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Why Some Nurses Obtain Specialty Certification and Others Do Not.

J Nurs Adm 2021 May;51(5):249-256

Author Affiliations: Assistant Professor (Dr Dierkes), Department of Acute and Tertiary Care, School of Nursing, University of Pittsburgh, Pennsylvania; Postdoctoral Fellow (Dr Schlak), School of Nursing, Columbia University, New York, New York; and Predoctoral Fellow (Ms French), Associate Director (Dr McHugh), and Director (Dr Aiken), Center for Health Outcomes and Policy Research, School of Nursing, University of Pennsylvania, Philadelphia.

Objective: The aim of this study was to determine whether there are modifiable characteristics of nurses and hospitals associated with nurse specialty certification.

Background: Hospitals, nurses, and patients benefit from nurse specialty certification, but little actionable evidence guides administrators seeking higher hospital certification rates.

Methods: This is a cross-sectional, secondary data analysis of 20 454 nurses in 471 hospitals across 4 states. Read More

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Telemedicine for adult congenital heart disease patients during the first wave of COVID-19 era: a single center experience.

J Cardiovasc Med (Hagerstown) 2021 Apr 20. Epub 2021 Apr 20.

Dipartimento di Scienze Cardiovascolari e Toraciche, Fondazione Policlinico Universitario A. Gemelli IRCCS Catholic University of the Sacred Heart Department of Pediatric Cardiology and Cardiac Surgery - Bambino Gesù Hospital, Rome, Italy.

Aim: To summarize our experience on the implementation of a telemedicine service dedicated to adult congenital heart disease (ACHD) patients during the lockdown for the first wave of COVID-19.

Methods: This is a prospective study enrolling all ACHD patients who answered a questionnaire dedicated telematic cardiovascular examination.

Results: A total of 289 patients were enrolled, 133 (47%) were male, 25 (9%) were affected by a genetic syndrome. Read More

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Prevalence and predictors of persistent sinus rhythm after elective electrical cardioversion for atrial fibrillation.

J Cardiovasc Med (Hagerstown) 2021 Apr 20. Epub 2021 Apr 20.

Cardiovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina, University of Trieste, Trieste, Italy.

Aims: To evaluate the prevalence and predictors of persistent sinus rhythm in a recent cohort of unselected patients undergoing electrical cardioversion for atrial fibrillation.

Methods: We enrolled all consecutive patients undergoing elective electrical cardioversion for atrial fibrillation between January 2017 and December 2018. We analysed baseline clinical and echocardiographic data as well as pharmacological antiarrhythmic therapy. Read More

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Diagnostic delay in axial spondyloarthritis - a past or current problem?

Curr Opin Rheumatol 2021 Apr 20. Epub 2021 Apr 20.

Department of Gastroenterology, Infectious Diseases and Rheumatology, Charité - Universitätsmedizin Berlin Epidemiology Unit, German Rheumatism Research Centre, Berlin, Germany.

Purpose Of Review: To evaluate recent data on diagnostic delay in axial spondyloarthritis (axSpA), factors affecting the delay, potential ways of early diagnosis improvement, and risks associated with early diagnostic approaches.

Recent Findings: Although axSpA can be diagnosed nowadays within the first months after symptom onset, the diagnostic delay remains with several years still remarkably high in many parts of the world. Female gender, human leukocyte antigen-B27 negativity, and younger age at disease onset are among factors associated with a delayed referral to a rheumatologist and consequently with a larger diagnostic delay. Read More

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Salvage Radiosurgery for Recurrent Supratentorial Primitive Neuroectodermal Tumors: A Single Institutional Series and Review of the Literature.

Stereotact Funct Neurosurg 2021 Apr 21:1-7. Epub 2021 Apr 21.

Department of Neurological Surgery, Mayo Clinic, Rochester, Minnesota, USA.

Introduction: Supratentorial primitive neuroectodermal tumor is a rare, aggressive intrinsic brain tumor with limited treatment options for recurrent disease. SRS as a treatment modality in the recurrent setting was investigated.

