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Family Caregiver and Provider Perspectives on Inclusive Care: Aligning Needs and Expectations.

Med Care 2021 Aug 4. Epub 2021 Aug 4.

Duke University Department of Population Health Sciences Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham Veterans Affairs Health Care System Duke-Margolis Center for Health Policy Sanford School of Public Policy, Duke University Duke University School of Medicine, Center for the Study of Aging and Human Development, Durham, NC General and Hospital Medicine Division, Department of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX Campaign for Inclusive Care, Elizabeth Dole Foundation National Caregiver Support Program, Department of Veterans Affairs, Washington, DC.

Background: Home-based and community-based health care for individuals with complex medical conditions is often provided by family caregivers. Yet caregivers often are not meaningfully included in interactions with clinical health care teams. Inclusive care means inviting the caregiver to participate in shared decision-making and treatment planning. Read More

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What Is an Innovation Article? A Systematic Overview of Innovation in Health Professions Education Journals.

Acad Med 2021 Aug 3. Epub 2021 Aug 3.

J.M. Colbert-Getz is associate professor and assistant dean of education quality improvement, University of Utah School of Medicine, Salt Lake City, Utah. S.B. Bierer is associate professor and director of assessment and evaluation, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio. A. Berry is executive director of faculty life, University of Central Florida College of Medicine, Orlando, Florida. E. Bradley is associate professor of medical education and director of curriculum evaluation, University of Virginia School of Medicine, Charlottesville, Virginia. H. Han is associate professor, Department of Medical Education, Southern Illinois University School of Medicine, Springfield, Illinois. C. Mooney is assistant professor of medicine and director of assessment, University of Rochester School of Medicine and Dentistry, Rochester, New York. K. Szauter is assistant dean of educational affairs, University of Texas Medical Branch, Galveston, Texas. C.R. Teal is assistant dean of assessment and evaluation, Office of Medical Education, University of Kansas School of Medicine, Kansas City, Kansas. J. Youm is assistant dean of education compliance and quality, University of California, Irvine School of Medicine, Irvine, California. B.C. O'Brien is professor, Department of Medicine, and education scientist, Center for Faculty Educators, University of California, San Francisco, San Francisco, California.

Purpose: Innovation articles have their own submission category and guidelines in health professions education (HPE) journals, which suggests innovation might be a unique genre of scholarship. Yet, the requirements for innovation submissions vary among journals, suggesting ambiguity about the core content of this type of scholarship. To reduce this ambiguity, the researchers conducted a systematic overview to identify key features of innovation articles and evaluate their consistency in use across journals. Read More

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Clinical Characteristics and Outcomes of Oral Mucositis Associated With Immune Checkpoint Inhibitors in Patients With Cancer.

J Natl Compr Canc Netw 2021 Aug 4. Epub 2021 Aug 4.

3Department of Gastroenterology, Hepatology, and Nutrition, The University of Texas MD Anderson Cancer Center, Houston, Texas.

Background: Immune checkpoint inhibitor (ICI) therapy predisposes patients to immune-related adverse events (irAEs). Data are limited regarding the incidence, management, and outcomes of one such irAE: mucositis. In this study, we evaluated the clinical characteristics, disease course, treatment, and outcomes of ICI-mediated mucositis. Read More

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Predictors of psychological distress in Syrian refugees with posttraumatic stress in Germany.

PLoS One 2021 4;16(8):e0254406. Epub 2021 Aug 4.

Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig, Leipzig, Germany.

Syria has been the main country of citizenship of refugees in Germany since 2013. Syrians face numerous human rights violations in their country that can be accompanied by the experience of potentially traumatic events, loss and displacement. Along the migration process, refugees are exposed to various factors that can have an impact on mental health. Read More

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Communicating Data, Information, and Knowledge in the Nursing Handoff.

Comput Inform Nurs 2021 Aug 2. Epub 2021 Aug 2.

Author Affiliations: University of Alabama at Birmingham School of Nursing (Dr Galatzan); and College of Nursing Health Professions, University of Florida, Gainesville (Dr Carrington).

Miscommunication occurring during the nursing handoff continues to be a primary cause of sentinel events and adverse patient outcomes. The primary purpose of the nursing handoff is to communicate essential patient data, information, and knowledge to ensure the safe continued continuity of care. The aim of this study was to examine the content of the nurse-to-nurse change-of-shift handoff communication in terms of data, information, and knowledge for both bedside and nonbedside handoffs of a patient who has experienced a clinical event. Read More

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Older Adults' Perception on and Use of Patient Portals: A Comparative Analysis of Two Samples.

