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Out-of-pocket payment for healthcare among urban citizens in Dhaka, Bangladesh.

PLoS One 2022 24;17(1):e0262900. Epub 2022 Jan 24.

Bangladesh Institute of Development Studies, Agargaon, Dhaka, Bangladesh.

Objectives: Out-of-pocket (OOP) payment is the major payment strategy for healthcare in Bangladesh, and the share of OOP expenditure has increased alarmingly. Dhaka is recognised as one of the fastest-growing megacities in the world. The objective of this study is to capture the self-reported illnesses among urban citizens and to identify whether and to what extent socioeconomic, demographic and behavioural factors of the population influence OOP healthcare expenditures. Read More

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January 2022

Comprehensive Analysis of Pediatric Pelvic Fracture Urethral Injury-Reconstructive Center Experience.

BJU Int 2022 Jan 19. Epub 2022 Jan 19.

Kulkarni Reconstructive Urology Center, Pune, India.

Objective: To analyze our experience in pelvic fracture urethral injury (PFUI) in children and adolescents. Various anastomotic urethroplasties used to accomplish tension-free anastomosis were described and their surgical outcomes was evaluated.

Materials And Methods: From 2008 to 2019, total of 192 cases includes both primary and redo PFUI, consist of 181 boys and 11 girls of ≤18 years. Read More

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January 2022

Long-term outcomes in a randomized controlled trial of multimodality imaging-guided left ventricular lead placement in cardiac resynchronization therapy.

Europace 2022 Jan 18. Epub 2022 Jan 18.

Department of Cardiology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus N, Denmark.

Aims: This study aims to investigate the long-term occurrence of the composite endpoint of heart failure (HF) hospitalization or all-cause death (primary endpoint) in patients randomized to cardiac resynchronization therapy (CRT) using individualized multimodality imaging-guided left ventricular (LV) lead placement compared with a routine fluoroscopic approach. Furthermore, this study aims to evaluate whether inter-lead electrical delay (IED) is associated with improved response rate of this endpoint.

Methods And Results: We reviewed follow-up data until November 2020 for all 182 patients included in the ImagingCRT trial for the occurrence of HF hospitalization and all-cause death. Read More

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January 2022

Effects of electrode size and placement on comfort and efficiency during low-intensity neuromuscular electrical stimulation of quadriceps, hamstrings and gluteal muscles.

BMC Sports Sci Med Rehabil 2022 Jan 16;14(1):11. Epub 2022 Jan 16.

Section of Orthopedics and Sports Medicine, Integrative Orthopedic Laboratory, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.

Background: Neuromuscular electrical stimulation (NMES) may prevent muscle atrophy, accelerate rehabilitation and enhance blood circulation. Yet, one major drawback is that patient compliance is impeded by the discomfort experienced. It is well-known that the size and placement of electrodes affect the comfort and effect during high-intensity NMES. Read More

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January 2022

Apnoeic oxygenation in morbid obesity: a randomised controlled trial comparing facemask and high-flow nasal oxygen delivery.

Br J Anaesth 2022 Jan 11. Epub 2022 Jan 11.

Imperial College Healthcare NHS Trust, London, UK.

Background: Obesity is a risk factor for airway-related incidents during anaesthesia. High-flow nasal oxygen has been advocated to improve safety in high-risk groups, but its effectiveness in the obese population is uncertain. This study compared the effect of high-flow nasal oxygen and low-flow facemask oxygen delivery on duration of apnoea in morbidly obese patients. Read More

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January 2022

Routinely measured cardiac troponin I and N-terminal pro-B-type natriuretic peptide as predictors of mortality in haemodialysis patients.

ESC Heart Fail 2022 Jan 13. Epub 2022 Jan 13.

Fukuoka Renal Clinic, Fukuoka, Japan.

Aims: Cardiac troponin (cTn) and B-type natriuretic peptide (BNP) are elevated in haemodialysis (HD) patients, and this elevation is associated with HD-induced myocardial stunning/myocardial strain. However, studies using data from the international Dialysis Outcomes and Practice Patterns Study (DOPPS) have shown that these cardiac biomarkers are measured in <2% of HD patients in real-world practice. This study aimed to examine whether routinely measured N-terminal pro-BNP (NT-proBNP) and cTnI (contemporary assay) are more appropriate than clinical models for reclassifying the risk of HD patients who have the highest risk of death. Read More

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January 2022

Risk associations of long-term HbA1c variability and obesity on cancer events and cancer-specific death in 15,286 patients with diabetes - A prospective cohort study.