Methods: A retrospective review of 8 patients treated with SRS for local or distant recurrence of supratentorial PNET from 1999 to 2014 was conducted. Read More

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Outcomes following Craniosynostosis Surgery at a Tertiary Care Center in the Middle East.

Pediatr Neurosurg 2021 Apr 21:1-9. Epub 2021 Apr 21.

Division of Neurosurgery, Department of Surgery, American University of Beirut Medical Center, Beirut, Lebanon.

Background: Despite advancements in craniosynostosis surgery, open surgical approaches remain crucial for the management of infants >6 months of age and in those with complex synostosis. The clinical features of craniosynostosis remain poorly characterized in the Middle East. This study sought to assess the clinical features and outcomes of infants undergoing craniosynostosis surgery at a tertiary care center in Lebanon. Read More

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Air Pollution Is Associated with Cognitive Deterioration of Alzheimer's Disease.

Gerontology 2021 Apr 21:1-9. Epub 2021 Apr 21.

Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.

Introduction: Dementia is one of the major causes of disability and dependency among older people worldwide. Alz-heimer's disease (AD), the most common cause of dementia among the elderly, has great impact on the health-care system of developed nations. Several risk factors are suggestive of an increased risk of AD, including APOE-ε4, male, age, diabetes mellitus, hypertension, and low social engagement. Read More

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Atopic Dermatitis and Infertility: A Nationwide Retrospective Cohort Study.

Dermatology 2021 Apr 21:1-7. Epub 2021 Apr 21.

Siaal Research Center for Family Medicine and Primary Care, Division of Community Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel.

Background: Given that common pathophysiological factors play a role in atopic dermatitis (AD) and infertility, we assumed that the 2 conditions might demonstrate an epidemiological association. Large-scale epidemiological data on this topic are lacking.

Objectives: The aim of this work was to evaluate the potential association between AD and infertility in a broad community-based population. Read More

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Accelerated Phase of Myeloproliferative Neoplasms.

Acta Haematol 2021 Apr 21:1-16. Epub 2021 Apr 21.

Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.

Background: Myeloproliferative neoplasms (MPNs) can transform into blast phase MPN (leukemic transformation; MPN-BP), typically via accelerated phase MPN (MPN-AP), in ∼20-25% of the cases. MPN-AP and MPN-BP are characterized by 10-19% and ≥20% blasts, respectively. MPN-AP/BP portend a dismal prognosis with no established conventional treatment. Read More

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Anterior cingulate cortex neuro-metabolic changes underlying lithium-induced euthymia in bipolar depression: A longitudinal H-MRS study.

Eur Neuropsychopharmacol 2021 Apr 18;49:93-100. Epub 2021 Apr 18.

University of Texas, USA.

The diagnosis and treatment of bipolar depression (BDep) poses complex clinical challenges for psychiatry. Proton magnetic resonance spectroscopy (H-MRS) is a useful imaging tool for investigating in vivo levels of brain neuro-metabolites, critical to understanding the process of mood dysregulation in Bipolar Disorder. Few studies have evaluated longitudinal clinical outcomes in BDep associated with H-MRS metabolic changes. Read More

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Real-world propensity score comparison of treatment effectiveness of peginterferon beta-1a vs. subcutaneous interferon beta-1a, glatiramer acetate, and teriflunomide in patients with relapsing-remitting multiple sclerosis.

Mult Scler Relat Disord 2021 Apr 8;51:102935. Epub 2021 Apr 8.

Biogen, 133 Boston Post Rd, Weston, MA 20493 USA. Electronic address:

Background: Multiple disease-modifying therapies (DMTs) have been approved by the U.S. Food & Drug Administration for the treatment of relapsing-remitting multiple sclerosis (RRMS). Read More

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The multidimensional prognostic index (MPI) for the prognostic stratification of older inpatients with COVID-19: A multicenter prospective observational cohort study.

Arch Gerontol Geriatr 2021 Apr 5;95:104415. Epub 2021 Apr 5.

