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Subcutaneous regular insulin use for the management of diabetic ketoacidosis in resource limited setting.

J Pediatr Endocrinol Metab 2021 Sep 27. Epub 2021 Sep 27.

Department of Internal Medicine, Saint Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia.

Objectives: The standard recommendation of insulin therapy for patients with DKA is the administration of slow continuous intravenous (IV) regular insulin. Currently subcutaneous insulin is being recommended as an alternative treatment of DKA in mild and moderate cases in resource-limited settings. The purpose of this study was to assess the effectiveness and safety of six-hourly subcutaneous regular insulin use for the treatment of DKA among children with type one diabetes mellitus. Read More

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September 2021

Effectiveness of a synthetic human recombinant epidermal growth factor in diabetic patients wound healing: Pilot, double-blind, randomized clinical controlled trial.

Wound Repair Regen 2021 Sep 25. Epub 2021 Sep 25.

Full Professor at Federal Fluminense University, Director of the College of Pharmacy, Federal Fluminense University, Niterói, Rio de Janeiro, Brazil.

To investigate whether the addition of human recombinant epidermal growth factor (h-EGF) to 2% carboxymethyl cellulose gel is more effective in diabetic wound healing than standard treatment, a pilot, double-blind, randomized and controlled clinical trial with therapeutic intervention was performed at a university hospital. The sample consisted of 25 patients (14 in the intervention group that used rh-EGF and 11 in the control group that used 2% carboxymethyl cellulose gel). Data were tabulated in SPSS and analysed by intention to treat, without loss or exclusion of participants. Read More

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September 2021

Skin Adverse Reactions to Novel Messenger RNA Coronavirus Vaccination: A Case Series.

Diseases 2021 Aug 27;9(3). Epub 2021 Aug 27.

Dermatology Clinic, Department Medical Sciences and Public Health, Cagliari State University, 09124 Cagliari, Italy.

Vaccines are actually the most effective strategy to control the COVID-19 spread and reduce mortality, but adverse reactions can occur. Skin involvement with novel messenger RNA coronavirus vaccines seems frequent but is not completely characterized. A real-world experience in the recent vaccination campaign among health care workers in Sardinia (Italy) is reported. Read More

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Emergency cricothyrotomy in morbid obesity: comparing the bougie-guided and traditional techniques in a live animal model.

Am J Emerg Med 2021 Sep 16;50:582-586. Epub 2021 Sep 16.

Department of Emergency Medicine, Hennepin County Medical Center, Minneapolis, MN, United States of America.

Background: Cricothyrotomy is a rare, time sensitive procedure that is more challenging to perform when anatomical landmarks are not easily palpated before the initial incision. There is a paucity of literature describing the optimal technique for cricothyrotomy in patients with impalpable airway structures, such as in morbid obesity. In this study, we used a live sheep model of morbid obesity to compare the effectiveness of two common cricothyrotomy techniques. Read More

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September 2021

Tumor volume measured using MR volumetry as a predictor of prognosis after surgical resection of single hepatocellular carcinoma.

Eur J Radiol 2021 Sep 20;144:109962. Epub 2021 Sep 20.

Department of Radiology, Seoul National University Hospital and Seoul National University College of Medicine, South Korea.

Purpose: To evaluate the clinical value of tumor volume-measurement using magnetic resonance (MR) volumetry for predicting prognosis after surgical resection of single small-to-medium-sized hepatocellular carcinoma (HCC) (≤5cm).

Method: This retrospective study included 162 consecutive patients who underwent preoperative gadoxetic acid-enhanced MRI and subsequent surgical resection for single HCC (≤5cm). Tumor volume was measured at hepatobiliary phase of MR images using semi-automated three-dimensional volumetric software program. Read More

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September 2021

Skin necrosis due to post-treatment care failure after photodynamic therapy of facial port-wine stain in Sturge-Weber Syndrome - A case report.

