255,323 results match your criteria hospital setting

Perioperative Continuous Positive Airway Pressure Therapy: A Review With the Emphasis on Randomized Controlled Trials and Obstructive Sleep Apnea.

Anesth Analg 2021 May;132(5):1306-1313

Department of Surgical and Perioperative Sciences, Surgery, Umeå University, Umeå, Sweden.

The perioperative use of continuous positive airway pressure (CPAP) therapy has increased substantially in recent years, particularly in relationship to the treatment of patients with known or suspected obstructive sleep apnea (OSA). OSA is common in the surgical population and is reported as an independent risk factor for postoperative complications, intensive care unit admission, and increased length of hospital stay. A large proportion of OSA patients are undiagnosed at the time of surgery and can therefore not be optimized preoperatively. Read More

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Perioperative Management of the Patient With Obstructive Sleep Apnea: A Narrative Review.

Anesth Analg 2021 May;132(5):1231-1243

From the Department of Anesthesiology, Perioperative Medicine and Intensive Care Medicine, Paracelsus Medical University, Salzburg, Austria.

The prevalence of obstructive sleep apnea (OSA) has reached 1 billion people worldwide, implying significant risk for the perioperative setting as patients are vulnerable to cardiopulmonary complications, critical care requirement, and unexpected death. This review summarizes main aspects and considerations for the perioperative management of OSA, a condition of public health concern. Critical determinants of perioperative risk include OSA-related changes in upper airway anatomy with augmented collapsibility, diminished capability of upper airway dilator muscles to respond to airway obstruction, disparities in hypoxemia and hypercarbia arousal thresholds, and instability of ventilatory control. Read More

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Outcomes of Sleep Apnea Surgery in Outpatient and Inpatient Settings.

Anesth Analg 2021 May;132(5):1215-1222

From the Department of Anesthesiology and Pain Management, University of Texas Southwestern Medical Center, Dallas, Texas.

Background: Upper airway surgery is an alternative treatment for patients with severe obstructive sleep apnea (OSA). However, there is controversy regarding selection criteria for outpatient versus inpatient settings for these surgical procedures. The aim of this retrospective study was to compare postoperative outcomes of patients undergoing airway surgery in outpatient and inpatient settings based on length of stay at the facility. Read More

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Multidimensional scale for child sexual abuse (MSCSA): Development and psychometric properties.

Asian J Psychiatr 2021 Apr 8;60:102643. Epub 2021 Apr 8.

Department of Psychiatry, All India Institute of Medical Sciences (AIIMS), New Delhi, India. Electronic address:

Background: In recognition to the rising incidences of child sexual abuse in India, various challenges of existing trauma measures and absence of indigenous efforts at development of comprehensive impact assessment scale, present study was conceptualized.

Objective: To develop and establish psychometric properties of Multidimensional Scale for Children with Sexual Abuse.

Participants And Settings: Outpatient department of government hospitals, non-governmental organizations and child care institutes were primary data setting from which a total of 457 participants were sampled. Read More

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Cost and clinical outcomes of postoperative intensive care unit versus general floor management in head and neck free flap reconstructive surgery patients.

Am J Otolaryngol 2021 Apr 12;42(5):103029. Epub 2021 Apr 12.

Department of Otolaryngology- Head and Neck Surgery, Mayo Clinic, 200 First St. SW, Rochester, MN 55905, USA. Electronic address:

Purpose: To compare clinical, surgical, and cost outcomes in patients undergoing head and neck free-flap reconstructive surgery in the setting of postoperative intensive care unit (ICU) against general floor management.

Methods: Retrospective analysis of head and neck free-flap reconstructive surgery patients at a single tertiary academic medical center. Clinical data was obtained from medical records. Read More

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Acute strabismus in neurological emergencies of childhood: A retrospective, single-centre study.

Eur J Paediatr Neurol 2021 Apr 2;32:80-85. Epub 2021 Apr 2.

Pediatric Emergency Department, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy. Electronic address:

Objectives: Acute strabismus (AS) is the most common ocular motility disorder in children. In the emergency setting evaluation, the primary concern is to exclude a potentially dangerous underlying condition, requiring immediate intervention. Our first aim was to describe the epidemiology, clinical features, and underlying causes of AS in a cohort of children presenting to the emergency department (ED). Read More

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Stem-loop-primer assisted isothermal amplification enabling high-specific and ultrasensitive nucleic acid detection.

