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Real-World Experience with Artificial Intelligence-Based Triage in Transferred Large Vessel Occlusion Stroke Patients.

Cerebrovasc Dis 2021 Apr 13:1-6. Epub 2021 Apr 13.

Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York, New York, USA.

Background And Purpose: Randomized controlled trials have demonstrated the importance of time to endovascular therapy (EVT) in clinical outcomes in large vessel occlusion (LVO) acute ischemic stroke. Delays to treatment are particularly prevalent when patients require a transfer from hospitals without EVT capability onsite. A computer-aided triage system, Viz LVO, has the potential to streamline workflows. Read More

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Automatic classification of idiopathic Parkinson's disease and atypical parkinsonian syndromes combining [C]raclopride PET uptake and MRI grey matter morphometry.

J Neural Eng 2021 Apr 13. Epub 2021 Apr 13.

Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), ICNAS Polo 3, Coimbra, 3000-548, PORTUGAL.

Objective: To explore the viability of developing a computer-aided diagnostic system for Parkinsonian syndromes using dynamic [11C]raclopride PET and T1-weighted MRI data.

Approach: The biological heterogeneity of Parkinsonian syndromes renders their statistical classification a challenge. The unique combination of structural and molecular imaging data allowed different classifier designs to be tested. Read More

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Association of Psychosocial Factors and Hospital Complications with Risk for Readmission After Trauma.

J Surg Res 2021 Apr 10;264:334-345. Epub 2021 Apr 10.

Harborview Injury Prevention and Research Center, University of Washington, Seattle, Washington; Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, Washington; Division of General Pediatrics, Department of Pediatrics, University of Washington, Seattle, Washington.

Background: Unplanned hospital readmissions are associated with morbidity and high cost. Existing literature on readmission after trauma has focused on how injury characteristics are associated with readmission. We aimed to evaluate how psychosocial determinants of health and complications of hospitalization combined with injury characteristics affect risk of readmission after trauma. Read More

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A Novel Color-Coded Liver Metastasis Mouse Model to Distinguish Tumor and Adjacent Liver Segment.

J Surg Res 2021 Apr 10;264:327-333. Epub 2021 Apr 10.

Department of Surgery, University of California San Diego, San Diego, California; Department of Surgery, VA San Diego Healthcare System, San Diego, California. Electronic address:

Background: It is difficult to distinguish between a tumor and its liver segment with traditional use of indocyanine green (ICG) alone. In the present study, a method was used to limit ICG to the liver segment adjacent to a tumor. A spectrally-distinct fluorescently-labeled tumor-specific antibody against human carcinoembryonic antigen-related cell-adhesion molecules was used to label the metastatic tumor in a patient-derived orthotopic xenograft mouse model to enable color-coded visualization and distinction of a colon-cancer liver metastases and its adjacent liver segment. Read More

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Palliation of malignant esophageal obstruction using an anti-migration self-expandable metal stent: results of a prospective multicenter study.

Clin Res Hepatol Gastroenterol 2021 Apr 10:101683. Epub 2021 Apr 10.

Department of Gastroenterology, General Hospital, Sanremo (IM), Italy.

Background: Self-expanding metal stents (SEMS) placement is primarily indicated to palliate dysphagia for patients with expected short-term survival. We aimed to assess the migration rate and other stent-related adverse events (AEs) of a fully covered SEMS with an anti-migration system (FCSEMS-AMS) for palliation of malignant dysphagia.

Methods: This is a prospective study including patients with inoperable esophageal cancer that received a FCSEMS-AMS (Taewoong, Niti-S Beta), in five tertiary-care endoscopic centers from January 2014 to February 2016. Read More

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Clinical Features and Outcomes in Patients with Cardiogenic Shock Complicating Acute Myocardial Infarction: Early versus Recent Experience with Impella.

Am Heart J 2021 Apr 10. Epub 2021 Apr 10.

Division of Cardiology, Department of Internal Medicine, St John Hospital and Medical Center, Detroit, MI, USA.

Objectives: To compare clinical features and outcomes in patients with acute myocardial infarction complicated by cardiogenic shock (AMICS) treated in the early experience with Impella percutaneous ventricular assist device and patients treated recently.

Background: Since pre-market approval (PMA) of Impella device as treatment for AMICS, use of the device has grown considerably.

