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Comparison in detection of prodromal Parkinson's disease patients using original and updated MDS research criteria in two independent cohorts.

Parkinsonism Relat Disord 2021 Apr 30;87:48-55. Epub 2021 Apr 30.

Department of Neurology, P. J. Safarik University, Trieda SNP 1, 04011, Kosice, Slovak Republic; Department of Neurology, University Hospital L. Pasteur, Rastislavova 43, 04190, Kosice, Slovak Republic.

Introduction: MDS research criteria for prodromal Parkinson's disease (pPD) were published in 2015 and updated in 2019. We aimed to determine the difference in pPD patient detection rates in two cohorts recruited via gastrointestinal symptoms (PARCAS study) and the presence of a probable REM sleep behaviour disorder (PDBIOM study) using the original and updated criteria.

Methods: We evaluated all risk and prodromal markers, except genetic testing, plasma urate and physical inactivity, in both cohorts and DaT scan, diabetes mellitus type II and cognitive deficit in the PARCAS cohort. Read More

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LCA and economic study on the local oxygen supply in Central Europe during the COVID-19 pandemic.

Sci Total Environ 2021 Apr 29;786:147401. Epub 2021 Apr 29.

AGH University of Science and Technology, Faculty of Energy and Fuels, Department of Coal Chemistry and Environmental Sciences, Al. Mickiewicza 30, 30-059 Kraków, Poland. Electronic address:

Medical oxygen is the key to survival for COVID-19 patients. To meet the pandemic-driven oxygen demand spike, local hospitals began searching for a suitable medical oxygen delivery system. Among the studies published on the impact of COVID-19 on a range of aspects, including the global economy and the environment, no study has been conducted on the environmental impact of medical oxygen supply to hospitals under epidemic conditions. Read More

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Content validation and usability of a chatbot of guidelines for wound dressing.

Int J Med Inform 2021 Apr 29;151:104473. Epub 2021 Apr 29.

Nursing Department of the Catholic University of Pernambuco, Pernambuco, Brazil. Electronic address:

Introduction: The growing demand from patients with wounds from various causes has significantly challenged primary care nurses. A chatbot, with duly validated evidence-based content, can assist both nurses and patients in managing care. This work describes the development process of such a chatbot (BOTCURATIVO) that aims to help the treatment of wounds by non-specialists, by giving guidelines about the recommended wound dressing procedures for each type of wound. Read More

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Clinical characteristics of paediatric Hashimoto's encephalopathy.R2 clean.

Eur J Paediatr Neurol 2021 Apr 30;32:122-127. Epub 2021 Apr 30.

Department of Paediatrics, Medical Centre Leeuwarden, P.O. Box 888, 8901, BR, Leeuwarden, the Netherlands. Electronic address:

Background: Hashimoto's encephalopathy, also known as steroid responsive encephalopathy, is associated with thyroid antibodies (SREAT) and is a rare but serious form of encephalopathy. In this paper, we describe the signs, symptoms, outcome, and treatments as noted in the case reports reviewed.

Methods: We searched PubMed, Embase, and the Cochrane library for articles in which cases of Hashimoto's encephalopathy were described. Read More

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Discordance in Appendicitis Grading and the Association with Outcomes: A Post-Hoc Analysis of an EAST Multicenter Study.

J Surg Res 2021 May 5;265:259-264. Epub 2021 May 5.

Division of Trauma and Surgical Critical Care, DeWitt Daughtry Family Department of Surgery, Jackson Memorial Hospital, University of Miami Miller School of Medicine, Miami, Florida.

Background: The American Association for the Surgery of Trauma (AAST) appendicitis severity grading criteria use independent subscales for radiologists (Rad), surgeons (Surg), and pathologists (Path). We reviewed the EAST Multicenter Study of the Treatment of Appendicitis in America: Acute, Perforated, and Gangrenous (MUSTANG) database to determine rates of discordance and clinical consequences of inaccuracy.

Materials And Methods: A confusion matrix was constructed for pairs among Rad, Surg, and Path. Read More

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Temporal trends in the incidence and prevalence of Multiple Sclerosis in the Northwest of Spain.

Mult Scler Relat Disord 2021 Apr 24;52:102979. Epub 2021 Apr 24.

Neurology Department, Hospital Clínico Universitario, Travesía da Choupana s/n, 15706, Santiago de Compostela, (A Coruña), Spain.

