35,409 results match your criteria large multicenter


Aftercare Needs Following Gender-Affirming Surgeries: Findings From the ENIGI Multicenter European Follow-Up Study.

J Sex Med 2021 Sep 18. Epub 2021 Sep 18.

Amsterdam University Medical Center (location VUmc), Department of Medical Psychology, Amsterdam, the Netherlands; Amsterdam Public Health Institute, Amsterdam, the Netherlands.

Background: While much emphasis has been put on the evaluation of gender-affirming surgery (GAS) approaches and their effectiveness, little is known about the health care needs after completion of these interventions.

Aim: To assess post-GAS aftercare needs using a mixed-method approach and relate these to participant characteristics.

Methods: As part of the ENIGI follow-up study, data was collected 5 years after first contact for gender-affirming treatments in 3 large European clinics. Read More

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September 2021

Endovascular Treatment of Acute Ischemic Stroke With the Penumbra System in Routine Practice: COMPLETE Registry Results.

Stroke 2021 Sep 22:STROKEAHA121034268. Epub 2021 Sep 22.

Mercy Health St. Vincent Medical Center, Toledo, OH (O.O.Z.).

Background And Purpose: The purpose of the COMPLETE (International Acute Ischemic Stroke Registry With the Penumbra System Aspiration Including the 3D Revascularization Device) registry was to evaluate the generalizability of the safety and efficacy of the Penumbra System (Penumbra, Inc, Alameda) in a real-world setting.

Methods: COMPLETE was a global, prospective, postmarket, multicenter registry. Patients with large vessel occlusion-acute ischemic stroke who underwent mechanical thrombectomy using the Penumbra System with or without the 3D Revascularization Device as frontline approach were enrolled at 42 centers (29 United States, 13 Europe) from July 2018 to October 2019. Read More

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September 2021

Should Pertrochanteric and Subtrochanteric Fractures Be Treated with a Short or Long Intramedullary Nail?: A Multicenter Cohort Study.

J Bone Joint Surg Am 2021 Sep 21. Epub 2021 Sep 21.

Department of Orthopaedic Surgery and Traumatology, Odense University Hospital, Odense, Denmark.

Background: The purpose of the present multicenter cohort study was to compare the rates of reoperation in elderly patients with pertrochanteric and subtrochanteric fractures that had been treated with a short or long intramedullary nail.

Methods: Eleven orthopaedic departments across Denmark delivered data that had been obtained from the Danish Multidisciplinary Hip Fracture Registry (DMHFR) and a review of health-care records. With use of surgical procedure codes for pertrochanteric and subtrochanteric fractures that had been treated with an intramedullary nail, the DMRHF was searched to identify patients who had been ≥65 years of age between 2008 and 2013. Read More

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September 2021

Epidemiological studies of CT scans and cancer risk: the state of the science.

Br J Radiol 2021 Oct;94(1126):20210471

Radiation Epidemiology Branch, Division of Cancer Epidemiology & Genetics, National Cancer Institute, Bethesda, MD, USA.

20 years ago, 3 manuscripts describing doses and potential cancer risks from CT scans in children raised awareness of a growing public health problem. We reviewed the epidemiological studies that were initiated in response to these concerns that assessed cancer risks from CT scans using medical record linkage. We evaluated the study methodology and findings and provide recommendations for optimal study design for new efforts. Read More

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October 2021

Open Versus Minimally Invasive Radical Hysterectomy in Cervical Cancer: The CIRCOL Group Study.

Ann Surg Oncol 2021 Sep 20. Epub 2021 Sep 20.

Department of Gynecologic Oncology, Aristides Maltez Hospital, Salvador, Brazil.

Purpose: To analyze the survival outcomes of patients in a Brazilian cohort who underwent minimally invasive surgery (MIS) compared with open surgery for early stage cervical cancer.

Methods: A multicenter database was constructed, registering 1280 cervical cancer patients who had undergone radical hysterectomy from 2000 to 2019. For the final analysis, we included cases with a tumor ≤ 4 cm (stages Ia2 to Ib2, FIGO 2018) that underwent surgery from January 2007 to December 2017. Read More

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September 2021

Individuals at increased risk for development of bipolar disorder display structural alterations similar to people with manifest disease.

Transl Psychiatry 2021 Sep 20;11(1):485. Epub 2021 Sep 20.

Department of Psychiatry and Psychotherapy, Carl Gustav Carus University Hospital, Technische Universität Dresden, Dresden, Germany.

