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Aortic neck IFU violations during EVAR for ruptured infrarenal aortic aneurysms are associated with increased in-hospital mortality.

Ann Vasc Surg 2021 May 2. Epub 2021 May 2.

Division of Vascular Surgery and Endovascular Therapy, The Johns Hopkins Medical Institutions, Baltimore, MD, USA.

Objective: Vascular surgeons treating patients with ruptured abdominal aortic aneurysm (rAAA) must make rapid treatment decisions and sometimes lack immediate access to endovascular devices meeting the anatomic specifications of the patient at hand. We hypothesized that endovascular treatment of rAAA (rEVAR) outside manufacturer instructions-for-use (IFU) guidelines would have similar in-hospital mortality compared to patients treated on-IFU or with an infrarenal clamp during open repair (rOAR).

Methods: Vascular Quality Initiative (VQI) datasets for endovascular and open aortic repair were queried for patients presenting with ruptured infrarenal AAA between 2013-2018. Read More

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A cluster-randomised controlled trial of the LifeLab education intervention to improve health literacy in adolescents.

PLoS One 2021 5;16(5):e0250545. Epub 2021 May 5.

NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom.

Adolescence offers a window of opportunity during which improvements in health behaviours could benefit long-term health, and enable preparation for parenthood-albeit a long way off, passing on good health prospects to future children. This study was carried out to evaluate whether an educational intervention, which engages adolescents in science, can improve their health literacy and behaviours. A cluster-randomised controlled trial of 38 secondary schools in England, UK was conducted. Read More

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Association of chorioamnionitis with failed conversion of epidural labor analgesia to cesarean delivery anesthesia: A retrospective cohort study.

PLoS One 2021 5;16(5):e0250596. Epub 2021 May 5.

Department of Anesthesiology, Juntendo University Hospital, Hongo, Bunkyo-ku, Tokyo, Japan.

Aim: This study aimed to examine the association between clinically diagnosed chorioamnionitis and failed conversion of epidural labor analgesia to cesarean delivery anesthesia.

Methods: This retrospective, single-center cohort study, conducted in a university hospital, enrolled term parturients undergoing emergency cesarean section after induction of epidural labor analgesia between September 2015 and May 2019. For the purpose of this study, all cases were re-examined to ensure that they fulfilled the criteria of chorioamnionitis, regardless of the actual indication for cesarean section proposed by obstetricians at the time of application. Read More

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Long-term Physical and Psychological Outcomes of Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis.

JAMA Dermatol 2021 May 5. Epub 2021 May 5.

Hennepin Healthcare, University of Minnesota Medical School, Minneapolis.

Importance: Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) is known to cause multiple end-organ complications in its acute phase, but less is known about the long-term association with patients' mental health and quality of life.

Objective: To examine the chronic physical and psychological sequelae affecting patients with SJS/TEN.

Design, Setting, And Participants: A survey study conducted at 11 academic health centers in the US evaluated 121 adults diagnosed with SJS/TEN by inpatient consultive dermatologists between January 1, 2009, and September 30, 2019. Read More

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Sustained Care Smoking Cessation Intervention for Individuals Hospitalized for Psychiatric Disorders: The Helping HAND 3 Randomized Clinical Trial.

JAMA Psychiatry 2021 May 5. Epub 2021 May 5.

Tobacco Research and Treatment Center, Massachusetts General Hospital, Harvard Medical School, Boston.

Importance: Smoking among individuals with serious mental illness (SMI) represents a major public health problem. Intervening during a psychiatric hospital stay may provide an opportunity to aid engagement in smoking cessation treatment and facilitate success in quitting.

Objective: To examine the effectiveness of a multicomponent, sustained care (SusC) smoking cessation intervention in adults with SMI receiving inpatient psychiatric care. Read More

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Association of social and economic conditions with the incidence of sleep disorders during the COVID-19 pandemic.

Cad Saude Publica 2021 30;37(3):e00218320. Epub 2021 Apr 30.

Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil.

Sleep is a fundamental aspect for maintaining physical and emotional health, as well as one's well-being. Few studies have assessed the effect of socioeconomic conditions on sleep in the COVID-19 pandemic. Our objective was to analyze the increase or incidence of sleep disorders according to demographic and economic conditions, prior to the pandemic, and according to changes in financial, occupational, and household conditions during the pandemic. Read More

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The analysis of ancestry with small-scale forensic panels of genetic markers.

Emerg Top Life Sci 2021 May 5. Epub 2021 May 5.

