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Prevalence of at-risk hyperandrogenism by age and race/ethnicity among females in the United States using NHANES III.

Eur J Obstet Gynecol Reprod Biol 2021 Mar 26;260:189-197. Epub 2021 Mar 26.

Office of Research Resources, Biostatistics and Epidemiology Consulting Lab, Texas Tech University Health Sciences Center El Paso, El Paso, Texas, USA; Division of Biostatistics & Epidemiology, Department of Molecular and Translational Medicine, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, Texas, USA. Electronic address:

Objective: Hyperandrogenism in females leads to multiple endocrine and metabolic disorders including polycystic ovary syndrome (PCOS) that yields adverse health outcomes across all ages. We sought to estimate the prevalence of hyperandrogenemia and at-risk hyperandrogenism among the US females of different age groups, racial/ethnic, and metabolic characteristics.

Materials And Methods: A retrospective population-based cross-sectional study of females 6 years or older having serum testosterone measures using the National Health and Nutrition Examination Surveys, 2013-2016 was conducted. Read More

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Injury Severity, Arrival Physiology, Coagulopathy, and Outcomes Among the Youngest Trauma Patients.

J Surg Res 2021 Apr 7;264:236-241. Epub 2021 Apr 7.

Department of Pediatric Surgery, Houston, Texas; Center for Surgical Trials and Evidence-based Practice, the McGovern Medical School at The University of Texas-Houston, Houston, Texas. Electronic address:

Background: Although physiologic differences exist between younger and older children, pediatric trauma analyses are weighted toward older patients. Trauma-induced coagulopathy, determined by rapid thrombelastography (rTEG), is a predictor of outcome in trauma patients, but the significance of rTEG values among very young trauma patients remains unknown. Our objective was to identify the prehospital or physiologic factors, including rTEG values, that were associated with mortality in trauma patients younger than 5 y old. Read More

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Voxelotor in adolescents and adults with sickle cell disease (HOPE): long-term follow-up results of an international, randomised, double-blind, placebo-controlled, phase 3 trial.

Lancet Haematol 2021 Apr 7. Epub 2021 Apr 7.

UCSF Benioff Children's Hospital Oakland, Oakland, CA, USA.

Background: For decades, patients with sickle cell disease have had only a limited number of therapies available. In 2019, voxelotor (1500 mg), an oral once-daily sickle haemoglobin polymerisation inhibitor, was approved in the USA for the treatment of sickle cell disease in patients aged 12 years and older on the basis of HOPE trial data. To further describe the applicability of voxelotor as a treatment for this chronic illness, we report the long-term efficacy and safety of this drug at 72 weeks of treatment; the conclusion of the placebo-controlled HOPE trial. Read More

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Genomic Risk Score for Melanoma in a Prospective Study of Older Individuals.

J Natl Cancer Inst 2021 Apr 10. Epub 2021 Apr 10.

Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.

Background: Recent genome-wide association meta-analysis for melanoma doubled the number of previously identified variants. We assessed the performance of an updated polygenic risk score (PRS) in a population of older individuals, where melanoma incidence and cumulative ultraviolet radiation exposure is greatest.

Methods: We assessed a PRS for cutaneous melanoma comprising 55 variants in a prospective study of 12,712 individuals in the ASPirin in Reducing Events in the Elderly trial. Read More

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Silver Book II: an international framework for urgent care of older people in the first 72 hours from illness or injury.

Age Ageing 2021 Apr 9. Epub 2021 Apr 9.

College of Medicine, University of Saskatchewan, Saskatoon SK S7N 5E5, Canada.

The new edition of the Silver Book, Silver Book II, provides a framework for the urgent care of older people in the first 72 hours from illness or injury. It incorporates principles of geriatric medicine, quality improvement (including patient reported outcome measures) and interdisciplinary care in a balanced, practical and evidence-rich manual on unscheduled and emergent care for older adults. Silver Book II shows how frailty, comprehensive geriatric assessment and shared decision-making can be locally adapted according to national practice and policy across the world. Read More

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Examining the role of specialist palliative care in geriatric care to inform collaborations: a survey on the knowledge, practice and attitudes of geriatricians in providing palliative care.