Methods: We retrospectively analyzed 649 AMICS patients treated with perioperative Impella, with 291 patients treated from 2008 to 2014 comprising the early experience cohort and 358 patients treated from 2017 to 2019 comprising the recent experience cohort. Read More

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Copanlisib plus rituximab versus placebo plus rituximab in patients with relapsed indolent non-Hodgkin lymphoma (CHRONOS-3): a double-blind, randomised, placebo-controlled, phase 3 trial.

Lancet Oncol 2021 Apr 9. Epub 2021 Apr 9.

IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli", and Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna, Italy.

Background: Copanlisib, an intravenous pan-class I PI3K inhibitor, showed efficacy and safety as monotherapy in patients with relapsed or refractory indolent non-Hodgkin lymphoma who had received at least two therapies. The CHRONOS-3 study aimed to assess the efficacy and safety of copanlisib plus rituximab in patients with relapsed indolent non-Hodgkin lymphoma.

Methods: CHRONOS-3 was a multicentre, double-blind, randomised, placebo-controlled, phase 3 study in 186 academic medical centres across Asia, Australia, Europe, New Zealand, North America, Russia, South Africa, and South America. Read More

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Comparison of Vibrating Mesh and Jet Nebulizers During Noninvasive Ventilation in Acute Exacerbation of Chronic Obstructive Pulmonary Disease.

J Aerosol Med Pulm Drug Deliv 2021 Apr 13. Epub 2021 Apr 13.

Division of Respiratory Care, Department of Cardiopulmonary Sciences, Rush University Medical Center, Chicago, Illinois, USA.

Advances in aerosol technology have improved drug delivery efficiency during noninvasive ventilation (NIV). Clinical evaluation of the efficacy of aerosol therapy during NIV in the treatment of acute exacerbation of chronic obstructive pulmonary disease (COPD) is very limited. The aim of our study was to compare the efficacy of bronchodilators administered through a vibrating mesh nebulizer (VMN) and jet nebulizer (JN) during NIV in patients with acute exacerbation of COPD. Read More

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Results of the Active Middle Ear Implantation in Patients With Mixed Hearing Loss After the Middle Ear Surgery: Prospective Multicenter Study (ROMEO Study).

Clin Exp Otorhinolaryngol 2021 Apr 9. Epub 2021 Apr 9.

Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea.

Objectives: To evaluate the user satisfaction, efficacy, and safety of round window (RW) vibroplasty using the Vibrant Soundbridge (VSB) in patients with persistent mixed hearing loss after mastoidectomy.

Methods: The study included twenty-seven patients (mean age, 58.7 years; age range, 28-76 years; 11 men and 16 women) with mixed hearing loss after mastoidectomy surgery from 15 tertiary referral centers in Korea. Read More

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The Current Management of Hepatorenal Syndrome-Acute Kidney Injury in the United States and the Potential of Terlipressin.

Liver Transpl 2021 Apr 13. Epub 2021 Apr 13.

Department of Internal Medicine and Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.

Acute kidney injury in the setting of cirrhosis (hepatorenal syndrome-acute kidney injury [HRS-AKI]) is a severe and often fatal complication of end-stage liver disease. The goals of treatment are to reverse renal failure and prolong survival in critically ill patients. However, interventions have limited efficacy, and mortality rates remain high. Read More

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Mindfulness Matters: Utilization and Perceptions of Mindfulness Practices Among Athletic Trainers.

J Athl Train 2021 Apr 13. Epub 2021 Apr 13.

Appalachian State University, Boone, NC.

Context: Mindfulness practices are effective for injury/illness recovery, decreasing stress and anxiety, and strengthening emotional resilience. They are also beneficial for healthcare professionals' well-being and improved patient outcomes and safety. However, mindfulness has not been studied in athletic trainers. Read More

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Physiological effects of intraperitoneal versus subcutaneous insulin infusion in patients with diabetes mellitus type 1: A systematic review and meta-analysis.

PLoS One 2021 13;16(4):e0249611. Epub 2021 Apr 13.

Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.

The intraperitoneal route of administration accounts for less than 1% of insulin treatment regimes in patients with diabetes mellitus type 1 (DM1). Despite being used for decades, a systematic review of various physiological effects of this route of insulin administration is lacking. Thus, the aim of this systematic review was to identify the physiological effects of continuous intraperitoneal insulin infusion (CIPII) compared to those of continuous subcutaneous insulin infusion (CSII) in patients with DM1. Read More

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United States Chronic Thromboembolic Pulmonary Hypertension Registry: Protocol Design.

JMIR Res Protoc 2021 Apr 13. Epub 2021 Apr 13.

Temple University Hospital, Philadelphia, US.