Comput Inform Nurs 2021 Aug 2. Epub 2021 Aug 2.

Author Affiliations: National Institutes of Health Clinical Center (Dr Son), Bethesda, MD; Department of Organizational Systems and Adult Health (Drs Nahm, Galik, Van de Castle, and Seidl) and Office of Research and Scholarship (Dr Zhu), University of Maryland School of Nursing, Baltimore, MD; and E-Health Department, University of Maryland Medical System (Mr Russomanno), Linthicum Heights, MD.

Older adults can benefit from using patient portals. Little is known whether perception of and use of patient portals differ among older adults in diverse healthcare contexts. This study analyzed the difference in perceived usability, self-efficacy, and use of patient portals between older adults recruited from a healthcare system (n = 174) and older adults recruited from nationwide communities (n = 126). Read More

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'How did you cope with such concerns?': insights from a monitored online infertility peer support forum.

Hum Fertil (Camb) 2021 Aug 4:1-15. Epub 2021 Aug 4.

Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada.

The Research Question posed was 'What coping strategies do fertility patients and trained peer supporters discuss in an online infertility peer support forum?' A thematic analysis was used to examine 244 online posts from a sample of 39 users (37 women and two men) for themes in coping with fertility-related stressors. Data were collected from Connect, a monitored online discussion forum with trained peer supporters. Connect users ranged from 27 to 44 years of age (mean = 34. Read More

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French speech-language therapy students' interest in evidence-based practice: A survey.

Int J Lang Commun Disord 2021 Aug 4. Epub 2021 Aug 4.

Université Lyon 1, ISTR, Lyon, France.

Background: Taking into account international studies interested in the development of evidence-based practice (EBP) in the speech and language therapy field, this survey investigated key issues with regard to students' perception of EBP.

Aims: To determine how final-year students in France conceive EBP; to know if they feel competent in this area; to investigate any barriers to the use of EBP; and to assess their intention of using the EBP approach in their professional practice after graduating.

Methods & Procedures: Between January and April 2019, 182 advanced French students from 15 French speech-language university training centres (SLUTC) completed an online survey addressing these questions. Read More

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Evaluation of shoulder balance in early onset scoliosis after definitive fusion and comparison with adolescent idiopathic scoliosis shoulder balance.

Spine Deform 2021 Aug 4. Epub 2021 Aug 4.

Department of Orthopedics, SUNY Upstate Medical University, 750 E. Adams St., Syracuse, NY, 13210, USA.

Study Design: The Children Spine Study Group registry was queried for early onset scoliosis (EOS) patients who had final definitive spinal fusion after their scoliosis was managed with either growing rods or VEPTR. The Harms Study Group registry was queried for adolescent idiopathic scoliosis (AIS) patients who had definitive fusion OBJECTIVE: The goal is to assess shoulder alignment in EOS patients after a definitive fusion and how these radiographic outcomes relate to the more familiar situation of post-definitive fusions shoulder alignment in AIS patients.

Background: EOS is a challenging pathology to manage. Read More

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The Link Between Positive and Negative Parenting Behaviors and Child Inflammation: A Systematic Review.

Child Psychiatry Hum Dev 2021 Aug 4. Epub 2021 Aug 4.

Department of Psychology, University of Oregon, 1451 Onyx Street, Eugene, OR, 97403, USA.

Children's inflammation may be an important link between parenting behaviors and health outcomes. The aims of this systematic review were to: (1) describe associations between parenting behaviors and child inflammatory markers, and (2) evaluate the relevance of existing literature to the review question. Database searches identified 19 studies that included a measure of positive or negative parenting behaviors and a marker of child inflammation, 53% of which measured parental responsiveness/warmth. Read More

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Antihypertensive medications and risks of recurrence and mortality in luminal, triple-negative, and HER2-overexpressing breast cancer.

Cancer Causes Control 2021 Aug 4. Epub 2021 Aug 4.

Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave. N, Seattle, WA, M4-C308, USA.

Purpose: Antihypertensives are commonly prescribed medications and their effect on breast cancer recurrence and mortality is not clear, particularly among specific molecular subtypes of breast cancer: luminal, triple-negative (TN), and HER2-overexpressing (H2E).

Methods: A population-based prospective cohort study of women aged 20-69 diagnosed with a first primary invasive breast cancer between 2004 and 2015 was conducted in the Seattle, Washington and Albuquerque, New Mexico greater metropolitan areas. Multivariable-adjusted Cox proportional hazards regression was used to estimate hazard ratios (HR) and 95% confidence intervals (CI) for risks of breast cancer recurrence, breast cancer-specific mortality, and all-cause mortality associated with hypertension and antihypertensives. Read More

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The Swedish RAND-36: psychometric characteristics and reference data from the Mid-Swed Health Survey.