Photodiagnosis Photodyn Ther 2021 Sep 22:102546. Epub 2021 Sep 22.

Department of Plastic and Reconstructive Surgery, Zhejiang Provincial People's Hospital, affiliated of Hangzhou Medical College, Hangzhou China.

We report on a case of photodynamic therapy (PDT) of large facial port-wine stain (PWS) in 5-year-old patient with Sturge-Weber Syndrome (SWS). Improvement was achieved after the first session without severe adverse reactions, however, prolonged swelling, infection and skin necrosis occurred after the second session, mainly due to failure of post-treatment care. The case demonstrates that post-treatment care is critical for PDT of large facial PWS, particularly for SWS patients. Read More

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September 2021

Neighborhood deprivation and preterm delivery during the coronavirus 2019 pandemic.

Am J Obstet Gynecol MFM 2021 Sep 22:100493. Epub 2021 Sep 22.

Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.

Background: Prior studies have reported decreases in preterm delivery (PTD) incidence during the coronavirus 2019 (COVID-19) pandemic, however findings are inconsistent. Given wide disparities in the pandemic's impact across communities, neighborhood deprivation may explain observed variation in the relationship between the COVID-19 pandemic and preterm delivery.

Objective: To characterize changes in the incidence of PTD during the COVID-19 pandemic with attention to effect modification introduced by neighborhood hardship. Read More

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September 2021

Is it possible to hospitalize patients in multiple-bed room without increasing the risk of hospital-acquired influenza? Description of a pragmatic preventive strategy in a French university hospital.

Am J Infect Control 2021 Sep 22. Epub 2021 Sep 22.

Univ. Grenoble Alpes, CNRS, MESP TIM-C, UMR 5525, Grenoble Alpes University Hospital, Infection Control Unit, CHU Grenoble CS 10217 38043 GRENOBLE Cedex 9, France. Electronic address:

Purpose: Large inrush of patients through Emergency Department during influenza season can be dramatic.The purpose of this study was to evaluate the impact of an emergency preventive strategy, namely admission of patients with influenza in multiple-bed room with patients free from influenza, on the occurrence of hospital-acquired influenza (HAI).

Methods: When a patient with an influenza RT-PCR diagnosis was hospitalized in a multiple-bed room, the emergency preventive strategy was applied: selection of non-immunocompromised neighbor, implementation of physical barriers (rigid screen pulled between beds, surgical mask for healthcare workers and visitors), preemptive Oseltamivir therapy for the neighbor. Read More

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September 2021

Characteristics and significance of "green snake" bites in Myanmar, especially by the pit vipers Trimeresurus albolabris and Trimeresurus erythrurus.

Toxicon 2021 Sep 22. Epub 2021 Sep 22.

University of Adelaide, Adelaide SA 5000, Australia; Department of Renal Medicine, Royal Adelaide Hospital, Adelaide SA 5000, Australia.

Snakebite is an important problem in Myanmar. Regionally, bites by Eastern Russell's vipers, Daboia siamensis (Viperidae, Viperinae), and monocled cobras, Naja kaouthia are considered medically important, but those categorised as "green snake" bites are not. However, these may include bites by green pit vipers, Trimeresurus spp. Read More

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September 2021

New World Leishmania spp. infection in people living with HIV: concerns about relapses and secondary prophylaxis.

Acta Trop 2021 Sep 22:106146. Epub 2021 Sep 22.

Laboratório de Imunidade Natural (LIN), Instituto de Patologia Tropical e Saúde Pública, Universidade Federal de Goiás, Goiânia, Goiás, Brazil.. Electronic address:

Coinfection with the human immunodeficiency virus (HIV) and Leishmania impairs immune responses, increases treatment failure and relapse rates in patients with American tegumentary leishmaniasis (ATL), as well as visceral leishmaniasis (VL). There is insufficient data on the treatment, relapse, and secondary prophylaxis in patients coinfected with HIV/Leishmania in Brazil. This study investigated patients with HIV/ATL and HIV/VL to describe the outcome of leishmaniasis in patients assisted at a referral hospital of Brazilian midwestern region. Read More

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September 2021

Factors Associated with Return to Work After Heart Transplantation: A Systematic Review of the Literature.

