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Intermediate vs Standard-dose Prophylactic Anticoagulation in Patients with COVID-19 Admitted to ICU: Ninety-day Results from the INSPIRATION Trial.

Thromb Haemost 2021 Apr 17. Epub 2021 Apr 17.

Rajaie Cardiovascular Medical and Research Center, Tehran, Iran (the Islamic Republic of).

Background: Thrombotic complications are considered among the main extrapulmonary manifestations of COVID-19. The optimal type and duration of prophylactic antithrombotic therapy in these patients remain unknown.

Methods: This manuscript reports the final (90-day) results of the Intermediate versus Standard-dose Prophylactic anticoagulation In cRitically-ill pATIents with COVID-19: An opeN label randomized controlled trial (INSPIRATION) study. Read More

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Inflammatory Bowel Disease as a Precondition for Stroke or TIA: A Matter of Crohn's Disease Rather than Ulcerative Colitis.

J Stroke Cerebrovasc Dis 2021 Apr 14;30(7):105787. Epub 2021 Apr 14.

Epidemiology, IQVIA, Frankfurt am Main, Germany.

Background: As a chronic systemic inflammation may be associated with an increased risk of vascular events, the aim of the present study was to assess the incidence of stroke and transient ischemic attack (TIA) in patients with inflammatory bowel disease over a period of 15 years.

Methods: This cohort study included patients for whom the initial diagnosis of an inflammatory bowel disease (IBD) (Crohn's disease: CD and ulcerative colitis: UC) was documented anonymously between 2000 and 2015 in 1,262 general practices in Germany. IBD patients were matched to patients without IBD using propensity scores based on age, sex, physician, co-diagnoses and co-therapies. Read More

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Real-world experience with botulinum toxin A for the treatment of hemifacial spasm: A study of 1138 injections.

Clin Neurol Neurosurg 2021 Apr 2;205:106632. Epub 2021 Apr 2.

Section of Neurology, Institute for Neurosciences, St. Luke's Medical Center, Quezon City, Philippines; Movement Disorders Service and Section of Neurology, Institute for Neurosciences, St. Luke's Medical Center, Quezon City, Philippines; Department of Neurosciences, College of Medicine - Philippine General Hospital, University of the Philippines Manila, Philippines; Movement Disorders Service and Section of Neurology, Institute for Neurosciences, St. Luke's Medical Center, Global City, Philippines. Electronic address:

Background: Hemifacial spasm (HFS) is a chronic, potentially disabling disorder that often requires long-term management with botulinum toxin (BoNT). In a country where healthcare costs limit compliance to medical follow-up and treatment, the study aims to provide a real-world experience on the use of BoNT for HFS among Filipinos.

Methods: We retrospectively collected data from 162 HFS patients who received 1138 botulinum toxin (BoNT) injections from 2006 to 2019 in our movement disorders center in the Philippines. Read More

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Chronical rhino-orbital mucormycosis in an immunocompetent host: A case report.

Int J Surg Case Rep 2021 Apr 10;82:105882. Epub 2021 Apr 10.

Faculté de Médecine et Pharmacie, Hassan II University of Casablanca, B.P 5696, Casablanca, Morocco; Service de Stomatologie et chirurgie Maxillo-faciale, Hôpital 20 Août, CHU Ibn Rochd, B.P 2698, Casablanca, Morocco.

Mucormycosis is an opportunistic fungal infection caused by molds within the order Mucorales. The rhino-orbital-cerebral localization is the most frequent. It is a destructive, necrotizing and potentially fatal disease. Read More

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Adult Hirschsprung's disease: A case report and literature review.

Int J Surg Case Rep 2021 Apr 10;82:105881. Epub 2021 Apr 10.

Trumbull Regional Medical Center, USA.

Introduction & Importance: Adult Hirschsprung's disease (AHD) is a difficult diagnosis to make due to its rarity, frequently after emergency interventions have been conducted. We present a case of possible AHD and sketch a classic presentation of Adult Hirschsprung's Disease. This would help recognize and include AHD in the differential diagnoses of chronic constipation where appropriate. Read More

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Indacaterol/glycopyrronium affects lung function and cardiovascular events in patients with chronic obstructive pulmonary diseases: A meta-analysis.

Heart Lung 2021 Apr 13;50(4):532-541. Epub 2021 Apr 13.