J Patient Rep Outcomes 2021 Aug 4;5(1):66. Epub 2021 Aug 4.

University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.

Background: This study aims to evaluate data quality, scaling properties, and reliability of the Swedish RAND-36 in a general population sample and to present reference data for the Swedish population.

Methods: Testing of data quality, scaling assumptions and reliability followed methods recommended for the International Quality of Life Assessment Project, previously used for psychometric testing of SF-36 and RAND-36. Data were collected via regular mail for a random stratified sample of the general population in a Swedish county. Read More

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Contemporary trends and in-hospital outcomes of catheter and stand-alone surgical ablation of atrial fibrillation.

Europace 2021 Aug 4. Epub 2021 Aug 4.

Division of Cardiovascular Medicine, University of Toledo Medical Center, 3000 Arlington Avenue, Toledo, OH 43614, USA.

Aims: The contemporary trends in catheter ablation (CA) and surgical ablation (SA) utilization and surgical techniques [open vs. thoracoscopic, with or without left atrial appendage closure (LAAC)] are unclear. In addition, the in-hospital outcomes of stand-alone SA compared with CA are not well-described. Read More

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Socioeconomic Disparities in Functional Status in a National Sample of Patients With Rheumatoid Arthritis.

JAMA Netw Open 2021 Aug 2;4(8):e2119400. Epub 2021 Aug 2.

Division of Rheumatology, School of Medicine, University of California, San Francisco.

Importance: Little is known about the association of poverty with functional status (FS) in patients with rheumatoid arthritis (RA) who use rheumatology care.

Objectives: To examine the association between socioeconomic status (SES) and FS among patients with RA and to evaluate the association between SES and functional declines over time in patients who received at least some rheumatology care.

Design, Setting, And Participants: This cohort study used data from the American College of Rheumatology's Rheumatology Informatics System for Effectiveness (RISE) registry between January 1, 2016, and December 31, 2018. Read More

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Effect of Graphic Warning Labels on Cigarette Packs on US Smokers' Cognitions and Smoking Behavior After 3 Months: A Randomized Clinical Trial.

JAMA Netw Open 2021 Aug 2;4(8):e2121387. Epub 2021 Aug 2.

Cancer Control Program, Moores Cancer Center, University of California, San Diego, La Jolla.

Importance: The US Food and Drug Administration's implementation of graphic warning labels (GWLs) on cigarette packs is under challenge in US courts.

Objective: To determine whether GWLs can affect US smokers' perceptions about their cigarettes or health consequences and changes in smoking behavior.

Design, Setting, And Participants: This study was a randomized clinical trial of the effect of a 3-month, real-world experience of cigarettes with GWL packaging. Read More

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Evaluation of Long-term Clearance Rates of Interventions for Actinic Keratosis: A Systematic Review and Network Meta-analysis.

JAMA Dermatol 2021 Aug 4. Epub 2021 Aug 4.

Department of Dermatology, Universitätsklinikum Erlangen, Friedrich-Alexander-University of Erlangen-Nürnberg (FAU), Erlangen, Germany.

Importance: Multiple interventions are available for the treatment of actinic keratosis (AK). However, most randomized clinical trials and meta-analyses focus on short-term efficacy outcomes.

Objective: To investigate and synthesize the long-term efficacy (≥12 months) of interventions for AK from parallel-arm randomized clinical trials. Read More

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Forecasting COVID-19 Hospital Census: A Multivariate Time-Series Model Based on Local Infection Incidence.

JMIR Public Health Surveill 2021 Aug 4;7(8):e28195. Epub 2021 Aug 4.

Center for Outcomes Research and Evaluation, Atrium Health, Charlotte, NC, United States.

Background: COVID-19 has been one of the most serious global health crises in world history. During the pandemic, health care systems require accurate forecasts for key resources to guide preparation for patient surges. Forecasting the COVID-19 hospital census is among the most important planning decisions to ensure adequate staffing, number of beds, intensive care units, and vital equipment. Read More

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Impact of a Simulation Workshop on Nursing Students' Attitudes Toward Poverty.

Authors:
Susan E Lowey

J Nurs Educ 2021 Aug 1;60(8):462-465. Epub 2021 Aug 1.

Background: Poverty is a global issue that negatively affects health outcomes and quality of life. Incorporating simulation in nursing education programs can help students develop a better understanding about poverty.