Age Ageing 2021 Apr 9. Epub 2021 Apr 9.

School of Nursing and Midwifery, Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia.

Background: The global population is ageing, and rates of multimorbidity and chronic illness are rapidly rising. Given specialist palliative care has been shown to improve overall care and reduce health care costs, how best to provide this care to older people is internationally significant.

Aim: To examine the knowledge, attitudes and practices of geriatricians in providing palliative care and working with specialist palliative care services. Read More

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Fatal adverse drug reactions: a worldwide perspective in the WHO pharmacovigilance database.

Br J Clin Pharmacol 2021 Apr 10. Epub 2021 Apr 10.

Service de Pharmacologie Médicale et Clinique, Centre de PharmacoVigilance de Pharmacoépidémiologie et d'Informations sur le Médicament, CIC INSERM 1436, Centre Hospitalier Universitaire-Faculté de Médecine de Toulouse, France.

Background: Adverse Drug Reactions (ADRs) are important causes of death. However, the main involved drugs are relatively unknown. The present study was performed to characterise death-related drugs recorded in a large pharmacovigilance database during the last ten years. Read More

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Trends in antipsychotic prescribing among long-term care residents receiving hospice care.

J Am Geriatr Soc 2021 Apr 9. Epub 2021 Apr 9.

Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan, USA.

Importance: The Centers for Medicare & Medicaid Services' (CMS) National Partnership to Improve Dementia Care in Nursing Homes ("CMS National Partnership") focuses on reducing antipsychotic prescribing to long-term care residents. Hospice enrollment is not an exclusionary condition for the antipsychotic quality measure reported by CMS. It is unclear how prescribing in hospice may have been impacted by the initiative. Read More

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Chronic kidney disease unawareness and determinants using 1999-2014 National Health and Nutrition Examination Survey Data.

J Public Health (Oxf) 2021 Apr 9. Epub 2021 Apr 9.

Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85724, USA.

Background: Although chronic kidney disease (CKD) affects 15% of the United States (US) population, <10% of the US CKD population is aware of their disease. This is significant as untreated CKD can progress to end-stage renal disease which would require dialysis or transplantation. This study aimed to provide updated information regarding US CKD unawareness. Read More

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Links Between Mortality and Socioeconomic Characteristics, Disease Burden, and Biological and Physical Functioning in the Aging Chinese Population.

J Gerontol B Psychol Sci Soc Sci 2021 Apr 10. Epub 2021 Apr 10.

Davis School of Gerontology, University of Southern California, CA, USA.

Objectives: Determinants of mortality may depend on the time and place where they are examined. China provides an important context in which to study the determinants of mortality at older ages because of its unique social, economic, and epidemiological circumstances. This study uses a nationally representative sample of persons in China to determine how socioeconomic characteristics, early-life conditions, biological and physical functioning, and disease burden predict four-year mortality after age 60. Read More

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A BERIBERI UNHEALTHY LATTE: ENCEPHALOPATHY AND SHOCK FROM SEVERE NUTRITIONAL DEFICIENCY.

J Emerg Med 2021 Apr 6. Epub 2021 Apr 6.

Department of Emergency Medicine, University of California, San Diego, San Diego, California; Division of Pulmonary, Critical Care and Sleep Medicine, University of California, San Diego, San Diego, California.

Background: Thiamine deficiency is an uncommon cause of severe illness in the United States that can lead to significant morbidity because of high-output cardiac failure, peripheral neuropathy, and permanent neurologic impairment. We report the case of a middle-aged woman with extreme malnutrition caused by complications of Roux-en-Y gastric bypass (RYGB) surgery who presented with signs and symptoms of severe thiamine deficiency and septic shock.

Case Report: A 43-year-old woman who had undergone RYGB surgery and who had multiple complications presented to the emergency department with agitation, confusion, and lethargy. Read More

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11p11.12p12 duplication in a family with intellectual disability and craniofacial anomalies.

BMC Med Genomics 2021 Apr 9;14(1):99. Epub 2021 Apr 9.

Medical Research Center, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang, China.