Division of Respiratory Medicine, The Affiliated Hospital of Hangzhou Normal University, Hangzhou 310015, China. Electronic address:

Background: Bronchodilators are the cornerstone for treating patients with chronic obstructive pulmonary diseases (COPD), although some studies have shown that dual bronchodilators may exacerbate incidence of adverse cardiovascular events. Here, we evaluated the cardiopulmonary safety of indacaterol/glycopyrronium (IND/GLY) using a meta-analysis.

Methods: We searched PubMed, OVID, Cochrane Library and Web of Science databases, using "indacaterol/glycopyrronium", "indacaterol/glycopyrrolate", "IND/GLY", "QVA149", "chronic obstructive pulmonary diseases", "COPD", "chronic obstructive airway disease", "chronic obstructive lung disease" as key words. Read More

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Estimated Glomerular Filtration Rate (eGFR) based on cystatin C was associated with increased risk of hip and proximal humerus fractures in women and decreased risk of hip fracture in men, whereas eGFR based on creatinine was not associated with fracture risk in both sexes: The Tromsø Study.

Bone 2021 Apr 14:115960. Epub 2021 Apr 14.

Women's Health and Perinatalogy Research Group, Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway; Department of Gynecology and Obstetrics, University Hospital of North Norway, Tromsø, Norway; Norwegian Research Centre for Women's Health, Oslo University Hospital, Oslo, Norway. Electronic address:

Purpose: Patients with end-stage kidney disease have an increased fracture risk. Whether mild to moderate reductions in kidney function is associated with increased fracture risk is uncertain. Results from previous studies may be confounded by muscle mass because of the use of creatinine-based estimates of the glomerular filtration rate (eGFRcre). Read More

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Comparison of different prognostic scores for patients with cirrhosis hospitalized with SARS-CoV-2 infection.

Ann Hepatol 2021 Apr 14:100350. Epub 2021 Apr 14.

Hepatology and Liver Transplant Unit, Hospital Universitario Austral, Pilar, Argentina; Latin American Liver Research Educational and Awareness Network (LALREAN), Argentina; Instituto de Efectividad Clínica y Sanitaria, Buenos Aires, Argentina.

Introduction And Objectives: Viral infections have been described to increase the risk of decompensation in patients with cirrhosis. We aimed to determine the effect of SARS-CoV-2 infection on outcome of hospitalized patients with cirrhosis and to compare the performance of different prognostic models for predicting mortality.

Patients: We performed a prospective cohort study including 2211 hospitalized patients with confirmed SARS-CoV-2 infection from April 15, 2020 through October 1, 2020 in 38 Hospitals from 11 Latin American countries. Read More

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Transcriptional regulator BOB.1: Molecular mechanisms and emerging role in chronic inflammation and autoimmunity.

Autoimmun Rev 2021 Apr 14:102833. Epub 2021 Apr 14.

Centre de Recherche en Transplantation et Immunologie UMR1064, INSERM, Université de Nantes, Nantes, France.

Lymphocytes constitute an essential and potent effector compartment of the immune system. Therefore, their development and functions must be strictly regulated to avoid inappropriate immune responses, such as autoimmune reactions. Several lines of evidence from genetics (e. Read More

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LAMP Assay Targeted RLEP for Detection of Mycobacterium Leprae in leprosy patients.

Int J Infect Dis 2021 Apr 14. Epub 2021 Apr 14.

State Key of Pharmaceutical Biotechnology, School of Life Science, Nanjing University, China. Electronic address:

Objective: Leprosy is a chronic infectious disease caused by Mycobacterium leprae and remains a significant health problem in several parts of the world. Early and accurate diagnosis of this disease is therefore important. Previously published LAMP protocols for detection of mycobacterial species used conventional specific primers and targeted the 16S rRNA, gyrB, and insertion sequence genes. Read More

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Cross National Comparison of Medical Students' Attitudes and Beliefs about Medical Cannabis and its Application for Pain Management.

Complement Ther Med 2021 Apr 14:102720. Epub 2021 Apr 14.

Regional Alcohol and Drug Abuse Research (RADAR) Center, Ben Gurion University of the Negev, Beer Sheva, Israel.

Objectives: To examine attitudes and beliefs about medical cannabis (MC), and specifically about its application for pain management, across medical students in Israel and Thailand.

Design: Cross-sectional survey which measured attitudes and beliefs about MC. Participants were additionally asked to rate the perceived efficacy of MC for different medical conditions that are related to pain (arthritis, chronic pain, fibromyalgia and multiple sclerosis). Read More

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Temporal trends and patient characteristics associated with 30-day hospital readmission rates after a first acute myocardial infarction.

