736,364 results match your criteria internal medicine


Disconnected pancreatic duct syndrome and outcomes of endoscopic ultrasound-guided treatment of pancreatic fluid collections: A systematic review and meta-analysis.

Dig Endosc 2021 Sep 20. Epub 2021 Sep 20.

Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.

Background: Disconnected pancreatic duct syndrome (DPDS) frequently occurs in patients with acute necrotizing pancreatitis and resultant pancreatic fluid collection (PFC). We performed a systematic review and meta-analysis to evaluate outcomes of endoscopic ultrasound-guided treatment of PFCs according to the presence of DPDS.

Methods: Using PubMed, Embase, and the Cochrane database, we identified clinical studies published until January 2021 with data comparing outcomes of endoscopic ultrasound-guided drainage of PFCs between DPDS and non-DPDS patients. Read More

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September 2021

Estimating Bleeding Risk in Patients with Cancer-Associated Thrombosis: Evaluation of Existing Risk Scores and Development of a New Risk Score.

Thromb Haemost 2021 Sep 20. Epub 2021 Sep 20.

Department of Acute Internal Medicine, University Medical Center Utrecht, Utrecht, The Netherlands.

Background:  Bleeding risk is highly relevant for treatment decisions in cancer-associated thrombosis (CAT). Several risk scores exist, but have never been validated in patients with CAT and are not recommended for practice.

Objectives:  To compare methods of estimating clinically relevant (major and clinically relevant nonmajor) bleeding risk in patients with CAT: (1) existing risk scores for bleeding in venous thromboembolism, (2) pragmatic classification based on cancer type, and (3) new prediction model. Read More

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September 2021

Mechanisms of Pharmacoresistance in Hepatocellular Carcinoma: New Drugs but Old Problems.

Semin Liver Dis 2021 Sep 20. Epub 2021 Sep 20.

Experimental Hepatology and Drug Targeting (HEVEPHARM), University of Salamanca, IBSAL, Salamanca, Spain.

Hepatocellular carcinoma (HCC) is a malignancy with poor prognosis when diagnosed at advanced stages in which curative treatments are no longer applicable. A small group of these patients may still benefit from transarterial chemoembolization. The only therapeutic option for most patients with advanced HCC is systemic pharmacological treatments based on tyrosine kinase inhibitors (TKIs) and immunotherapy. Read More

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September 2021

Microstructural Characterization of Resistance Artery Remodelling in Diabetes Mellitus.

J Vasc Res 2021 Sep 20:1-11. Epub 2021 Sep 20.

Department of Physics, University of Exeter, Exeter, United Kingdom.

Introduction: Microvascular remodelling is a symptom of cardiovascular disease. Despite the mechanical environment being recognized as a major contributor to the remodelling process, it is currently only understood in a rudimentary way.

Objective: A morphological and mechanical evaluation of the resistance vasculature in health and diabetes mellitus. Read More

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September 2021

Comparison of Outcomes between Percutaneous and Surgical Placement of Peritoneal Dialysis Catheters in Uremic Patients: A Meta-Analysis.

Blood Purif 2021 Sep 20:1-17. Epub 2021 Sep 20.

Division of Nephrology, Kidney Institute of CPLA, Changzheng Hospital, Second Military Medical University, Shanghai, China.

Background: The optimal technique for inserting peritoneal dialysis catheters in uremic patients remains debated. This meta-analysis aimed to summarize the current evidence evaluating the efficacy and safety of percutaneous insertion methods compared to surgical methods.

Method: A literature search was performed in the PubMed, EMBASE, Cochrane, and Web of Science databases. Read More

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September 2021

Effect of the COVID-19 Pandemic Preparation and Response on Essential Health Services in Primary and Tertiary Healthcare Settings of Amhara Region, Ethiopia.

Am J Trop Med Hyg 2021 Sep 20. Epub 2021 Sep 20.

Amsterdam UMC, University of Amsterdam, Department of Dermatology, Amsterdam Institute for Infection and Immunity (AI&I), Location Academic Medical Centre, Amsterdam, The Netherlands.

