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Abdominal Wall Thickness Predicts Surgical Site Infection in Emergency Colon Operations.

J Surg Res 2021 Jun 12;267:37-47. Epub 2021 Jun 12.

Division of Trauma, Emergency Surgery, and Surgical Critical Care, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts. Electronic address:

Background: Body mass index (BMI) does not reliably predict Surgical site infections (SSI). We hypothesize that abdominal wall thickness (AWT) would serve as a better predictor of SSI for patients undergoing emergency colon operations.

Methods: We retrospectively evaluated our Emergency Surgery Database (2007-2018). Read More

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Surrogate Endpoints in Oncology: Overview of Systematic Reviews and Their Use for Health Decision Making in Mexico.

Value Health Reg Issues 2021 Jun 12;26:75-88. Epub 2021 Jun 12.

CENETEC (National Center for Health Technology Excellence), Mexico City, Mexico.

Objectives: The use of surrogate endpoints (SEs) for cancer drug approval in health systems is common. The objectives of this study were to identify systematic reviews (SRs) that evaluated the correlation of SEs with overall survival (OS) in cancer drugs to analyze the applications of approved cancer drugs with SEs in Mexico and to apply the validation framework proposed by the Institute for Quality and Efficiency in Health Care (IQWiG).

Methods: An overview of SRs was conducted according to Cochrane Collaboration methodology. Read More

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Refeeding syndrome occurs among older adults regardless of refeeding rates: A systematic review.

Nutr Res 2021 May 21;91:1-12. Epub 2021 May 21.

Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo 0130, Norway; Regional Advisory Unit for Palliative Care, Department of Oncology, Oslo University Hospital, Oslo 0424, Norway. Electronic address:

Refeeding syndrome is a life-threatening clinical disorder that can occur when treating malnutrition. The aim was to examine the current knowledge of refeeding syndrome in patients ≥ 65 + years with special focus on the incidence of hypophosphatemia (HP) in relation to refeeding rate (kcal/kg/day), number of days until the lowest level of phosphate occurs (day of nadir), refeeding rates and adverse events, and death. Specifically, we hypothesized that higher energy provision would cause a higher incidence of HP. Read More

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Treatment breaks in first line treatment of advanced colorectal cancer: An individual patient data meta-analysis.

Cancer Treat Rev 2021 May 19;99:102226. Epub 2021 May 19.

MRC Clinical Trials Unit at UCL, United Kingdom. Electronic address:

Background: Intermittent systemic anti-cancer therapy in patients with advanced colorectal cancer (aCRC) may improve quality of life without compromising overall survival (OS). We aimed to use individual patient data meta-analysis (IPDMA) from multiple randomised controlled trials evaluating intermittent strategies to inform clinical practice. We also aimed to validate whether thrombocytosis as a predictive biomarker identified patients with significantly reduced OS receiving a complete treatment break. Read More

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Clinical characteristics and outcomes of community-acquired pneumonia in western Saudi Arabia: A four-year retrospective analysis of medical records.

J Infect Public Health 2021 May 27;14(7):960-966. Epub 2021 May 27.

Infection Prevention and Control, King Abdulaziz Medical City, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia; King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.

Background: Community-acquired pneumonia (CAP) is a significant cause of morbidity and mortality, especially for the elderly and people who suffer from chronic conditions. This study was conducted to assess the clinical and microbiological characteristics and disease outcomes associated with the occurrence of CAP.

Methods: This retrospective chart review was conducted at King Abdulaziz Medical City, Jeddah, Saudi Arabia. Read More

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The immunological response among COVID-19 patients with acute respiratory distress syndrome.

J Infect Public Health 2021 May 26;14(7):954-959. Epub 2021 May 26.

Faculty Member at King Saud Abdul-Aziz University for Health Sciences, Riyadh, Saudi Arabia; Department of Rehabilitation Science, School of Health Profession, University of Alabama at Birmingham, Birmingham, AL, United States; King Abdullah International Medical Research Center (KAIMRC), Riyadh, Saudi Arabia. Electronic address:

Coronavirus disease 2019 (COVID-19) often results in pneumonia and can lead to acute respiratory distress syndrome (ARDS). ARDS is one of the most significant causes of death in patients with COVID-19. The development of a "cytokine storm" in patients with COVID-19 causes progression to ARDS. Read More

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A retrospective evaluation of the value of COVID-19 screening and testing in patients with cancer: Aiming at a moving target.

J Infect Public Health 2021 May 26;14(7):949-953. Epub 2021 May 26.

Department of Oncology, King Abdulaziz Medical City, King Abdullah International Medical Research Center, King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs (MNGHA), Riyadh, Saudi Arabia.