Am J Med Sci 2021 Sep 22. Epub 2021 Sep 22.

Cardiology Service, Department of Internal Medicine, Fundación Valle del Lili, Cali, Columbia.

Background: Heart transplantation represents one of the last treatment options for advanced heart failure. Little is known about the factors associated with return to work in patients after heart transplantation. The aim of this study is to identify those factors. Read More

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September 2021

Predictors and management of relapse to axicabtagene ciloleucel in patients with aggressive B-cell lymphoma.

Hematol Oncol Stem Cell Ther 2021 Sep 20. Epub 2021 Sep 20.

Department of Internal Medicine, Division Hematology-Oncology, Mayo Clinic, Phoenix, AZ, USA. Electronic address:

Objective/background: Despite the success of chimeric antigen receptor (CAR) T-cell therapy in patients with aggressive non-Hodgkin lymphoma (aNHL), some patients still fail treatment, and their prognosis is dismal.

Methods: We performed a retrospective study of aNHL patients treated with axicabtagene ciloleucel (axi-cel) at two Mayo Clinic centers between 2018 and 2020. We evaluated predictive factors, toxicities, and responses to salvage regimens after CAR T-cell therapy. Read More

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September 2021

Adjunctive interleukin-2 for the treatment of drug-susceptible tuberculosis: a randomized control trial in China.

Infection 2021 Sep 25. Epub 2021 Sep 25.

Fuyang No.2 Hospital, Fuyang, China.

Purpose: Evaluation of the efficacy and safety of IL-2 in the treatment of drug-susceptible tuberculosis.

Methods: First, the cases of diagnosed drug-susceptible tuberculosis were randomized into two groups-the control group that received the background regimen of isoniazid, rifampin, pyrazinamide, and ethambutol, and the experimental group that received the background regimen plus IL-2. The efficacy and safety evaluations were performed throughout the therapy process as well as 12 months after the treatment completion. Read More

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September 2021

A prospective study of the use of central venous catheters in patients newly diagnosed with acute myeloid leukemia treated with induction chemotherapy.

Support Care Cancer 2021 Sep 25. Epub 2021 Sep 25.

Division of Hematology-Oncology, University of Pittsburgh School of Medicine, UPMC Hillman Cancer Center, 5150 Center Ave, Suite 564, Pittsburgh, PA, 15232, USA.

Purpose: Central venous catheters (CVCs) are widely used in acute myeloid leukemia (AML) patients. Complications associated with CVCs are frequently encountered and contribute to morbidity and mortality. Prospective studies investigating and comparing complications of different types of CVCs in AML patients and their effects on the quality of life are limited. Read More

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September 2021

Procedural complications in patients undergoing microsurgical treatment of unruptured intracranial aneurysms: a single-center experience with 1923 aneurysms.

Acta Neurochir (Wien) 2021 Sep 25. Epub 2021 Sep 25.

Department of Neurosurgery, National Brain Aneurysm and Tumor Center, United Hospital, 3033 Excelsior Boulevard, Suite 495, Minneapolis, MN, USA.

Background: With the growing use of endovascular therapy (EVT) to manage unruptured intracranial aneurysms (IAs), detailed information regarding periprocedural complication rates of microsurgical clipping and EVT becomes increasingly important in determining the optimal treatment for individual cases. We report the complication rates associated with open microsurgery in a large series of unruptured IAs and highlight the importance of maintaining surgical skill in the EVT era.

Methods: We reviewed all cases of unruptured IAs treated with open microsurgery by a single neurosurgeon between July 1997 and June 2019. Read More

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September 2021

Intra-abdominal vascularized lymph node transfer for treatment of lymphedema: A systematic literature review and meta-analysis.