Countries like Ethiopia have had to make difficult decisions to balance between the demands of the COVID-19 pandemic and maintaining the essential health service delivery. We assessed the effect of preventive COVID-19 measures on essential healthcare services in selected health facilities of Ethiopia. In a comparative cross-sectional study, we analyzed and compared data from seven health facilities over two periods: the pre-COVID-19 period before the first reported COVID-19 case in the country and during the COVID-19 period. Read More

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September 2021

Identification of a Novel Antigen for Serological Diagnosis of Scrub Typhus.

Am J Trop Med Hyg 2021 Sep 20. Epub 2021 Sep 20.

Research Center for Bioconvergence Analysis, Korea Basic Science Institute, Cheongju, Republic of Korea.

Scrub typhus is an acute infectious disease caused by the bacterium Orientia tsutsugamushi, which is widely distributed in northern, southern, and eastern Asia. Early diagnosis is essential because the average case fatality rate is usually >10% but can be as high as 45% if antimicrobial treatment is delayed. Although an O. Read More

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September 2021

Increased Detection of Mycobacterium tuberculosis Disease Using a Tissue-Based Laboratory-Developed Polymerase Chain Reaction Assay Compared to Standard Diagnostics.

Am J Trop Med Hyg 2021 Sep 20. Epub 2021 Sep 20.

Section of Infectious Diseases, Yale University School of Medicine, New Haven, Connecticut.

Standard diagnostics for Mycobacterium tuberculosis (MTB) including acid-fast bacilli (AFB) smear and culture, and Xpert™ MTB/RIF real-time Polymerase Chain Reaction (RT-PCR; Xpert) have variable sensitivity and/or long turnaround times. We describe the clinical performance of a laboratory-developed tissue-based MTB PCR compared with AFB culture and Xpert using a composite reference standard (CRS). Over an 8-year period, MTB PCR was performed on pulmonary, pleural, or lymph node specimens for 36 patients. Read More

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September 2021

A Machine Learning Model for Evaluating Imported Disease Screening Strategies in Immigrant Populations.

Am J Trop Med Hyg 2021 Sep 20. Epub 2021 Sep 20.

Tropical Medicine Unit, Hospital Universitario Central de Asturias (HUCA), Oviedo, Spain.

Given the high prevalence of imported diseases in immigrant populations, it has postulated the need to establish screening programs that allow their early diagnosis and treatment. We present a mathematical model based on machine learning methodologies to contribute to the design of screening programs in this population. We conducted a retrospective cross-sectional screening program of imported diseases in all immigrant patients who attended the Tropical Medicine Unit between January 2009 and December 2016. Read More

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September 2021

First Reported Use of a Visualization Device for the Radial Artery With Near-Infrared Rays Through the Transradial Approach.

J Invasive Cardiol 2021 Sep 17. Epub 2021 Sep 17.

Division of Cardiology, Department of Internal Medicine, Tokai University Hachioji Hospital, 1838 Ishikawa-cho Hachioji City, Tokyo 192-0032, Japan.

Objectives: The transradial approach (TRA) is recommended in coronary catheterization due to the lower rate of bleeding complications compared with the transfemoral approach. However, a disadvantage of TRA is difficulty in puncturing under palpation of the radial pulse alone without arterial visibility. To overcome this limitation, a vessel visualization device using near-infrared rays, Art View (Forte Grow Medical Company), was used in the puncture of the radial artery (RA). Read More

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September 2021

Real-world survey of pneumonitis and its impact on durvalumab consolidation therapy in patients with non-small cell lung cancer who received chemoradiotherapy after durvalumab approval (HOPE-005/CRIMSON).

Lung Cancer 2021 Sep 5;161:86-93. Epub 2021 Sep 5.

Department of Radiation Oncology, Kobe City Medical Center General Hospital, Hyogo, Japan.

Objectives: The incidence of real-world pneumonitis and durvalumab rechallenge during chemoradiotherapy and durvalumab consolidation for non-small cell lung cancer is unknown.