Lancet Reg Health West Pac 2022 Jan 12;18:100315. Epub 2021 Nov 12.

Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong SAR China.

Background: Obesity, cancer and diabetes frequently coexist. The association of glycaemic variability (GV) and obesity with cancer events had not been explored in diabetes.

Methods: In the prospective Hong Kong Diabetes Register cohort (1995-2019), we used cox proportional hazards models to examine the risk associations of GV with all-site cancer (primary outcome) and cause-specific death (secondary outcome). Read More

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January 2022

The status and predictors of self-care among older adults with hypertension in China using the Chinese version of Self-Care of Hypertension Inventory - A cross-sectional study.

Nurs Open 2022 Jan 11. Epub 2022 Jan 11.

First School of Clinical Medicine, Nanjing Medical University, Nanjing, China.

Aim: To investigate the status and predictors of self-care among older adults with hypertension in China by the Chinese version of Self-Care of Hypertension Inventory.

Design: A cross-sectional questionnaire survey.

Methods: A convenience sampling of 544 older adults with hypertension was surveyed using the Chinese version of Self-Care of Hypertension Inventory. Read More

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January 2022

Validation of the days alive and out of hospital outcome measure after emergency laparotomy: a retrospective cohort study.

Br J Anaesth 2022 Jan 7. Epub 2022 Jan 7.

Surgical Outcomes Research Centre (SOuRCe), Centre for Perioperative Medicine, Division of Surgical and Interventional Science, University College London, London, UK; Department of Anaesthesia and Perioperative Medicine, University College London Hospitals, London, UK.

Background: Days alive and out of hospital (DAOH) is a composite, patient-centred outcome measure describing a patient's postoperative recovery, encompassing hospitalisation and mortality. DAOH is the number of days not in hospital over a defined postoperative period; patients who die have DAOH of zero. The Standardising Endpoints in Perioperative Medicine (StEP) group recommended DAOH as a perioperative outcome. Read More

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January 2022

Triiodothyronine (T3), inflammation and mortality risk in patients with acute myocardial infarction.

Eur Thyroid J 2022 Jan 1. Epub 2022 Jan 1.

A Zaman, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom of Great Britain and Northern Ireland.

Objectives: To study the relationship between serum free T3 (FT3), C-reactive protein (CRP), and all-cause mortality in patients with acute myocardial infarction (AMI).

Design: Prospective multicentre longitudinal cohort study.

Methods: Between December 2014 and December 2016, thyroid function and CRP were analysed in AMI (both ST- and non-ST-elevation) patients from the ThyrAMI-1 study. Read More

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January 2022

Dignity, coercion and involuntary psychiatric care: a study of involuntary and voluntary psychiatry inpatients in Dublin.

Int J Psychiatry Clin Pract 2022 Jan 9:1-8. Epub 2022 Jan 9.

Psychological Medicine Service, St. James' Hospital, Dublin 8, Ireland.

Objectives: There is a paucity of research about psychiatric inpatients' experience of dignity. Most of the limited literature on this topic is qualitative. Our study provides quantitative data about self-rated dignity among involuntary and voluntary psychiatry inpatients. Read More

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January 2022

Association of genetic variations in ACE2, TIRAP and factor X with outcomes in COVID-19.

PLoS One 2022 7;17(1):e0260897. Epub 2022 Jan 7.

Meander Medical Centre, Department of Internal Medicine, Amersfoort, The Netherlands.

Background: Coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), can manifest with varying disease severity and mortality. Genetic predisposition influences the clinical course of infectious diseases. We investigated whether genetic polymorphisms in candidate genes ACE2, TIRAP, and factor X are associated with clinical outcomes in COVID-19. Read More

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January 2022

Assessor burden, inter-rater agreement and user experience of the RoB-SPEO tool for assessing risk of bias in studies estimating prevalence of exposure to occupational risk factors: An analysis from the WHO/ILO Joint Estimates of the Work-related Burden of Disease and Injury.