Am J Med 2021 Apr 14. Epub 2021 Apr 14.

Meyers Primary Care Institute, Worcester, MA 01655; Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, 01655.

Background: Limited data exists about relatively recent trends in the magnitude and characteristics of patients who are re-hospitalized after hospital admission for an acute myocardial infarction (AMI). This study examined trends in the frequency and socio-demographic and clinical characteristics of patients readmitted to the hospital within 30 days after an initial acute myocardial infarction.

Methods: We reviewed the medical records of 3,116 individuals who were hospitalized for a validated first acute myocardial infarction in six study periods between 2003 and 2015 at the three major medical centers in central Massachusetts. Read More

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Characterization of chronic active multiple sclerosis lesions with sodium ( Na) MRI - preliminary observations.

Eur J Neurol 2021 Apr 17. Epub 2021 Apr 17.

Department of Neurology, Medical Faculty Mannheim and Mannheim Center for Translational Neurosciences (MCTN), University of Heidelberg, 68167, Mannheim, Germany.

Background: There has been an increasing interest in chronic active multiple sclerosis (MS) lesions as a new magnetic resonance imaging (MRI) marker of disease progression. Chronic active lesions are characterized by progressive tissue matrix damage, axonal loss and chronic inflammation. Sodium ( Na) MRI provides a biochemical marker of cell integrity and tissue viability in a quantitative manner. Read More

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Incidence, risk factors, treatment, and consequences of antibody-mediated kidney transplant rejection: A systematic review.

Clin Transplant 2021 Apr 17:e14320. Epub 2021 Apr 17.

Department of Medicine, Hennepin County Medical Center, Hennepin Healthcare, Minneapolis Minnesota.

Background: Antibody-mediated rejection (AMR) is a leading cause of kidney allograft failure, but its incidence, risk factors, and outcomes are not well understood.

Methods: We searched Ovid MEDLINE, Cochrane, EMBASE, and Scopus from January 2000-January 2020 to identify published cohorts of ≥ 500 incident adult or 75 pediatric kidney transplant recipients followed for ≥ 1 year posttransplant.

Results: At least two reviewers screened 5061 articles and abstracts; 28 met inclusion criteria. Read More

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Psychometric properties of the brief version of the questionnaire of olfactory disorders in patients with chronic rhinosinusitis.

Int Forum Allergy Rhinol 2021 Apr 17. Epub 2021 Apr 17.

Division of Rhinology and Sinus Surgery, Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA.

Background: The Questionnaire of Olfactory Disorders-Negative Statements (QOD-NS) is a 17-item instrument measuring olfactory-specific quality of life (QOL). However, in clinical research patients can be overwhelmed with multiple questionnaires. We recently developed the 7-item brief QOD-NS (B-QOD). Read More

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Disease involvement in the central compartment in eosinophilic chronic rhinosinusitis.

Int Forum Allergy Rhinol 2021 Apr 17. Epub 2021 Apr 17.

Department of Otolaryngology-Head and Neck Surgery, Medical College of Georgia-Augusta University, Augusta, Georgia, USA.

Objective: To evaluate disease presence in the central compartment (CC) in patients with eosinophilic chronic rhinosinusitis (CRS).

Methods: Patients with eosinophilic CRS were divided into three endotypes: aspirin-exacerbated respiratory disease (AERD), allergic fungal rhinosinusitis (AFRS), and eosinophilic CRS with nasal polyps (eCRSwNP). CT scans were reviewed for CC involvement, defined as the area between the superior nasal septum (SNS) and middle turbinate (MT). Read More

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Association of APOE genotype with lipid profiles and type 2 diabetes mellitus in a Korean population.

Genes Genomics 2021 Apr 17. Epub 2021 Apr 17.

Department of Life Science, Sogang University, Seoul, 04107, Republic of Korea.

Background: Type 2 diabetes mellitus (T2DM) is associated with chronic hyperglycemia and lipid metabolism. A previous genome-wide association study revealed the TOMM40-APOE region as novel locus for T2DM susceptibility.

Objective: This association study was conducted to determine the genetic effects of APOE single nucleotide polymorphisms (SNPs) on T2DM susceptibility and lipid profiles in a Korean population. Read More

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Surgical therapy for chronic internal carotid artery occlusion: a systematic review and meta-analysis.