Forensic Genetics Unit, Institute of Forensic Sciences, University of Santiago de Compostela, Santiago, Spain.

In the last 10 years, forensic genetic analysis has been extended beyond identification tests that link a suspect to crime scene evidence using standard DNA profiling, to new supplementary tests that can provide information to investigators about a suspect in the absence of a database hit or eyewitness testimony. These tests now encompass the prediction of physical appearance, ancestry and age. In this review, we give a comprehensive overview of the full range of DNA-based ancestry inference tests designed to work with forensic contact traces, when the level of DNA is often very low or highly degraded. Read More

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The epidemiology of mescaline use: Pattern of use, motivations for consumption, and perceived consequences, benefits, and acute and enduring subjective effects.

J Psychopharmacol 2021 May 5:2698811211013583. Epub 2021 May 5.

Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands.

Background: Mescaline is a naturally occurring psychoactive phenethylamine found in several cacti and historically used ceremonially by Indigenous and Latin American populations. Broader recognition of its possible therapeutic value in Western science began in the 1950s; however, knowledge of the safety profile of mescaline and the extent of its use remains limited. The primary aim of this study is to examine the epidemiology of mescaline use among English-speaking adults. Read More

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Perspectives of scientists on disseminating research findings to non-research audiences.

J Clin Transl Sci 2020 Dec 7;5(1):e61. Epub 2020 Dec 7.

Adult and Child Consortium of Outcome Research and Delivery Science (ACCORDS), University of Colorado School of Medicine, Aurora, CO, USA.

Background: Little is known about practices used to disseminate findings to non-research, practitioner audiences. This study describes the perspectives, experience and activities of dissemination & implementation (D&I) scientists around disseminating their research findings.

Methods: The study explored D&I scientists' experiences and recommendations for assessment of dissemination activities to non-research audiences. Read More

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December 2020

Association between surgery with anesthesia and cognitive decline in older adults: Analysis using shared parameter models for informative dropout.

J Clin Transl Sci 2020 Aug 4;5(1):e27. Epub 2020 Aug 4.

Department of Health Sciences Research, Division of Biomedical Statistics and Informatics, Mayo Clinic College of Medicine and Science, Rochester, MN, USA.

Objectives/goals: The association between surgery with general anesthesia (exposure) and cognition (outcome) among older adults has been studied with mixed conclusions. We revisited a recent analysis to provide missing data education and discuss implications of biostatistical methodology for informative dropout following dementia diagnosis.

Methods/study Population: We used data from the Mayo Clinic Study of Aging, a longitudinal study of prevalence, incidence, and risk factors for mild cognitive impairment (MCI) and dementia. Read More

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Switch from intravenous to subcutaneous immunoglobulin IgPro20 in CIDP patients: a prospective observational study under real-world conditions.

Ther Adv Neurol Disord 2021 16;14:17562864211009100. Epub 2021 Apr 16.

Department of Neurology, Hannover Medical School, Carl-Neuberg-Str. 1, Hannover 30625, Germany.

Background: IgPro20 is the first approved subcutaneous immunoglobulin (SCIg) preparation for the treatment of patients with chronic inflammatory demyelinating polyneuropathy (CIDP). Two different doses of the SCIg preparation were investigated in the pivotal PATH study. Real-world data, and particularly the efficacy of an equivalent dose switch from intravenous immunoglobulin (IVIg) to SCIg, are still not available. Read More

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Multidisciplinary program based on early management of psychological factors reduces disability of patients with subacute low back pain. Results of a randomised controlled study with one year follow-up.

Eur J Phys Rehabil Med 2021 May 5. Epub 2021 May 5.

Physical Medicine and Rehabilitation Unit, Scientific Institute of Lissone, Clinical and Scientific Institutes Maugeri, Institute of Care and Research, Lissone, Monza Brianza, Italy.

Background: Multidisciplinary rehabilitation induces disability improvement, pain reduction and favours return-to-work in patients with subacute low back pain (LBP). Current research advises additional high-quality trials.

Aim: To test the effect of a multidisciplinary rehabilitative programme incorporating cognitivebehavioural interventions compared to general physiotherapy alone to treat subacute LBP, and to appraise its long-term extent. Read More

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Management and outcome of patients with acute ischemic stroke and tandem carotid occlusion in the ESCAPE-NA1 trial.

J Neurointerv Surg 2021 May 4. Epub 2021 May 4.