Environ Int 2022 01 30;158:107005. Epub 2021 Nov 30.

Department of Environment, Climate Change and Health, World Health Organization, Geneva, Switzerland. Electronic address:

Background: As part of the development of the World Health Organization (WHO)/International Labour Organization (ILO) Joint Estimates of the Work-related Burden of Disease and Injury, WHO and ILO carried out several systematic reviews to determine the prevalence of exposure to selected occupational risk factors. Risk of bias assessment for individual studies is a critical step of a systematic review. No tool existed for assessing the risk of bias in prevalence studies of exposure to occupational risk factors, so WHO and ILO developed and pilot tested the RoB-SPEO tool for this purpose. Read More

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January 2022

High-grade preoperative osteoarthritis of the index compartment is a major predictor of meniscal allograft failure.

Arch Orthop Trauma Surg 2022 Jan 5. Epub 2022 Jan 5.

Department of Orthopaedic Surgery, UPMC Freddie Fu Sports Medicine Center, University of Pittsburgh, 3200 S. Water St, Pittsburgh, PA, 15203, USA.

Introduction: Preoperatively available predictors of meniscal allograft failure would help in patient counseling and surgical indication for meniscal allograft transplantation (MAT). It was hypothesized that young patient age, high posterior tibial slope (PTS), and high-grade osteoarthritis (OA) are predictors of meniscal allograft failure.

Materials And Methods: Patients undergoing MAT with a minimum follow-up of 2 years were included in this retrospective study. Read More

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January 2022

Suspected Adverse Drug Reactions in Pediatric Cancer Patients in China: An Analysis of Henan Province Spontaneous Reporting System Database.

Front Oncol 2021 20;11:807171. Epub 2021 Dec 20.

School of Pharmacy, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

Introduction: Adverse drug reactions (ADRs) in pediatric cancer patients have not yet received due attention in the world. Antineoplastic drugs are frequently related to ADRs. Few studies focus on the ADR and the intervention measures in pediatric cancer patients. Read More

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December 2021

Descriptive analysis of routine childhood immunisation timeliness in the Western Cape, South Africa.

Vaccine X 2022 Apr 13;10:100130. Epub 2021 Dec 13.

Vaccines for Africa Initiative, School of Public Health and Family Medicine, University of Cape Town, Western Cape, South Africa.

Adherence to recommended age-specific immunisation schedules is critical in ensuring vaccine effectiveness against vaccine preventable diseases (VPDs). There is limited data on immunisation timeliness in sub-Saharan Africa. Therefore, this study assessed the timeliness of age-specific routine childhood immunisation within the Western Cape Province of South Africa. Read More

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Prognostic value of the MELD-XI score in patients undergoing cardiac resynchronization therapy.

ESC Heart Fail 2022 Jan 4. Epub 2022 Jan 4.

Division of Cardiology, Department of Medicine, Nihon University School of Medicine, 30-1 Ohyaguchi-kamicho, Itabashi-ku, Tokyo, 173-8610, Japan.

Aims: Multi-organ dysfunction was recently reported to be a common condition in patients with heart failure (HF). The Model for End-stage Liver Disease eXcluding International normalized ratio (MELD-XI) score reflects liver and kidney function. The prognostic relevance of this score has been reported in patients with a variety of cardiovascular diseases who are undergoing interventional therapies. Read More

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January 2022

A risk-adjustment model for patients presenting to hospitals with out-of-hospital cardiac arrest and ST-elevation myocardial infarction.

Resuscitation 2021 Dec 27;171:41-47. Epub 2021 Dec 27.

Saint Luke's Mid America Heart Institute, Kansas City, MO, USA; University of Missouri-Kansas City, Kansas City, MO, USA. Electronic address:

Background: Patients with ST-elevation myocardial infarction (STEMI) complicated by an out-of-hospital-cardiac-arrest (OHCA) may vary widely in their probability of dying. Large variation in mortality may have implications for current national efforts to benchmark operator and hospital mortality rates for coronary angiography. We aimed to build a risk-adjustment model of in-hospital mortality among OHCA survivors with concurrent STEMI. Read More

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December 2021

Elevated circulating high-sensitivity cardiac troponin t and cardiac remodeling in obesity.