Background: Potocki-Shaffer syndrome (PSS) is a rare contiguous gene deletion syndrome marked by haploinsufficiency of genes in chromosomal region 11p11.2p12. Approximately 50 cases of PSS have been reported; however, a syndrome with a PSS-like clinical phenotype caused by 11p11. Read More

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Multimorbidity and leisure-time physical activity over the life course: a population-based birth cohort study.

BMC Public Health 2021 Apr 9;21(1):700. Epub 2021 Apr 9.

Postgraduate Program in Physical Education, Universidade Federal de Pelotas, Rua Luís de Camões, 625, Pelotas, 96055630, Brazil.

Background: We aimed to test which life course model best described the association between leisure-time physical activity (LTPA) and multimorbidity at age 55. We analyzed data from birth to age 55 using the database from the 1958 National Child Development Survey.

Methods: Multimorbidity was considered as the presence of more than one chronic condition. Read More

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Cognitive leisure activity and all-cause mortality in older adults: a 4-year community-based cohort.

BMC Geriatr 2021 Apr 9;21(1):236. Epub 2021 Apr 9.

School of Public Health, Fudan University, Shanghai, 200032, China.

Background: Cognitive leisure activity, such as reading, playing mahjong or cards and computer use, is common among older adults in China. Previous studies suggest a negative correlation between cognitive leisure activity and cognitive impairment. However, the relationship between cognitive leisure activity and all-cause mortality has rarely been reported. Read More

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Minority stress process among older Black Americans: the role of age, perceived discrimination, and anxiety.

Aging Ment Health 2021 Apr 9:1-9. Epub 2021 Apr 9.

Alabama Research Institute on Aging, The University of Alabama, Tuscaloosa, Alabama, USA.

Prolonged experiences of discrimination can be a major source of physical and health-related stress, particularly in older Black Americans. However, there is limited information on the relation between discrimination and anxiety, particularly within the context of other constructs that influence the manifestation of anxiety symptoms. For example, several studies have suggested that ethnic identification may provide psychological and social resources to deal with the effects of discrimination. Read More

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Breaking the Age Barrier: Physicians' Perceptions on Candidacy for Allogeneic Hematopoietic Cell Transplantation in Older Adults.

Transplant Cell Ther 2021 Apr 6. Epub 2021 Apr 6.

City of Hope, Duarte, CA.

Background: Despite continued increases in use of allogeneic hematopoietic cell transplantation (alloHCT) among older adults, no standardized geriatric assessment (GA) has been established to risk-stratify for transplant-related morbidity. We conducted a survey of transplant physicians to determine perceptions of the impact of older age (≥60 years) on alloHCT candidacy, and utilization of tools to gauge candidacy.

Methods: We conducted a 23-item, online cross-sectional survey of HCT physicians caring for adults in the United States between May and July 2019. Read More

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Prospective Randomized Study of Advance Directives in Allogeneic Hematopoietic Cell Transplant Recipients.

Transplant Cell Ther 2021 Apr 6. Epub 2021 Apr 6.

Stanford University Medical Center, Stanford, CA. Electronic address:

Background: Patients undergoing allogeneic HCT are at risk for high morbidity and mortality. Advance directives (AD) allow patients to express wishes regarding their care at the end of life, but these are not completed in the majority of patients undergoing HCT, with only 44% of deceased allogeneic HCT recipients at this institution completing an AD in the past decade. Increasing AD completion rate can improve quality of care for allogeneic HCT recipients. Read More

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6-month neurological and psychiatric outcomes in 236 379 survivors of COVID-19: a retrospective cohort study using electronic health records.

Lancet Psychiatry 2021 Apr 1. Epub 2021 Apr 1.

Department of Psychiatry, University of Oxford, Oxford, UK; Oxford Health NHS Foundation Trust, Oxford, UK. Electronic address:

Background: Neurological and psychiatric sequelae of COVID-19 have been reported, but more data are needed to adequately assess the effects of COVID-19 on brain health. We aimed to provide robust estimates of incidence rates and relative risks of neurological and psychiatric diagnoses in patients in the 6 months following a COVID-19 diagnosis.

