51,245 results match your criteria interquartile range


Delay in Hip Fracture Repair in the Elderly: A Missed Opportunity Towards Achieving Better Outcomes.

J Surg Res 2021 May 11;266:142-147. Epub 2021 May 11.

Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois; Department of Surgery, University of Michigan Health System, Ann Arbor, Michigan. Electronic address:

Background: Hip fractures are a major cause of morbidity and mortality in the elderly. The American Academy of Orthopedic Surgeons (AAOS) recommends surgical repair within 48 hours of admission, as this is associated with lower postoperative mortality and complications. This study demonstrates the association between patient demographics, level of care, and hospital region to delay in hip fracture repair in the elderly. Read More

View Article and Full-Text PDF

Factors Associated with Postpartum Readmission for Hypertensive Disorders of Pregnancy.

Am J Obstet Gynecol MFM 2021 May 12:100397. Epub 2021 May 12.

The Permanente Medical Group, Kaiser Permanente Santa Clara Medical Center, Department of Obstetrics and Gynecology, Division of Obstetric Hospitalists, Santa Clara, CA.

Background: Postpartum readmission (PPR) has negative implications for patients and health systems. Prior studies suggest that up to 5% of women with hypertensive disorders of pregnancy (HDP) experience PPR. Studies examining factors associated with PPR for hypertension have had small sample sizes and conflicting results. Read More

View Article and Full-Text PDF

Metabolites from mid-trimester plasma of pregnant patients at high-risk for preterm birth.

Am J Obstet Gynecol MFM 2021 May 12:100393. Epub 2021 May 12.

Institute for Environmental Health Solutions, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, Chapel Hill, NC; Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, Chapel Hill, NC.

Background: There is an increased awareness regarding the association between exposure to environmental contaminants and adverse pregnancy outcomes including preterm birth. Whether an individual's metabolic profile can be utilized during pregnancy to differentiate the subset of patients who are ultimately destined to deliver preterm remains uncertain but could have significant clinical implications.

Objective: We sought to objectively quantify metabolomic profiles of patients at high risk for preterm birth by evaluating mid-trimester maternal plasma, and to measure whether endogenous metabolites and exogenous environmental substances differ among those who ultimately deliver preterm compared to those who deliver at term. Read More

View Article and Full-Text PDF

Adolescent-adult nonmetastatic Ewing sarcoma-Experience from a large developing country.

Pediatr Blood Cancer 2021 May 15:e29081. Epub 2021 May 15.

Tata Memorial Hospital, Homi Bhabha National Institute (HBNI), Mumbai, Maharashtra, India.

Background: Outcome and toxicity data in adolescent-adult Ewing sarcoma (AA-ES) patients are sparse and merits exploration.

Methods: Histopathologically confirmed, nonmetastatic AA-ES patients, who received standard institutional combination chemotherapy regimen (Ewing's family of tumors-2001 [EFT-2001]) comprising of ifosfamide plus etoposide and vincristine, doxorubicin plus cyclophosphamide, lasting a total of 12 months between 2013 and 2018, were analyzed for treatment-related toxicities, event-free survival (EFS), and overall survival (OS).

Results: There were 235 patients (primary safety cohort [PSC]) with median age of 23 (15-61) years; 159 (67. Read More

View Article and Full-Text PDF

Baveno criteria perform better than expanded Baveno and Rete Sicilia Selezione Terapia-Hepatitis C virus criteria for predicting varices needing treatment.

Indian J Gastroenterol 2021 May 15. Epub 2021 May 15.

Department of Gastroenterology and Human Nutrition Unit, All India Institute of Medical Sciences, New Delhi, 110 029, India.

Background And Aims: Endoscopy is the gold standard for the detection and staging of varices. Baveno, expanded Baveno, and Rete Sicilia Selezione Terapia-hepatitis C virus (RESIST-HCV) criteria predict varices non-invasively in patients with cirrhosis. We assessed the performance of these criteria for predicting varices needing treatment (VNT). Read More

View Article and Full-Text PDF

Electrolyte monitoring during regional citrate anticoagulation in continuous renal replacement therapy.

J Clin Monit Comput 2021 May 15. Epub 2021 May 15.

Department of Intensive Care Medicine, Gelre Hospitals, Apeldoorn, The Netherlands.