BMC Cardiovasc Disord 2021 12 28;21(1):620. Epub 2021 Dec 28.

Shanghai Institute of Cardiovascular Diseases, Shanghai Institute of Clinical Bioinformatics, Zhongshan Hospital, Shanghai Medical College of Fudan University, Shanghai, China.

Background: It is well established that body mass index (BMI) and troponins are independently associated. However, whether the obesity could cause myocardial injury independent of coronary heart disease (CHD) remains unclear. This study focuses on the relationship between BMI and troponins, and whether this relationship is being attenuated when CHD is accounted for. Read More

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December 2021

Validation and clinical outcome in assessing donor-derived cell-free DNA monitoring insights of kidney allografts with longitudinal surveillance (ADMIRAL) study.

Kidney Int 2021 Dec 22. Epub 2021 Dec 22.

Washington University in St. Louis.

The use of routine monitoring of donor-derived cell-free DNA (dd-cfDNA) after kidney transplant may allow clinicians to identify subclinical allograft injury and intervene prior to development of clinically evident graft injury. To evaluate this, data from 1092 kidney transplant recipients monitored for dd-cfDNA over a three year period was analyzed to assess the association of dd-cfDNA with histologic evidence of allograft rejection. Elevation of dd-cfDNA (0. Read More

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December 2021

Histomorphological and inflammatory changes of white adipose tissue in gastrointestinal cancer patients with and without cachexia.

J Cachexia Sarcopenia Muscle 2021 Dec 22. Epub 2021 Dec 22.

Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy.

Background: During cancer cachexia, several alterations occur in peripheral tissues, and the adipose tissue may be involved during the catabolic state. We aimed at investigating histological rearrangement and infiltration of inflammatory cells in subcutaneous adipose tissue (SAT) of patients with cancer undergoing surgery, according to the presence/absence of cachexia.

Methods: We considered gastrointestinal cancer patients and controls with non-malignant diseases undergoing surgery. Read More

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December 2021

Identification of traumatic acid as a potential plasma biomarker for sarcopenia using a metabolomics-based approach.

J Cachexia Sarcopenia Muscle 2021 Dec 22. Epub 2021 Dec 22.

Department of Family Medicine, National Taiwan University Hospital, National Taiwan University, Taipei, Taiwan.

Background: The pathogenesis of sarcopenia is complex and has not been well explored. Identifying biomarkers is a promising strategy for exploring the mechanism of sarcopenia. This study aimed to identify potential biomarkers of sarcopenia through a metabolomic analysis of plasma metabolites in elderly subjects (≥65 years of age) vs. Read More

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December 2021

The reliability of the Wagner Scale for evaluation the diabetic wounds: A literature review.

Diabetes Metab Syndr 2021 Dec 13;16(1):102369. Epub 2021 Dec 13.

Vice Chancellery for Research and Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran.

Background And Aims: Classification of wound severity is important in medical care decisions specially in diabetic patients. The Wagner Scale provides a structure to determine the severity of a wound by examining its depth and extent. The adequate reliability of this instrument, like other instruments for measuring health status, is important. Read More

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December 2021

N-terminal pro-B-type natriuretic peptide testing patterns in patients with heart failure with reduced ejection fraction.

ESC Heart Fail 2022 Feb 16;9(1):87-99. Epub 2021 Dec 16.

Merck & Co., Inc., Kenilworth, NJ, USA.

Aims: The N-terminal pro-B-type natriuretic peptide (NT-proBNP) is a commonly used biomarker in heart failure for diagnosis and prognostication. We aimed to determine the prevalence of NT-proBNP testing, distribution of NT-proBNP concentrations, and factors associated with receiving an NT-proBNP test in patients with heart failure with reduced ejection fraction (HFrEF), including the subset with a worsening heart failure event (WHFE).

Methods And Results: This was a retrospective cohort study using two US databases: (i) the de-identified Humana Research Database between January 2015 and December 2018 and (ii) the Veradigm PINNACLE Registry between July 2013 and September 2017. Read More

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February 2022

Impact of early chest radiography on delay in pulmonary tuberculosis case notification in Ethiopia.