Background: Diagnosis of COVID-19 infection in cancer patients is critical to co-manage their underlying disease and infection appropriately. Our study aimed at evaluating the sensitivity and specificity of screening patients with cancer for COVID-19 infection.

Methods: All oncology patients receiving care at Department of Oncology at King Abdulaziz Medical City in Riyadh were screened using the acute respiratory infection (ARI) survey. Read More

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Early multidrug treatment of SARS-CoV-2 infection (COVID-19) and reduced mortality among nursing home (or outpatient/ambulatory) residents.

Med Hypotheses 2021 Jun 5;153:110622. Epub 2021 Jun 5.

Concerned Ontario Doctors, Toronto, ON, Canada. Electronic address:

The outbreak of COVID-19 from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread all over the world with tremendous morbidity and mortality in the elderly. In-hospital treatment addresses the multifaceted nature of the illness including initial viral replication, cytokine storm, and endothelial injury with thrombosis. We identified nine reports of early treatment outcomes in COVID-19 nursing home patients. Read More

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Clusters of comorbidities in idiopathic pulmonary fibrosis.

Respir Med 2021 Jun 1;185:106490. Epub 2021 Jun 1.

Center for Rare Lung Diseases, Department of Respiratory Diseases and Allergy, Aarhus University Hospital, Aarhus, Denmark.

Introduction: Comorbidities are common in patients with idiopathic pulmonary fibrosis (IPF) and negatively impact health-related quality of life, health-care costs and mortality. Retrospective studies have focused on individual comorbidities, but clusters of multiple comorbidities have rarely been analysed. This study aimed to comprehensively and prospectively assess comorbidities in a multicentre, real-world cohort of patients with IPF, including prespecified conditions of special interest and to analyse clusters of comorbidities and examine characteristics, disease course and mortality of the clusters. Read More

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The advice given by physiotherapists to people with back pain in primary care.

Musculoskelet Sci Pract 2021 May 29;55:102403. Epub 2021 May 29.

University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton, UK; School of Health Sciences, University of Southampton, Highfield, Southampton, UK. Electronic address:

Background: Back pain guidelines endorse giving advice to enable people to self-manage and continue normal activities. Little is known however, about the content of advice that clinicians give and this project aimed to identify the advice given by clinicians to patients with back pain at their initial consultation.

Methods: A secondary analysis was conducted with 25 audio-recordings and transcriptions of consultations between patients with back pain and physiotherapists in a primary care outpatients department. Read More

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Nutritional Risk at intensive care unit admission and outcomes in survivors of critical illness.

Clin Nutr 2021 May 11;40(6):3868-3874. Epub 2021 May 11.

Critical Illness, Brain Dysfunction, and Survivorship (CIBS) Center, Nashville, TN, USA; Division of Pulmonary, Critical Care, and Sleep Medicine, The Ohio State University College of Medicine, Columbus OH, USA; Davis Heart and Lung Research Institute, The Ohio State University Wexner Medical Center, Columbus, OH, USA. Electronic address:

Background And Aims: Risk factors for poor outcomes after critical illness are incompletely understood. While nutritional risk is associated with mortality in critically ill patients, its association with disability, cognitive, and health-related quality of life is unclear in survivors of critical illness. This study's objective was to determine whether greater nutritional risk at ICU admission is associated with greater disability, worse cognition, and worse HRQOL at 3 and 12-month follow-up. Read More

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From hospital unit to intestinal failure center: Twenty years of history.

Clin Nutr 2021 Apr 27;40(6):3787-3792. Epub 2021 Apr 27.

Department of Clinical Nursing, Institute of Nursing and Midwifery, Faculty of Health Care, Jagiellonian University, Krakow, Poland.

Aim: Home parenteral nutrition (HPN) is one of the most demanding medical therapies as it is the only option for patients for intestinal failure (IF). No unequivocal policy on how to start and progress with HPN has ever been presented. The IF Center at the Stanley Dudrick's Memorial Hospital in Skawina is one of the biggest centers in Poland, celebrating its twentieth birthday last year. Read More

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Are muscle parameters obtained by computed tomography associated with outcome after esophagectomy for cancer?

Clin Nutr 2021 May 1;40(6):3729-3740. Epub 2021 May 1.

Department of Intensive Care Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany.

Background & Aims: Esophageal cancer patients often suffer from cancer-related malnutrition and, as a result, sarcopenia. Whether sarcopenia worsens the outcome after esophagectomy is unclear. Inconsistent study results are partly caused by varying cut-off values used for defining sarcopenia. Read More

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The goldilocks problem: Nutrition and its impact on glycaemic control.

