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8-Hydroxy-2'-Deoxyguanosine and Reactive Oxygen Species as Biomarkers of Oxidative Stress in Mental Illnesses: A Meta-Analysis.

Psychiatry Investig 2021 Jul 22;18(7):603-618. Epub 2021 Jul 22.

Department of Chemical Engineering, Lee Kong Chian Faculty of Engineering and Science, Universiti Tunku Abdul Rahman, Kajang, Malaysia.

Objective: Mental illnesses may be caused by genetic and environmental factors. Recent studies reported that mental illnesses were accompanied by higher oxidative stress level. However, the results were inconsistent. Read More

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Restricted sub-tree learning to estimate an optimal dynamic treatment regime using observational data.

Kelly Speth Lu Wang

Stat Med 2021 Aug 2. Epub 2021 Aug 2.

Department of Biostatistics, University of Michigan, Ann Arbor, Michigan, USA.

Dynamic treatment regimes (DTRs), consisting of a sequence of tailored treatment decision rules that span multiple stages of care, present a unique opportunity in our drive toward personalized medicine. Given that estimation of optimal DTRs is often exploratory and communication with clinicians is vital, robust and flexible methods that yield interpretable results are needed. Tree-based methods utilizing a purity measure defined on the full set of covariates have enjoyed much success in meeting this goal. Read More

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Determination of Cytokines and Oxidative Stress Biomarkers in Cognitive Impairment Induced by Methylmalonic Acidemia.

Neuroimmunomodulation 2021 Aug 2:1-9. Epub 2021 Aug 2.

Department of Medical Laboratory, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.

Objective: Methylmalonic acidemia (MMA) is the most common organic acidemia in children. Many patients with MMA suffered from cognitive impairments. The aim of this study was to identify the significance of cytokines and oxidative stress biomarkers in MMA-induced cognitive impairment. Read More

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The Association between Sarcopenia as a Comorbid Disease and Incidence of Institutionalisation and Mortality in Geriatric Rehabilitation Inpatients: REStORing health of acutely unwell adulTs (RESORT).

Gerontology 2021 Aug 2:1-11. Epub 2021 Aug 2.

Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Melbourne, Victoria, Australia.

Introduction: Sarcopenia is associated with poor health outcomes and highly prevalent in individuals with age-related diseases. This study aimed to determine whether sarcopenia as a comorbid disease is associated with the incidence of institutionalisation and mortality in geriatric rehabilitation inpatients.

Methods: REStORing health of acutely unwell adulTs (RESORT) includes geriatric rehabilitation patients assessed for sarcopenia (the European Working Group on Sarcopenia in Older People [EWGSOP, 2010], EWGSOP2 [2018], and the Asian Working Group for Sarcopenia [AWGS 2019]), multimorbidity, disease severity, and specific diseases (Charlson Comorbidity Index and Cumulative Illness Rating Scale) at admission. Read More

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Body Adiposity Index Is Predictive of Weight Loss after Roux-en-Y Gastric Bypass.

Ann Nutr Metab 2021 Aug 2:1-10. Epub 2021 Aug 2.

Department of Endocrinology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China.

Background/aims: Roux-en-Y gastric bypass (RYGB) is one of the most effective therapies for morbid obesity, yet some patients who have taken the surgery still undergo insufficient weight loss. Visceral adiposity index (VAI), lipid accumulation product (LAP), body adiposity index (BAI), and cardiometabolic index (CMI) have been regarded as clinical indicators of adiposity phenotypes that associated closely with obesity-related metabolic diseases. However, no studies have evaluated the relationship between these indexes and weight loss after bariatric surgery. Read More

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Response to Immune Checkpoint Inhibitors in Recurrent or Metastatic Esophageal Squamous Cell Carcinoma May Be Affected by Tumor Sites.

Oncology 2021 Aug 2:1-7. Epub 2021 Aug 2.

Department of Medical Oncology, National Taiwan University Cancer Center, Taipei, Taiwan.

Introduction: Heterogeneous tumor response has been reported in cancer patients treated with immune checkpoint inhibitors (ICIs). This study investigated whether the tumor site is associated with the response to ICIs in patients with recurrent or metastatic esophageal squamous cell carcinoma (ESCC).

Methods: Patients with ESCC who had measurable tumors in the liver, lung, or lymph node (LN) according to the response evaluation criteria in solid tumors (RECIST) 1. Read More

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The Role of Apolipoprotein E ε4 in Early and Late Mild Cognitive Impairment.