Method: A cross-sectional mixed-methods pre- and posttest survey design was used with two cohorts of undergraduate nursing students who participated in a poverty simulation. Read More

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Predicting depression in dementia caregivers: do religious/spiritual struggles play a role?

Aging Ment Health 2021 Aug 4:1-7. Epub 2021 Aug 4.

Psychology, Bridgewater College, Bridgewater, VA, USA.

Objectives: Using a stress process framework model, the goal of this study was to address the current gap in our understanding of the prevalence and predictive power of specific types of religious/spiritual struggles for mental health outcomes in informal dementia caregivers.

Method: A convenience sample of 156 informal dementia caregivers completed a scale measuring six domains of religious/spiritual struggles, as well as other measures of primary stressors, background/contextual variables, and mental health outcome (depression).

Results: Overall levels of religious/spiritual struggle were low, but 26 percent of the sample were classified as possible cases of clinically significant religious/spiritual struggle for at least one of the six domains. Read More

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Combination of AST to ALT and neutrophils to lymphocytes ratios as predictors of locally advanced disease in patients with bladder cancer subjected to radical cystectomy: Results from a single-institutional series.

Urologia 2021 Aug 4:3915603211035191. Epub 2021 Aug 4.

IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy.

Background: Bladder cancer (BC) staging is challenging. There is an important need for available and affordable predictors to assess, in combination with imaging, the presence of locally-advanced disease.

Objective: To determine the role of the De Ritis ratio (DRR) and neutrophils to lymphocytes ratio (NLR) in the prediction of locally-advanced disease defined as the presence of extravescical extension (pT ⩾ 3) and/or lymph node metastases (LNM) in patients with BC treated with radical cystectomy (RC). Read More

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COVID-19 pandemic year in a sample of Polish myasthenia gravis patients: an observational study.

Neurol Neurochir Pol 2021 Aug 4. Epub 2021 Aug 4.

Department of Exercise Physiology and Functional Anatomy, Ludwik Rydygier Collegium Medicum in Bydgoszcz Nicolaus Copernicus University in Torun, Bydgoszcz, Poland.

Aim Of The Study: Coronavirus disease 2019 (COVID-19) incidence, mortality, recovery and hospitalisation rates vary in different countries. This study aimed to present the clinical characteristics of a sample of unvaccinated Polish myasthenia gravis (MG) patients during the first year of the COVID-19 pandemic, taking into account the number of MG exacerbations, a detailed description of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection course, and the need to modify immunosuppressive therapies. Clinical rationale for the study: To assess the impact of the first COVID-19 pandemic year on MG course in a sample of unvaccinated patients. Read More

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Prospective Evaluation of Health Outcomes in a Nationwide Sample of Aeromedical Evacuation Casualties: Methods From a Pilot Study.

Mil Med 2021 Aug 4. Epub 2021 Aug 4.

Medical Modeling, Simulation, and Mission Support Department, Naval Health Research Center, San Diego, CA 92106, USA.

Introduction: Although retrospective analyses have found that combat-injured service members are at high risk for mental and physical health outcomes following injury, relatively little is known about the long-term health of injured service members. To better understand long-term health outcomes after combat injury, a large, prospective observational cohort collecting both subjective and objective health data is needed. Given that a study of this nature would be costly and face many logistical challenges, we first conducted a pilot to assess the feasibility of a larger, definitive study. Read More

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Characterizing employment of colorectal cancer survivors using electronic health records.

JAMIA Open 2021 Jul 2;4(3):ooab061. Epub 2021 Aug 2.

Kaiser Permanente Center for Health Research, Portland, Oregon, USA.

Objective: Although the value of collecting occupational data is well-established, these data are not systematically collected in clinical practice. We assessed the availability of electronic health record (EHR)-based occupation data within a large integrated health care system to determine the feasibility of its use in research.

Materials And Methods: We used a mixed-methods approach to extract EHR data and define employment status, employer, and employment industry of 1107 colorectal cancer survivors. Read More

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Establishing the impact of COVID-19 on the health outcomes of domiciliary care workers in Wales using routine data: a protocol for the OSCAR study.

Int J Popul Data Sci 2020 14;5(4):1656. Epub 2021 Jul 14.

Centre for Trials Research, Cardiff University, Cardiff, CF14 4YS.