Clin Nutr 2021 May 11;40(6):3677-3687. Epub 2021 May 11.

Department of Intensive Care, Christchurch Hospital, Christchurch, 8011, New Zealand. Electronic address:

Background: Glucose intolerance and insulin resistance manifest as hyperglycaemia in intensive care, which is associated with mortality and morbidities. Glycaemic control (GC) may improve outcomes, though safe and effective control has proven elusive. Nutritional glucose intake affects blood glucose (BG) outcomes, but few protocols actively control it. Read More

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The usefulness of ultrasound before induction of labor.

Am J Obstet Gynecol MFM 2021 Jun 12:100423. Epub 2021 Jun 12.

Obstetric Unit, Department of Medical and Surgical Sciences, University of Bologna and IRCCS Azienda Ospedaliero-Universitaria S.Orsola-Malpighi, Bologna, Italy.

The indications for induction of labor have been consistently on the rise. These indications are mainly medical (maternal or fetal), social or indications that are related to convenience or maternal preferences. With the increase in prevalence of these indications, the incidence rates of induction of labor are expected to continue to rise. Read More

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Analysis of neurosurgical cases before and during the COVID-19 pandemic from a tertiary care centre in India.

World Neurosurg 2021 Jun 12. Epub 2021 Jun 12.

Professor, Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi India.

Objective: We present the unique administrative issues as well as specific patient and surgeon related challenges and solutions implemented while treating neurosurgical cases during the COVID pandemic vis-à-vis the pre COVID times at our tertiary care center.

Methods: This is a retrospective study comparing the outcome of the neurosurgical patients treated from the beginning of lockdown in India on 25 March 2020 to 30 November 2020 with that of same period in the previous year, 2019.

Results: We had a total of 687 admissions under neurosurgery this year during the study period as compared to 2550 admissions in 2019. Read More

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Influence of outpatient total knee arthroplasty compared to inpatient surgery on medical and economic outcomes.

Acta Orthop Belg 2021 Mar;87(1):103-109

Firstly, this study compared the rate of readmission after a total knee arthroplasty between selected out- patients (no hospitalization, directly sent home after surgery) and inpatients (3 days hospitalization) at 6 weeks. Secondly, it examined the mobility and the complications in the two groups after the same period of time. The rate of readmission, complications and knee mobility of 32 outpatients (M-age : 61 years ± 10 ; 10 females), were compared against those of 32 birth- matched inpatients (M-age : 64 years ± 8. Read More

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Subcuticular sutures versus staples for skin closure after primary hip arthroplasty.

Acta Orthop Belg 2021 Mar;87(1):55-64

High-quality and cost-effective health care are highly recommended especially in joint replacement surgeries, particularly in total hip arthroplasty. Therefore, it is indispensable for orthopaedic surgeons to spot the potential areas of quality improvement. Evaluating the efficacy of the different ways of skin closure is an unacknowledged topic. Read More

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Specialist paediatric transport team provided appropriate respiratory and haemodynamic support to stabilise critically ill children.

Acta Paediatr 2021 Jun 15. Epub 2021 Jun 15.

Emergency Transport System, Hospital Sant Joan de Déu, Barcelona, Spain.

Critically ill infants are often transferred to a referral hospital after they are assessed and stabilised by their local emergency department. The ideal composition and training of transport teams remains unclear. Transport generalists may be more available, but clinical complications during transfers can increase. Read More

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The use of cleaning products and its relationship with the increasing health risks during the Covid-19 pandemic.

Int J Clin Pract 2021 Jun 15:e14534. Epub 2021 Jun 15.

Mersin University, Nursing Faculty, Department of Public Helath Nursing.

Objective: The present study aimed to determine the factors affecting the use of cleaning products at the home environment and the frequency of problems during the COVID-19 pandemic.

Materials And Methods: This cross-sectional research was performed online between 30.08. Read More

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The discrepancy between admission and discharge diagnoses: Underlying factors and potential clinical outcomes in a low socioeconomic country.

PLoS One 2021 15;16(6):e0253316. Epub 2021 Jun 15.

Department of Medicine, Section of Internal Medicine, Aga Khan University Hospital, Karachi, Pakistan.

Objective: The discrepancy between admission and discharge diagnosis can lead to possible adverse patient outcomes. There are gaps in integrated studies, and less is understood about its characteristics and effects. Therefore, this study was conducted to determine the frequency, characteristics, and outcomes of diagnostic discrepancies at admission and discharge. Read More

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Symptom trajectories of non-cancer patients in the last six months of life: Identifying needs in a population-based home care cohort.

PLoS One 2021 15;16(6):e0252814. Epub 2021 Jun 15.