Background: Background: Chronic thromboembolic pulmonary hypertension (CTEPH) is a rare sequela of acute pulmonary embolism that is treatable when recognized. Awareness of this disease has increased with recent advancements in therapeutic options, but delays in diagnosis remain common and diagnostic and treatment guidelines are often not followed. Data gathered from international registries has improved our understanding of CTEPH, but this data may not be applicable to the U. Read More

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Investigating the effects of Citrullus colocynthis on cognitive performance and anxiety-like behaviors in STZ-induced diabetic rats.

Int J Neurosci 2021 Apr 13:1-18. Epub 2021 Apr 13.

Student Research Committee, Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran.

Diabetes can impair cognitive performance and lead to dementia. Patients with type 1 diabetes mellitus (T1DM) are reported with different levels of cognitive dysfunctions in various cognitive domains ranging from general intellectual testing to specific deficits with visuospatial abilities, motor speed, writing, attention, reading, and psychomotor efficiency. The present study aimed to investigate the effect of cognitive functions. Read More

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Cochlear Implantation Following Explorative Tympanotomy in Patients With Sudden Sensorineural Hearing Loss: Surgical Features and Audiological Outcomes.

Ear Nose Throat J 2021 Apr 13:1455613211009141. Epub 2021 Apr 13.

Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, 9171Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany.

Objective: To investigate the anatomical status of the round window niche and hearing outcome of cochlear implantation (CI) after explorative tympanotomy (ExT) with sealing of the round window membrane in patients with sudden sensorineural hearing loss at a tertiary referral medical center.

Methods: Between January 1, 2007, and July 30, 2020, 1602 patients underwent CI at our department. Out of these, all patients previously treated by ExT with sealing of the round window membrane because of unilateral sudden hearing loss were included in the study. Read More

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Transcanal Endoscopic Retrograde Mastoidectomy for Cholesteatoma: A Prospective Study.

Ear Nose Throat J 2021 Apr 13:1455613211009439. Epub 2021 Apr 13.

Department of Otorhinolaryngology, 475268Patan Academy of Health Sciences, School of Medicine, Lagankhel, Lalitpur, Nepal.

Objectives: To evaluate the feasibility, morphological, and functional outcomes of endoscopic retrograde transcanal mastoidectomy.

Study Design: Prospective study.

Settings: Tertiary Referral Hospital. Read More

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A Pilot Study of a Collaborative Palliative and Oncology Care Intervention for Patients with Head and Neck Cancer.

J Palliat Med 2021 Apr 13. Epub 2021 Apr 13.

Cancer Prevention and Control Program, Fox Chase Cancer Center, Philadelphia, Pennsylvania, USA.

Palliative care improves symptoms and coping in patients with advanced cancers, but has not been evaluated for patients with curable solid malignancies. Because of the tremendous symptom burden and high rates of psychological distress in head and neck cancer (HNC), we evaluated feasibility and acceptability of a palliative care intervention in patients with HNC receiving curative-intent chemoradiation therapy (CRT). This was a prospective single-arm study in HNC patients receiving CRT at a single center in the United States. Read More

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Does successful urethral calibration rule out significant female urethral stenosis? confronting the confounder- an outcome analysis of successfully treated female urethral strictures.

Int Braz J Urol 2021 Jul-Aug;47(4):829-840

Department of Urology and Renal Transplantation, JIPMER, Puducherry, India.

Objective: The diagnosis and treatment of female urethral stricture disease (FUSD) are practiced variably due to the scarcity of data on evaluation, variable definitions, and lack of long-term surgical outcomes. FUSD is difficult to rule out solely on the basis of a successful calibration with 14F catheter. In this study, we have tried to characterize the variable clinical presentation of FUSD, the diagnostic utility of calibration, videourodynamic study(VUDS), and urethroscopy in planning surgical management. Read More

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September 2020

Comparative Efficacy and Safety of Ozanimod and Dimethyl Fumarate for Relapsing-Remitting Multiple Sclerosis Using Matching-Adjusted Indirect Comparison.

CNS Drugs 2021 Apr 13. Epub 2021 Apr 13.

Bristol Myers Squibb, Princeton, NJ, USA.

Background: Patients with multiple sclerosis (MS) experience relapses and sustained disability progression. Since 2004, the number of disease-modifying therapies (DMTs) for MS has grown substantially. As a result, patients, healthcare providers, and insurers are increasingly interested in comparative efficacy and safety evaluations to distinguish between treatment options, but head-to-head studies between DMTs are limited. Read More

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The Molecular Mechanisms of Cardiotoxicity Induced by HER2, VEGF, and Tyrosine Kinase Inhibitors: an Updated Review.