Department of Clinical Neurosciences and Hotchkiss Brain Institute, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada

Background: The optimal treatment and prognosis for stroke patients with tandem cervical carotid occlusion are unclear. We analyzed outcomes and treatment strategies of tandem occlusion patients in the ESCAPE-NA1 trial.

Methods: ESCAPE-NA1 was a multicenter international randomized trial of nerinetide versus placebo in 1105 patients with acute ischemic stroke who underwent endovascular treatment. Read More

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Cervical ripening at home or in-hospital-prospective cohort study and process evaluation (CHOICE) study: a protocol.

BMJ Open 2021 May 4;11(5):e050452. Epub 2021 May 4.

Edinburgh Clinical Trials Unit (ECTU) Usher Institute, University of Edinburgh, Edinburgh, UK.

Introduction: The aim of the cervical ripening at home or in-hospital-prospective cohort study and process evaluation (CHOICE) study is to compare home versus in-hospital cervical ripening to determine whether home cervical ripening is safe (for the primary outcome of neonatal unit (NNU) admission), acceptable to women and cost-effective from the perspective of both women and the National Health Service (NHS).

Methods And Analysis: We will perform a prospective multicentre observational cohort study with an internal pilot phase. We will obtain data from electronic health records from at least 14 maternity units offering only in-hospital cervical ripening and 12 offering dinoprostone home cervical ripening. Read More

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Control Crohn Safe with episodic adalimumab monotherapy as first-line treatment study (CoCroS): study protocol for a randomised controlled trial.

BMJ Open 2021 May 4;11(5):e042885. Epub 2021 May 4.

Gastroenterology and Hepatology, Maastricht UMC+, Maastricht, The Netherlands.

Introduction: Crohn's disease (CD) is a chronic inflammatory bowel disease with a heterogeneous clinical presentation, relapse rate and treatment response. At present, no markers are available to adequately predict disease course at diagnosis. To prevent overtreatment of patients with a relative mild disease course, a step-up approach starting with corticosteroids is usually applied. Read More

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Evaluating pictorial support in person-centred care for children (PicPecc): a protocol for a crossover design study.

BMJ Open 2021 May 4;11(5):e042726. Epub 2021 May 4.

University of Gothenburg Centre for Person-Centred Care, and Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden.

Introduction: This study protocol outlines the evaluation of the pictorial support in person-centred care for children (PicPecc). PicPecc is a digital tool used by children aged 5-17 years to self-report symptoms of acute lymphoblastic leukaemia, who undergo high-dose methotrexate treatments. The design of the digital platform follows the principles of universal design using pictorial support to provide accessibility for all children regardless of communication or language challenges and thus facilitating international comparison. Read More

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Risk of colorectal cancer in first degree relatives of patients with colorectal polyps: nationwide case-control study in Sweden.

BMJ 2021 05 4;373:n877. Epub 2021 May 4.

Department of Medical Epidemiology and Biostatistics, Karolinska Institute, 171 77 Stockholm, Sweden

Objective: To assess the risk of colorectal cancer (CRC) in first degree relatives (parents and full siblings) of patients with precursor lesions (polyps) for CRC.

Design: Case-control study.

Setting: Linkage to the multi-generation register and gastrointestinal ESPRESSO (Epidemiology Strengthened by histoPathology Reports in Sweden) histopathology cohort in Sweden. Read More

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Outcome of selective CT vs. pan-CT scan in elderly trauma patients: A retrospective cohort study in a level 1 trauma center.

Chin J Traumatol 2021 Apr 25. Epub 2021 Apr 25.

Department of Trauma and Orthopaedics, Princess Alexandra Hospital NHS Foundation Trust, London, United Kingdom.

Purpose: There are currently no clear guidelines for use of pan- or selective CT in elderly trauma patients and this subject matter remains controversial. The aim of this study is to compare the outcome of elderly trauma patients in a level 1 trauma centre who required a pan- or selective CT scan on admission.

Methods: The Trauma Audit Research Network database was reviewed to identify eligible patients (65 years old and older) over a one-year period, from January 2018 to January 2019. Read More

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A comprehensive multidisciplinary care pathway for hip fractures better outcome than usual care?

Injury 2021 Apr 16. Epub 2021 Apr 16.

Department of Surgery-Traumatology University of Groningen, University Medical Center Groningen, P.O. Box 300019700 RB Groningen, The Netherlands.