Eur Neurol 2021 Aug 2:1-9. Epub 2021 Aug 2.

General Medical Wards, The Affiliated Children's Hospital of Chongqing Medical University, Chongqing, China.

Background: Apolipoprotein E (APOE) ε4 is highly associated with mild cognitive impairment (MCI). However, the specific influence of APOE ε4 status on tau pathology and cognitive decline in early MCI (EMCI) and late MCI (LMCI) is poorly understood. Our goal was to evaluate the association of APOE ε4 with cerebrospinal fluid (CSF) tau levels and cognition in EMCI and LMCI patients in the Alzheimer's Disease Neuroimaging Initiative database, and whether this association was mediated by amyloid-β (Aβ). Read More

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Neuroendocrine and Adrenal Tumors, Version 2.2021, NCCN Clinical Practice Guidelines in Oncology.

J Natl Compr Canc Netw 2021 Jul 28;19(7):839-868. Epub 2021 Jul 28.

7Vanderbilt-Ingram Cancer Center.

The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Neuroendocrine and Adrenal Gland Tumors focus on the diagnosis, treatment, and management of patients with neuroendocrine tumors (NETs), adrenal tumors, pheochromocytomas, paragangliomas, and multiple endocrine neoplasia. NETs are generally subclassified by site of origin, stage, and histologic characteristics. Appropriate diagnosis and treatment of NETs often involves collaboration between specialists in multiple disciplines, using specific biochemical, radiologic, and surgical methods. Read More

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Chemotherapy-Induced Peripheral Neurotoxicity in Cancer Survivors: Predictors of Long-Term Patient Outcomes.

J Natl Compr Canc Netw 2021 Jul 28;19(7):821-828. Epub 2021 Jul 28.

5Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, Camperdown, Australia.

Background: Chemotherapy-induced peripheral neurotoxicity (CIPN) is a major adverse effect of cancer treatment. However, its impact remains poorly understood. This study aimed to investigate the impact associated with CIPN on the lives of cancer survivors. Read More

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Patients characteristics related to screening mammography cancellation and rescheduling rates during the COVID-19 pandemic.

Clin Imaging 2021 Jul 29;80:205-210. Epub 2021 Jul 29.

Center for Evidence-Based Imaging, Brigham and Women's Hospital, Harvard Medical School, 1620 Tremont Street, Boston, MA 02120, United States of America. Electronic address:

Purpose: To identify patient characteristics associated with screening mammography cancellations and rescheduling during the COVID-19 pandemic.

Methods: Scheduled screening mammograms during three time periods were retrospectively reviewed: state-mandated shutdown (3/17/2020-6/16/2020) during which screening mammography was cancelled, a period of 2 months immediately after screening mammography resumed (6/17/2020-8/16/2020), and a representative period prior to COVID-19 (6/17/2019-8/16/2019). Relative risk of cancellation before COVID-19 and after reopening was compared for age, race/ethnicity, insurance, history of chronic disease, and exam location, controlling for other collected variables. Read More

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Transfer learning artificial intelligence for automated detection of atrial fibrillation in patients undergoing evaluation for suspected obstructive sleep apnoea: a feasibility study.

Sleep Med 2021 Jul 17;85:166-171. Epub 2021 Jul 17.

School of Medicine, The University of Notre Dame Australia, 21 Henry St., Fremantle, WA, 6160, Australia; Bendat Respiratory Research and Development Fund, SJOG Subiaco, WA, 6008, Australia.

Background: Individuals with obstructive sleep apnoea (OSA) experience a higher burden of atrial fibrillation (AF) than the general population, and many cases of AF remain undetected. We tested the feasibility of an artificial intelligence (AI) approach to opportunistic detection of AF from single-lead electrocardiograms (ECGs) which are routinely recorded during in-laboratory polysomnographic sleep studies.

Methods: Using transfer learning, an existing ECG AI model was applied to 1839 single-lead ECG traces recorded during in-laboratory sleep studies without any training of the algorithm. Read More

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Proton beam therapy in rectal cancer: A systematic review and meta-analysis.

Surg Oncol 2021 Jul 27;38:101638. Epub 2021 Jul 27.