Patients with acute kidney injury who need continuous renal replacement therapy with locoregional citrate anticoagulation are at risk of citrate accumulation with disruption of the calcium balance. We aimed to evaluate the safety of detecting citrate accumulation and adjusting electrolyte disbalances during continuous venovenous hemodialysis (CVVHD) in critically ill patients with acute kidney injury using a blood sample frequency every 6 h. A prospective single center study in critically ill intensive care unit patients who suffered from acute kidney injury with the need of renal replacement therapy. Read More

View Article and Full-Text PDF

Leap-2/ghrelin interplay in adult growth hormone deficiency: cause or consequence? A pilot study.

IUBMB Life 2021 May 15. Epub 2021 May 15.

Dipartimento di Sicurezza e Bioetica, Sezione di Farmacologia, Università Cattolica del Sacro Cuore - Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia.

Ghrelin and its endogenous antagonist liver-expressed antimicrobial peptide-2 (LEAP-2) are involved in GH secretion and glucose/lipids metabolism. LEAP-2 expression in conditions of metabolic impairment may be upregulated, usually pairing with a concomitant reduction in ghrelin secretion. Adult growth hormone deficiency (aGHD) is characterized by insulin resistance, weight gain and increased fat mass. Read More

View Article and Full-Text PDF

Are treatment effect assumptions in orthodontic studies overoptimistic?

Eur J Orthod 2021 May 15. Epub 2021 May 15.

Department of Orthodontics and Dentofacial Orthopedics, Dental School/Medical Faculty, University of Bern, Bern, Switzerland.

Background: At the clinical trial design stage, assumptions regarding the treatment effects to be detected should be appropriate so that the required sample size can be calculated. There is evidence in the medical literature that sample size assumption can be overoptimistic. The aim of this study was to compare the distribution of the assumed effects versus that of the observed effects as a proxy for overoptimistic treatment effect assumptions at the study design stage. Read More

View Article and Full-Text PDF

Body composition reference ranges in community-dwelling adults using dual-energy X-ray absorptiometry: the Australian Body Composition (ABC) Study.

J Cachexia Sarcopenia Muscle 2021 May 14. Epub 2021 May 14.

Department of Medicine-Western Health, Melbourne Medical School, The University of Melbourne, St Albans, Melbourne, Vic., Australia.

Background: Reference ranges for lean mass (LM) and fat mass (FM) are essential in identifying soft tissue disorders; however, no such reference ranges exist for the most commonly used Hologic dual-energy X-ray absorptiometry (DXA) machine in Australia.

Methods: Cross-sectional study of community-dwelling adults (aged 18-88 years) who underwent a Hologic DXA scan at one of three commercialized densitometry centres in Australia. Age-specific and sex-specific percentile curves were generated for LM [LM, appendicular lean mass (ALM), ALM adjusted for height squared (ALM/h ), and ALM adjusted for body mass index (ALM/BMI)] and FM [FM, FM adjusted for height squared (FM/h ), appendicular fat mass, and android and gynoid fat] parameters using the LMS statistical method. Read More

View Article and Full-Text PDF

Characteristics of emergency patients admitted to hospital with asthma: A population-based cohort study in Queensland, Australia.

Emerg Med Australas 2021 May 15. Epub 2021 May 15.

School of Biomedical Sciences, Institute for Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia.

Objective: Patient characteristics with exacerbation of asthma accessing care in the ED who are at risk of hospital admission have not been determined in subtropical climates. The objective of the study was to investigate the spatiotemporal burden of asthma hospital admissions across Queensland (QLD) and model risk factors for asthma hospital admission following an ED visit.

Methods: Six years of routinely collected data (2012-2017) from 28 QLD public hospitals were extracted from Queensland Health's Emergency Data Collection. Read More

View Article and Full-Text PDF

Health-seeking behaviour of foreign workers in Singapore: Insights from emergency department visits.

Ann Acad Med Singap 2021 Apr;50(4):315-324

Department of Emergency Medicine, Singapore General Hospital, Singapore.

Introduction: Foreign workers (FWs) on work permit face unique health challenges and potential barriers to healthcare. We aimed to examine the epidemiology, attendance patterns, disposition, and adherence to follow-up, by FWs on work permit to two emergency departments (EDs) in Singapore.

Methods: In this retrospective observational study, we included consecutive FWs on work permit who registered at the EDs of two public restructured hospitals from 1 May 2016 to 31 October 2016. Read More

View Article and Full-Text PDF

Endoscopic Treatment of Enterocutaneous Fistulas in Crohn's Disease.

Dis Colon Rectum 2021 May 13. Epub 2021 May 13.

Department of gastroenterology, Amiens University hospital, Picardie University, Amiens, France Department of digestive surgery, Amiens University hospital, Picardie University, Amiens, France.