Background: During the last decades, the frequency of multiple sclerosis (MS) is increasing worldwide. Nevertheless, the higher sensibility of the new diagnostic criteria obscures the comparison between studies performed in different decades.

Methods: The evolution of the frequency of MS in Santiago de Compostela (North-West of Spain) between 2003 and 2015 was analyzed using Poisson regression. Read More

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Alpha 1 adrenoceptor expression in skin, nerves and blood vessels of patients with painful diabetic neuropathy.

Auton Neurosci 2021 May 3;234:102814. Epub 2021 May 3.

College of Science, Health, Engineering and Education, Murdoch University, Perth, Western Australia, Australia.

Diabetic neuropathy (dNP) patients often suffer from severe neuropathic pain. It was suggested that alpha-1 adrenoceptor (α-AR) hyperresponsiveness contributes to pain in dNP. The aim of our study was to quantify α-AR expression using immunohistochemistry in skin biopsies of nine patients with painful diabetic neuropathy compared to 10 healthy controls. Read More

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Encephalocele-Associated Drug Resistant Epilepsy of Adult-Onset: Diagnosis, Management, and Outcomes.

World Neurosurg 2021 May 5. Epub 2021 May 5.

Epileptogenic encephaloceles, most frequently located in the temporal lobe, are a known lesional cause of focal epilepsy. Data are limited regarding diagnosis, management, and outcomes of patients with epilepsy in the setting of an encephalocele, as the literature is mostly comprised of case reports, case series, and retrospective studies. We conducted a broad literature review for manuscripts related to encephaloceles and epilepsy regardless of level of evidence. Read More

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Clinical presentation, diagnostic findings, and long-term survival time in 182 dogs with meningoencephalitis of unknown origin from Central Europe that were administered glucocorticosteroid monotherapy.

Top Companion Anim Med 2021 May 5:100539. Epub 2021 May 5.

Institute of Mathematics and Statistics, Masaryk University, Brno, 60200 Czech Republic.

Canine non-infectious inflammatory meningoencephalomyelitis is termed meningoencephalomyelitis of unknown origin (MUO) and may affect dogs of every breed at any age. Treatment with immunosuppressive medication, the survival time based on MRI, and cerebrospinal fluid (CSF) findings has been widely reported; however, these studies only included a small number of patients, or they are summaries from the literature. Therefore, the aim of this study was to compare the clinical presentation, diagnostic findings, treatment protocol and long-term survival time in many dogs diagnosed with MUO in one clinic with previously published studies. Read More

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Clinical validation of Whole Genome Sequencing for cancer diagnostics.

J Mol Diagn 2021 May 5. Epub 2021 May 5.

Hartwig Medical Foundation, Science Park 408, 1098 XH Amsterdam, the Netherlands; Center for Molecular Medicine and Oncode Institute, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, the Netherlands.

Whole genome sequencing (WGS) using fresh frozen tissue and matched blood samples from cancer patients is becoming in reach as the most complete genetic tumor test. With a trend towards the availability of small biopsies and the need to screen an increasing number of (complex) biomarkers, the use of a single all-inclusive test is preferred over multiple consecutive assays. To meet high-quality diagnostics standards, we optimized and clinically validated WGS sample and data processing procedures resulting in a technical success rate of 95. Read More

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Diagnostic accuracy of rapid nucleic acid tests for group A streptococcal pharyngitis: systematic review and meta-analysis.

Clin Microbiol Infect 2021 May 5. Epub 2021 May 5.

Université de Paris, Centre of Research in Epidemiology and Statistics (CRESS), INSERM, F-75004, Paris, France; Necker-Enfants malades Hospital, APHP, Université de Paris, Department of General Pediatrics and Pediatric Infectious Diseases, Paris, France. Electronic address:

Background: Acute pharyngitis is one of the most common conditions in outpatient settings and an important source of inappropriate antibiotic prescribing. Rapid antigen detection tests (RADTs) offer diagnosis of group A streptococcus (GAS) at the point of care but have limited sensitivity. Rapid nucleic acid tests (RNATs) are now available; a systematic review of their accuracy is lacking. Read More

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Effects of brain radiotherapy on cognitive performance in adult low-grade glioma patients: A Systematic Review.

Radiother Oncol 2021 May 5. Epub 2021 May 5.

Department of Neurosurgery, Leeds General Infirmary, Great George Street, Leeds, UK.