Department of Primary Care, District 3, ULSS 3, Venice, Italy,; Department of Internal Medicine and Geriatrics, University of Palermo, Italy. Electronic address:

Background: The topic of prognosis in COVID-19 research may be important in adopting appropriate clinical decisions. Multidimensional prognostic index (MPI) is a frailty assessment tool widely used for stratifying prognosis in older people, but data regarding inpatients, affected by COVID-19, are not available.

Objectives: To evaluate whether MPI can predict in-hospital mortality and the admission to intensive care unit (ICU) in older inpatients hospitalized for COVID-19 infection. Read More

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3D analysis of facial morphology in Dutch children with cancer.

Comput Methods Programs Biomed 2021 Apr 9;205:106093. Epub 2021 Apr 9.

Department of Human Genetics, KU Leuven, Leuven, Belgium; Big Data Institute and Nuffield Department of Women's & Reproductive Health, University of Oxford, Oxford, United Kingdom.

Background and Objective; Genetic risk factors for childhood cancer may also influence facial morphology. 3D photography can be used in the recognition of differences in face shape among individuals. In previous research, 3D facial photography was used to identify increased facial asymmetry and greater deviation from normal facial morphology in a group of individuals with distinct morphological features who had childhood cancer compared to healthy controls. Read More

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Biomarker support for ADHD diagnosis based on Event Related Potentials and scores from an attention test.

Psychiatry Res 2021 Mar 19;300:113879. Epub 2021 Mar 19.

Neuropsychiatric Team, Åsebråten Clinic, Østfold Hospital Trust, Fredrikstad, Norway; Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden; Institute of Psychology, Norwegian Institute of Science and Technology (NTNU), Trondheim, Norway. Electronic address:

ADHD is a heterogeneous neurodevelopmental disorder associated with dysfunctions in several brain systems. Objective markers of brain dysfunction for clinical assessment are lacking. Many studies applying electroencephalography (EEG) and neuropsychological tests find significant differences between ADHD and controls, but the effect sizes (ES) are often too small for diagnostic purposes. Read More

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Survival predictors and outcomes of patients with recurrent and/or metastatic head and neck cancer treated with chemotherapy plus cetuximab as first-line therapy: A real-world retrospective study.

Cancer Treat Res Commun 2021 Apr 14;27:100375. Epub 2021 Apr 14.

Instituto Português de Oncologia de Coimbra Francisco Gentil Av. Prof. Dr. Bissaya Barreto n.º 98, 3000-075 Coimbra Portugal.

Background: In patients with recurrent or metastatic head and neck squamous cell carcinoma (R/M HNSCC) the estimated prognosis is usually poor. Patient-specific factors that affect prognosis should be considered when choosing therapy. We conducted a retrospective, single-center analysis in patients treated with first line platinum and antiEGFR antibody-containing regimen. Read More

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Clinical outcomes of non-small cell lung cancer patients with leptomeningeal metastases after immune checkpoint inhibitor treatments.

Eur J Cancer 2021 Apr 18;150:23-30. Epub 2021 Apr 18.

Guangdong Lung Cancer Institute, Guangdong Provincial Key Laboratory of Translational Medicine in Lung Cancer, Guangdong Provincial People's Hospital & Guangdong Academy of Medical Sciences, School of Medicine, South China University of Technology, Guangzhou, China. Electronic address:

Objective: Leptomeningeal metastases (LM) occur in up to 5% of non-small cell lung cancer (NSCLC) patients and often develop after previous systemic treatments. In this article, we explored whether immune checkpoint inhibitors (ICIs) enhanced the dismal survival of patients with LM.

Materials And Methods: Data on NSCLC patients with LM prescribed ICIs were collected at the Guangdong Lung Cancer Institute. Read More

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Accelerated aging in the brain, epigenetic aging in blood, and polygenic risk for schizophrenia.

Schizophr Res 2021 Apr 17;231:189-197. Epub 2021 Apr 17.

Center for Neurobehavioral Genetics, University of California, Los Angeles, United States; Department of Psychiatry, Erasmus University Medical Center, Rotterdam, the Netherlands.

