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Occult Hepatocellular Carcinoma Associated with Transjugular Intrahepatic Portosystemic Shunts in Liver Transplant Recipients.

Liver Transpl 2021 Apr 14. Epub 2021 Apr 14.

Hospital of the University of Pennsylvania, Department of Surgery, Philadelphia, PA, USA.

Introduction: Transplant eligibility for hepatocellular carcinoma (HCC) is determined by the imaging identification of tumor burden within Milan criteria. Transjugular intrahepatic portosystemic shunts (TIPS) reduce portal hypertension but may impact HCC visualization. It was hypothesized that the presence of pre-transplant TIPS would correlate with occult HCC and reduced survival. Read More

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Clinical Profile and Mutations Associated with Multiple Endocrine Neoplasia-Type1 (MEN1) and Their First-Degree Relatives at Risk of Developing MEN1: A Prospective Study.

Horm Metab Res 2021 Apr 14;53(4):245-256. Epub 2021 Apr 14.

Department of Endocrinology, Diabetes and Metabolism, Christian Medical College, Vellore, Tamil Nadu, India.

Multiple Endocrine Neoplasia type-1 (MEN1) is an autosomal dominant disorder with a combined occurrence of tumours of parathyroid glands, pancreatic islets, and anterior pituitary. About 90% of these patients carry mutations in the MEN1 gene, though the spectrum is not well defined in India. Forty clinically suspected cases of MEN1 were enrolled prospectively over six years; 32 patients (23 index-cases and nine affected relatives) with≥2 classical endocrine tumours of MEN1 were considered definite, and eight were categorised as 'MEN1-like'. Read More

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Withdrawal method inquiries and user experiences: an analysis of content posted on four gendered forums on Reddit.

Contraception 2021 Apr 11. Epub 2021 Apr 11.

Section of Family Planning, Department of Obstetrics and Gynecology, Keck School of Medicine of the University of Southern California. Electronic address:

Objectives: Limited research and guidance on the use of "withdrawal" or coitus interruptus for contraception lead to inconsistent or even inaccurate physician recommendations regarding its use. Consequently, patients rely on online communities to learn about this commonly used contraceptive method. To identify knowledge gaps and concerns between men and women, as well as explore how they use withdrawal, we examined withdrawal-related posts on the popular internet discussion forum, Reddit. Read More

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Development and Validation of a Clinical-Genetic Risk Score to Predict Hepatic Encephalopathy in Patients With Liver Cirrhosis.

Am J Gastroenterol 2021 Mar 2. Epub 2021 Mar 2.

SeLiver Group at Institute of Biomedicine of Seville (IBiS), Virgen del Rocio University Hospital/CSIC/University of Seville, Seville, Spain; CIBERehd, Instituto de Salud Carlos III, Madrid, Spain; UCM Digestive Diseases, Virgen del Rocío University Hospital, Seville, Spain; Department of Immunology, Hospital Universitario Virgen del Rocío, Seville, Spain; IIS Isabial, Hospital Universitario de Alicante, Alicante, Spain; Department of Clinical Medicine, Miguel Hernández University, Alicante, Spain; Department of Gastroenterology, Hospital de la Santa Creu y Sant Pau, Barcelona, Spain.

Introduction: We aimed to define the impact of the genetic background on overt hepatic encephalopathy (HE) in patients with liver cirrhosis by developing a combined clinical-genetic risk score.

Methods: Patients suffering from liver cirrhosis from the outpatient clinics of 4 hospitals (n = 600) were included and followed up for at least 5 years until HE bouts, liver transplant, or death. Patients were genotyped for 60 candidate single nucleotide polymorphisms together with the microsatellite in the promoter region of the gene GLS. Read More

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Outcomes, Time-Trends, and Factors Associated With Ancillary Study Use for the Determination of Brain Death.

Crit Care Med 2021 Apr 12. Epub 2021 Apr 12.

Department of Neurology, Neurological Institute, Cleveland Clinic, Cleveland, OH. Division of Neurocritical Care, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, OH. Department of Neurointensive Care, Cerebrovascular Center, Cleveland Clinic, Cleveland, OH. Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA. Department of Neurology, Boston University Medical Center, Boston, MA. Division of Neuroscience Critical Care, Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD. Division of Neuroscience Critical Care, Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD. Division of Neuroscience Critical Care, Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.