Biosens Bioelectron 2021 Apr 12;184:113239. Epub 2021 Apr 12.

Department of Clinical Laboratory, Affiliated Hospital of North Sichuan Medical College, Nanchong, 637000, PR China; Department of Laboratory Medicine, North Sichuan Medical College, Nanchong, 637000, PR China; Translational Medicine Research Center, North Sichuan Medical College, Nanchong, 637000, PR China. Electronic address:

It is highly desired to perform accurate and rapid nucleic acid detections for disease diagnosis at resource-limited setting, such as small clinics, remote areas and home. However, the challenges in sample handling, expensive equipment and complicated operation make canonical polymerase chain reaction (PCR) impossible to run the point-of-care testing (POCT). Herein we report a novel nucleic acid detection method, named stem-loop-primer assisted isothermal amplification (SPA), which specifically and sensitively amplifies target nucleic acid by using Bst DNA polymerase, a pair of canonical PCR primers and their stem-loop derivatives. Read More

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Comparison of Trendelenburg angle in vaginal, laparoscopic, and robotic uterovaginal apical prolapse repairs.

J Minim Invasive Gynecol 2021 Apr 12. Epub 2021 Apr 12.

Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA. Electronic address:

Study Objective: To compare the Trendelenburg angle used in laparoscopic uterovaginal apical prolapse repairs to the angle used in vaginal and robotic uterovaginal apical prolapse repairs.

Design: Prospective, multi-center cohort study from May 2015-December 2016 SETTING: Two academic teaching hospitals PATIENTS: Sixty patients who underwent vaginal high uterosacral ligament suspension, laparoscopic sacrocolpopexy or robotic sacrocolpopexy among 6 surgeons board-certified in Female Pelvic Medicine and Reconstructive Surgery.

Interventions: Measurement of Trendelenburg angle and time spent in Trendelenburg during surgery. Read More

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Responsiveness of Routine Diagnostic Tests for Vertebral Osteomyelitis May be Influenced by the Infecting Organism.

Spine J 2021 Apr 12. Epub 2021 Apr 12.

University of Missouri Department of Orthopaedic Surgery, Columbia, MO, USA. Electronic address:

Background Context: Vertebral osteomyelitis (VO) becomes increasingly more prevalent as people age, and it is a condition seen frequently by referral center spine surgeons. It can take as long as six months for a proper diagnosis to be made. Staphylococcus aureus (S. Read More

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Evaluation of Global Alignment and Proportion Score in an Independent Database.

Spine J 2021 Apr 12. Epub 2021 Apr 12.

Department of Orthopedic Surgery, Barnes-Jewish Institute of Health, Washington University, St Louis, Missouri, USA.

Background Context: Sagittal spinopelvic alignment has been associated with patient-reported outcome measures and mechanical complication rates. Recently, it was claimed that linear numerical values of pelvic tilt and lumbar lordosis measurements may be misleading for patients that have different magnitudes of pelvic incidence. The use of "relative" measurements embedded in a weighted scoring of Global Alignment and Proportion (GAP) was proposed. Read More

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Hematopoietic Stem Cell Transplantation in T-cell and NK-cell lymphomas-Update on Recent Advances.

Transplant Cell Ther 2021 Apr 12. Epub 2021 Apr 12.

Department of Hematology-Oncology, National University Cancer Institute, Singapore; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore. Electronic address:

Mature T- and natural killer (NK)-cell non-Hodgkin lymphoma (T-cell NHL) have a poor prognosis. Data from existing retrospective and prospective studies has suggested that high-dose chemotherapy (HDT) followed by autologous hematopoietic cell transplantation (auto-HCT) may improve the survival in patients with chemosensitive disease, either in the upfront or salvage setting. Auto-HCT is currently recommended to be used as frontline consolidation in peripheral T-cell lymphoma not otherwise specified (PTCL-nos), angioimmunoblastic T-cell lymphoma (AITL), anaplastic large cell lymphoma-anaplastic lymphoma kinase (ALCL-ALK) negative, NK/T-cell (disseminated), and enteropathy-associated T-cell lymphoma (EATL). Read More

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GRADE guidelines 32: GRADE offers guidance on choosing targets of GRADE certainty of evidence ratings.