Updates Surg 2021 Apr 17. Epub 2021 Apr 17.

Division of Vascular and Endovascular Surgery, Department of Surgery, University of Washington, Seattle, WA, USA.

Chronic internal carotid artery occlusion (CICAO) significantly increases the risk of recurrent stroke. Given unfavorable outcomes, revascularization procedures are not generally recommended for CICAO. In the last several years, loads of studies reported successful surgical revascularization for CICAO with promising success rate and favorable short-term outcomes. Read More

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Cross-walk of the Assessment of Spondyloarthritis International Society Health Index and Ankylosing Spondylitis Quality of Life Scores in Ankylosing Spondylitis and Non-radiographic Axial Spondyloarthritis Patients.

Rheumatol Ther 2021 Apr 17. Epub 2021 Apr 17.

Eli Lilly and Company, Indianapolis, IN, USA.

Introduction: Axial spondyloarthritis (axSpA) is a chronic rheumatic disease affecting the spine and sacroiliac joints, encompassing both ankylosing spondylitis (AS) and non-radiographic axial spondyloarthritis (nr-axSpA) patients. Patient quality of life (QoL) is assessed using the Ankylosing Spondylitis Quality of Life (ASQoL) (disease-specific measure) and the Assessment of SpondyloArthritis International Society Health Index (ASAS HI) (disease-specific measure). Both ASQoL and ASAS HI have similar parameters and scoring ranges, however, their performance relative to each other is unknown. Read More

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Management and endovascular therapy of ureteroarterial fistulas: experience from a single center and review of the literature.

CVIR Endovasc 2021 Apr 17;4(1):36. Epub 2021 Apr 17.

Department of Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.

Background: Ureteroarterial fistula (UAF) is a rare but potentially life threatening disease. The aim of this study was to evaluate the outcome of endovascular therapy for UAF treatment.

Methods: This retrospective case series evaluates a single center experience of percutaneous stent graft (SG) angioplasty and/or coil embolization for UAF. Read More

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Management of Refractory Pain After Total Joint Replacement.

Curr Pain Headache Rep 2021 Apr 17;25(6):42. Epub 2021 Apr 17.

Department of Orthopedic Surgery, North Shore University Hospital, Manhasset, NY, USA.

Purpose Of Review: Chronic pain after total joint replacement (TJA), specifically total knee replacement (TKA), is becoming more of a burden on patients, physicians, and the healthcare system as the number of joint replacements performed increases year after year. The management of this type of pain is critical, and therefore, understanding the various modalities physicians can use to help patients with refractory pain after TJA is essential.

Recent Findings: The modalities by which chronic pain can be successfully managed include genicular nerve radioablation therapy (GN-RFA), neuromuscular electrical stimulation (NMES), transcutaneous electrical nerve stimulation (TENS), and peripheral subcutaneous field stimulation (PSFS). Read More

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Structural MRI substrate of long-duration response to levodopa in Parkinson's disease: an exploratory study.

J Neurol 2021 Apr 17. Epub 2021 Apr 17.

Department of Medical, Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, Via Santa Sofia 78, 95123, Catania, Italy.

Objective: The long-duration response (LDR) to L-dopa is a sustained benefit deriving from chronic administration of therapy to patients with Parkinson's disease (PD). Almost all patients with early PD may develop the LDR to L-dopa, even if some patients could not at given dosages of the drug. Aim of this exploratory study is to investigate whether a neuroanatomical substrate may underlie the development of the of LDR using structural magnetic resonance imaging (MRI) and voxel-based morphometry (VBM) analysis. Read More

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Systemic sclerosis-associated myositis features minimal inflammation and characteristic capillary pathology.

Acta Neuropathol 2021 Apr 17. Epub 2021 Apr 17.

Department of Neuropathology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Charitéplatz 1, 10117, Berlin, Germany.

Systemic sclerosis represents a chronic connective tissue disease featuring fibrosis, vasculopathy and autoimmunity, affecting skin, multiple internal organs, and skeletal muscles. The vasculopathy is considered obliterative, but its pathogenesis is still poorly understood. This may partially be due to limitations of conventional transmission electron microscopy previously being conducted only in single patients. Read More

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Correlations of typical pain patterns with SPECT/CT findings in unhappy patients after total knee arthroplasty.

Knee Surg Sports Traumatol Arthrosc 2021 Apr 17. Epub 2021 Apr 17.

University of Basel, 4051, Basel, Switzerland.