Objectives: Brain death determination often requires ancillary studies when clinical determination cannot be fully or safely completed. We aimed to analyze the results of ancillary studies, the factors associated with ancillary study performance, and the changes over time in number of studies performed at an academic health system.

Design: Retrospective cohort. Read More

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[Urgent-start PD: a viable approach].

G Ital Nefrol 2021 Apr 14;38(2). Epub 2021 Apr 14.

UOC di Nefrologia, Dialisi e Trapianti di Rene, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italia; Scuola di Specializzazione in Nefrologia, Università degli Studi di Milano, Milano, Italia.

Despite the many potential benefits of peritoneal dialysis (PD), the percentage of dialysis patients treated with PD is around 10% worldwide. Up to 70% of the subjects who progress to end-stage renal disease (ESRD) start dialysis without a well-defined therapy plan. Most of these patients are unaware of having chronic kidney disease, while others with stable CKD incur in unpredictable and acute worsening of kidney function. Read More

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Outcome of pituitary hormone deficits after surgical treatment of nonfunctioning pituitary macroadenomas.

Endocrine 2021 Apr 14. Epub 2021 Apr 14.

Department of Endocrinology and Nutrition, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium.

Objectives: Nonfunctionning pituitary macroadenomas (NFPMA) are benign tumors that cause symptoms of mass effects including hypopituitarism. Their primary treatment is transsphenoidal surgery. We aimed to determine the outcome of pituitary hormone deficits after surgical treatment of NFPMA and to identify factors predicting hormonal recovery. Read More

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Immune Status in Merkel Cell Carcinoma: Relationships With Clinical Factors and Independent Prognostic Value.

Ann Surg Oncol 2021 Apr 14. Epub 2021 Apr 14.

Department of Radiation Oncology, University of Louisville School of Medicine, Louisville, KY, USA.

Background: Immunosuppression (IS) currently is not considered in staging for Merkel cell carcinoma (MCC). An analysis of the National Cancer Database (NCDB) was performed to investigate immune status as an independent predictor of overall survival (OS) for patients with MCC and to describe the relationship between immune status and other prognostic factors.

Methods: The NCDB was queried for patients with a diagnosis of MCC from 2010 to 2016 who had known immune status. Read More

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Evolving changes in mortality of 13,301 critically ill adult patients with COVID-19 over 8 months.

Intensive Care Med 2021 Apr 14. Epub 2021 Apr 14.

D'Or Institute for Research and Education (IDOR), Rio de Janeiro, RJ, Brazil.

Purpose: Clinical characteristics and management of COVID-19 patients have evolved during the pandemic, potentially changing their outcomes. We analyzed the associations of changes in mortality rates with clinical profiles and respiratory support strategies in COVID-19 critically ill patients.

Methods: A multicenter cohort of RT-PCR-confirmed COVID-19 patients admitted at 126 Brazilian intensive care units between February 27 and October 28, 2020. Read More

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A community study of the risk for obstructive sleep apnea and respiratory inflammation in an adult Chinese population.

Postgrad Med 2021 Apr 15:1-10. Epub 2021 Apr 15.

The Department of Respiratory and Critical Care Medicine, Peking University First Hospital, Beijing, China.

: We aimed to investigate the relationship between obstructive sleep apnea (OSA) risk and respiratory inflammation evaluated by the exhaled breath condensate (EBC) interleukin-6 (IL-6) and plasma surfactant protein-D (SP-D), based on the Berlin questionnaire (BQ) screening values in an adult, urban community in Beijing, China.: Volunteers aged >40 years were recruited from the Shichahai community of central Beijing (Registration number: NCT04832711). Their general information and disease history were recorded. Read More

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Anti-Ro52/TRIM21 is independently associated with pulmonary arterial hypertension and mortality in a cohort of systemic sclerosis patients.

Scand J Rheumatol 2021 Apr 14:1-6. Epub 2021 Apr 14.

Departments of Rheumatology and Immunology, Flinders Medical Centre, Bedford Park, Australia.

: We undertook a comprehensive cross-sectional analysis of a multicentred Australian cohort of systemic sclerosis (SSc) patients to evaluate the associations of anti-Ro52/TRIM21 with SSc pulmonary involvement.: The study included 596 patients from the Australian Scleroderma Cohort Study database whose anti-Ro52/TRIM21 status was known. Anti-Ro52/TRIM21 was measured via line immunoassay. Read More

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Predictive value of incidental right ventricular abnormalities identified on SPECT for mortality and pulmonary hypertension.