Int J Mycobacteriol 2021 Oct-Dec;10(4):364-372

Centre for Innovative Drug Development and Therapeutic Trials for Africa, College of Health Sciences, Addis Ababa University; Ohio State Global One Health Initiative, Office of International Affairs, The Ohio State University, Addis Ababa, Ethiopia.

Background: One-third of tuberculosis (TB) cases are missed each year and delays in the diagnosis of TB are hampering the whole cascade of care. Early chest X-ray (CXR) in patients with cough irrespective of duration may reduce TB diagnostic and treatment delays and increase the number of TB patients put into TB care. We aimed to evaluate the impact of CXR on delay in the diagnosis of pulmonary tuberculosis (PTB) among people with cough of any duration. Read More

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January 2022

The effect of transnasal humidified rapid-insufflation ventilator exchange (THRIVE) versus nasal prongs on safe apnoea time in paralysed obese patients: a randomised controlled trial.

Br J Anaesth 2022 Feb 8;128(2):375-381. Epub 2021 Dec 8.

Department of Anaesthesia and Perioperative Medicine, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia; Faculty of Medicine, The University of Queensland, Herston, Queensland, Australia.

Background: Evidence is lacking regarding the efficacy of Optiflow transnasal humidified rapid-insufflation ventilator exchange (THRIVE™) in obese patients. We compared the impact of this technique at 70 L min with 4 L min oxygen via nasal prongs on safe apnoea times of paralysed obese patients.

Methods: We randomised adults with a BMI >35 kg m undergoing elective bariatric surgery. Read More

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February 2022

Osteomyelitis in Immunocompromised children and neonates, a case series.

BMC Pediatr 2021 12 11;21(1):568. Epub 2021 Dec 11.

Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.

Background: Osteomyelitis in immunocompromised children can present differently from immunocompetent children and can cause devastating sequelae if treated inadequately. We aim to review the aetiology, clinical profile, treatment and outcomes of immunocompromised children with osteomyelitis.

Methods: Retrospective review of all immunocompromised children aged < 16 years and neonates admitted with osteomyelitis in our hospital between January 2000 and January 2017, and referred to the Paediatric Infectious Disease Service. Read More

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December 2021

Exercise capacity after total cavopulmonary anastomosis: a longitudinal paediatric and adult study.

ESC Heart Fail 2022 Feb 10;9(1):337-344. Epub 2021 Dec 10.

Children's Heart Centre, Second Faculty of Medicine, Charles University in Prague and Motol University Hospital, Prague, Czech Republic.

Aims: Fontan palliation is a surgical strategy for patients with complex congenital heart disease, in whom biventricular circulation cannot be achieved. Long-term survival is negatively affected by the absence of sub-pulmonary ventricle and increased systemic venous pressure. Exercise capacity is a known predictor of overall survival and quality of life in congenital heart defects. Read More

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February 2022

Electroencephalography-demonstrated mechanisms of dexmedetomidine-mediated deepening of propofol anesthesia: an observational study.

Perioper Med (Lond) 2021 Dec 9;10(1):44. Epub 2021 Dec 9.

Department of Anesthesiology, The First Affiliated Hospital of Anhui Medical University, Anhui Medical University, Hefei, Anhui, China.

Background: Although dexmedetomidine (Dex) is known to reduce bispectral index (BIS) values and propofol dosage, there is little information regarding raw electroencephalography (EEG) changes related to Dex deepening of propofol general anesthesia (GA). This study investigated the Dex effects on propofol GA via analysis of EEG changes.

Methods: A study cohort of 21 surgical patients (age range, 20-60 years) categorized as American Society of Anesthesiologists (ASA) class I or II was enrolled. Read More

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December 2021

Intravenous iron to treat anaemia following critical care: a multicentre feasibility randomised trial.

Br J Anaesth 2022 Feb 3;128(2):272-282. Epub 2021 Dec 3.

Radcliffe Department of Medicine, University of Oxford, Oxford, UK; Haematology Theme, NIHR Oxford Biomedical Research Centre, Oxford, UK; Department of Haematology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.

Background: Anaemia is common and associated with poor outcomes in survivors of critical illness. However, the optimal treatment strategy is unclear.

Methods: We conducted a multicentre, feasibility RCT to compare either a single dose of ferric carboxymaltose 1000 mg i. Read More

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February 2022