Cardiovasc Drugs Ther 2021 Apr 13. Epub 2021 Apr 13.

Department of Cardiology, The Affiliated Hospital of Qingdao University, No. 59 Haier Road, Qingdao, 266100, Shandong, China.

Aim: In recent decades, there has been a revolutionary decrease in cancer-related mortality and an increase in survival due to the introduction of novel targeted drugs. Nevertheless, drugs targeting human epidermal growth factor receptor 2 (HER-2), angiogenesis, and other tyrosine kinases also come with unexpected cardiac side effects, including heart failure, hypertension, arterial thrombosis, and arrhythmias, and have mechanisms that are unlike those of classic chemotherapeutic agents. In addition, it is challenging to address some problems, as the existing guidelines need to be more specific, and further large-scale clinical trials and experimental studies are required to confirm the benefit of administering cardioprotective agents to patients treated with targeted therapies. Read More

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Assessment of Potentially Preventable Hospital Readmissions After Major Surgery and Association With Public vs Private Health Insurance and Comorbidities.

JAMA Netw Open 2021 Apr 1;4(4):e215503. Epub 2021 Apr 1.

Department of Surgery, University of Michigan, Ann Arbor.

Importance: Rehospitalization after major surgery is common and represents a significant cost to the health care system. Little is known regarding the causes of these readmissions and the degree to which they may be preventable.

Objective: To evaluate the degree to which readmissions after major surgery are potentially preventable. Read More

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Association of Prehospital Oxygen Saturation to Inspired Oxygen Ratio With 1-, 2-, and 7-Day Mortality.

JAMA Netw Open 2021 Apr 1;4(4):e215700. Epub 2021 Apr 1.

Data Analysis Unit, Health Research Institute, Hospital de la Princesa, Madrid, Spain.

Importance: The early identification of patients at high risk of clinical deterioration represents one of the greatest challenges for emergency medical services (EMS).

Objective: To assess whether use of the ratio of prehospital oxygen saturation measured by pulse oximetry (Spo2) to fraction of inspired oxygen (Fio2) measured during initial contact by EMS with the patient (ie, the first Spo2 to Fio2 ratio) and 5 minutes before the patient's arrival at the hospital (ie, the second Spo2 to Fio2 ratio) can predict the risk of early in-hospital deterioration.

Design, Setting, And Participants: A prospective, derivation-validation prognostic cohort study of 3606 adults with acute diseases referred to 5 tertiary care hospitals in Spain was conducted between October 26, 2018, and June 30, 2020. Read More

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A call to action for new global approaches to cardiovascular disease drug solutions.

Eur Heart J 2021 Apr 13. Epub 2021 Apr 13.

Université de Lorraine, INSERM CIC 1493, INI CRCT, CHRU Nancy, France.

Whilst we continue to wrestle with the immense challenge of implementing equitable access to established evidence-based treatments, substantial gaps remain in our pharmacotherapy armament for common forms of cardiovascular disease including coronary and peripheral arterial disease, heart failure, hypertension, and arrhythmia. We need to continue to invest in the development of new approaches for the discovery, rigorous assessment, and implementation of new therapies. Currently, the time and cost to progress from lead compound/product identification to the clinic, and the success rate in getting there reduces the incentive for industry to invest, despite the enormous burden of disease and potential size of market. Read More

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Posterior Open-wedge Osteotomy and Glenoid Concavity Reconstruction Using an Implant-free, J-shaped Iliac Crest Bone Graft in Atraumatic Posterior Instability with Pathologic Glenoid Retroversion and Dysplasia: A Preliminary Report.

Clin Orthop Relat Res 2021 Apr 12. Epub 2021 Apr 12.

L. Ernstbrunner, T. Häller, M. Waltenspül MD, K. Wieser MD, C. Gerber, Department of Orthopedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.

Background: Atraumatic posterior shoulder instability in patients with pathologic glenoid retroversion and dysplasia is an unsolved problem in shoulder surgery.

Questions/purposes: In a preliminary study of a small group of patients with atraumatic posterior shoulder instability associated with glenoid retroversion ≥ 15° and glenoid dysplasia who underwent posterior open-wedge osteotomy and glenoid concavity reconstruction using an implant-free, J-shaped iliac crest bone graft, we asked: (1) What proportion of the patients had persistent apprehension? (2) What were the improvements in patient-reported shoulder scores? (3) What were the radiographic findings at short-term follow-up?