J Nucl Cardiol 2021 Apr 13. Epub 2021 Apr 13.

Division of Cardiovascular Diseases, University of Cincinnati College of Medicine, Cincinnati, OH, USA.

Background: The clinical significance of incidentally found RV abnormalities on low-risk SPECT studies is not well-defined. The objective of this study was to determine the predictive value of incidental right ventricular (RV) abnormalities identified on single photon emission computed tomography (SPECT) scans for mortality and pulmonary hypertension (PH).

Methods: We retrospectively analyzed all low-risk SPECT studies in patients without known coronary artery or pulmonary vascular disease, performed at our institution, from 2007-2020. Read More

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FLAIR vascular hyperintensities and functional outcome in nonagenarians with anterior circulation large-vessel ischemic stroke treated with endovascular thrombectomy.

Eur Radiol 2021 Apr 14. Epub 2021 Apr 14.

Department of Neuroradiology, Hôpital Gui de Chauliac, Montpellier University Medical Center, 80, Avenue Augustin Fliche, Montpellier, France.

Objectives: To establish whether imaging assessments of irreversibly injured ischemic core and potentially salvageable penumbral volumes and collateral circulation were associated with functional outcome in nonagenarians (90 years or older) undergoing endovascular thrombectomy (EVT).

Methods: Data from a prospectively maintained institutional registry of consecutive stroke patients treated with EVT from January 2012 to December 2018 were retrospectively analyzed. Functional outcome was evaluated with the modified Rankin scale (mRS) at 3 months. Read More

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The "drive to eat" hypothesis: energy expenditure and fat-free mass but not adiposity are associated with milk intake and energy intake in 12 week infants.

Am J Clin Nutr 2021 Apr 13. Epub 2021 Apr 13.

Appetite Control and Energy Balance Research Group, School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, United Kingdom.

Background: Recent work has challenged the long-held assumption that appetite functions to maintain stable body mass and fat mass (FM), suggesting instead that appetite matches food intake to energy expenditure and its correlate, fat-free mass (FFM). Whether this scenario applies to young infants, in chronic positive energy balance, remains unknown.

Objectives: To test associations of components of energy expenditure and body composition with milk intake (MI) and energy intake (EI) in 12-week infants, by reanalyzing published cross-sectional data. Read More

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Orthostatic Hypertension and Hypotension and Outcomes in CKD: The CRIC (Chronic Renal Insufficiency Cohort) Study.

Kidney Med 2021 Mar-Apr;3(2):206-215.e1. Epub 2021 Feb 6.

School of Medicine, Case Western Reserve University, Cleveland, OH.

Rationale & Objective: There are limited data about the prevalence and prognostic significance of orthostatic hypo- and hypertension in patients with chronic kidney disease. The objective of this study is to determine the prevalence of orthostatic hypo- and hypertension in a cohort of patients with chronic kidney disease and examine their association with clinical outcomes.

Study Design: Prospective cohort study: Chronic Renal Insufficiency Cohort (CRIC) Study. Read More

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February 2021

Comparison of CECT and CT perfusion in differentiating benign from malignant neck nodes in oral cavity cancers.

Eur J Radiol Open 2021 26;8:100339. Epub 2021 Mar 26.

Department of Pathology, Maulana Azad Medical College & Associated Hospitals, New Delhi, Delhi, India.

Aim: The objective of the study was to assess the performance of CT Perfusion in comparison to CECT for preoperative detection of metastases to lymph nodes in squamous cell cancers of oral cavity.

Methods: Twenty-five patients with squamous cell cancers of oral cavity underwent CECT and CTP. Two radiologists evaluated CECT and CTP parameters independently. Read More

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Risk factors for lymph node metastasis of the left recurrent laryngeal nerve in patients with esophageal squamous cell carcinoma.

Ann Transl Med 2021 Mar;9(6):476

Department of Minimally Invasive Esophagus Surgery, Key Laboratory of Prevention and Therapy, National Clinical Research Center of Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China.

Background: The factors for left recurrent laryngeal nerve (RLN) lymph node (LN) metastasis have important guiding significance for whether the left RLN LNs should be dissected in patients with esophageal squamous cell carcinoma (ESCC), but few studies are currently available. To analyze the risk factors of LN metastasis of the left RLN area and to assess which LNs should be dissected in ESCC.