Methods: For this retrospective cohort study and time-to-event analysis, we used data obtained from the TriNetX electronic health records network (with over 81 million patients). Read More

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Health-Related Quality of Life With Trastuzumab Monotherapy Versus Trastuzumab Plus Standard Chemotherapy as Adjuvant Therapy in Older Patients With HER2-Positive Breast Cancer.

J Clin Oncol 2021 Apr 9:JCO2002751. Epub 2021 Apr 9.

Biostatistics Division, Clinical Research Support Center, The University of Tokyo Hospital, Tokyo, Japan.

Purpose: We report findings on quality of life (QoL) in the RESPECT trial, which compared adjuvant trastuzumab monotherapy with trastuzumab plus chemotherapy in older patients with human epidermal growth factor receptor 2 (HER2)-positive breast cancer (BC).

Patients And Methods: Patients age 70-80 years with human epidermal growth factor receptor 2-positive surgically treated breast cancer were randomly assigned to receive trastuzumab (T) or trastuzumab plus chemotherapy (T + C). QoL was assessed using the Functional Assessment of Cancer Therapy-General (FACT-G), Philadelphia Geriatric Center Morale Scale, Hospital Anxiety and Depression Scale, Patient Neurotoxicity Questionnaire, and Tokyo Metropolitan Institute of Gerontology Index of Competence at baseline and after 2, 12, and 36 months. Read More

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Determinants of patient activation and its association with cardiovascular disease risk in chronic kidney disease: A cross-sectional study.

Health Expect 2021 Apr 9. Epub 2021 Apr 9.

Leicester Kidney Lifestyle Team, Department of Health Sciences, University of Leicester, Leicester, UK.

Background: Patient activation describes the knowledge, skills and confidence in managing one's own health. Promoting patient activation is being prioritized to reduce costs and adverse outcomes such as cardiovascular disease (CVD). The increasing prevalence of chronic kidney disease (CKD) presents a need to understand the characteristics that influence patient activation and the effect on health outcomes. Read More

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Unmet needs of the oldest old primary care patients with common somatic and psychiatric disorders-A psychometric evaluation.

Int J Methods Psychiatr Res 2021 Apr 9. Epub 2021 Apr 9.

Institute of Social Medicine, Occupational Health and Public Health, Medical Faculty, University of Leipzig, Leipzig, Germany.

Objectives: Unmet needs are common in older patients and should be assessed via suitable instruments. The adapted German version of the Camberwell Assessment of Need for the Elderly (CANE) represents an often used tool to determine the needs in older individuals. Evidence on the psychometric properties of the CANE is still pending. Read More

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Real-World Hypertension Prevalence, Awareness, Treatment, and Control in Adult Diabetic Individuals: An Italian Nationwide Epidemiological Survey.

High Blood Press Cardiovasc Prev 2021 Apr 9. Epub 2021 Apr 9.

Hypertension and Cardiovascular Prevention Unit, Division of Internal Medicine and Nephrology, Department of Life, Health and Environmental Sciences, San Salvatore Hospital, University of L'Aquila, Building Delta 6, Coppito, 67100, L'Aquila, Italy.

Introduction: Hypertesion is the leading cause of morbidity and mortality, worldwide, and its prevalence has been increasing in several countries, including Italy.

Aims: To assess hypertension prevalence, awareness, treatment, and control in a real-world sample of adults with self-reported diabetes compared with nondiabetic individuals.

Methods: Following the 2018 World Hypertension Day, a nationwide, cross-sectional epidemiological survey on cardiovascular risk factors ("Abbasso la Pressione!") in 3956 Italian pharmacies enrolled 47217 self-presenting volunteers (≥ 18 years). Read More

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Changes in Incidence and Epidemiological Characteristics of Pulmonary Tuberculosis in Mainland China, 2005-2016.

JAMA Netw Open 2021 Apr 1;4(4):e215302. Epub 2021 Apr 1.

School of Public Health, Capital Medical University, Beijing, China.

Importance: The World Health Organization End TB (Tuberculosis) Strategy aims to decrease the global incidence and mortality of TB by 90% and 95%, respectively, as of 2035.

Objective: To characterize the recent epidemiological trend of pulmonary TB (PTB) in mainland China based on the national surveillance data.