Background: Management of enterocutaneous fistulas in Crohn's disease is challenging. The majority of patients still need intestinal resection in the biologic era.

Objective: The aim of this study was to evaluate the efficacy of endoscopic treatment for enterocutaneous fistulas. Read More

View Article and Full-Text PDF

Prevalence of winter migration to warmer destinations among Ontarians ("snowbirds") and patterns of their use of health care services: a population-based analysis.

CMAJ Open 2021 Apr-Jun;9(2):E491-E499. Epub 2021 May 14.

ICES Western (Shariff, Dixon, Garg, Clemens); Arthur Labatt Family School of Nursing (Shariff), Western University; Lawson Health Research Institute (Shariff, Garg, Clemens), London, Ont.; ICES Central (Paterson), Toronto, Ont.; Department of Family Medicine (Paterson), McMaster University, Hamilton, Ont.; Institute of Health Policy, Management and Evaluation (Paterson), University of Toronto, Toronto, Ont.; Department of Epidemiology and Biostatistics (Dixon, Garg), Western University, London, Ont.; Department of Mathematics and Statistics (Dixon), University of Guelph, Guelph, Ont.; Department of Medicine (Garg, Clemens), Western University; St. Joseph's Health Care London (Clemens), London, Ont.

Background: Older Canadians frequently migrate to warmer destinations for the winter season (snowbirds). Our aim was to examine the prevalence of migration to warmer destinations among Ontarians, and to compare the characteristics and use of health care services of snowbirds to those of older Ontarians who did not migrate for the winter.

Methods: We conducted a population-based analysis using health administrative databases from Ontario. Read More

View Article and Full-Text PDF

Embolization versus Surgery for Stabilized Patients with Solid Organ Injury.

J Vasc Interv Radiol 2021 May 11. Epub 2021 May 11.

Department of Emergency Medicine, Gunma University Graduate School of Medicine, Maebashi, Japan.

Purpose: Embolization is generally limited to stable patients with solid organ injury. The effectiveness of embolization versus laparotomy for unstable patients who responded to initial resuscitation with solid organ injury remains unknown. The aim of this study was to compare embolization with laparotomy for the management of unstable patients who responded to initial resuscitation with isolated solid organ injury. Read More

View Article and Full-Text PDF

Readmission after Hospitalization with Staphylococcus aureus Bacteremia in Children.

Am J Infect Control 2021 May 11. Epub 2021 May 11.

Department of Pediatrics, University of Mississippi Medical Center, 2500 N State Street, Jackson, Mississippi, USA. Electronic address:

Background: Readmission rate is an important quality measure and can inform patient care. However, readmission of S. aureus bacteremia in children requires further research. Read More

View Article and Full-Text PDF

Cyclohexanone Exposure in Children on Extracorporeal Membrane Oxygenation Support.

ASAIO J 2021 May 12. Epub 2021 May 12.

From the Department of Anesthesiology and Critical Care Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland Department of Pediatrics, Division of Pediatric Cardiac Critical Care, Children's National Hospital, Washington, DC Department of Neurology, Johns Hopkins School of Medicine, Baltimore, Maryland Kennedy Krieger Institute, Baltimore, Maryland Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, Maryland Molecular Determinants Core, Johns Hopkins All Children's Hospital, St Petersburg, Florida Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, Maryland.

The aim of this study was to determine if plasma cyclohexanone and metabolites are associated with clinical outcomes of children on extracorporeal membrane oxygenation (ECMO) support. We performed a secondary analysis of a prospective observational study of children on ECMO support at two academic centers between July 2010 and June 2015. We measured plasma cyclohexanone and metabolites on the first and last days of ECMO support. Read More

View Article and Full-Text PDF

Umbilical Cord Blood Metal Mixtures and Birth Size in Bangladeshi Children.

Environ Health Perspect 2021 May 14;129(5):57006. Epub 2021 May 14.

Environmental and Occupational Medicine and Epidemiology Program, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.

Background: Studies have evaluated environmental exposure to toxic metals such as arsenic (As), cadmium (Cd), manganese (Mn), or lead (Pb) on birth size; however, information on potential effects of exposures to metal mixtures is limited.

Objectives: We assessed the association between metal mixtures (As, Cd, Mn, Pb) in umbilical cord blood and neonate size in Bangladeshi children.

Methods: In this birth cohort study, pregnant women who were of age with an ultrasound-confirmed singleton pregnancy of gestation were recruited from two Bangladesh clinics between 2008 and 2011. Read More

View Article and Full-Text PDF

Comparing the supine and erect pelvis radiographic examinations: an evaluation of anatomy, image quality and radiation dose.