Grade II gliomas are slow growing tumours that usually affect younger patients. The mainstream treatment modality at present is surgical. The role of radiation therapy in the management of grade II gliomas has been the subject of considerable debate. Read More

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Regional Variation in Treatment for Highest-Risk Patients with Non-Small Cell Lung Cancer Patients.

Ann Thorac Surg 2021 May 5. Epub 2021 May 5.

Division of Thoracic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA. Electronic address:

Background: Non-small cell lung cancer (NSCLC) patients with multiple high-risk socioeconomic factors experience treatment and survival disparities. We aim to assess whether disparities in treatment and survival vary by region for patients with three or more high-risk socioeconomic factors.

Methods: The National Cancer Database was queried for patients with clinical stage I-IIA NSCLC diagnosed between 2010-2015. Read More

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Pre-incision Adjunctive Prophylaxis for Cesarean Sections: A Systematic Review and Meta-analysis.

Am J Obstet Gynecol 2021 May 5. Epub 2021 May 5.

ObGyn & Women's Health Institute, 9500 Euclid Avenue, Cleveland, Ohio 44195. Electronic address:

Objective: To systematically review the relative effectiveness of pre-incision cefazolin with or without adjunctive prophylaxis (macrolides or metronidazole), versus cefazolin alone, in decreasing the incidence of post-Cesarean surgical site infections.

Data Sources: We performed a systematic search of PubMed, Ovid EMBASE, Google Scholar, ClinicalTrials.gov and Cochrane Central Register of Controlled Trials from October 25 to November 25, 2020, to identify studies comparing cefazolin with adjunctive macrolides or metronidazole to cefazolin alone. Read More

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When to ask for an MRI of the scrotum.

Andrology 2021 May 8. Epub 2021 May 8.

Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome Viale Regina Elena, 324, 00161, Roma, Italy.

Background: Multiparametric MRI of the scrotum has been established as a useful second-line diagnostic tool for the investigation of scrotal diseases. Recently, recommendations on clinical indications for scrotal MRI were issued by the Scrotal and Penile Imaging Working Group of the European Society of Urogenital Radiology.

Objective: To update current research on when to ask for an MRI of the scrotum. Read More

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A novel study on SARS-COV-2 virus associated bradycardia as a predictor of mortality-retrospective multicenter analysis.

Clin Cardiol 2021 May 8. Epub 2021 May 8.

Divison of Cardiology, Loma Linda University School of Medicine, Loma Linda, California, USA.

Background: SARS-CoV2 has affected more than 73.8 million individuals. While SARS-CoV2 is considered a predominantly respiratory virus, we report a trend of bradycardia among hospitalized patients, particularly in association with mortality. Read More

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Does preoperative neoadjuvant chemotherapy impact short-term surgical outcomes in patients with locally advanced colon cancer?

Int J Colorectal Dis 2021 May 8. Epub 2021 May 8.

Department of Surgery, University of Arizona Medical Center, Tucson, AZ, USA.

Background: Preoperative neoadjuvant chemotherapy (NAC) for colon cancer in advanced stages is associated with improved outcomes and tumor regression. The aim of our study was to identify outcomes in patients with colon cancer who received preoperative NAC.

Methods: A 4-year analysis of the American College of Surgeons-National Surgical Quality Improvement Program (ACS-NSQIP) was performed. Read More

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Double hindfoot arthrodesis using a single-incision medial approach in the correction of adult-acquired flatfoot deformity: a case series.

Int Orthop 2021 May 8. Epub 2021 May 8.

Head of Foot and Ankle Surgery Group, Orthopaedics and Traumatology Unit, Prevent Senior, São Paulo, Brazil.

Background: Hindfoot arthrodesis is used in patients with advanced-stage acquired flatfoot, usually associated with degenerative joint disease. The objective of the present study was to evaluate the clinical and radiographic results of hindfoot arthrodesis using the single-incision medial approach.

Methods: A case series of 18 consecutive patients undergoing surgical correction between 2015 and 2018 with hindfoot arthrodesis using the medial approach was evaluated. Read More

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Femoral tunnel malposition is the most common indication for revision medial patellofemoral ligament reconstruction with promising early outcomes following revision reconstruction: a systematic review.

Knee Surg Sports Traumatol Arthrosc 2021 May 8. Epub 2021 May 8.

Division of Orthopaedic Surgery, Department of Surgery, McMaster University Medical Centre, 1200 Main St West 4E14, Hamilton, ON, L8N 3Z5, Canada.

