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Trials and Tribulations: mHealth Clinical Trials in the COVID-19 Pandemic.

Yearb Med Inform 2021 Apr 21. Epub 2021 Apr 21.

Graduate School of Biomedical Engineering, The University of New South Wales, Sydney, Australia.

Introduction: Mobile phone-based interventions in cardiovascular disease are growing in popularity. A randomised control trial (RCT) for a novel smartphone app-based model of care, named TeleClinical Care - Cardiac (TCC-Cardiac), commenced in February 2019, targeted at patients being discharged after care for an acute coronary syndrome or episode of decompensated heart failure. The app was paired to a digital sphygmomanometer, weighing scale and a wearable fitness band, all loaned to the patient, and allowed clinicians to respond to abnormal readings. Read More

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[Concepts for diagnosis, course and fall risk assessment in neurological gait disorders].

Fortschr Neurol Psychiatr 2021 Apr 21. Epub 2021 Apr 21.

Klinikum der Universität München, Deutsches Schwindel- und Gleichgewichtszentrum.

Quantitative gait assessment is increasingly applied in the diagnosis, disease monitoring, and risk stratification of neurological gait disorders. However, it is unclear, which measurement approaches, examination conditions, and gait characteristics are appropriate for answering specific clinical questions. The aim of this review was to provide generally applicable concepts and strategies for the measurement, analysis, and interpretation of gait function in the clinical context and to discuss their implementation in clinical practice. Read More

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Effects of Different Therapeutic Modalities on the Clicking Sound and Quantitative Assessment of the Vertical and Lateral Mandibular Movements of Patients with Internal Derangements of the Temporomandibular Joint.

Int J Prosthodont 2021 Mar-Apr;34(2):173-182

Purpose: To compare the efficacy of low-dose laser therapy to that of conservative treatment using two different occlusal splints (stabilization and anterior repositioning splints) in patients with internal derangements of the temporomandibular joint (TMJ).

Materials And Methods: The study population consisted of patients with disc displacement with reduction diagnosed according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) Axis I and Axis II. In addition, disc displacement with reduction was confirmed in all patients using TMJ ultrasonography. Read More

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Initial Choice of Spinal Manipulative Therapy for Treatment of Chronic Low Back Pain Leads to Reduced Long-term Risk of Adverse Drug Events Among Older Medicare Beneficiaries.

Spine (Phila Pa 1976) 2021 Apr 19. Epub 2021 Apr 19.

Southern California University of Health Sciences, Whittier, CA Geisel School of Medicine at Dartmouth, Hanover, NH.

Study Design: Retrospective observational study.

Objective: Opioid Analgesic Therapy (OAT) and Spinal Manipulative Therapy (SMT) are evidence-based strategies for treatment of chronic low back pain (cLBP), but the long-term safety of these therapies is uncertain. The objective of this study was to compare OAT versus SMT with regard to risk of adverse drug events (ADEs) among older adults with cLBP. 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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Assessment of Exercise Intolerance in Patients with Pre-Dialysis CKD with Cardiopulmonary Function Testing: Translation to Everyday Practice.

Am J Nephrol 2021 Apr 21:1-15. Epub 2021 Apr 21.

Department of Nephrology, Hippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.

Background: Chronic kidney disease (CKD) is often characterized by increased prevalence of cardiovascular risk factors and increased incidence of cardiovascular events and death. Reduced cardiovascular reserve and exercise intolerance are common in patients with CKD and are associated with adverse outcomes.

Summary: The gold standard for identifying exercise limitation is cardiopulmonary exercise testing (CPET). 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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From Obesity to Chronic Kidney Disease: How Can Adipose Tissue Affect Renal Function?

Nephron 2021 Apr 21:1-5. Epub 2021 Apr 21.

Departamento de Ciencias Básicas de la Salud, Área de Bioquímica y Biología Molecular, Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos, Madrid, Spain.