Introduction: Hip fracture surgery is among the most performed surgical procedures in elderly patients. Mortality rates are high, however, and patients often fail to live independently following a hip fracture. To improve outcome, multidisciplinary care pathways have been initiated, but longer-term results are lacking. Read More

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Developing a core set of outcome measure domains to study Raynaud's phenomenon and digital ulcers in systemic sclerosis: Report from OMERACT 2020.

Semin Arthritis Rheum 2021 Apr 21. Epub 2021 Apr 21.

Division of Rheumatology, Department of Medicine, Division of Clinical Epidemiology, Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia, PA, USA.

Raynaud's phenomenon (RP) and digital ulcers (DUs) are important disease manifestations of systemic sclerosis (SSc) that can lead to significant pain and disability. It is essential when studying these disease features to utilize outcome measures that fully evaluate the complexities of RP and DUs . The Outcome Measures in Rheumatology (OMERACT) Vascular Disease in SSc Working Group is applying the OMERACT filter 2. Read More

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Influence of the second stage of labor on maternal and neonatal outcomes in vaginal births after caesarean section: a multicenter study in Germany.

BMC Pregnancy Childbirth 2021 May 4;21(1):356. Epub 2021 May 4.

Department of Obstetrics and Gynecology, University Hospital Schleswig Holstein, Campus Kiel, Kiel, Germany.

Background: The American College of Obstetricians and Gynecologists (ACOG) introduced a new standard of care in 2014, extending the duration of the second stage of labor in order to reduce caesarean delivery (CD) rates and its severe complications. The aim of the present study is to evaluate success rates of trial of labor after caesarean section (TOLAC), as well as maternal and neonatal outcomes after the establishment of the recent guidelines.

Methods: A retrospective study was performed at two large departments in Germany from January 2008 to January 2018. Read More

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Single Fetal Demise in Twin Pregnancy-A Great Concern but Still a Favorable Outcome.

Diseases 2021 Apr 29;9(2). Epub 2021 Apr 29.

Department of Morphological Sciences, Faculty of Medicine and Pharmacy, University "Dunarea de Jos" Galati, 800008 Galati, Romania.

The incidence of multiple pregnancies has increased in the last decades, mostly explained by the more frequent use of ovulation induction drugs and assisted reproduction techniques. Although single fetal death in the first trimester of twin pregnancy is not an uncommon event nor does it have serious consequences on the survival fetus, the death of one fetus in the second or third trimester of pregnancy is associated with a serious increase in morbidity and mortality for the surviving co-twin. Preterm labor, preeclampsia, intrauterine growth restriction (IUGR), neurological complications or even the death of the surviving twin have been associated with single fetal demise after mid gestation. Read More

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Treatment of Periprosthetic Joint Infection in Total Knee Arthroplasty with a Temporary Intramedullary Nail: Is a Long or Short Nail Better?

J Knee Surg 2021 May 4. Epub 2021 May 4.

Center for Joint Preservation and Replacement, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, Maryland.

To our knowledge, no studies have compared postoperative outcomes between patients who received a temporary short or long intramedullary (IM) nail in the setting of infected total knee arthroplasty (TKA). Therefore, the aim of this study was to compare short-term outcomes for patients who underwent long or short IM nail insertion for treatment of periprosthetic knee infection. Specifically, we compared: (1) success rates; (2) patient reported/functional outcomes; and (3) complications between patients implanted with a short or a long IM nail following PJI of the knee. Read More

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Role of progesterone, cerclage and pessary in preventing preterm birth in twin pregnancies: A systematic review and network meta-analysis.

Eur J Obstet Gynecol Reprod Biol 2021 Apr 24;261:166-177. Epub 2021 Apr 24.

Fetal Medicine Unit, Saint George's University of London, London, United Kingdom; Vascular Biology Research Centre, Molecular and Clinical Sciences Research Institute, St George's University of London, United Kingdom.

Objective: To determine the role of progesterone, pessary and cervical cerclage in reducing the risk of (preterm birth) PTB in twin pregnancies and compare these interventions using pairwise and network meta-analysis.

Study Design: Medline, Embase, CINAHL and Cochrane databases were explored. The inclusion criteria were studies in which twin pregnancies were randomized to an intervention for the prevention of PTB (any type of progesterone, cervical cerclage, cervical pessary, or any combination of these) or to a control group (e. Read More

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Multi- and trans-generational disturbances of perfluorobutane sulfonate and perfluorohexane sulfonate on lipid metabolism in Caenorhabditis elegans.

Chemosphere 2021 Apr 27;280:130666. Epub 2021 Apr 27.