Department of Colorectal Surgery, Countess of Chester NHS Foundation Trust, UK; Institute of Systems, Molecular and Integrative Biology, University of Liverpool, 200 London Road, Liverpool, L3 9TA, UK. Electronic address:

Introduction: Locally advanced rectal cancer is often treated with neoadjuvant chemoradiotherapy and surgery. Radiotherapy carries significant risk of toxicity to organs at risk (OAR). Proton beam therapy (PBT) has demonstrated to be effective in other cancers, delivering equivalent dosimetric radiation but with the benefit of improved sparing of OAR. Read More

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Antiseizure medication nonadherence and its associated factors among Epileptic patients in Ethiopia, a systematic review and meta-analysis.

Seizure 2021 Jul 26;91:462-475. Epub 2021 Jul 26.

College of Nursing, University of Saskatchewan, Saskatoon, Canada; School of Life Sciences and Bioengineering, Nelson Mandela African Institute of Science and Technology, Arusha, Tanzania. Electronic address:

Background: The majority of patients with epilepsy in resource-poor countries never receive proper treatment, and those who are started on anti-seizure medications quickly discontinue them. Medication noncompliance is extremely common, with estimates ranging from 26 to 79 percent. Non-adherence to antiseizure medications is associated with poor seizure control, increased morbidity, increased hospitalization time, poor quality of life, increased health care costs, and increased mortality in adults. Read More

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Clinical profile, antifungal susceptibility, and molecular characterization of Candida auris isolated from patients in a South Indian surgical ICU.

J Mycol Med 2021 Jul 21;31(4):101176. Epub 2021 Jul 21.

Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, 1600012. Electronic address:

Background: Candida auris is an emerging multidrug resistant yeast which causes blood stream infection especially among critically ill patients. This yeast can also colonize patients and are isolated from hospital environment causing outbreaks in hospital settings.

Objective: To describe possible outbreak of C. Read More

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CT-defined emphysema in COPD patients and risk for change in desaturation status in 6-min walk test.

Respir Med 2021 Jul 23;187:106542. Epub 2021 Jul 23.

Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.

Background: Emphysema and exercise induced desaturation (EID) are both related to poorer COPD prognosis. More knowledge of associations between emphysema and desaturation is needed for more efficient disease management.

Research Question: Is emphysema a risk factor for both new and repeated desaturation, and is emphysema of more or less importance than other known risk factors?

Methods: 283 COPD patients completed a 6-min walk test (6MWT) at baseline and one year later in the Bergen COPD cohort study 2006-2011. Read More

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High-flow nasal oxygen (HFNO) for patients with Covid-19 outside intensive care units.

Respir Med 2021 Jul 28;187:106554. Epub 2021 Jul 28.

Department of Internal Medicine, Södersjukhuset, Stockholm, Sweden; Karolinska Institutet, Department of Clinical Science and Education, Södersjukhuset, Stockholm, Sweden.

Introduction: High-flow nasal oxygen (HFNO) has traditionally only been used in intensive care units (ICU) especially in acute respiratory distress syndrome (ARDS).

Methods: We studied the use of HFNO at Södersjukhuset, Stockholm, in patients with moderate to severe ARDS related to Covid-19 as well as its benefits both for patients and to offload the ICU. The patients were observed with frequent controls to assess the need of ICU in case of deterioration. Read More

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Association of N-terminal pro-brain natriuretic peptide level with adverse outcomes in patients with acute myocardial infarction: A meta-analysis.

Heart Lung 2021 Jul 30;50(6):863-869. Epub 2021 Jul 30.

Department of Cardiology, Tongde Hospital of Zhejiang Province, Hangzhou City, Zhejiang Province, 310012, PR China. Electronic address:

Background: Studies evaluating the association of blood level of N-terminal pro-brain natriuretic peptide (NT-proBNP) with adverse prognosis have yielded conflicting results in patients with acute myocardial infarction (AMI). This meta-analysis sought to evaluate the prognostic value of blood level of NT-proBNP in patients with AMI.

Methods: Two authors independently searched articles in PubMed and Embase databases up to June 13, 2021. Read More

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Immune checkpoint inhibitors at any treatment line in advanced NSCLC: Real-world overall survival in a large Italian cohort.

Lung Cancer 2021 Jul 17;159:145-152. Epub 2021 Jul 17.

Epidemiology Unit, Agency for Health Protection (ATS) of Milan, C.so Italia 52, 20122 Milano, Italy. Electronic address:

Objectives: To estimate the average treatment effect of immune checkpoint inhibitors in any line of treatment in a 2016-2018 population-based cohort of patients with advanced non-small-cell lung cancer (NSCLC).