Schizophrenia patients show signs of accelerated aging in cognitive and physiological domains. Both schizophrenia and accelerated aging, as measured by MRI brain images and epigenetic clocks, are correlated with increased mortality. However, the association between these aging measures have not yet been studied in schizophrenia patients. Read More

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Safety and efficacy of antiplatelet use before intravenous thrombolysis for acute Ischemic stroke.

J Neurol Sci 2021 Apr 15;425:117451. Epub 2021 Apr 15.

Departments of Neurology and Neurosurgery, University of Cincinnati Medical Center, Cincinnati, OH, United States of America.

Aim: To study the effects of pretreatment with Antiplatelet (AP) before IV thrombolysis (IVT) on the rate of symptomatic intracranial hemorrhage (sICH) and functional outcome in patients with Acute Ischemic stroke (AIS).

Method: In this retrospective study, the medical records and cerebrovascular images of all the patients who received IVT for AIS in our center in a 9.6-year period were reviewed. Read More

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Macromolecular fraction (MMF) from 3D ultrashort echo time Cones magnetization transfer (3D UTE-Cones-MT) imaging predicts meniscal degeneration and knee osteoarthritis.

Osteoarthritis Cartilage 2021 Apr 18. Epub 2021 Apr 18.

University of California San Diego, San Diego, CA, United States. Electronic address:

Objective: Meniscal degeneration is strongly associated with osteoarthritis (OA). We aimed to evaluate a 3D ultrashort-echo-time Cones magnetization transfer (UTE-Cones-MT) sequence for quantification of macromolecular fraction (MMF) and MT ratio (MTR) in menisci of healthy volunteers and patients with different degrees of OA.

Methods: Patients with mild OA (n=19;37-86 years;10 males) or advanced OA (n=12;52-88 years;4 males) and healthy volunteers (n=17;20-49 years;7 males) were scanned with T2-FSE and UTE-Cones-MT sequences at 3T. Read More

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Association of epigenetic age acceleration with risk factors, survival, and quality of life in patients with head and neck cancer.

Int J Radiat Oncol Biol Phys 2021 Apr 18. Epub 2021 Apr 18.

Emory University School of Nursing.

Purpose: Epigenetic age acceleration (EAA) is robustly linked with mortality and morbidity. This study examined risk factors of EAA and its association with overall survival (OS), progression-free survival (PFS), and quality of life (QOL) in patients with head and neck cancer (HNC) receiving radiotherapy.

Methods And Materials: Patients without distant metastasis were enrolled and followed before and end of radiotherapy, and 6-months and 12-months post-radiotherapy. Read More

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Surgical and percutaneous management of aboriginal Australians with rheumatic heart disease: Timeliness and concordance between practice and guidelines.

Int J Cardiol 2021 Apr 18. Epub 2021 Apr 18.

Aboriginal Health Equity Theme, South Australian Health and Medical Research Institute, Adelaide, Australia; Adelaide Medical School, The University of Adelaide, Adelaide, Australia.

Background: Rheumatic heart disease (RHD) affects over 40 million people globally who are predominantly young and from impoverished communities. The barriers to valvular intervention are complex and contribute to the high morbidity and mortality associated with RHD. The rates of guideline indicated intervention in patients with significant RHD have not yet been reported. Read More

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The incidence and relevance of Non-Fatty components in trunk and extremity lipomatous soft tissue masses.

Br J Radiol 2021 Apr 21:20201403. Epub 2021 Apr 21.

Department of Radiology, Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Middlesex HA7 4LP, UK.

Objectives: To determine the incidence and diagnostic relevance of non-fatty 'solid appearing' components within lipomatous tumours of the trunk and extremity.

Methods And Materials: Retrospective review of patients referred to a specialist musculoskeletal oncology service over a 12 month period with a lipomatous trunk or extremity soft tissue tumour. The presence and morphology (solitary/multifocal; homogeneous/heterogeneous; well-defined/poorly-defined) of non-fatty components was recorded based on MRI, and compared with the final histological diagnosis. Read More

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Sacituzumab Govitecan in Metastatic Triple-Negative Breast Cancer.