In psychiatry, there has been a growing focus on identifying at-risk populations. For schizophrenia, these efforts have led to the development of early recognition and intervention measures. Despite a similar disease burden, the populations at risk of bipolar disorder have not been sufficiently characterized. Read More

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September 2021

Postoperative delirium and neurocognitive disorders.

Curr Opin Crit Care 2021 Sep 20. Epub 2021 Sep 20.

Department of General Anesthesiology Department of Outcomes Research, Cleveland Clinic, Cleveland, Ohio, USA.

Purpose Of Review: Postoperative neurocognitive disorders (NCD) are significant causes of morbidity and mortality. In this paper, we will review our understanding and potential management of postoperative NCD.

Recent Findings: Postoperative delirium, delayed neurocognitive recovery and postoperative cognitive dysfunction (POCD) are recognized as a part of the continuous spectrum of postoperative NCD. Read More

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September 2021

Minimal Extrathyroidal Extension in Predicting 1-Year Outcomes: A Longitudinal Multicenter Study of Low-to-Intermediate-Risk Papillary Thyroid Carcinoma (ITCO#4).

Thyroid 2021 Sep 19. Epub 2021 Sep 19.

Istituto Nazionale Tumori IRCCS Fondazione Pascale, 18730, Struttura Complessa Chirurgia Oncologica della Tiroide, Napoli, Campania, Italy;

Background: The role of minimal extrathyroidal extension (mETE) as a risk factor for persistent papillary thyroid carcinoma (PTC) is still debated. The aim of this study was to assess the clinical impact of mETE as a predictor of worse initial treatment response in PTC patients and to verify the impact of radioiodine therapy after surgery in patients with mETE.

Methods: We reviewed all records in the Italian Thyroid Cancer Observatory (ITCO) database and selected 2237 consecutive patients with PTC who satisfied the inclusion criteria (PTC with no lymph node metastases and at least 1 year of follow-up). Read More

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September 2021

Varied RLN Course is Associated with Increased Risk of Nerve Dysfunction during Thyroidectomy:Results of the Surgical Anatomy of the RLN in Thyroid Surgery (SAR) Study, an International Multicenter Prospective Anatomic and Electrophysiologic Study of 1000 Monitored Nerves at Risk from the International Neural Monitoring Study Group (INMSG).

Thyroid 2021 Sep 19. Epub 2021 Sep 19.

MEEI, 1866, Otolaryngology, Boston, Massachusetts, United States;

Background: The recurrent laryngeal nerve (RLN) can be injured during thyroid surgery, which can negatively affect a patient's quality of life. The impact of intraoperative anatomic variations of the RLN on nerve injury remains unclear. Objectives of this study were to (1) better understand the detailed surgical anatomic variability of the RLN with a world-wide perspective; (2) establish potential correlates between intraoperative RLN anatomy and electrophysiologic responses; and (3) use the information to minimize complications and assure accurate and safe intraoperative neural monitoring (IONM). Read More

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September 2021

Cognitive profiles of patients with mild cognitive impairment due to Alzheimer's versus Parkinson's disease defined using a base rate approach: Implications for neuropsychological assessments.

Alzheimers Dement (Amst) 2021 14;13(1):e12223. Epub 2021 Sep 14.

Department of Neurodegenerative Diseases and Gerontopsychiatry University Hospital of Bonn University of Bonn Bonn Germany.

Introduction: Large studies on cognitive profiles of patients with mild cognitive impairment (MCI) due to Alzheimer's disease (AD-MCI) compared to Parkinson's disease (PD-MCI) are rare.

Methods: Data from two multicenter cohort studies in AD and PD were merged using a unified base rate approach for the MCI diagnosis. Cognitive profiles were compared using scores derived from the Consortium to Establish a Registry for Alzheimer's Disease battery. Read More

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September 2021

Acute Thromboembolic Ischemic Stroke From Complex Aortic Arch Plaque.

Cureus 2021 Aug 7;13(8):e16977. Epub 2021 Aug 7.

Neurology, Hamad Medical Corporation, Doha, QAT.

Atherosclerosis is a systemic pathologic process, may involve aorta and is important cause of systemic embolization. The risk of embolism is increased for mobile and complex aortic plaques that are >4 mm thick. The most common manifestations are stroke, transient ischemic attack (TIA) and peripheral embolization. Read More

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A Prospective Multicenter Registry on Feasibility, Safety, and Outcome of Endovascular Recanalization in Childhood Stroke (Save ChildS Pro).