Purpose: The diagnostic process in patients after painful total knee arthroplasty (TKA) is challenging. The more clinical and radiological information about a patient with pain after TKA is included in the assessment, the more reliable and sustainable the advice regarding TKA revision can be. The primary aim was to investigate the position of TKA components and evaluate bone tracer uptake (BTU) using pre-revision SPECT/CT and correlate these findings with previously published pain patterns in painful patients after TKA. Read More

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Br J Pharmacol 2021 Apr 17. Epub 2021 Apr 17.

Cyclerion Therapeutics Inc., 301 Binney Street, Cambridge, MA, 02142, USA.

Background And Purpose: Reduced nitric oxide (NO) bioavailability, a hallmark of sickle cell disease (SCD), contributes to intravascular inflammation, vasoconstriction, vaso-occlusion, and organ damage observed in SCD patients. Soluble guanylyl cyclase (sGC) catalyzes synthesis of cyclic guanosine monophosphate (cGMP) in response to NO. cGMP amplifying agents, including NO donors and phosphodiesterase 9 inhibitors, alleviate tumor necrosis factor alpha (TNFα)-induced inflammation in wild-type C57BL/6 mice and in "humanized" mouse models of SCD. Read More

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Rational drug use habits of patients with chronic diseases: a cross-sectional examination focusing on the use of technological devices.

Int J Clin Pract 2021 Apr 16:e14222. Epub 2021 Apr 16.

Istanbul Medical Faculty, Department of Internal Medicine, Division of Hematology, Istanbul University, Istanbul, Turkey.

Objective: The aim of this study was to investigate the factors affecting rational drug use habits and the use of technological devices in patients with chronic diseases.

Methods: Adults who applied to the internal medicine outpatient clinics of a university hospital between March and December 2019, who used medications for chronic disease were included in the study. Using a questionnaire, data on demographic characteristics, technology use, smoking and alcohol use, knowledge, and behavior on rational drug use were collected. Read More

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Elderly patients and falls: a systematic review and meta-analysis.

Aging Clin Exp Res 2021 Apr 16. Epub 2021 Apr 16.

Faculty of Health Sciences, Bahçeşehir University, İstanbul, Turkey.

Objective: The predetermination of the risk for falls in elderly patients, who will have or had a surgery, enables one to carry out the protective/preventive interventions on this matter. The aim of this review was to provide an up-to-date meta-analysis with regard to falls in elderly surgical patients.

Materials And Methods: The studies, which were carried out on elderly patients between January 2009 and November 2019 and which investigated the risk factors for falls in elderly surgical patients, were screened on the databases of Google Scholar, Pubmed, Ovid, Cinahl through various combinations of keywords, such as "geriatrics", "aged", "surgery", "accidental falls" in English or Turkish, to determine the risk factors for the falls in elderly surgical patients. Read More

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The zone 2 concept and distal stent graft positioning in TH 2-3 are associated with high rates of secondary aortic interventions in frozen elephant trunk surgery.

Eur J Cardiothorac Surg 2021 Apr 17. Epub 2021 Apr 17.

Sana Cardiac Surgery, Stuttgart, Germany.

Objectives: The goal of this study was to investigate the association between the localization of the distal anastomosis (zone 2/3), the stent graft length (100-160 mm), the position of the distal end of the hybrid prosthesis and the need for secondary aortic intervention (SAI) in acute and chronic thoracic aortic disease after the frozen elephant trunk procedure.

Methods: From 2009 through 2020, a total of 232 patients (137 men; mean age, 61.7 ± 13. Read More

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An IgD-Fc-Ig fusion protein restrains the activation of T and B cells by inhibiting IgD-IgDR-Lck signaling in rheumatoid arthritis.

Acta Pharmacol Sin 2021 Apr 16. Epub 2021 Apr 16.

Institute of Clinical Pharmacology, Anhui Medical University, Key Laboratory of Anti-inflammatory and Immune Medicine, Ministry of Education, Anhui Collaborative Innovation Center of Anti-inflammatory and Immune Medicine, Hefei, 230032, China.

Rheumatoid arthritis (RA) is a chronic systemic autoimmune disease characterized by synovitis and the destruction of small joints. Emerging evidence shows that immunoglobulin D (IgD) stimulation induces T-cell activation, which may contribute to diseases pathogenesis in RA. In this study, we investigated the downstream signaling pathways by which IgD activated T cells as well as the possible role of IgD in the T-B interaction. Read More

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