State Key Laboratory of Pollution Control and Resource Reuse, Key Laboratory of Yangtze River Water Environment, Ministry of Education, College of Environmental Science and Engineering, Tongji University, Shanghai, 200092, PR China; Shanghai Institute of Pollution Control and Ecological Security, Shanghai, 200092, PR China.

Short-chained perfluorobutane sulfonate (PFBS, four-carbon) and perfluorohexane sulfonate (PFHxS, six-carbon) are widely employed to substitute long-chained per- and poly-fluoroalkyl substances (PFASs). Recent studies showed the potential persistence of PFBS and PFHxS, and also reported their correlation with obesity. However, the long-term outcome and underlying mechanisms remained poorly understood. Read More

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Reverse tracing anti-thrombotic active ingredients from dried Rehmannia Radix based on multidimensional spectrum-effect relationship analysis of steaming and drying for nine cycles.

J Ethnopharmacol 2021 May 1:114177. Epub 2021 May 1.

Research Center for Traceability and Standardization of TCMs, School of Traditional Chinese Pharmacy, China Pharmaceutical University, Nanjing, 211198, China; State Key Laboratory of Natural Medicines, School of Traditional Chinese Pharmacy, China Pharmaceutical University, Nanjing, 210009, China. Electronic address:

Ethnopharmacological Relevance: In traditional Chinese medicine (TCM) and modern pharmacodynamics, dried Rehmannia Radix (DRR) possesses prominent anti-thrombotic activity that decreases after processing by nine steaming and drying cycles to develop processed Rehmannia Radix (PRR). Due to the complexity of the DRR components, the chemical mechanism leading to efficacy changes of DRR caused by processing is still unclear.

Aim Of Study: This study aimed to trace the anti-thrombotic active compounds of DRR and different degrees of processed RR (PRR) and to evaluate the synergistic effects among different active components. Read More

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Anticancer properties of caudatin and related C-21 steroidal glycosides from Cynanchum plants.

Authors:
Christian Bailly

Steroids 2021 May 1:108855. Epub 2021 May 1.

OncoWitan, Lille (Wasquehal), 59290, France. Electronic address:

Numerous C-21 steroidal glycosides have been isolated from Cynanchum plants. Many of them derive from the aglycone caudatin (CDT) which includes a tetracyclic deacylmetaplexigenin unit and an ikemaoyl ester side chain. CDT can be found in diverse traditional medicines, such as Baishouwu radix used to treat gastro-intestinal disorders. Read More

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How to measure sustained psychic transformations in long-term treatments of chronically depressed patients: Symptomatic and structural changes in the LAC Depression Study of the outcome of cognitive-behavioural and psychoanalytic long-term treatments.

Int J Psychoanal 2019 Feb;100(1):99-127

Sigmund-Freud-Institut, Frankfurt a.M., Germany.

Worldwide, the pressure on psychoanalysis to prove the results of its treatments according to the criteria of so-called evidence-based medicine has increased. While a large number of studies on the results of psychoanalytic short-term therapies are now available, such studies are still largely lacking on psychoanalysis and psychoanalytic long-term therapies. In a large multicentre study, the results of psychoanalytical and cognitive-behavioural longterm therapies in chronically depressed patients were compared, Both psychotherapies led to statistically highly significant changes in depressive symptoms three years after the start of the treatments However, the focus of psychoanalytic treatments is not exclusively on reducing psychopathological symptoms, but on changes in the inner world of the patients that are reminiscent of the goal of psychoanalyses that Freud has characterized as developing "the ability to love, work and enjoy life. Read More

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February 2019

Cardiometabolic therapy and mortality in very old patients with diabetes hospitalized due to COVID-19.

J Gerontol A Biol Sci Med Sci 2021 May 4. Epub 2021 May 4.

Internal Medicine Department, Regional University Hospital of Málaga, Biomedical Research Institute of Málaga (IBIMA), University of Málaga (UMA), Málaga, Spain.

Background: The effects of cardiometabolic drugs on the prognosis of diabetic patients with COVID-19, especially very old patients, are not well-known. This work aims to analyze the association between preadmission cardiometabolic therapy (antidiabetic, antiaggregant, antihypertensive, and lipid-lowering drugs) and in-hospital mortality among patients ≥80 years with type 2 diabetes mellitus hospitalized for COVID-19.

Methods: We conducted a nationwide, multicenter, observational study in patients ≥80 years with type 2 diabetes mellitus hospitalized for COVID-19 between March 1 and May 29, 2020. Read More

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