Introduction: Domiciliary care workers (DCWs) continued providing social care to adults in their own homes throughout the COVID-19 pandemic. Evidence of the impact of COVID-19 on health outcomes of DCWs is currently mixed, probably reflecting methodological limitations of existing studies. The risk of COVID-19 to workers providing care in people's homes remains unknown. Read More

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A mixed-methods study to explore opportunities and challenges with using a mHealth approach to engage men who have sex with men in HIV prevention, treatment and care in Lomé, Togo.

Mhealth 2021 20;7:47. Epub 2021 Jul 20.

Association de Soutien à l'Autopromotion Sanitaire Urbaine (ASAPSU), Cellule de recherche opérationnelle, Abidjan, Côte d'Ivoire.

Background: In Togo, men who have sex with men (MSM) experience disproportionately high rates of human immuno-deficiency virus (HIV), with prevalence at 13% compared to the countrywide general HIV prevalence of 2.5%. Mobile phone adoption has grown rapidly in West Africa in recent years and mobile health (mHealth) provides an opportunity to engage high-risk populations in HIV prevention, treatment and care (PTC). Read More

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Brief original report: Does smoking status provide information relevant to screening for other substance use among US adults?

Prev Med Rep 2021 Sep 6;23:101483. Epub 2021 Jul 6.

Department of Population Health, New York University Grossman School of Medicine, New York, NY, United States.

We assessed whether tobacco screening provides clinically meaningful information about other substance use, including alcohol and other drug use, potentially facilitating targeting of screening for substance use. Using data from the Veterans Aging Cohort Study survey sample (VACS; N = 7510), we calculated test performance characteristics of tobacco use screening results for identification of other substance use including sensitivity, specificity, positive-likelihood-ratio (+LR = [sensitivity/(1-specificity)]: increase in odds of substance use informed by a positive tobacco screen), and negative-likelihood-ratio (-LR: [(1-sensitivity)/specificity]: reduction in odds of substance use informed by a negative tobacco screen). The sample was 95% male, 75% minority, and 43% were current and 33% were former smokers. Read More

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September 2021

Employment Status and Its Association With Psychological Distress and Alcohol Consumption.

Cureus 2021 Jun 30;13(6):e16054. Epub 2021 Jun 30.

Family Medicine, Larkin Community Hospital, Miami, USA.

Purpose: The objective of this analysis was to find an association between employment status, psychological distress, and alcohol consumption.

Methods: Data from the 2020 Health Information National Trends Survey (HINTS) data was used. Patient health questionnaire-4 (PHQ-4) data and an average number of drinks per week were used to assess psychological distress and drinking status. Read More

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Effect of high cut-off dialysis for acute kidney injury secondary to cast nephropathy in patients with multiple myeloma: a systematic review and meta-analysis.

Clin Kidney J 2021 Aug 12;14(8):1894-1900. Epub 2020 Dec 12.

Renal and Metabolic Division, George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia.

Background: Acute kidney injury (AKI) caused by cast nephropathy is associated with increased morbidity and mortality among patients with multiple myeloma (MM). High cut-off haemodialysis (HCO-HD) has proven to be effective in the removal of serum light chains but the effect on clinical outcomes, especially renal recovery, remains uncertain.

Methods: A systematic review and meta-analysis were performed examining all randomized controlled trials (RCTs) and observational studies (OBSs) assessing the effect of HCO-HD on clinical outcomes of patients with MM complicated by cast nephropathy-induced severe AKI. Read More

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Assessment of judgment ability in a Brazilian sample of patients with mild cognitive impairment and dementia.

Dement Neuropsychol 2021 Apr-Jun;15(2):200-209

Behavioral and Cognitive Neurology Unit, Department of Neurology, Cognitive Disorders Reference Center, Hospital das Clínicas, Universidade de São Paulo ‒ São Paulo, SP, Brazil.

Judgment is the ability to make sound decisions after consideration of relevant information, possible solutions, likely outcomes, and contextual factors. Loss of judgment is common in patients with mild cognitive impairment (MCI) and dementia. The Test of Practical Judgment (TOP-J) evaluates practical judgment in adults and the elderly, with 15- and 9-item versions that require individuals to listen to scenarios about everyday problems and report their solutions. Read More

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September 2020

Hemoperfusion in patients with severe COVID-19 respiratory failure, lifesaving or not?

J Res Med Sci 2021 27;26:34. Epub 2021 May 27.

Isfahan Kidney Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.

Background: The new coronavirus outbreak quickly filled hospital beds and stunned the world. Intensive care is required for 5% of patients, and the mortality rate for critically ill patients is 49%. The "cytokine storm" is considered as the main cause of pathogenesis for coronavirus disease-19 (COVID-19)-related respiratory failure, hemoperfusion may be a modality for treatment of disease. Read More

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