J Clin Epidemiol 2021 Apr 12. Epub 2021 Apr 12.

Department of Health Research Methods, Evidence and Impact, McMaster University, 1280 Main Street West, Hamilton, Ontario, Canada, L8S 4L8; Department of Medicine, McMaster University, 1280 Main Street West, Hamilton, Ontario, Canada, L8S 4K1.

Objective: To provide practical principles and examples to help GRADE users make optimal choices regarding their ratings of certainty of evidence using a minimally or partially contextualized approach.

Study Design And Setting: Based on the GRADE clarification of certainty of evidence in 2017, a project group within the GRADE Working Group conducted iterative discussions and presentations at GRADE Working Group meetings to refine this construct and produce practical guidance.

Results: Systematic review and health technology assessment authors need to clarify what it is in which they are rating their certainty of evidence (i. Read More

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2020 Women in Thoracic Surgery update on the status of women in cardiothoracic surgery.

Ann Thorac Surg 2021 Apr 12. Epub 2021 Apr 12.

University of Chicago, Chicago, Illinois.

Background: Women in Thoracic Surgery (WTS) has previously reported on the status of women in cardiothoracic (CT) surgery. We sought to provide a 10-year update on women in CT.

Methods: An anonymous REDCap survey link was emailed to female diplomats of the ABTS. Read More

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Adjuvant pembrolizumab versus placebo in resected stage III melanoma (EORTC 1325-MG/KEYNOTE-054): health-related quality-of-life results from a double-blind, randomised, controlled, phase 3 trial.

Lancet Oncol 2021 Apr 12. Epub 2021 Apr 12.

Princess Máxima Center, Utrecht, Netherlands; University Medical Center Utrecht, Utrecht, Netherlands.

Background: The European Organisation for Research and Treatment of Cancer (EORTC) 1325-MG/KEYNOTE-054 trial in patients with resected, high-risk stage III melanoma demonstrated improved recurrence-free survival with adjuvant pembrolizumab compared with placebo (hazard ratio 0·57 [98·4% CI 0·43-0·74]; p<0·0001). This study reports the results from the health-related quality-of-life (HRQOL) exploratory endpoint.

Methods: This double-blind, randomised, controlled, phase 3 trial was done at 123 academic centres and community hospitals across 23 countries. Read More

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Neighborhood education status drives racial disparities in clinical outcomes in PPCM.

Am Heart J 2021 Apr 12. Epub 2021 Apr 12.

Division of Cardiovascular Medicine, Perelman School of Medicine, University of Pennsylvania.

Importance: Peripartum cardiomyopathy (PPCM) disproportionately affects women of African ancestry. Additionally, clinical outcomes are worse in this subpopulation compared to White women with PPCM. The extent to which socioeconomic parameters contribute to these racial disparities is not known. Read More

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Pneumococcal vaccine implementation in the African meningitis belt countries: the emerging need for alternative strategies.

Expert Rev Vaccines 2021 Apr 15. Epub 2021 Apr 15.

Department of Paediatrics, University Hospitals of Geneva, Geneva, Switzerland.

Introduction: : Besides meningococcal disease, the African meningitis belt (AMB) region is also affected by pneumococcal disease. Most AMB countries have introduced pneumococcal conjugate vaccines (PCV) following a schedule of 3 primary doses without a booster or a catch-up campaign. PCV is expected to help control pneumococcal disease through both direct and indirect effects. Read More

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Rapid Adoption of Telemedicine Along with Emergent Use of Continuous Glucose Monitors in the Ambulatory Care of Young Persons with New-Onset Type 1 Diabetes in the Time of COVID-19: A Case Series.

Telemed J E Health 2021 Apr 15. Epub 2021 Apr 15.

Section on Clinical, Behavioral and Outcomes Research, Joslin Diabetes Center, Boston, Massachusetts, USA.

The COVID-19 pandemic has caused strain on hospital systems and potential delay in diagnosis of type 1 diabetes (T1D). Outpatient diagnosis and treatment of metabolically stable young persons with new-onset T1D have been shown to be equivalent to inpatient. We describe an approach to outpatient management of newly diagnosed T1D during the COVID-19 pandemic using an interdisciplinary team, telemedicine, and diabetes technologies including rapid implementation of continuous glucose monitoring (CGM). Read More

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Risk Factors for Intra-Abdominal Infections Caused by Carbapenemase-Producing in a Surgical Setting.