Materials And Methods: We retrospectively evaluated the medical records of 302 consecutive patients diagnosed with non-small cell lung cancer who started chemoradiotherapy between May 2018 and May 2019.

Results: Median age was 70 (range: 40-87) years. Read More

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September 2021

Reply - Letter to the editor - Derivation and validation of a simple anthropometric equation to predict fat-free mass in patients with chronic hepatitis C.

Clin Nutr 2021 Sep 14;40(10):5336-5338. Epub 2021 Sep 14.

Sciences Applied to Adult Health Care Post-Graduate Programme, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG) Belo Horizonte, Brazil; Outpatient Clinic of Viral Hepatitis, Instituto Alfa de Gastroenterologia, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil; Department of Internal Medicine, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil. Electronic address:

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September 2021

Distinguishing vegan-, vegetarian-, and omnivorous diets by hair isotopic analysis.

Clin Nutr 2021 Sep 9;40(10):5335. Epub 2021 Sep 9.

Institute of Medicine, Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy at the University of Gothenburg, Sweden.

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September 2021

Modest decrease in severity of obesity in adolescence associates with low arterial stiffness.

Atherosclerosis 2021 Sep 14;335:23-30. Epub 2021 Sep 14.

Murdoch Children's Research Institute, The Royal Children's Hospital, Parkville, Victoria, Australia; Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia.

Background And Aims: Childhood obesity is associated with cardiovascular risk factors (CVRF), subclinical cardiovascular phenotypes (carotid intima-media thickness, cIMT; pulse-wave velocity, PWV; and carotid elasticity), and adult cardiovascular disease (CVD) mortality. In youth with obesity (body mass index, BMI ≥95th centile), we investigated associations between changes in adiposity and CVRF in early adolescence and subclinical cardiovascular phenotypes in late adolescence.

Methods: Participants had adiposity measures (the severity of obesity in percentage >95th BMI-centile (%>95th BMI-centile)), waist circumference (WC), percentage total body fat (%BF) and CVRF (systolic blood pressure, SBP; glycoprotein acetyls, GlycA; and low-density lipoprotein cholesterol) assessed in early (mean age 10. Read More

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September 2021

A snapshot of the immunogenicity, efficacy and safety of a full course of BNT162b2 anti-SARS-CoV-2 vaccine in cancer patients treated with PD-1/PD-L1 inhibitors: a longitudinal cohort study.

ESMO Open 2021 Sep 1;6(5):100272. Epub 2021 Sep 1.

Molecular Virology Unit, Department of Microbiology and Virology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.

Background: Very few cancer patients were enrolled in coronavirus disease-2019 vaccine studies. In order to address this gap of knowledge, real-world studies are mandatory. The aim of this study was to assess both humoral and cellular response after a messenger RNA vaccination schedule. Read More

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September 2021

The impact of radiological assessment schedules on progression-free survival in metastatic breast cancer: A systemic review and meta-analysis.

Cancer Treat Rev 2021 Sep 13;100:102293. Epub 2021 Sep 13.

Oncology Institute, Shaare Zedek Medical Center, and the Hebrew University Faculty of Medicine, Jerusalem, Israel. Electronic address:

Background: The impact of interval of restaging on the observed magnitude of benefit of progression-free survival (PFS) is undefined.

Materials And Methods: Phase 3 randomized controlled trials (RCTs) investigating anti-neoplastic drugs for metastatic breast cancer which reported the restaging interval and hazard ratio (HR) for PFS were included. Data on study design and study population were collected. Read More

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September 2021

Clozapine-induced myocarditis in Russia: animal studies but no clinical studies.

Rev Psiquiatr Salud Ment 2021 Sep 17. Epub 2021 Sep 17.

Mental Health Research Center, Eastern State Hospital, Lexington, KY, USA; Psychiatry and Neurosciences Research Group (CTS-549), Institute of Neurosciences, University of Granada, Granada, Spain; Biomedical Research Centre in Mental Health Net (CIBERSAM), Santiago Apostol Hospital, University of the Basque Country, Vitoria, Spain. Electronic address:

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September 2021

Cross-Talk Between Non-Alcoholic Fatty Liver Disease and Cardiovascular Disease: Implications for Future Trial Design.