Microsurgery 2021 Sep 25. Epub 2021 Sep 25.

Department of Plastic and Reconstructive Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.

Background: As a promising treatment for lymphedema, vascularized lymph node transfer (VLNT) is associated with a risk of iatrogenic lymphedema. Intra-abdominal vascularized lymph node flap has been increasingly applied to minimize complication.

Methods: PubMed, EMBASE, Web of Sciences, and Cochrane databases were searched systematically. Read More

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September 2021

Epidemiology of Occupational Electrical Injuries.

J Burn Care Res 2021 Sep 25. Epub 2021 Sep 25.

Department of General Surgery, School of Medicine, Burn Research Center, Shahid Motahari Burns Hospital, Iran University of Medical Sciences, Tehran, Iran.

Electrical injuries are an uncommon but very destructive type of burn, with serious complications and disabilities for the victims. This study was conducted due to the importance of understanding the epidemiology of electrical accidents in planning to prevent their occurrence. This is a retrospective cross-sectional study that was performed on patients with electrical burns referred to Shahid Motahari Educational and Medical Center from 2017 to 2018. Read More

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September 2021

Cardiac troponin and recurrent major vascular events after minor stroke or TIA.

Ann Neurol 2021 Sep 25. Epub 2021 Sep 25.

Department of Neurology, Charité - Universitätsmedizin Berlin, Berlin, Germany.

Objective: To investigate whether high-sensitivity cardiac troponin T (hs-cTnT) is associated with major adverse cardiovascular events (MACE) in patients with minor stroke or transient ischemic attack (TIA), and whether this association differs after risk stratification based on the "Age, Blood pressure, Clinical features, Duration of symptoms, Diabetes" (ABCD ) score.

Methods: INSPiRE-TMS was a randomized controlled trial allocating patients with minor stroke or TIA to an intensified support program or conventional care. In this post-hoc analysis, participants were categorized using hs-cTnT levels (5 Generation, Roche, 99 percentile upper reference limit [URL] 14ng/L). Read More

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September 2021

Tranexamic acid after cardiopulmonary bypass does not increase risk of postoperative seizures: a retrospective study.

Gen Thorac Cardiovasc Surg 2021 Sep 24. Epub 2021 Sep 24.

Department of Anesthesiology and Translational Neuroscience Center, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.

Objective: To evaluate the effects of administering tranexamic acid (TXA) after cardiopulmonary bypass, instead of after anesthesia induction, on postoperative seizures and blood transfusion requirements.

Methods: Adult patients who underwent valve surgery and/or coronary artery bypass grafting at West China Hospital between July 1, 2011 and December 31, 2016 were retrospectively analyzed. Patients either received TXA after bypass (n = 2062) or not (n = 4236). Read More

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September 2021

A new hybrid stent using endoscopic vacuum therapy in treating esophageal leaks: a prospective single-center experience of its safety and feasibility with mid-term follow-up.

Dis Esophagus 2021 Sep 24. Epub 2021 Sep 24.

Department of General, Visceral, Cancer and Transplantation Surgery, University Hospital of Cologne, Cologne, Germany.

Self-expandable metal stents (SEMS) and endoscopic vacuum therapy (EVT) are endoscopic options for treating leaks of the esophagus. VACStent® is a variant of SEMS that aims to combine the advantages of SEMS and EVT in one device. Due to this unique construction, VACStent® can build a barrier to the leak and facilitate wound healing with EVT, all while maintaining intestinal passage. Read More

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September 2021

Fetal and Neonatal Outcomes Following Maternal Aortic Balloon Occlusion for Hemorrhage in Pregnancy: A Review of the Literature.

J Trauma Acute Care Surg 2021 Sep 24. Epub 2021 Sep 24.

