Genomics 2021 Jun 12. Epub 2021 Jun 12.

Department of Cell Biology, Zhejiang University School of Medicine, Hangzhou 310058, China; Institute of Gastroenterology, Zhejiang University, Hangzhou 310016, China; Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, Zhejiang 310003, China; Department of Molecular Genetics, University of Toronto, Toronto, ONM5S 1A8, Canada. Electronic address:

The AJCC staging system is considered as the golden standard in clinical practice. However, it remains some pitfalls in assessing the prognosis of gastric cancer (GC) patients with similar clinicopathological characteristics. We aim to develop a new clinic and genetic risk score (CGRS) to improve the prognosis prediction of GC patients. Read More

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Non-pharmacologic direct cost of a simplified strategy with glecaprevir/pibrentasvir for 8 weeks in naïve non-cirrhotic patients with hepatitis C implemented in clinical practice. The Just SIMPLE Study.

Gastroenterol Hepatol 2021 Jun 12. Epub 2021 Jun 12.

Digestive Diseases, Hospital La Paz, Madrid.

Background And Objective: The emergence of highly tolerable, effective, and shorter duration direct-acting antivirals (DAAs) regimens offers the opportunity to simplify hepatitis C virus management but medical costs are unknown. Thus, we aimed to determine the direct medical costs associated with a combo-simplified strategy (one-step diagnosis and low monitoring) to manage HCV infection within an 8-week glecaprevir/pibrentasvir (GLE/PIB) regimen in clinical practice in Spain.

Patients And Methods: Healthcare resources and clinical data were collected retrospectively from medical charts of 101 eligible patients at 11 hospitals. Read More

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Identification of Prognostic alternative splicing signatures and their clinical significance in uveal melanoma.

Exp Eye Res 2021 Jun 12:108666. Epub 2021 Jun 12.

Department of Ophthalmology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China. Electronic address:

As a posttranscriptional regulatory mechanism, alternative splicing (AS) has the potential to generate a large amount of protein diversity from limited genes. The purpose of our study was to assess the usefulness of prognostic splicing events as novel diagnostic and therapeutic signatures for uveal melanoma (UM). The datasets, clinical traits and AS data of UM were obtained from The Cancer Genome Atlas (TCGA) database and TCGA SpliceSeq database. Read More

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Molecular classification and diagnostics of upper urinary tract urothelial carcinoma.

Cancer Cell 2021 Jun;39(6):793-809.e8

Department of Pathology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan.

Upper urinary tract urothelial carcinoma (UTUC) is one of the common urothelial cancers. Its molecular pathogenesis, however, is poorly understood, with no useful biomarkers available for accurate diagnosis and molecular classification. Through an integrated genetic study involving 199 UTUC samples, we delineate the landscape of genetic alterations in UTUC enabling genetic/molecular classification. Read More

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Paradigm shift in the management of metastatic Non-small Cell Lung Cancer.

Int J Clin Pract 2021 Jun 15:e14533. Epub 2021 Jun 15.

William Beaumont Hospital, Department of Hematology and Medical Oncology, Royal Oak.

Background: Lung cancer is one of the leading causes of cancer mortality in the US. The use of precision medicine in the past 10 years has significantly changed the therapeutic landscape of lung cancer. Management of advanced non-small cell lung cancer (NSCLC) has transitioned from a chemotherapeutic approach to targeted treatments and immunotherapeutic agents. Read More

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Unraveling the Interplay of Image Formation, Data Representation and Learning in CT-based COPD Phenotyping Automation: The Need for a Meta-Strategy.

Med Phys 2021 Jun 15. Epub 2021 Jun 15.

Siemens Healthineers, CT R&D Image Analytics, Forchheim, Germany.

Purpose: In the literature on automated phenotyping of Chronic Obstructive Pulmonary Disease (COPD), there is a multitude of isolated classical machine learning and deep learning techniques, mostly investigating individual phenotypes, with small study cohorts and heterogeneous meta-parameters, e.g. different scan protocols or segmented regions. Read More

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Long-term Continuity of Antipsychotic Treatment for Schizophrenia: A Nationwide Study.

Schizophr Bull 2021 Jun 15. Epub 2021 Jun 15.

Department of Forensic Psychiatry, Niuvanniemi Hospital, University of Eastern Finland, Kuopio, Finland.

Schizophrenia often requires long-term treatment with antipsychotic medication. This study aims to measure the continuity of antipsychotic treatment over the course of illness in schizophrenia, as well as factors involved in the interruption of treatment. For this, we followed up a national cohort of first-episode psychosis patients in Finland for up to 18 years. Read More

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Development of a Self-reported Olfactory Dysfunction Questionnaire (SODQ) to screen olfactory disorders in China.

Rhinology 2021 Jun 15. Epub 2021 Jun 15.

Chemical Senses and Mental Health Laboratory, Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China.

Background: The diagnosis of olfactory dysfunction is challenging given the negligence during routine physical examination, inconvenience of diagnosis in clinical practice, and the inattention to cross-cultural adaptability. The study aimed to develop and validate a simple and effective self-reported olfactory dysfunction questionnaire (SODQ) for the initial screening of clinical olfactory disorders in China.

Methods: A total of 121 subjects participated in the study; of these, 96 subjects completed the T&T olfactometer test and 12-item questionnaire, and 25 participants were retested using the SODQ after one week. Read More

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The discrepancy between admission and discharge diagnoses: Underlying factors and potential clinical outcomes in a low socioeconomic country.

PLoS One 2021 15;16(6):e0253316. Epub 2021 Jun 15.

Department of Medicine, Section of Internal Medicine, Aga Khan University Hospital, Karachi, Pakistan.

Objective: The discrepancy between admission and discharge diagnosis can lead to possible adverse patient outcomes. There are gaps in integrated studies, and less is understood about its characteristics and effects. Therefore, this study was conducted to determine the frequency, characteristics, and outcomes of diagnostic discrepancies at admission and discharge. Read More

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Immune status changing helps diagnose osteoarticular tuberculosis.

PLoS One 2021 15;16(6):e0252875. Epub 2021 Jun 15.

Spine and Osteopathy Ward, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, People's Republic of China.

Objective: This study is aimed to develop a new nomogram for the clinical diagnosis of osteoarticular tuberculosis (TB).

Methods: xCell score estimation to obtained the immune cell type abundance scores. We downloaded the expression profile of GSE83456 from GEO and proceed xCell score estimation. Read More

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Population-based incidence and mortality of community-acquired pneumonia in Germany.

PLoS One 2021 15;16(6):e0253118. Epub 2021 Jun 15.

Pfizer Deutschland GmbH, Berlin, Germany.

Background: Little information on the current burden of community-acquired pneumonia (CAP) in adults in Germany is available.

Methods: We conducted a retrospective cohort study using a representative healthcare claims database of approx. 4 million adults to estimate the incidence rates (IR) and associated mortality of CAP in 2015. Read More

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Toe-brachial index is beyond a peripheral issue in patients with type 2 diabetes.

PLoS One 2021 15;16(6):e0253138. Epub 2021 Jun 15.

Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences (IUMS), Tehran, Iran.

Background: Atherosclerosis is the leading cause of death in patients with diabetes. We aimed to evaluate the association between ankle-brachial index (ABI) and toe-brachial index (TBI) with carotid intima-media thickness (CIMT) in patients with type 2 diabetes (T2DM).

Methods: This cross sectional study included 296 patients with T2DM who met the American Diabetes Association criteria for the assessment of peripheral arterial atherosclerosis. Read More

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