Front Neurol 2021 3;12:736092. Epub 2021 Sep 3.

Department of Radiology, University Hospital, Munich, Germany.

Early evidence for the benefit of mechanical thrombectomy (MT) in pediatric patients with intracranial large vessel occlusion has been shown in previous retrospective cohorts. Higher-level evidence is needed to overcome the limitations of these studies such as the lack of a control group and the retrospective design. Randomized trials will very likely not be feasible, and several open questions remain, for example, the impact of arteriopathic etiologies or a possible lower age limit for MT. Read More

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September 2021

Using the World Apheresis Association Registry Helps to Improve the Treatment Quality of Therapeutic Apheresis.

Transfus Med Hemother 2021 Aug 5;48(4):234-239. Epub 2021 Jan 5.

Department of Nephrology, University Hospital, Huddinge, Sweden.

Therapeutic apheresis (TA) is prescribed to patients that suffer from a severe progressive disease that is not sufficiently treated by conventional medications. A way to gain more knowledge about this treatment is usually by the local analysis of data. However, the use of large quality assessment registries enables analyses of even rare findings. Read More

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Multicenter study evaluating novel multi-specimen pooling assay for the detection of SARS-CoV-2: High sensitivity and high throughput testing.

J Microbiol Immunol Infect 2021 Sep 2. Epub 2021 Sep 2.

Division of Clinical Pathology, Department of Pathology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC. Electronic address:

Background/purpose: Mass screening for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is important to prevent the spread of coronavirus disease 2019 (COVID-19). Pooling samples can increase the number of tests processed. LabTurbo AIO 48 is an automated platform that allows ribonucleic acid extraction and sample analysis on the same instrument. Read More

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September 2021

How Accurate Is ICD-10 Coding for Revision Total Knee Arthroplasty?

J Arthroplasty 2021 Aug 28. Epub 2021 Aug 28.

Department of Orthopedics and Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, IA, USA.

Background: The International Classification of Diseases-10 (ICD-10) came into effect in October 2015. The new procedural codes (ICD-10-PCS) were designed to specify granular aspects of the procedure, including laterality and revised components. This specificity could improve data collection in institutional databases, large registries, and administrative claims data. Read More

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Prevalence and Risk Factors for Hypertension in Adolescents Aged 12 to 17 Years: A School-Based Study in China.

Hypertension 2021 Sep 20:HYPERTENSIONAHA12117300. Epub 2021 Sep 20.

Department of Cardiology, National Center for Cardiovascular Disease, Fuwai Hospital Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China. (K.L., C.L., R.H., X.J., Y. Zou, Y. Zhang, L.S.).

Hypertension in adolescents has attracted increasing attention. However, large, well-designed studies accurately demonstrating epidemiological characteristics of adolescent hypertension remain insufficient. We, therefore, conducted a population-based multicenter study with repeated blood pressure visits to offer precise prevalence of it. Read More

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September 2021

Blood Pressure in the First 6 Hours Following Endovascular Treatment for Ischemic Stroke Is Associated With Outcome.

Stroke 2021 Sep 20:STROKEAHA120033657. Epub 2021 Sep 20.

Department of Neurology, Erasmus MC University Medical Center, Rotterdam, the Netherlands. (N.S., R.A.v.d.G., K.B., W.v.d.S., B.R., D.W.J.D.).

Background And Purpose: Optimal blood pressure (BP) management in the acute phase of ischemic stroke remains an unresolved issue. It is uncertain whether guidelines for BP management during and after intravenous alteplase can be extrapolated to endovascular treatment (EVT) for stroke due to large artery occlusion in the anterior circulation. We evaluated the associations between systolic BP (SBP) in the first 6 hours following EVT and functional outcome as well as symptomatic intracranial hemorrhage. Read More

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September 2021

Perioperative goal-directed therapy in high-risk abdominal surgery. A multicenter randomized controlled superiority trial.

J Clin Anesth 2021 Sep 15;75:110506. Epub 2021 Sep 15.

Department of Anesthesiology, Maastricht University Medical Center, Maastricht, the Netherlands. Electronic address:

Study Objective: The potential of perioperative goal-directed therapy (PGDT) to improve outcome after high-risk abdominal surgery remains subject of debate. In particular, there is a need for large, multicenter trials focusing on relevant patient outcomes to confirm the evidence found in small, single center studies including minor complications in their composite endpoints. The present study therefore aims to investigate the effect of an arterial waveform analysis based PGDT algorithm on the incidence of major complications including mortality after high-risk abdominal surgery. Read More

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September 2021

Pulmonary hypertension among children with in-hospital cardiac arrest: a multicenter study.