Diabetes Metab 2021 Sep 17:101281. Epub 2021 Sep 17.

Dept. of Internal medicine, Virginia Commonwealth University School of Medicine, Richmond, VA 23298.

The natural history of non-alcoholic fatty liver disease (NAFLD) is still not fully elucidated. Patients with NAFLD have a low risk of liver complications, unless substantial liver fibrosis has developed. On the other hand, NAFLD has been linked with excess metabolic and cardiovascular complications. Read More

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September 2021

Kidney Disease, Hypertension Treatment, and Cerebral Perfusion and Structure.

Am J Kidney Dis 2021 Sep 17. Epub 2021 Sep 17.

Department of Radiology, University of Pennsylvania Perelman School of Medicine, Philadelphia PA.

Rationale And Objective: The safety of intensive blood pressure (BP) targets is controversial for persons with chronic kidney disease (CKD). We studied the effects of hypertension treatment on cerebral perfusion and structure in those with and without CKD.

Study Design: Neuroimaging substudy of a randomized trial. Read More

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September 2021

Revisiting Mild Asthma: Current Knowledge and Future Needs.

Chest 2021 Sep 17. Epub 2021 Sep 17.

Section of Pulmonary, Critical Care and Sleep Medicine, Baylor College of Medicine, Houston, Texas.

Asthma is a common chronic airway disease with significant impact on patients, caregivers, and the healthcare system. While most research and novel interventions have mainly focused on patients with uncontrolled severe asthma, the majority of patients with asthma have mild disease. Epidemiologic studies suggest that many patients with mild asthma report frequent exacerbations of their disease and uncontrolled symptoms. Read More

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September 2021

Comparative efficacy of different methods for difficult biliary cannulation in ERCP: a systematic review and network meta-analysis.

Gastrointest Endosc 2021 Sep 17. Epub 2021 Sep 17.

Center for Advanced Therapeutic Endoscopy (CATE), Porter Adventist Hospital/PEAK Gastroenterology, Denver, Colorado, USA. Electronic address:

Background And Aims: Several methods with variable efficacy have been proposed for difficult biliary cannulation in ERCP. We assessed the comparative efficacy of different strategies for difficult biliary cannulation, through a network meta-analysis combining direct and indirect treatment comparisons.

Methods: We identified 17 randomized controlled trials (RCTs) (2015 patients) that compared the efficacy of different adjunctive methods for difficult biliary cannulation (needle-knife techniques, pancreatic guidewire-assisted technique, pancreatic-assisted technique, and transpancreatic sphincterotomy) either with each other or with persistence with the standard cannulation techniques. Read More

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September 2021

Ex vivo Akt inhibition reverses castration induced internal pudendal artery and penile endothelial dysfunction.

Life Sci 2021 Sep 17:119966. Epub 2021 Sep 17.

Department of Physiology, Brody School of Medicine, East Carolina University, Greenville, NC, USA. Electronic address:

Aims: Androgen deprivation therapy is a common prostate cancer treatment which causes men to have castrate levels of testosterone. Unfortunately, most testosterone deficient patients will suffer severe erectile dysfunction (ED) and have no effective ED treatment options. Testosterone deficiency causes endothelial dysfunction and impairs penile vasodilation necessary to maintain an erection. Read More

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September 2021

Physical Resilience in Daily Functioning Among Acutely Ill Hospitalized Older Adults: The Hospital-ADL Study.

J Am Med Dir Assoc 2021 Sep 17. Epub 2021 Sep 17.

Amsterdam UMC, University of Amsterdam, Internal Medicine, Section of Geriatric Medicine, Amsterdam Public Health Research Institute, Amsterdam, Netherlands; ACHIEVE - Centre of Applied Research, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, Netherlands.