N Engl J Med 2021 Apr;384(16):1529-1541

From the Division of Medical Oncology, Massachusetts General Hospital Cancer Center (A. Bardia), and the Department of Medical Oncology, Dana-Farber Cancer Institute (S.M.T.) - both in Boston; the University of California, Los Angeles, Jonsson Comprehensive Cancer Center, Los Angeles (S.A.H.); the Medical Oncology Department and the Department of Drug Development and Innovation, Institut Curie, Paris (D.L.), Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse (F.D.), and the Department of Medical Oncology, Centre Eugène Marquis, Rennes (V.D.) - all in France; the Department of General Medical Oncology and Multidisciplinary Breast Center, Leuven Cancer Institute, University Hospitals Leuven, Leuven (K.P.), and the Clinical Trials Conduct Unit (P.A.), Institut Jules Bordet-Université Libre de Bruxelles (M.J.P.), Brussels - all in Belgium; the Medical Oncology Department and Breast Cancer Group, Vall d'Hebron University Hospital and Vall d'Hebron Institute of Oncology (M.O.), and the International Breast Cancer Center, Quiron Group (J.C.) - all in Barcelona; Magee-Womens Hospital and the Hillman Cancer Center, University of Pittsburgh Medical Center, Pittsburgh (A. Brufsky); Ohio State University Wexner Medical Center, Columbus (S.D.S.); Columbia University Irving Medical Center (K.K.) and Memorial Sloan Kettering Cancer Center (T.T.) - both in New York; Northside Hospital, Atlanta (A.B.Z.); Florida Cancer Specialists, Tampa (R.W.); Georgetown Lombardi Comprehensive Cancer Center, Washington, DC (F.L.); Rocky Mountain Cancer Centers, Greenwood Village, CO (S.D.); Baylor University Medical Center and Texas Oncology, Dallas (J.O.); Segal Cancer Centre, Jewish General Hospital, Montreal (C.F.); Barts Cancer Institute, Queen Mary University of London, London (P.S.); University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill (L.A.C.); Gianni Bonadonna Foundation, Milan (L.G.); the Department of Medicine and Research, Hämatologisch-Onkologische Gemeinschaftspraxis am Bethanien-Krankenhaus, Frankfurt, Germany (S.L.); Immunomedics, Morris Plains, NJ (D.M.G., Q.H., M.S.O., L.M.I.); and the University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco (H.S.R.).

Background: Patients with metastatic triple-negative breast cancer have a poor prognosis. Sacituzumab govitecan is an antibody-drug conjugate composed of an antibody targeting the human trophoblast cell-surface antigen 2 (Trop-2), which is expressed in the majority of breast cancers, coupled to SN-38 (topoisomerase I inhibitor) through a proprietary hydrolyzable linker.

Methods: In this randomized, phase 3 trial, we evaluated sacituzumab govitecan as compared with single-agent chemotherapy of the physician's choice (eribulin, vinorelbine, capecitabine, or gemcitabine) in patients with relapsed or refractory metastatic triple-negative breast cancer. Read More

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Clinical characteristics and outcome of hospitalized children and adolescent patients with type 1 diabetes during the COVID-19 pandemic: data from a single center surveillance study in Egypt.

J Pediatr Endocrinol Metab 2021 Apr 22. Epub 2021 Apr 22.

Division of Pediatric and Adolescent Diabetes Unit (PADU), Department of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo, Egypt.

Objectives: COVID-19 pandemic significantly impacted the diagnosis of type 1 diabetes and its acute complications. Thus, the study aimed to evaluate the characteristics of pediatric patients with type 1 diabetes hospitalized during the first wave of the pandemic and the prevalence of new onset diabetes among patients with evidence of COVID-19 infection.

Methods: A single-center surveillance study included all patients with diabetes admitted to Children's Hospital, Ain Shams University, in Egypt between May to August 2020. Read More

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"Blepharophimosis-plus" syndromes: Frequency of systemic genetic disorders that also include blepharophimosis.

Clin Exp Ophthalmol 2021 Apr 21. Epub 2021 Apr 21.

Division of Ophthalmology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.

Background: To determine the frequency of isolated blepharophimosis-ptosis-epicanthus inversus syndrome (BPES) vs. systemic genetic disorders in patients presenting with blepharophimosis.