Purpose: The purpose of this study was to identify the causes of failure of previous medial patellofemoral ligament reconstruction (MPFL-R), and to furthermore report the surgical techniques available for MPFL revision surgery.

Methods: Four databases [PubMed, Ovid (MEDLINE), Cochrane Database, and EMBASE] were searched until September 29, 2020 for human studies pertaining to revision MPFL. Two reviewers screened the literature independently and in duplicate. Read More

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Prevalence of transthyretin amyloidosis in patients with heart failure and no left ventricular hypertrophy.

ESC Heart Fail 2021 May 8. Epub 2021 May 8.

Department of Cardiology, IIS - Fundación Jiménez Díaz University Hospital - Quironsalud, Av. Reyes Católicos, 2, Madrid, 28040, Spain.

Aims: As evidenced by scintigraphy imaging, the prevalence of transthyretin (TTR) cardiac amyloidosis in heart failure patients with preserved ejection fraction (HFpEF) and left ventricular hypertrophy (LVH) ranges between 13% and 19%. The natural evolution of cardiac amyloidosis begins with the deposition of amyloid material in the myocardium, with LVH ensuing at later stages. With current imaging modalities, it is possible to detect TTR cardiac amyloidosis before the hypertrophic stage. Read More

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Systematic review and meta-analysis of cervical metastases in oral maxillary squamous cell carcinoma.

Cancer Rep (Hoboken) 2021 May 8:e1410. Epub 2021 May 8.

University of Sydney, Camperdown, New South Wales, Australia.

Background: Management of the node-negative neck in oral maxillary squamous cell carcinoma (SCC), encompassing the hard palate and upper alveolar subsites of the oral cavity, is controversial, with no clear international consensus or recommendation regarding elective neck dissection in the absence of cervical metastases.

Aim: To assess the occult metastatic rate in patients with clinically node negative oral maxillary SCC; both as an overall metastatic rate, and a comparison of patients managed with an elective neck dissection at index surgery, compared to excision of the primary with clinical observation of the neck.

Methods And Results: A systematic review was performed by two independent investigators for studies relating to oral maxillary SCC and analysed according to PRISMA criteria. Read More

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Persistence of abnormal global longitudinal strain in women with peripartum cardiomyopathy.

Echocardiography 2021 May 8. Epub 2021 May 8.

Department of Cardiovascular Medicine, Dartmouth-Hitchcock Medical Center and Geisel School of Medicine, Lebanon, NH, USA.

Objectives: Data regarding the longitudinal relationship of global longitudinal strain (GLS) and echocardiographic parameters are lacking in peripartum cardiomyopathy (PPCM). We evaluated GLS and its correlation with change (∆) in left ventricular ejection fraction (LVEF).

Methods: We retrospectively identified women age ≥16 years hospitalized at Montefiore Medical Center in Bronx, NY from 1999-2015 with International Statistical Classification of Diseases and Related Health Problems, 9th revision codes for PPCM or an occurrence of unexplained heart failure during or up to 5 months postpartum. Read More

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Cytokine Storm in Severe COVID-19 Pneumonia.

J Med Virol 2021 May 8. Epub 2021 May 8.

Gaziosmanpasa Taksim Egitim ve Arastirma Hastanesi, Department of Dermatology, Gaziosmanpasa Research and Training Hospital, University of Health Sciences, Istanbul, Turkey.

Objective: In this study, laboratorial parameters of hospitalized covid -19 patients, who were complicated with severe pneumonia, were compared with the findings of cytokine storm developing in macrophage activation syndrome (MAS)/secondary hemophagocytic lymphohistiocytosis(sHLH). Severe pneumonia occurred as a result of cytokine storm in some patients who needed intensive care unit(ICU), and it is aimed to determine the precursive parameters in this situation. Also in this study, the aim is to identify laboratory criteria that predict worsening disease and ICU intensification, as well as the development of cytokine storm. Read More

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Evaluation of Dosing Strategies and Trough Concentrations of Vancomycin in Patients Undergoing Continuous Venovenous Hemofiltration.

Pharmacotherapy 2021 May 8. Epub 2021 May 8.

Harper University Hospital, Detroit, Michigan, USA.