Methods: This was a retrospective study of patients who underwent McKeown minimally invasive esophagectomy (MIE) (no neoadjuvant therapy) at Tianjin Medical University Cancer Institute and Hospital (from January 2016 to December 2019). Read More

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Improvement of pathological staging system for neuroendocrine tumors of the lung.

Ann Transl Med 2021 Mar;9(6):447

Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University, Shanghai, China.

Background: Currently, the tumor, node, and metastasis (TNM) staging system has a limited value in prognostic stratification for neuroendocrine tumors of the lung (NETL). A specific pathological staging system was therefore explored.

Methods: Two cohorts were assessed: the training cohort was composed of surgically treated patients from the Surveillance, Epidemiologic, and End Results (SEER) database [2004-2015]; the Shanghai cohort included Shanghai resident patients treated at Shanghai Pulmonary Hospital [2009-2018]. Read More

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Are We Overradiating Patients with Irritable Bowel Syndrome?

Inflamm Intest Dis 2021 Feb 9;6(1):32-37. Epub 2020 Dec 9.

Internal Medicine, West Virginia University, Morgantown, West Virginia, USA.

Introduction: Protracted exposures to small doses of radiation, even cumulative effective doses (CED) as low as 50-100 mSv, may increase the risk for malignancy. Medical radiation exposure has not been rigorously examined for patients with irritable bowel syndrome (IBS). We examined medical radiation exposure in patients with IBS at a tertiary care center in the USA. Read More

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February 2021

Abdominal Surgery in Crohn's Disease: Risk Factors for Complications.

Inflamm Intest Dis 2021 Feb 26;6(1):18-24. Epub 2020 Oct 26.

Department of Colon and Rectal Surgery, Hospital das Clínicas, University of São Paulo Medical School, São Paulo, Brazil.

Introduction: Abdominal surgery in patients with Crohn's disease (CD) is challenging, especially in the biologic era. The aim of this study was to evaluate factors associated with increased risk for postoperative complications in CD.

Methods: A retrospective study was conducted with consecutive patients who underwent abdominal surgery for CD from January 2012 to January 2018. Read More

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February 2021

Inflammatory bowel disease and risk of urinary cancers: a systematic review and pooled analysis of population-based studies.

Transl Androl Urol 2021 Mar;10(3):1332-1341

Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China.

Background: The aim of this study is to elucidate the risk of urologic cancers in patients with Crohn's disease (CD) and ulcerative colitis (UC).

Methods: Electronic databases including PubMed, the Cochrane Library, Embase and Web of Science, and manual retrieval were conducted from inception to June 2020. Two reviewers independently searched the above databases and selected the studies using prespecified standardized criteria. Read More

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Associations between neighbourhood street pattern, neighbourhood socioeconomic status and sleep in adults.

Prev Med Rep 2021 Jun 11;22:101345. Epub 2021 Mar 11.

Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Canada.

Sleep duration is a risk factor for poor health and all-cause mortality. Evidence suggests that neighbourhood characteristics such as built environment and socioeconomic status (SES) may affect sleep duration in adults. This study examined the relationship between neighbourhood built environment (i. Read More

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Circulating IL-37 levels are elevated in patients with hypertension.

Exp Ther Med 2021 Jun 26;21(6):558. Epub 2021 Mar 26.

Department of Cardiology, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi 530021, P.R. China.

Interleukin-37 (IL-37) has been reported to be closely linked to vascular diseases, including atherosclerosis and aortic calcification. The present study aimed to assess the expression levels of IL-37 in patients with hypertension. Blood samples were collected from control subjects (n=20) and patients with hypertension (n=45). Read More

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Elevated plasma fatty acid-binding protein 3 is related to prolonged corrected QT interval and reduced ejection fraction in patients with stable angina.

Int J Med Sci 2021 11;18(9):2076-2085. Epub 2021 Mar 11.

Department of Emergency, E-Da Hospital, Kaohsiung, 82445 Taiwan.

Higher concentrations of plasma fatty acid-binding protein 3 (FABP3) play a role in the development of cardiovascular events, cerebrovascular deaths, and acute heart failure. However, little is known about the relationship between plasma FABP3 level and prolonged QT interval and reduced ejection fraction (EF). This study aimed to investigate the relationship between plasma FABP3 level and prolonged corrected QT (QTc) interval and reduced EF in patients with stable angina. Read More

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Hemogram as marker of in-hospital mortality in COVID-19.