Methods: Between 2016 and 2018, we treated seven patients for atraumatic posterior shoulder instability. We performed this intervention when posterior shoulder instability symptoms were unresponsive to physiotherapy for at least 6 months and when it was associated with glenoid retroversion ≥ 15° and dysplasia of the posteroinferior glenoid. Read More

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Effectiveness of different types of skin grafting for treating venous leg ulcers: A protocol for systematic review and network meta-analysis.

Medicine (Baltimore) 2021 Apr;100(15):e25597

Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang, Jiangxi Province, China.

Background: Venous leg ulcers (VLUs) are the most common ulcer on the lower extremity, with 4% of patients over the age of 65 suffering from VLUs worldwide. As a recurrent, chronic, disabling disease, VLUs are associated with prolonged disability, substantial socioeconomic impact, and significant psychosocial morbidity. At present, Skin grating is one of the most effective treatments for non-healing ulcers. Read More

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Efficacy of cognitive behavioral therapy on mood and quality of life for patients with COVID-19: A protocol for systematic review and meta-analysis.

Medicine (Baltimore) 2021 Apr;100(15):e25512

Department of Psychiatry.

Background: There is no study that has conducted a review or meta-analysis investigating a cognitive behavioral therapy (CBT) intervention to patients with COVID19, with the aim of improving their psychological health. Therefore, in order to provide new evidence-based medical evidence for clinical treatment, we undertook a systematic review and meta-analysis to assess the effectiveness of CBT in relieving patients' psychological distress and improving quality of life during the COVID-19 epidemic.

Methods: Seven electronic databases including Web of Science, Embase, PubMed, Wanfang Data, Scopus, Science Direct, Cochrane Library will be searched in April 2021 by 2 independent reviewers. Read More

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Effects of trimetazidine in combination with bisoprolol in patients with chronic heart failure and concomitant chronic obstructive pulmonary disease: A protocol for systematic review and meta-analysis.

Medicine (Baltimore) 2021 Apr;100(15):e25491

Department of Critical Care Medicine, Yantaishan Hospital, Shandong, China.

Background: To the best of our knowledge, there is no study that has conducted a review investigating the clinical efficacy and safety of bisoprolol combined with trimetazidine on chronic heart failure (CHF) patients with chronic obstructive pulmonary disease (COPD). Therefore, in order to provide new evidence-based medical evidence for clinical treatment, we undertook a systematic review and meta-analysis to assess the effectiveness and safety of bisoprolol combined with trimetazidine on CHF patients with COPD.

Methods: Seven electronic databases including Web of Science, Embase, PubMed, Wanfang Data, Scopus, Science Direct, Cochrane Library will be searched in April 2021 by 2 independent reviewers. Read More

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Ventralis oralis anterior (Voa) deep brain stimulation plus Gamma Knife thalamotomy in an elderly patient with essential tremor: A case report.

Medicine (Baltimore) 2021 Apr;100(15):e25461

Department of Neuroscience, Graduate School.

Rationale: Deep brain stimulation (DBS) of the ventralis intermedius nucleus (Vim) provides a safe and effective therapy for medically refractory essential tremor (ET). However, DBS may be risky in elderly patients and those with ischemic brain lesions. Gamma Knife radiosurgery (GKS) is a minimally invasive procedure, but bilateral thalamotomy is dangerous. Read More

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Nonconvulsive status epilepticus manifesting as rapidly progressive dementia and infarction in the splenium of the corpus callosum: A case report.

Medicine (Baltimore) 2021 Apr;100(15):e25263

Department of Neurology, Neuroscience Center.

Rationale: Nonconvulsive status epilepticus (NCSE) is a heterogeneous disease with multiple subtypes. NCSE poses great diagnostic and therapeutic challenges due to the lack of typical symptoms. Here, we report a case of NCSE manifesting as rapidly progressive dementia (RPD) and infarction in the splenium of the corpus callosum. Read More

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Myocardial strain features by 2D-STE during the course of fulminant myocarditis: Correlation with characteristics by CMR and clinical implications.

Medicine (Baltimore) 2021 Apr;100(15):e25050

Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan.

Abstract: Myocardial strain analysis by 2D speckle tracking echocardiography could determine the left ventricular function. Our purpose is to investigate the global longitudinal strain (GLS) changes during the course of fulminant myocarditis (FM) and evaluate their correlation with cardiac magnetic resonance (CMR).Patients with clinical diagnosis of FM from June 30, 2017 to June 30, 2019 were screened prospectively. Read More

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