Resuscitation 2021 Sep 15. Epub 2021 Sep 15.

Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.

Aims: To determine the prevalence of pulmonary hypertension (PH) among children with in-hospital cardiac arrest (IHCA) and its association with survival.

Methods: Children (<18 years) admitted to ICUs participating in the Virtual Pediatric Systems multicenter registry between January 2011 and December 2017 who had an IHCA during their hospitalization were included. Patients were classified by whether they had a documented diagnosis of PH at the time of IHCA. Read More

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September 2021

Relation of Pre-stroke Aspirin Use With Cerebral Infarct Volume and Functional Outcomes.

Ann Neurol 2021 Sep 18. Epub 2021 Sep 18.

Department of Neurology, Dongguk University Ilsan Hospital, Goyang, Korea.

Objective: We investigated a) the associations between pre-stroke aspirin use and thrombus burden, infarct volume, hemorrhagic transformation, early neurological deterioration (END), and functional outcome, and b) whether stroke subtypes modify these associations in first-ever ischemic stroke.

Methods: This multicenter MRI-based study included 5,700 consecutive patients with acute first-ever ischemic stroke, who did not undergo intravenous thrombolysis or endovascular thrombectomy, from May-2011 through February-2014. Propensity score-based augmented inverse probability weighting was performed to estimate adjusted effects of pre-stroke aspirin use. Read More

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September 2021

Regression in melanoma is significantly associated with a lower regional recurrence rate and better recurrence-free survival.

J Surg Oncol 2021 Sep 17. Epub 2021 Sep 17.

Division of Surgical Oncology, Oregon Health & Science University, Portland, Oregon, USA.

Background And Objectives: The prognostic significance of regression in predicting melanoma recurrences is unknown. We present a large multicenter study correlating regression with recurrence.

Methods: The Sentinel Lymph Node Working Group database was queried from 1993 to 2018 for cases with regression data. Read More

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September 2021

Fixed Versus Variable Dosing of Prothrombin Complex Concentrate for Bleeding Complications of Vitamin K Antagonists-The PROPER3 Randomized Clinical Trial.

Ann Emerg Med 2021 Sep 14. Epub 2021 Sep 14.

Department of Haematology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.

Study Objective: To determine if a fixed dose of 1000 IU of 4-factor prothrombin complex concentrate (4F-PCC) is as effective as traditional variable dosing based on body weight and international normalized ratio (INR) for reversal of vitamin K antagonist (VKA) anticoagulation.

Methods: In this open-label, multicenter, randomized clinical trial, patients with nonintracranial bleeds requiring VKA reversal with 4F-PCC were allocated to either a 1,000-IU fixed dose of 4F-PCC or the variable dose. The primary outcome was the proportion of patients with effective hemostasis according to the International Society of Thrombosis and Haemostasis definition. Read More

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September 2021

Laparoscopic versus open liver resection for intrahepatic cholangiocarcinoma: Report of an international multicenter cohort study with propensity score matching.

Surgery 2021 Sep 14. Epub 2021 Sep 14.

Department of Hepatobiliary and Liver Transplantation Surgery, AP-HP, Hôpital Pitié Salpêtrière, CRSA, Sorbonne Université, Paris, France. Electronic address:

Background: Intrahepatic cholangiocarcinoma is a rare disease with a poor prognosis. In patients where surgical resection is possible, outcome is influenced by perioperative morbidity and lymph node status. Laparoscopic liver resection is associated with improved clinical and oncological outcomes in primary and metastatic liver cancer compared with open liver resection, but evidence on intrahepatic cholangiocarcinoma is still insufficient. Read More

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September 2021

Acute ischemic stroke with cervical internal carotid artery steno-occlusive lesion: multicenter analysis of endovascular approaches.

BMC Neurol 2021 Sep 17;21(1):362. Epub 2021 Sep 17.

UOC Neurologia e Rete Stroke metropolitana Ospedale Maggiore CA Pizzardi - IRCCS delle scienze Neurologiche di Bologna, Bologna, Italy.