Surg Infect (Larchmt) 2021 Apr 15. Epub 2021 Apr 15.

Department of General Surgery, Hospital Universitario de La Princesa, Madrid, Spain.

The aim of this study was to identify risk factors for acquisition of intra-abdominal infections (IAI) caused by carbapenemase-producing Enterobacteriaceae (CPE) in surgical patients. A matched case-control study was performed. We included all cases with CPE-related IAI acquired during admission to a general surgery department from January 2013 to December 2018, and they were matched with control subjects with IAI caused by non-resistant bacteria (ratio 1:3). Read More

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Viral sequencing reveals US healthcare personnel rarely become infected with SARS-CoV-2 through patient contact.

Clin Infect Dis 2021 Apr 15. Epub 2021 Apr 15.

Department of Pathobiological Sciences, University of Wisconsin-Madison, Madison, WI, United States of America.

Background: Healthcare personnel (HCP) are at increased risk of infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We posit current infection control guidelines generally protect HCP from SARS-CoV-2 infection in a healthcare setting.

Methods: In this retrospective case series, we use viral genomics to investigate the likely source of SARS-CoV-2 infection in HCP at a major academic medical institution in the Upper Midwest of the United States between 25 March - 27 December, 2020. Read More

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Predictors of adverse outcomes using a multidimensional nursing assessment in an Italian community hospital.

PLoS One 2021 15;16(4):e0249630. Epub 2021 Apr 15.

Section of Hygiene and Public Health, Università Politecnica delle Marche, Ancona, Italy.

Background: There is growing evidence about the role of nurses in patient outcomes in several healthcare settings. However, there is still a lack of evidence about the transitional care setting. We aimed to assess the association between patient characteristics identified in a multidimensional nursing assessment and outcomes of mortality and acute hospitalization during community hospital stay. Read More

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Examining the mental health outcomes of school-based peer-led interventions on young people: A scoping review of range and a systematic review of effectiveness.

PLoS One 2021 15;16(4):e0249553. Epub 2021 Apr 15.

Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, United Kingdom.

Schools worldwide have implemented many different peer-led interventions with mixed results, but the evidence base on their effectiveness as mental health interventions remains limited. This study combines a scoping review and systematic review to map the variations of peer-led interventions in schools and to evaluate the quality of the existing evidence base. This scoping review and systematic review evaluated the existing literature across 11 academic databases. Read More

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Intestinal endometriotic nodules with a length greater than 2.25 cm and affecting more than 27% of the circumference are more likely to undergo segmental resection, rather than linear nodulectomy.

PLoS One 2021 15;16(4):e0247654. Epub 2021 Apr 15.

Department of Obstetrics and Gynecology of Santa Casa de de Misericórdia São Paulo, Sector of Gynecological Endoscopy and Endometriosis at Santa Casa de São Paulo, São Paulo, São Paulo, Brazil.

Study Objective: To analyze the efficacy of intestinal ultrasonography with bowel preparation (TVUSBP) for endometriosis mapping in evaluating intestinal endometriosis to choose the surgical technique (segmental resection or linear nodulectomy) for treatment.

Design: Cross-sectional observational study.

Setting: University Hospital-Center for Advanced Endoscopic Gynecologic Surgery from April 2010 to November 2014. Read More

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Advantages of a New Low-Cost Negative Pressure Wound Therapy Using the "Turtle VAC": A Case Series.

JBJS Case Connect 2021 Apr 15;11(2). Epub 2021 Apr 15.

Department of Orthopaedic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.

Case: We present a clinical case and technique guide demonstrating the use and effectiveness of a novel, low-cost negative pressure wound therapy (NPWT) device to achieve soft-tissue coverage in a 34-year-old patient with failed rotational flap and Masquelet technique on infected tibial nonunion. Local debridement was executed, NPWT initiated, and treatment culminated with complete wound healing.

Conclusion: The "Turtle VAC" offers an effective low-cost alternative to commercially vacuum-assisted closure systems for post-traumatic wounds in low-resource setting of Haiti. Read More

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Consensus for Treatment of Metastatic Castration-Sensitive Prostate Cancer: Report From the First Global Prostate Cancer Consensus Conference for Developing Countries (PCCCDC).