University of California Davis Medical Center, 2335 Stockton Blvd Room 5107, Sacramento, CA, 95817, USA University of California Davis Medical Center, 2335 Stockton Blvd Room 5107, Sacramento, CA, 95817, USA. Rutgers Cancer Institute of New Jersey, 195 Little Albany St, New Brunswick, NJ, 08901, USA. University of California Davis Medical Center, 2335 Stockton Blvd Room 5107, Sacramento, CA, 95817, USA. University of California Davis Medical Center, 2335 Stockton Blvd Room 5107, Sacramento, CA, 95817, USA.

Background: Hemorrhage is a leading cause of maternal death worldwide, with increased risk in women with abnormal placentation. Aortic balloon occlusion (ABO), including resuscitative endovascular balloon occlusion (REBOA), has been used for obstetrical hemorrhage for 20 years, and is associated with decreased operative blood loss, fewer transfusions, and lower rates of hysterectomy. However, the effect of aortic occlusion on fetal/neonatal outcomes is not well known. Read More

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September 2021

Coronavirus Disease 2019 Cluster Originating in a Primary School Teachers' Room in Japan.

Pediatr Infect Dis J 2021 Sep 23. Epub 2021 Sep 23.

From the Department of Pediatrics, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan Department of Active Aging, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan Department of Health and Welfare, Niigata Prefectural Office, Niigata, Japan Kashiwazaki Health Care Center, Niigata, Japan Department of Pediatrics, Niigata City General Hospital, Niigata, Japan Pediatric liaison, Niigata Prefectural Patient Control Center, Niigata, Japan Department of Virology, Niigata Prefectural Institute of Public Health and Environmental Science, Niigata, Japan; and Department of International Health (Public Health), Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.

Background: School closures are a subject of debate during the present coronavirus disease 2019 (COVID-19) pandemic. Because children are not the main driver of COVID-19 transmission in the community, school education must be prioritized in conjunction with appropriate infection prevention and control measures, as determined by local COVID-19 incidence.

Methods: We investigated the causes and transmission routes of a primary school cluster of COVID-19 that occurred during November and December 2020 in Niigata, Japan. Read More

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September 2021

Slow and Steady Wins the Race: A Solid Case for a Three Stage Approach in Ulcerative Colitis.

Dis Colon Rectum 2021 Aug 30. Epub 2021 Aug 30.

Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA Department of Medicine, Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.

Background: Approximately 10-20% of ulcerative colitis patients require surgery during their disease course, of which the most common is the staged restorative proctocolectomy with ileal pouch-anal anastomosis.

Objective: The aim was to compare the rates of anastomotic leaks among all staged restorative proctocolectomy with ileal pouch-anal anastomosis procedures.

Design: This was a retrospective cohort study. Read More

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Exploring the meaning of life from the perspective of patients with depression: A phenomenological study.

Arch Psychiatr Nurs 2021 Oct 22;35(5):427-433. Epub 2021 Jun 22.

Department of Nursing, I-Shou University, No. 8, Yida Rd., Jiaosu Village, Yanchao District, Kaohsiung City 82445, Taiwan. Electronic address:

This study explored the perceptions of meaning of life for patients with depression. A qualitative phenomenology approach was used. Patients with depression (n = 20) were recruited until data saturation occurred. Read More

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October 2021

Prediction of acute kidney injury after cardiac surgery from preoperative N-terminal pro-B-type natriuretic peptide.

Br J Anaesth 2021 Sep 21. Epub 2021 Sep 21.

Department of Anaesthesiology, Fuwai Hospital, National Centre for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

Background: Acute kidney injury (AKI) is common after cardiac surgery and is difficult to predict. N-terminal pro-B-type natriuretic peptide (NT-proBNP) is highly predictive for perioperative cardiovascular complications and may also predict renal injury. We therefore tested the hypothesis that preoperative NT-proBNP concentration is associated with renal injury after major cardiac surgery. Read More

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September 2021

Transposition Mucosal Flap Combined With Autologous Fat Transplantation to Repair Lip Defects Caused by Sclerotherapy of Hemangioma.