Obesity is directly associated with an increased risk of developing CKD, regardless of other comorbid conditions. Although the molecular mechanisms that link both diseases are not well established, the role of adipose tissue (AT) is becoming increasingly important in obesity-associated kidney damage. In the context of obesity, lipotoxicity and the alteration of AT secretion profile promote inflammation, oxidative stress, and fibrosis in the kidney, which ultimately leads to impaired renal function. Read More

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Visceral Mycoses as a Cause of Severe HIV Infection and Death.

Int Arch Allergy Immunol 2021 Apr 21:1-7. Epub 2021 Apr 21.

Department of Pathology, Central City Clinical Hospital, Veliky Novgorod, Russian Federation.

Introduction: In recent years, there has been an increase in the number of systemic fungal infections among HIV-infected individuals. The article aimed to examine the frequency of invasive mycoses among the HIV-infected patients at the time of their urgent and/or planned admission to a specialized hospital.

Methods: The diagnostic methods used in this study involved physical examination, laboratory testing, bacteriological examination, immunological examination, molecular genetic testing, and radiological imaging. 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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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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Computer tomographic differential diagnosis of ameloblastoma and odontogenic keratocyst: classification using a convolutional neural network.

Dentomaxillofac Radiol 2021 Apr 21:20210002. Epub 2021 Apr 21.

Division of Oral and Maxillofacial Radiology, Federal University of Bahia, Salvador, Brazil.

Objective: To analyse the automatic classification performance of a convolutional neural network (CNN), Google Inception v3, using tomographic images of odontogenic keratocysts (OKCs) and ameloblastomas (AMs).

Methods: For construction of the database, we selected axial multidetector CT images from patients with confirmed AM ( = 22) and OKC ( = 18) based on a conclusive histopathological report. The images ( = 350) were segmented manually and data augmentation algorithms were applied, totalling 2500 images. Read More

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Differentiation between endometriosis-associated ovarian cancers and non- endometriosis-associated ovarian cancers based on magnetic resonance imaging.

Br J Radiol 2021 Apr 21:20201441. Epub 2021 Apr 21.

Department of Radiology, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.

Objectives: Endometriosis-associated ovarian cancer (EAOC) patients show different clinical characteristics compared with non-EAOC patients. However, a few studies are focused on the imaging characteristics of EAOC until now. We assessed MRI characteristics in differentiating EAOC and non-EAOC. 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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Quantification of penile fat infiltration using the mDIXON quant sequence: a pilot study on the correlation with penis hardness and erectile dysfunction.

Br J Radiol 2021 Apr 21:20201400. Epub 2021 Apr 21.

Department of Radiology, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.

Objective: The purpose of this study was to determine fat/water signal ratios using the mDIXON Quant sequence, quantitatively assess fat infiltration in the penis, and explore its possible relationship with penile hardness and erectile dysfunction.

Methods: Routine pelvic magnetic resonance imaging with the mDIXON Quant sequence was performed in 62 subjects, including 22 people in the normal group, 20 people in the normal erectile hardness group, and 20 people in the ED group. The fat/water signal ratio in the penis was measured using the mDIXON Quant sequence. Read More

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Comparison of prostate imaging reporting and data system v2.1 and 2 in transition and peripheral zones: evaluation of interreader agreement and diagnostic performance in detecting clinically significant prostate cancer.

Br J Radiol 2021 Apr 21:20201434. Epub 2021 Apr 21.

Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan.

Objectives: To evaluate the interreader agreement and diagnostic performance of the Prostate Imaging Reporting and Data System (PI-RADS) v2.1, in comparison with v2.

Methods: Institutional review board approval was obtained for this retrospective study. Read More

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MRI-based radiomics as response predictor to radiochemotherapy for metastatic cervical lymph node in nasopharyngeal carcinoma.

Br J Radiol 2021 Apr 21:20201212. Epub 2021 Apr 21.

Department of Radiology, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.

Objective: To establish and substantiate MRI-based radiomic models to predict the treatment response of metastatic cervical lymph node to radiochemotherapy in patients with nasopharyngeal carcinoma (NPC).