Br J Radiol 2021 May 14:20210047. Epub 2021 May 14.

Mid Yorkshire Hospitals NHS Trust, Wakefield, UK.

Objectives: Pelvis radiographs are usually acquired supine despite standing imaging reflecting functional anatomy. We compared the supine and erect radiographic examinations for anatomical features, radiation dose and image quality.

Methods: Sixty patients underwent pelvis radiography in both supine and erect positions at the same examination appointment. Read More

View Article and Full-Text PDF

Associations of residential greenness with hypertension and blood pressure in a Chinese rural population: a cross-sectional study.

Environ Sci Pollut Res Int 2021 May 14. Epub 2021 May 14.

Department of Global Health, School of Health Sciences, Wuhan University, Wuhan, Hubei, China.

Limited epidemiological literature identified the associations between residential greenness and hypertension in low-/middle-income countries. A random sampling strategy was adopted to recruit 39,259 residents, ≥ 18 years, and from 5 counties in central China. Blood pressure was measured based on the protocol of the American Heart Association. Read More

View Article and Full-Text PDF

Impact of COVID-19 on New Graduate Nurses' Transition to Practice: Loss or Gain?

Nurse Educ 2021 May 3. Epub 2021 May 3.

Author Affiliations: Nurse Residency Program Director (Ms Smith), Nurse Resident (Ms Robbins), Nurse Residency Program Lead (Ms Horst), and Senior Director of Nursing Research (Dr Ivory), Vanderbilt University Medical Center; Associate Dean of Nursing at Belmont University School of Nursing (Dr Buckner); and Assistant Dean for Academics, Generalist Nursing Practice at Vanderbilt University School of Nursing (Dr Jessee), Nashville, Tennessee.

Background: The COVID-19 pandemic disrupted nursing education and required modification of instructional methods and clinical experiences. Given the variation in education, rapid transition to virtual platforms, and NCLEX-RN testing stressors, this cohort faced unique losses and gains influencing their transition into clinical practice.

Purpose: This study examined the impact of COVID-19 and preparedness for professional practice of 340 new graduate nurses (NGNs) at an academic medical center. Read More

View Article and Full-Text PDF

Fecal Diversion for Perianal Crohn Disease in the Era of Biologic Therapies: A Multicenter Study.

Inflamm Bowel Dis 2021 May 14. Epub 2021 May 14.

Department of Medicine, University of British Columbia, Vancouver, Canada.

Background: The natural history of perianal Crohn disease (PCD) after fecal diversion in the era of biologics is poorly understood. We assessed clinical and surgical outcomes after fecal diversion for medically refractory PCD and determined the impact of biologics.

Methods: We performed a retrospective, multicenter study from 1999 to 2020. Read More

View Article and Full-Text PDF

Multidrug-resistant tuberculosis imported into low-incidence countries-a GeoSentinel analysis, 2008-2020.

J Travel Med 2021 May 12. Epub 2021 May 12.

Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden.

Background: Early detection of imported multidrug-resistant tuberculosis (MDR-TB) is crucial, but knowledge gaps remain about migration- and travel-associated MDR-TB epidemiology. The aim was to describe epidemiologic characteristics among international travelers and migrants with MDR-TB.

Methods: Clinician-determined and microbiologically confirmed MDR-TB diagnoses deemed to be related to travel or migration were extracted from GeoSentinel, a global surveillance network of travel and tropical medicine clinics, from January 2008 through December 2020. Read More

View Article and Full-Text PDF

Clinical features in coronavirus disease 2019 (COVID-19) patients with early clearance and prolonged shedding of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA.

Ann Transl Med 2021 Apr;9(8):665

Department of Respiratory and Critical Care Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

Background: Since the outbreak of coronavirus disease 2019 (COVID-19), the pattern of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA shedding has not been well characterized.

Methods: In our study, 652 patients in Wuhan Designated Hospital were recruited, and their clinical and laboratory findings were extracted and analyzed.

Results: The median duration of SARS-CoV-2 RNA detection was 23 days [interquartile range (IQR), 18 days] from symptom onset. Read More

View Article and Full-Text PDF

Residual β-cell function after 10 years of autoimmune type 1 diabetes: prevalence, possible determinants, and implications for metabolism.

Ann Transl Med 2021 Apr;9(8):650

National Clinical Research Center for Metabolic Disease, Key Laboratory of Diabetes Immunology, Ministry of Education, Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, China.