J Craniofac Surg 2021 Sep 22. Epub 2021 Sep 22.

Department of Cleft Lip and Palate, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shijingshan Department of Stomatology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.

Abstract: Infantile hemangiomas are the most common benign childhood tumors and can occur on any part of the human body. Sclerosing agents are used in the early stage of treatment of infantile hemangioma. Sometimes a lip defect remains after sclerosing agent treatment. Read More

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September 2021

Nesfatin-1 facilitates IL-1β production in osteoarthritis synovial fibroblasts by suppressing miR-204-5p synthesis through the AP-1 and NF-κB pathways.

Aging (Albany NY) 2021 Sep 24;13(undefined). Epub 2021 Sep 24.

Department of Veterinary Medicine, College of Veterinary Medicine, National Chung-Hsing University, Taichung, Taiwan.

The progression of osteoarthritis (OA) is mediated by adipokines, one of which is nesfatin-1, which is responsible for the production of inflammatory cytokines. However, how this molecule may affect the synthesis of the proinflammatory cytokine interleukin 1 beta (IL-1β) in OA is unclear. Our analyses of records from the Gene Expression Omnibus (GEO) dataset and clinical specimens of synovial tissue revealed higher levels of nesfatin-1 and IL-1β in OA samples compared with normal healthy tissue. Read More

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September 2021

Clinical and radiologic outcomes after stereotactic radiosurgery for meningiomas in direct contact with the optic apparatus: an international multicenter study.

J Neurosurg 2021 Sep 24:1-7. Epub 2021 Sep 24.

17Department of Radiation Oncology, University of Southern California, Los Angeles, California.

Objective: Resection of meningiomas in direct contact with the anterior optic apparatus carries risk of injury to the visual pathway. Stereotactic radiosurgery (SRS) offers a minimally invasive alternative. However, its use is limited owing to the risk of radiation-induced optic neuropathy. Read More

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September 2021

Preoperative pelvic obliquity: possible relation to postoperative coronal decompensation in thoracolumbar/lumbar adolescent idiopathic scoliosis.

J Neurosurg Spine 2021 Sep 24:1-10. Epub 2021 Sep 24.

1Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka.

Objective: Pelvic obliquity is frequently observed in patients with adolescent idiopathic scoliosis with thoracolumbar/lumbar (TL/L) curve. This study aimed to assess pelvic obliquity changes and their effects on clinical outcomes of posterior fusion surgery.

Methods: Data in 80 patients (69 with type 5C and 11 with type 6C adolescent idiopathic scoliosis) who underwent posterior fusion surgery were retrospectively analyzed. Read More

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September 2021

Does large NGS panel analysed using exome tumour sequencing improve the management of advanced non-small-cell lung cancers?

Lung Cancer 2021 Aug 29;161:98-107. Epub 2021 Aug 29.

Department of Medical Oncology, Georges François Leclerc Cancer Center - UNICANCER, 1 rue du Professeur Marion, Dijon 21000, France; University of Burgundy-Franche Comté, Maison de l'université Esplanade Erasme, 21000 Dijon, France; Platform of Transfert in Biological Oncology, Georges François Leclerc Cancer Center - UNICANCER, 1 rue du Professeur Marion, Dijon 21000, France; Genomic and Immunotherapy Medical Institute, Dijon University Hospital, 14 rue Paul Gaffarel 21000 Dijon, France; UMR INSERM 1231, 7 Boulevard Jeanne d'Arc, 21000 Dijon, France. Electronic address:

Introduction: Non-small-cell lung cancer (NSCLC) is one of the most common and deadly cancers. Several molecular drivers of oncogene addiction are now known to be strong predictive biomarkers for target therapies. Advances in large Next Generation Sequencing (LNGS) have improved the ability to detect potentially targetable mutations. Read More

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