Background: Occlusion of the internal carotid artery (ICA), whether isolated or in the setting of a tandem lesion (TL) have a poor response to treatment with intravenous thrombolysis. Previous studies ​​have demonstrated the superiority of mechanical thrombectomy in the treatment of acute ischemic stroke (AIS) following large vessel occlusion, compared to standard intravenous fibrinolysis. The aim of our study was to describe endovascular treatment (EVT) in AIS due to isolated ICA occlusion or TL. Read More

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September 2021

Predicting regression of cervical intraepithelial neoplasia grade 2 in women under 25 years.

Am J Obstet Gynecol 2021 Sep 14. Epub 2021 Sep 14.

National Women's Health, Auckland District Health Board, Auckland, New Zealand; Department of Obstetrics and Gynaecology, University of Auckland, Auckland, New Zealand.

Background: A number of retrospective and prospective studies have documented significant rates of regression in cervical intraepithelial neoplasia grade 2 (CIN2) lesions in young women. The initial observational management of CIN2 is increasingly accepted as appropriate for women under 25 years of age with screen detected abnormalities, and is included in a number of clinical guidelines. However, there has been a paucity of large prospective studies of observational management with strict inclusion criteria. Read More

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September 2021

Efficacy and factors affecting procedure results of short-type single-balloon enteroscopy-assisted ERCP for altered anatomy: a multicenter cohort in JAPAN.

Gastrointest Endosc 2021 Sep 14. Epub 2021 Sep 14.

Department of Gastroenterology, Kitasato University of Medicine.

Background And Aims: Although single-balloon enteroscopy (SBE)-assisted or short-type SBE (short SBE)-assisted endoscopic retrograde cholangiopancreatography (ERCP) has been reported as useful in patients with surgically altered anatomy, most of the studies had small sample sizes or single-center designs. This study aimed to evaluate the efficacy and factors affecting the procedure results of short SBE-assisted ERCP in patients with surgically altered anatomy.

Methods: This multicenter retrospective study was conducted at 8 tertiary referral care centers in Japan. Read More

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September 2021

Study protocol of the PEruvian Registry of ST-segment Elevation Myocardial Infarction II (PERSTEMI-II) study.

PLoS One 2021 17;16(9):e0257618. Epub 2021 Sep 17.

Centro de Investigación Epidemiológica en Salud Global, Universidad Privada Norbert Wiener, Lima, Peru.

Background: Myocardial infarction (MI) is the most prevalent cardiovascular disease globally and is considered a public health problem. In Peru, MI is the second leading cause of death at the national level, with a mortality rate that exceeds 10% in the hospital setting. The study aims to determine the clinical and epidemiological characteristics of ST-segment elevation myocardial infarction (STEMI) in tertiary care facilities belonging to the Peruvian public health system. Read More

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September 2021

Characteristics and Research Waste Among Randomized Clinical Trials in Gastric Cancer.

JAMA Netw Open 2021 Sep 1;4(9):e2124760. Epub 2021 Sep 1.

Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, China.

Importance: The results of numerous large randomized clinical trials (RCTs) have changed clinical practice in gastric cancer (GC). However, research waste (ie, unpublished data, inadequate reporting, or avoidable design limitations) is still a major challenge for evidence-based medicine.

Objectives: To determine the characteristics of GC RCTs in the past 20 years and the presence of research waste and to explore potential targets for improvement. Read More

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September 2021

Racial and ethnic disparities in emergency department restraint use: A multicenter retrospective analysis.

Acad Emerg Med 2021 09;28(9):957-965

Department of Emergency Medicine, Center for Social Justice and Health Equity, Massachusetts General Hospital, Boston, Massachusetts, USA.

Background: Research regarding disparities in physical restraint use in the emergency department (ED) is limited. We evaluated the role of race, ethnicity, and preferred language on the application of physical restraint among ED patients held under a Massachusetts section 12(a) order for mandatory psychiatric evaluation.

Methods: We identified all ED patient encounters with a section 12(a) order across a large integrated 11-hospital health system from January 2018 through December 2019. Read More

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September 2021

Efficacy of Naoxueshu in acute spontaneous intracerebral hemorrhage: a multicenter observational study.

Neurol Sci 2021 Sep 16. Epub 2021 Sep 16.

Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China.

Objective: To evaluate the efficacy and safety outcome and related risk factors of Naoxueshu in the treatment of acute SICH.

Methods: Two hundred twenty patients were enrolled in this study. Diagnosis of SICH was based on neuroimaging. Read More

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September 2021