J Investig Med 2021 Apr 13. Epub 2021 Apr 13.

Fundación de Investigación, HM Hospitales, Madrid, Spain.

The clinical impact of COVID-19 disease calls for the identification of routine variables to identify patients at increased risk of death. Current understanding of moderate-to-severe COVID-19 pathophysiology points toward an underlying cytokine release driving a hyperinflammatory and procoagulant state. In this scenario, white blood cells and platelets play a direct role as effectors of such inflammation and thrombotic response. Read More

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Non-functional pancreatic neuroendocrine tumours: ATRX/DAXX and alternative lengthening of telomeres (ALT) are prognostically independent from ARX/PDX1 expression and tumour size.

Gut 2021 Apr 13. Epub 2021 Apr 13.

Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA

Objective: Recent studies have found aristaless-related homeobox gene (ARX)/pancreatic and duodenal homeobox 1 (PDX1), alpha-thalassemia/mental retardation X-linked (ATRX)/death domain-associated protein (DAXX) and alternative lengthening of telomeres (ALT) to be promising prognostic biomarkers for non-functional pancreatic neuroendocrine tumours (NF-PanNETs). However, they have not been comprehensively evaluated, especially among small NF-PanNETs (≤2.0 cm). Read More

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Impact of hospital volume on resource use after elective cardiac surgery: A contemporary analysis.

Surgery 2021 Apr 10. Epub 2021 Apr 10.

Cardiovascular Outcomes Research Laboratories, Division of Cardiac Surgery, Department of Surgery, University of California, Los Angeles, Los Angeles, CA. Electronic address:

Background: Institutional experience has been associated with reduced mortality after coronary artery bypass grafting and valve operations. Using a contemporary, national cohort, we examined the impact of hospital volume on hospitalization costs and postdischarge resource utilization after these operations.

Methods: Adults undergoing elective coronary artery bypass grafting or valve operations were identified in the 2016 to 2017 Nationwide Readmissions Database. Read More

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The contribution of depressive 'disorder characteristics' to determinations of prognosis for adults with depression: an individual patient data meta-analysis.

Psychol Med 2021 Apr 14:1-14. Epub 2021 Apr 14.

Centre for Outcomes Research and Effectiveness (CORE), Research Department of Clinical, Educational & Health Psychology, University College London, LondonWC1E 7HB, UK.

Background: This study aimed to investigate general factors associated with prognosis regardless of the type of treatment received, for adults with depression in primary care.

Methods: We searched Medline, Embase, PsycINFO and Cochrane Central (inception to 12/01/2020) for RCTs that included the most commonly used comprehensive measure of depressive and anxiety disorder symptoms and diagnoses, in primary care depression RCTs (the Revised Clinical Interview Schedule: CIS-R). Two-stage random-effects meta-analyses were conducted. Read More

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Association of Adult Socioeconomic Status with Body Mass Index: A Within- and Between-Twin Study.

Twin Res Hum Genet 2021 Apr 14:1-7. Epub 2021 Apr 14.

Genetic Technologies Ltd., Melbourne, Victoria, Australia.

Adult socioeconomic status (SES) has been consistently associated with body mass index (BMI), but it is unclear whether it is linked to BMI independently of childhood SES or other potentially confounding factors. Twin studies can address this issue by implicitly controlling for childhood SES and unmeasured confounders. This co-twin control study used cross-sectional data from Twins Research Australia's Health and Lifestyle Questionnaire (N = 1918 twin pairs). Read More

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Quantitative assessment of the association between erector spinae muscle and in-hospital mortality in elderly patients with pulmonary tuberculosis.

BMC Res Notes 2021 Apr 13;14(1):134. Epub 2021 Apr 13.

Department of Respiratory Medicine and Infectious Diseases, Oita University Faculty of Medicine, 1-1 Idaigaoka, Hasama-machi, Yufu, Oita, 879-5593, Japan.

Objective: Skeletal muscle size is considered a predictor of prognosis in patients with respiratory diseases including Mycobacterium avium complex lung disease. However, no research focused on its impact on prognosis in patients with pulmonary tuberculosis (TB). Thus, this study aimed to assess the association between erector spinae muscle (ESM) size and in-hospital mortality among patients with pulmonary TB. Read More

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