Design, Setting, And Participants: This cross-sectional study collected demographic and clinical data of all patients reported in the national Tuberculosis Information Management System of China from January 1, 2005, to November 21, 2016. Read More

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Which Risk Factors Are Associated with Pain and Patient-reported Function in Patients with a Rotator Cuff Tear?

Clin Orthop Relat Res 2021 Apr 8. Epub 2021 Apr 8.

N. G. Lemaster, N. Heebner, Department of Rehabilitation Science, University of Kentucky, Lexington, KY, USA.

Background: Patient-reported measures guide physicians in clinical decision making and therefore it is critical to determine what clinical factors are associated with these scores. Psychological and physical factors are commonly studied separately in patients with rotator cuff tears to determine their influence on outcomes. It is well established that psychological distress and scapular motion change in the presence of a symptomatic rotator cuff tear. Read More

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TLM Outcomes in Elderly Patients with Glottic Pre-Malignancy and Early Malignancy; A 12-Year Retrospective Study.

Ann Otol Rhinol Laryngol 2021 Apr 9:34894211007819. Epub 2021 Apr 9.

Castle Hill Hospital, Cottingham, Hull, UK.

Introduction: UK population ageing and associated cancer risk predicts an increase in the prevalence of laryngeal cancer in elderly patients. Whilst trans-oral laser microsurgery (TLM) has been demonstrated to achieve excellent control of early disease with few complications, data specifically related to its safety and efficacy in older patients is lacking. We report the largest series to date. Read More

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Elective ventral hernia repair provides significant abdominal wall quality of life improvements in older patients.

Surg Endosc 2021 Apr 8. Epub 2021 Apr 8.

Department of Surgery, Ohio State University Wexner Medical Center, Columbus, OH, USA.

Background: An increasing proportion of ventral hernia patients are over age 65. These patients are frequently offered watchful waiting rather than surgical intervention due to their frail state or perioperative risk. However, many in this age group suffer from significant quality of life impacts that are not well understood. Read More

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Infant Oral Healthcare and Anticipatory Guidance Practices among Dentists in a Pediatric Care Shortage Area.

Int J Dent 2021 23;2021:6645279. Epub 2021 Mar 23.

Department of Preventive Dental Services, College of Dentistry, King Faisal University, Al Baha, Saudi Arabia.

Objectives: To assess dentists' practices and barriers towards infant oral healthcare (IOH) and anticipatory guidance (AG) in eastern Saudi Arabia.

Methods: A regional, cross-sectional survey was distributed to 340 (323 general dentists (GPs) and 17 pediatric dentists (PDs)) working in a governmental setting in eastern Saudi Arabia. A 23 close-ended, pilot-tested questionnaire was developed. Read More

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Childhood hunger experiences and chronic health conditions later in life among Brazilian older adults.

Rev Panam Salud Publica 2021 6;45:e39. Epub 2021 Apr 6.

University of California at Los Angeles Los Angeles United States of America University of California at Los Angeles, Los Angeles, United States of America.

Objectives: To assess the association between childhood hunger experiences and the prevalence of chronic diseases later in life.

Methods: A cross-sectional study was conducted using baseline data from the Brazilian Longitudinal Study of Aging (ELSI-Brazil), a nationally representative study of persons aged 50 years and older (n = 9 412). Univariate and bivariate analyses were used to describe the sample, and multivariate logistic regressions to examine the association between childhood hunger and hypertension, diabetes, arthritis and osteoporosis. Read More

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Ten Years of Research on Automatic Voice and Speech Analysis of People With Alzheimer's Disease and Mild Cognitive Impairment: A Systematic Review Article.

Front Psychol 2021 23;12:620251. Epub 2021 Mar 23.

Faculty of Psychology, University of Salamanca, Salamanca, Spain.

The field of voice and speech analysis has become increasingly popular over the last 10 years, and articles on its use in detecting neurodegenerative diseases have proliferated. Many studies have identified characteristic speech features that can be used to draw an accurate distinction between healthy aging among older people and those with mild cognitive impairment and Alzheimer's disease. Speech analysis has been singled out as a cost-effective and reliable method for detecting the presence of both conditions. Read More

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