Methods: A total of 145 consecutive patients with NPC were enrolled including 102 in primary cohort and 43 in validation cohort. Metastatic lymph nodes were diagnosed according to radiologic criteria and treatment response was evaluated according to the Response Evaluation Criteria in Solid Tumors. 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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Understanding the diagnostic delays and pathways for diabetes in eastern Uganda: A qualitative study.

PLoS One 2021 21;16(4):e0250421. Epub 2021 Apr 21.

Department of Epidemiology and Biostatistics, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda.

Background: Type 2 diabetes is rapidly becoming a significant challenge in Uganda and other low and middle-income countries. A large proportion of the population remains undiagnosed. To understand diagnostic delay, we explored the diagnostic pathways for diabetes among patients receiving care at a semi-urban district hospital in eastern Uganda. Read More

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COVID-19 infection with asymptomatic or mild disease severity in young patients: Clinical course and association between prevalence of pneumonia and viral load.

PLoS One 2021 21;16(4):e0250358. Epub 2021 Apr 21.

Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Korea University Ansan Hospital, Ansan, Republic of Korea.

Few studies have focused on clinical courses or viral loads in young asymptomatic or mild patients with COVID-19 infection. We sought to better understand the clinical course and association between viral load and prevalence of pneumonia in young COVID-19 patients with asymptomatic or mild disease severity. In this retrospective study, 106 COVID-19 young patients with asymptomatic or mild disease severity were analyzed for clinical characteristics, clinical course, prevalence of radiologically proven pneumonia and viral load. Read More

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Impact of cachexia on oncologic outcomes of sarcopenic patients with upper tract urothelial carcinoma after radical nephroureterectomy.

PLoS One 2021 21;16(4):e0250033. Epub 2021 Apr 21.

Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.

Objectives: To investigate the prognostic significance of sarcopenic cachexia compared to sarcopenia without cachexia in the outcomes of upper urinary tract urothelial carcinoma (UTUC) patients treated with radical nephroureterectomy (RNU).

Materials And Methods: Between 2011 and 2016, 163 patients with UTUC who received RNU at a tertiary medical center were included. Pre-operatively clinical data, history, and abdominal computer tomography scans were analyzed retrospectively. Read More

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Correlates of variability in endurance shuttle walk test time in patients with chronic obstructive pulmonary disease.

PLoS One 2021 21;16(4):e0249786. Epub 2021 Apr 21.

Department of Pulmonary Diseases, Dekkerswald Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands.

Background: The endurance shuttle walk test (ESWT) is used to evaluate exercise tolerance in patients with chronic obstructive pulmonary disease (COPD). The recommended pre-intervention tolerated duration (Tlim) is between 3-8 minutes for optimal interpretation of treatment effects. However, this window may be exceeded and factors determining ESWT Tlim are not completely understood. Read More

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T-staging of rectal cancer: Utility of single-shot turbo spin-echo diffusion-weighted imaging with T2-weighted images and fusion images.

PLoS One 2021 21;16(4):e0249433. Epub 2021 Apr 21.

Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.

Purpose: The purpose of this study was to evaluate the usefulness of turbo spin-echo (TSE) DWI with fusion images in the T-staging compared with T2-weighted imaging (T2WI) alone and conventional echo-planner imaging (EPI) DWI.

Methods: In this prospective study, 4-mm-thick axial EPI-DWI, TSE-DWI, and T2WI were performed with the same slice locations for 20 patients with rectal cancer. Fusion images of DWI and T2WI were created for both EPI-DWI and TSE-DWI. Read More

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Use of hemoglobin A1c to identify dysglycemia in cystic fibrosis.

PLoS One 2021 21;16(4):e0250036. Epub 2021 Apr 21.

University of Massachusetts Medical School, Worcester, MA, United States of America.

Background: Cystic fibrosis (CF) leads to pancreatic endocrine dysfunction with progressive glycemic disturbance. Approximately 30%-50% of people with CF eventually develop CF-related diabetes (CFRD). Pre-CFRD states progress from indeterminant glycemia (INDET) to impaired fasting glucose (IFG) or impaired glucose tolerance (IGT). Read More

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