JCO Glob Oncol 2021 Apr;7:550-558

Oncology Institute of Southern Switzerland (IOSI), Bellinzona and Università della Svizzera Italiana, Lugano, Switzerland.

Purpose: International guideline recommendations may not always be extrapolated to developing countries where access to resources is limited. In metastatic castration-sensitive prostate cancer (mCSPC), there have been successful drug and imaging advancements that were addressed in the Prostate Cancer Consensus Conference for Developing Countries for best-practice and limited-resource scenarios.

Methods: A total of 24 out of 300 questions addressed staging, treatment, and follow-up for patients with mCSPC both in best-practice settings and resource-limited settings. Read More

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Human amniotic membrane: an improvement in the treatment of Medication-related osteonecrosis of the jaw (MRONJ)? A case-control study.

Cell Tissue Bank 2021 Apr 15. Epub 2021 Apr 15.

Unit of Oral and Maxillofacial Surgery, Ca Foncello Hospital, 31100, Treviso, Italy.

The aim of this article is to report the results obtained by the use of HAM in surgical wound healing and the reduction of relapse in patients affected by Medication-related osteonecrosis of the jaw (MRONJ).The study involved patients with the diagnosis of MRONJ, surgically treated between October 2016 and April 2019, in a case-control setting. Enrolled patients were randomly divided into 2 groups. Read More

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Does methotrexate have no beneficial effect in reducing flares in the treatment of polymyalgia rheumatica patients?

Rheumatol Int 2021 Apr 15. Epub 2021 Apr 15.

Systematic Review Workshop Peer Support Group (SRWS-PSG), Osaka, Japan.

We read the article by Marsman et al. regarding the efficacy of methotrexate (MTX) in the treatment of polymyalgia rheumatica (PMR) with great interest. This study added new insights regarding the use of MTX in a real-world clinical setting and its effect on the incidence rates of flares. Read More

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Radiation dose reduction with the wide-volume scan mode for interstitial lung diseases.

Eur Radiol 2021 Apr 15. Epub 2021 Apr 15.

Department of Radiology, Bichat Claude-Bernard Hospital, APHP, 46 rue Henri Huchard, F-75018, Paris, France.

Objectives: The wide-volume mode, available on wide-area detector row CTs, has the advantage of reducing exposure time and radiation dose. It is infrequently used for lung diseases. The purpose of this study is to compare image quality and radiation dose of wide-volume chest CT to those of standard helical CT in the setting of interstitial lung diseases. Read More

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Strategies to optimize a pediatric magnetic resonance imaging service.

Pediatr Radiol 2021 Apr 15. Epub 2021 Apr 15.

Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St., Ellison 237, Boston, MA, 02114, USA.

A pediatric MRI service is a vital component of a successful radiology department. Building an efficient and effective pediatric MRI service is a multifaceted process that requires detailed planning for considerations related to finance, operations, quality and safety, and process improvement. These are compounded by the unique challenges of caring for pediatric patients, particularly in the setting of the recent coronavirus disease 2019 (COVID-19) pandemic. Read More

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Basics of magnetic resonance imaging and quantitative parameters T1, T2, T2*, T1rho and diffusion-weighted imaging.

Suraj D Serai

Pediatr Radiol 2021 Apr 15. Epub 2021 Apr 15.

Department of Radiology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd., Philadelphia, PA, 19104, USA.

Magnetic resonance imaging is widely available and accepted as the imaging method of choice for many pediatric body imaging applications. Traditionally, it has been used in a qualitative way, where the images are reported non-numerically by radiologists. But now MRI machines have built-in post-processing software connected to the scanner and the database of MR images. Read More

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Bibliometric Analysis of Neurology Articles Published in General Medicine Journals.

JAMA Netw Open 2021 Apr 1;4(4):e215840. Epub 2021 Apr 1.

Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada.

Importance: A significant portion of neurology literature is published in general medicine journals. Despite this, a detailed examination of publication patterns of neurology articles in these journals has not yet been carried out.

Objective: To examine the publication patterns of neurology articles in general medicine journals during a 10-year period using a bibliometric approach. Read More

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