Methods: Retrospective clinical records review. Read More

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A prospective clinical and transcriptomic feasibility study of oral-only hormonal therapy with radiation for unfavorable prostate cancer in men 70 years of age and older or with comorbidity.

Cancer 2021 Apr 21. Epub 2021 Apr 21.

Department of Radiation and Cellular Oncology, University of Chicago Medicine, Chicago, Illinois.

Background: Androgen deprivation therapy (ADT) improves outcomes in unfavorable-risk prostate cancer (PCa) treated with radiation therapy (RT). It was hypothesized that replacing luteinizing hormone-releasing hormone (LHRH) agonists with a 5-α-reductase inhibitor (5-ARI) would improve hormonal health-related quality of life (HRQOL) without differentially suppressing androgen-responsive (AR) gene expression.

Methods: Patients with localized unfavorable-risk PCa, aged ≥70 years or Charlson Comorbidity Index score ≥2 were treated with oral ADT (oADT), consisting of 4 months of bicalutamide, a 5-ARI, and RT at 78 Gy. Read More

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Efficacy of Miniscrew-Assisted Rapid Palatal Expansion (MARPE) in late adolescents and adults: a systematic review and meta-analysis.

Eur J Orthod 2021 Apr 21. Epub 2021 Apr 21.

Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Oral and Maxillofacial Surgery, Nijmegen, The Netherlands.

Background: Miniscrew-Assisted Rapid Palatal Expansion (MARPE) is a non-surgical treatment for transverse maxillary deficiency. However, there is limited evidence concerning its efficacy.

Objectives: This systematic review aims to evaluate the efficacy of MARPE in late adolescents and adults by assessing success rate and skeletal and dental transverse maxillary expansion, as well as treatment duration, dental and periodontal side effects and soft tissue effects. Read More

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Retrospective Evaluation Of The Accuracy Of Five Different Severity Scores To Predict The Mortality In Burns Patients.

J Burn Care Res 2021 Apr 21. Epub 2021 Apr 21.

Plastic Surgery Division, Faculty of Medicine, University of São Paulo.

Background: Patients with great clinical impairment, due to extensive burns, need to be admitted to intensive care units, in these treatment sites, indices are used to classify the severity of patients. The aim of the study was to compare the accuracy of the FLAMES score in relation to the Acute Physiologic and Chronic Health Evaluation II (APACHE II), the Simplified Acute Physiologic Score II (SAPS II), the Logistic Organ Dysfunction System (LODS) and the Abbreviated Burn Severity Index (ABSI) applied to the severe burn patient facing mortality in an ICU of a reference center for burns in Brazil.

Methods: A retrospective study conducted in ICU comparing the accuracy the APACHE II, SAPS II, LODS, ABSI and FLAMES instruments were applied to all the selected medical records. Read More

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Effectiveness and cardiac safety of bedaquiline-based therapy for drug-resistant tuberculosis: a prospective cohort study.

Clin Infect Dis 2021 Apr 21. Epub 2021 Apr 21.

Wellcome Centre for Infectious Diseases Research in Africa, Institute of Infectious Disease and Molecular Medicine, and Department of Medicine, University of Cape Town, Cape Town, South Africa.

Background: Bedaquiline improves treatment outcomes in patients with rifampin-resistant TB (RR-TB) but prolongs the QT-interval and carries a black-box warning by the U.S. Food and Drug Administration. Read More

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Diabetes self-care practice and associated factors among type 2 diabetic patients in public hospitals of Tigray regional state, Ethiopia: A multicenter study.

PLoS One 2021 21;16(4):e0250462. Epub 2021 Apr 21.

Department of Nursing, College of Health Sciences, Debre Berhan University, Debre Berhan, Ethiopia.

Background: The prevalence of type 2 diabetes is increasing steadily at an alarming rate. Ethiopia is placed fourth among the top five countries of the African region members of the international diabetes federation. This study aimed to determine the level of diabetes self-care practice and associated factors among patients with type 2 diabetes mellitus attending public hospitals of the Tigray region. Read More

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