Materials And Methods: The cohort, and information on the tumor, were derived from the cancer registry of the Agency for Health Protection of Milan, Italy. Inclusion criteria were adult age, microscopically confirmed NSCLC, stage IIIB or IV at diagnosis, and having received at least one line of treatment. Read More

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UniPortal thoracoscopic pneumonectomy does not compromise perioperative and long-term survival in patients with NSCLC: A retrospective, multicenter, and propensity score matching study.

Lung Cancer 2021 Jul 24;159:135-144. Epub 2021 Jul 24.

Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200433, People's Republic of China. Electronic address:

Objectives: To compare the perioperative and oncologic outcomes following pneumonectomy performed by uniportal video-assisted thoracoscopic surgery (U-VATS) and thoracotomy in patients with centrally located non-small cell lung cancer (NSCLC).

Materials And Methods: Patients with NSCLC who underwent pneumonectomy at the Shanghai Pulmonary Hospital (SPH) and Sun Yat-sen University Cancer Center (SYUCC) with the U-VATS approach or open approach between 2011 and 2016 were selected. Propensity score matching (1:3) was performed to balance the baseline covariates. Read More

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Increased Relative Functional Gain and Improved Stroke Outcomes: A Linked Registry Study of the Impact of Rehabilitation.

J Stroke Cerebrovasc Dis 2021 Jul 30;30(10):106015. Epub 2021 Jul 30.

Florey Institute of Neuroscience and Mental Health, Heidelberg, VIC, Australia; Translational Public Health and Evaluation Division, Stroke and Ageing Research, School of Clinical Sciences at Monash Health, Monash University, Level 3 Hudson Institute Building, 27-31 Wright Street, Clayton, VIC 3168, Australia. Electronic address:

Objectives: It is unclear how acute care influences patient outcomes in those who receive rehabilitation. We aimed to determine the associations between acute stroke therapies, outcomes during inpatient rehabilitation and self-reported outcomes at 90-180 days after stroke.

Materials And Methods: Patient-level data from adults with acute stroke registered in the Australian Stroke Clinical Registry (AuSCR, 2014-2017) were linked with data from the Australasian Rehabilitation Outcomes Centre (AROC). Read More

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Gender Differences in Insurance, Surgical Admissions and Outcomes at a Kenyan Referral Hospital.

J Surg Res 2021 Jul 30;268:199-208. Epub 2021 Jul 30.

Department of General Surgery, Indiana University School of Medicine, Indianapolis, IND; Moi University, Kesses, Eldoret, Kenya.

Introduction: Gender is an important factor in determining access to healthcare resources. Women face additional barriers, especially in low- and middle-income countries. Surgical costs can be devastating, which can exacerbate engendered disparities. Read More

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The effect of postoperative steroid dosing on readmission rates following radiofrequency ablation tonsillectomy.

Int J Pediatr Otorhinolaryngol 2021 Jul 29;149:110862. Epub 2021 Jul 29.

Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati, Cincinnati, Ohio, USA; Division of Pediatric Otolaryngology - Head and Neck Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA; Division of Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA. Electronic address:

Objective: To examine the effect of postoperative steroid dosage on postoperative telephone calls, emergency department (ED) visits, and hemorrhage rates for two groups receiving different steroid dosing following radiofrequency ablation tonsillectomy.

Study Design: Retrospective chart review between January 1, 2014 and January 1, 2019.

Setting: Tertiary care pediatric hospital. Read More

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Needle aspiration of lateral neck abscess in children: A simple and effective treatment.

Int J Pediatr Otorhinolaryngol 2021 Jul 21;149:110850. Epub 2021 Jul 21.

Department of Otorhinolaryngology, Children's Hospital "Ospedale Pediatrico Bambino Gesù - IRCCS", Rome, Italy.

Background: Cervical abscesses frequently occurred in pediatric patients. Surgical drainage is currently recommended in the cases not responding to medical therapy. Needle aspiration may represent a simple, effective and minimally invasive treatment for acute neck suppuration in selected cases. Read More

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Hyper- and hypo-connectivity in sensorimotor network of drug-naïve patients with cervical dystonia.

Parkinsonism Relat Disord 2021 Jul 22;90:15-20. Epub 2021 Jul 22.

Center for Movement Disorders, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing, China; Parkinson's Disease Center, Beijing Institute for Brain Disorders, Beijing, China. Electronic address:

Background: Cervical dystonia (CD) is the most common form of focal dystonia with involuntary movements and postures of the head. The pathogenesis and neural mechanisms underlying CD have not been fully elucidated.