Background: Type 1 diabetes (T1D) has long been considered a progressive autoimmune disease resulting in the failure of pancreatic β-cell function and absolute endogenous insulin deficiency. However, several studies have demonstrated patients with T1D have detectable C-peptide levels long after diagnosis, which has remarkable clinical significance. Since this issue has not been systematically explored in non-Caucasian populations, we aimed to identify the prevalence of residual β-cell function and its related clinical features in Chinese long-term T1D patients. Read More

View Article and Full-Text PDF

Impact of variceal eradication on rebleeding and prognosis in cirrhotic patients undergoing secondary prophylaxis.

Ann Transl Med 2021 Apr;9(7):540

Department of Gastroenterology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.

Background: Endoscopic therapy has been widely applied to prevent variceal rebleeding, but data addressing the effect of endoscopic variceal eradication (VE) are lacking. We aimed to clarify the clinical impact of VE and reveal the long-term incidence and mortality of gastrointestinal rebleeding.

Methods: This prospective study included 228 cirrhotic patients who underwent secondary prophylaxis for variceal bleeding and achieved VE through a systematic procedure we proposed as endoscopic sequential therapy (EST). Read More

View Article and Full-Text PDF

Behavior and complications of hepatocellular adenoma during pregnancy and puerperium: a retrospective study and systematic review.

HPB (Oxford) 2021 Apr 28. Epub 2021 Apr 28.

University of Groningen, University Medical Center Groningen, Department of Surgery, the Netherlands. Electronic address:

Background: Hepatocellular adenomas (HCA) are benign liver tumors at risk of hemorrhage. The influence of pregnancy on HCA growth and potential bleeding remains unclear. This study investigates HCA-associated behavior and bleeding complications during or shortly after pregnancy. Read More

View Article and Full-Text PDF

The impact of intravenous acetaminophen pricing on opioid utilization and outcomes for children with appendicitis.

Surgery 2021 May 10. Epub 2021 May 10.

Division of Pediatric Surgery, Children's Hospital Los Angeles, CA Department of Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, CA; Department of Preventive Medicine, University of Southern California, Los Angeles, CA. Electronic address:

Background: In 2014, the price of intravenous acetaminophen more than doubled. This study determined whether increased intravenous acetaminophen cost was associated with decreased utilization and increased opioid use for children undergoing appendectomy.

Methods: A multicenter retrospective cohort study using the Pediatric Health Information System database between 2011 and 2017 was performed. Read More

View Article and Full-Text PDF

Supplemental medial small fragment fixation adds stability to distal femur fixation: A biomechanical study.

Injury 2021 May 1. Epub 2021 May 1.

Department of Orthopaedic Surgery, Stanford Hospitals and Clinics, 300 Pasteur Drive, Room R144, Stanford CA, United States.

Introduction: Bridge plating of distal femur fractures with lateral locking plates is susceptible to varus collapse, fixation failure, and nonunion. While medial and lateral dual plating has been described in clinical series, the biomechanical effects of dual plating of distal femur fractures have yet to be clearly defined. The purpose of this study was to compare dual plating to lateral locked bridge plating alone in a cadaveric distal femur gap osteotomy model. Read More

View Article and Full-Text PDF

The Safety of Continuous Infusion Propofol in Mechanically Ventilated Adults With Coronavirus Disease 2019.

Ann Pharmacother 2021 May 14:10600280211017315. Epub 2021 May 14.

NewYork-Presbyterian Hospital/Weill Cornell Medical Center, New York, New York, USA.

Background: Propofol is commonly used to achieve ventilator synchrony in critically ill patients with coronavirus disease 2019 (COVID-19), yet its safety in this patient population is unknown.

Objective: To evaluate the safety, in particular the incidence of hypertriglyceridemia, of continuous infusion propofol in patients with COVID-19.

Methods: This was a retrospective study at 1 academic medical center and 1 affiliated teaching hospital in New York City. Read More

View Article and Full-Text PDF

A prospective cohort study of ambient air pollution exposure and risk of uterine leiomyomata.

Hum Reprod 2021 May 13. Epub 2021 May 13.

Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA.

Study Question: To what extent are ambient concentrations of particulate matter <2.5 microns (PM2.5), nitrogen dioxide (NO2) and ozone (O3) associated with risk of self-reported physician-diagnosed uterine leiomyomata (UL)?

Summary Answer: In this large prospective cohort study of Black women, ambient concentrations of O3, but not PM2. Read More

View Article and Full-Text PDF