Objectives: Insight into older adults' physical resilience is needed to predict functional recovery after hospitalization. We assessed functional trajectories in response to acute illness and subsequent hospitalization and investigated baseline variables and dynamic variables associated with these trajectories.

Design: Prospective observational cohort study (Hospitalization-Associated Disability and impact on daily Life Study). Read More

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September 2021

Extended therapy with letrozole as adjuvant treatment of postmenopausal patients with early-stage breast cancer: a multicentre, open-label, randomised, phase 3 trial.

Lancet Oncol 2021 Sep 15. Epub 2021 Sep 15.

Epidemiology Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.

Background: The benefit of extending aromatase inhibitor therapy beyond 5 years in the context of previous aromatase inhibitors remains controversial. We aimed to compare extended therapy with letrozole for 5 years versus the standard duration of 2-3 years of letrozole in postmenopausal patients with breast cancer who have already received 2-3 years of tamoxifen.

Methods: This multicentre, open-label, randomised, phase 3 trial was done at 69 hospitals in Italy. Read More

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September 2021

Letter to the Editor: On the Mechanisms of Biliary Flux.

Hepatology 2021 Sep 20. Epub 2021 Sep 20.

Department of Internal Medicine, Yale University Medical School, United States.

Vartak et al's recent publicatioin reviews their previous provocative data that water flow into the bile canaliculus is not in response to an osmotic gradient, as initially proposed by Sperber. However their technique, photoactivation of a non-fluorescent precursor of fluorescein, has not been validated. In contrast, a similar technique, enzymatic activation of a non-fluorescent precursor of fluorescein supported the concept of osmotically generated canalicular water flow and confirmed that peristalsis also participates in the flow of fluid from the canaliculi into the duct system as originally described by Philips. Read More

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September 2021

First-Line Pembrolizumab Versus Chemotherapy in Metastatic Non-Small-Cell Lung Cancer: KEYNOTE-024 Japan Subset.

Cancer Sci 2021 Sep 20. Epub 2021 Sep 20.

Center for Innovative Clinical Medicine, Okayama University Hospital, Okayama, Japan.

This prespecified subanalysis of the global, randomized controlled phase 3 KEYNOTE-024 study of pembrolizumab versus chemotherapy in previously untreated metastatic non-small-cell lung cancer without EGFR/ALK alterations and a PD-L1 tumor proportion score ≥50% evaluated clinical outcomes among patients enrolled in Japan. Treatment consisted of pembrolizumab 200 mg every 3 weeks (35 cycles) or platinum-based chemotherapy (4-6 cycles). The primary endpoint was progression-free survival; secondary endpoints included overall survival and safety. Read More

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September 2021

How physicians evaluate patients with dementia who present with shortness of breath.

J Am Geriatr Soc 2021 Sep 20. Epub 2021 Sep 20.

Center for the Study of Healthcare Innovation, Implementation, and Policy, VA Greater Los Angeles Healthcare System, Los Angeles, California, USA.

Background: Whether the presence of dementia in patients makes it difficult for physicians to assess the risk such patients might have for serious conditions such as pulmonary embolism (PE) is unknown. Our objective was to examine the differential association of four clinical factors (deep venous thrombosis (DVT)/PE, malignancy, recent surgery, and tachycardia) with PE testing for patients with dementia compared to patients without dementia.

Methods: We performed a cross-sectional study of emergency department (ED) visits to 104 Veterans Affairs (VA) hospitals from 2011 to 2018 by patients aged 60 years and over presenting with shortness of breath (SOB). Read More

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September 2021

Plasma polyamines as an additional to imaging biomarker in MEN1 patients with duodenopancreatic neuroendocrine tumors.

J Clin Endocrinol Metab 2021 Sep 20. Epub 2021 Sep 20.

Department of Propaedeutic Internal Medicine, National and Kapodistrian University of Athens, Greece.

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September 2021

Off-label use of direct oral anticoagulants compared with warfarin for left ventricular thrombi after myocardial infarction.

Eur Heart J Cardiovasc Pharmacother 2021 Sep 20. Epub 2021 Sep 20.

Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Austria.

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September 2021