Methods: Twenty-seven newly drug-naïve patients with CD and 21 healthy controls (HCs) were recruited with clinical assessment and resting-state functional magnetic resonance imaging (rs-fMRI) scanning. Read More

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Ferroptosis-related gene model to predict overall survival of papillary thyroid carcinoma.

Am J Otolaryngol 2021 Jul 26;42(6):103163. Epub 2021 Jul 26.

Department of Endocrinology, Affiliated Hospital of Guizhou Medical University, Guiyang 550004, Guizhou, China. Electronic address:

Background: Ferroptosis is a form of programmed cell death that is closely associated with the development of various tumors. However, the correlation between ferroptosis and papillary thyroid carcinoma (PTC) is unclear. This study was performed to investigate the expression and prognostic value of ferroptosis-related genes (FRG) in PTC. Read More

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Low monoenergetic DECT detection of pyelonephritis extent.

Eur J Radiol 2021 Jul 8;142:109837. Epub 2021 Jul 8.

Department of Radiology, Hadassah Medical Center, Hebrew University of Jerusalem, The Faculty of Medicine, Jerusalem 91120, Israel. Electronic address:

Objectives: To determine whether contrast enhanced DECT low monoenergetic can improve diagnostic conspicuity of inflamed kidney foci in acute pyelonephritis compared to conventional images.

Materials And Methods: A retrospective study of 45 patients with clinical signs of acute pyelonephritis undergoing contrast-enhanced exams on a single source-DECT was conducted. Representative conventional and monoenergetic images were randomized and presented to four abdominal radiologists to determine their preference for inflamed kidney foci detection, and to determine the number of foci identified. Read More

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Cost-effectiveness of point-of-care creatinine testing to assess kidney function prior to contrast-enhanced computed tomography imaging.

Eur J Radiol 2021 Jul 27;142:109872. Epub 2021 Jul 27.

Centre for Health Economics, University of York, Heslington, UK.

Background: Patients undergoing contrast-enhanced computed tomography (CECT) imaging in a non-emergency outpatient setting often lack a recent estimated Glomerular Filtration Rate measurement. This may lead to inefficiencies in the CECT pathway. The use of point-of-care (POC) creatinine tests to evaluate kidney function in these patients may provide a safe and cost-effective alternative to current practice, as these can provide results within the same CECT appointment. Read More

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IncobotulinumtoxinA Efficacy/Safety in Upper-Limb Spasticity in Pediatric Cerebral Palsy: Randomized Controlled Trial.

Pediatr Neurol 2021 May 21;123:10-20. Epub 2021 May 21.

LMU Klinikum Munich, Division of Pediatric Neurology & LMU Center for Children with Medical Complexity, Dr. von Hauner Children's Hospital, Ludwig-Maximilians-University, Munich, Germany.

Background: This randomized phase 3 study with double-blind main period (MP) and open-label extension (OLEX; NCT02002884) assessed incobotulinumtoxinA safety and efficacy for pediatric upper-limb spasticity treatment in ambulant/nonambulant (Gross Motor Function Classification System [GMFCS] I-V) patients, with the option of combined upper- and lower-limb treatment.

Methods: Patients were aged two to 17 years with unilateral or bilateral spastic cerebral palsy (CP) and Ashworth Scale (AS) score ≥2 in treatment-selected clinical patterns. In the MP, patients were randomized (2:1:1) to incobotulinumtoxinA 8, 6, or 2 U/kg body weight (maximum 200, 150, 50 U/upper limb), with optional lower-limb injections in one of five topographical distributions (total body dose ≤16 to 20 U/kg, maximum 400 to 500 U, depending on body weight and GMFCS level). Read More

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The potential impact of discrepancies between automated susceptibility platforms and other testing metho`dologies for cefazolin in the treatment of Enterobacterales bloodstream infections.

Diagn Microbiol Infect Dis 2021 Jul 9;101(2):115483. Epub 2021 Jul 9.

Department of Pharmacy, University of Maryland School of Pharmacy, Baltimore, MD, USA.

Revised breakpoints for cefazolin (CFZ) against Enterobacterales may be difficult to implement with current automated susceptibility testing platforms and could falsely report organisms as susceptible, leading to inappropriate treatment for bloodstream infections (BSI). This was a retrospective cohort of adult patients with Enterobacterales BSI reported CFZ susceptible per Vitek®2. The primary outcome was the percentage susceptible by minimum inhibitory concentration (MIC) Gradient Test Strips and disk diffusion. Read More

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