Background: Recommendations regarding vancomycin dosing in critically ill patients on continuous venovenous hemofiltration (CVVH) are limited. The purpose of this study was to evaluate current dosing practices of pharmacists for patients treated with CVVH, develop guidelines for optimal dosing and monitoring of vancomycin to improve target trough attainment, and reduce pharmacist workload.

Methods: A retrospective cohort study was performed of critically ill adult patients at an academic medical center in Detroit, Michigan, from January 2015 to December 2018. Read More

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The prevalence of renal stone and outcomes of conservative treatment in kidney transplantation: A systematic review and meta-analysis.

Urol J 2021 May 8. Epub 2021 May 8.

Urology Research Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Background: Nephrolithiasis is a rare complication in transplanted kidneys and limited information is available about its therapeutic options. This study aimed to review the conservative management of urinary lithiasis and its outcomes in renal transplanted patients.

Methods: A systematic review and meta-analysis of the scientific literature were performed in the Medline, Scopus, and Embase databases. Read More

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Selective Laser Trabeculoplasty Versus MIGS: Forgotten Art or First-Step Procedure in Selected Patients with Open-Angle Glaucoma.

Ophthalmol Ther 2021 May 7. Epub 2021 May 7.

Department of Ophthalmology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Berlin Institute of Health, Humboldt-Universität Zu Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.

Introduction: To evaluate the long-term effect on intraocular pressure (IOP) and glaucoma medication of selective laser trabeculoplasty (SLT) compared to minimally invasive glaucoma surgery (MIGS) in primary open-angle glaucoma (POAG) and its potential in clinical practice.

Methods: A total of 342 consecutive patients (stand-alone procedures) were included. One hundred and five patients underwent SLT treatment (360° SLT, 95-105 spots, Trabeculas SLT ARCLaser, Nürnberg, DE), 107 patients had an ab interno-derived trabeculotomy (Trabectome, NeoMedix, Tustin, USA), and 130 patients received iStent inject implantation (2 implants-Glaukos, CA, USA). Read More

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Nonfunctional adrenal adenomas and impaired glucose metabolism: a systematic review and meta-analysis.

Endocrine 2021 May 7. Epub 2021 May 7.

First Department of Internal Medicine, Unit of Endocrinology, Laiko Hospital, National and Kapodistrian University of Athens, Athens, Greece.

Purpose: Evidence on nonfunctioning adrenal incidentaloma's (NFAI) associated comorbidities and in particular, glucose disorders, is unclear in contrast to adrenal tumors with mild autonomous cortisol secretion. The current systematic review and meta-analysis aimed to assess the burden of impaired glucose metabolism including diabetes mellitus type 2 (T2DM), fasting blood glucose (FBG), and fasting blood insulin (FBI) levels in patients with NFAI and 1-mg overnight dexamethasone suppression test (ODST) ≤ 1.8 μg/dl across published studies. Read More

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Impact of the Affordable Care Act Medicaid Expansion on Reimbursement in Emergency General Surgery.

J Gastrointest Surg 2021 May 7. Epub 2021 May 7.

Department of Surgery, University of Kentucky, Lexington, KY, USA.

Background: Kentucky had one of the nation's largest increases in insurance coverage with the Affordable Care Act's (ACA) Medicaid expansion, quadrupling the proportion of Kentuckians with insurance coverage. This study compares reimbursement rates for surgical procedures performed by emergency general surgery (EGS) services at the University of Kentucky (UK) before and after Medicaid expansion in January 2014.

Methods: This IRB-approved, single-institution study retrospectively evaluated all patients undergoing surgical treatment by our EGS team from 1/1/2011 to 12/31/2016. Read More

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Percutaneous vertebroplasty versus conservative treatment and placebo in osteoporotic vertebral fractures: meta-analysis and critical review of the literature.

Eur Radiol 2021 May 7. Epub 2021 May 7.

Department of Radiology, Virgen de las Nieves University Hospital, Fuerzas Armadas Av. 2, 18014, Granada, Spain.

Objectives: To assess the current evidence regarding the efficacy of percutaneous vertebroplasty (PVP) over conservative treatment (CT) and placebo in osteoporotic vertebral fractures (OVFs) by performing a meta-analysis of randomized controlled trials (RCTs).

Materials And Methods: A systematic search was conducted on PubMed, EMBASE, and Cochrane databases. The main outcomes were pain relief, improvement of functional disability, and quality of life at different time points: short-term (1-2 weeks), medium-term (1-3 months), and long-term (≥ 6 months). Read More

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