Department of Family Medicine, Division of Palliative Care, McMaster University, Hamilton, Ontario, Canada.

Introduction: The end-of-life symptom prevalence of non-cancer patients have been described mostly in hospital and institutional settings. This study aims to describe the average symptom trajectories among non-cancer patients who are community-dwelling and used home care services at the end of life.

Materials And Methods: This is a retrospective, population-based cohort study of non-cancer patients who used home care services in the last 6 months of life in Ontario, Canada, between 2007 and 2014. Read More

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Attitudes, beliefs and behaviors of religiosity, spirituality, and cultural competence in the medical profession: A cross-sectional survey study.

PLoS One 2021 15;16(6):e0252750. Epub 2021 Jun 15.

University of South Carolina School of Medicine Greenville, Greenville, South Carolina, United States of America.

Introduction: Religion and spirituality play important roles in the lives of many, including healthcare providers and their patients. The purpose of this study was to examine the relationships between religion, spirituality, and cultural competence of healthcare providers.

Methods: Physicians, residents, and medical students were recruited through social platforms to complete an electronically delivered survey, gathering data regarding demographics, cultural competency, religiosity, and spirituality. Read More

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Factors driving choices between types and brands of influenza vaccines in general practice in Austria, Italy, Spain and the UK.

PLoS One 2021 15;16(6):e0252836. Epub 2021 Jun 15.

Centre for Health Economics Research & Modelling Infectious Diseases, Vaccine & Infectious Disease Institute, University of Antwerp, Antwerp, Belgium.

Influenza vaccine effectiveness (IVE) assessment is increasingly stratified by vaccine type or brand, such as done by the European network of DRIVE. In 2019/2020, eleven influenza vaccines were licensed in Europe. If more than one vaccine type is recommended or if more than one vaccine brand is available for a specific risk group, it is not clear which factors affect the choice of a specific vaccine (type or brand) by a health practitioner for individual patients. Read More

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Disability, pain, and wound-specific concerns self-reported by adults at risk of limb loss: A cross-sectional study using the World Health Organization Disability Assessment Schedule 2.0.

PLoS One 2021 15;16(6):e0253288. Epub 2021 Jun 15.

Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.

Introduction: There has been limited study of patient-reported outcomes (PROs) in patients at risk of limb loss. Our primary objective was to estimate the prevalence of disability in this patient population using the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2. Read More

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Use of a Tourniquet and Spinal Anesthesia Increases Satisfactory Outcomes After Total Knee Arthroplasty: A Randomized Study.

J Bone Joint Surg Am 2021 Jun 15. Epub 2021 Jun 15.

Department of Anesthesiology, Intensive Care, and Pain Medicine, Peijas Hospital, HUS Helsinki University Hospital, Helsinki, Finland.

Background: Total knee arthroplasty (TKA) is usually performed successfully with or without a tourniquet and under spinal anesthesia (SA) or general anesthesia (GA). However, 10% to 34% of patients experience dissatisfaction and pain after TKA. We aimed to compare the effects of tourniquet use and SA or GA on TKA outcomes. Read More

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Understanding the Prevalence of Prediabetes and Diabetes in Patients With Cancer in Clinical Practice: A Real-World Cohort Study.

J Natl Compr Canc Netw 2021 Mar 10:1-10. Epub 2021 Mar 10.

2Huntsman Cancer Institute, and.

Background: This study aimed to understand the prevalence of prediabetes (preDM) and diabetes mellitus (DM) in patients with cancer overall and by tumor site, cancer treatment, and time point in the cancer continuum.

Methods: This cohort study was conducted at Huntsman Cancer Institute at the University of Utah. Patients with a first primary invasive cancer enrolled in the Total Cancer Care protocol between July 2016 and July 2018 were eligible. Read More

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Time-Driven Activity-Based Costing for Cataract Surgery in Canada: The Case of the Kensington Eye Institute.

Healthc Policy 2021 May;16(4):97-108

Director, Health System Strategy, Medtronic ULC, Brampton, ON.

Time-driven activity-based costing (TDABC) has received considerable attention globally as a way to measure value in healthcare systems. This study aimed to apply TDABC for cataract surgery at the Kensington Eye Institute (KEI). During a field evaluation, a detailed process map was created for cataract surgery at KEI. Read More

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Putting the Patient First: A Scoping Review of Patient Desires in Canada.

Healthc Policy 2021 May;16(4):46-69

Director, North American Observatory on Health Systems and Policies; Professor, Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON.

Patient-centred care is a key priority for governments, providers and stakeholders, yet little is known about the care preferences of patient groups. We completed a scoping review that yielded 193 articles for analysis. Five health states were used to account for the diversity of possible preferences based on health needs. Read More

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