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No association of both serum pro-brain-derived neurotrophic factor (proBDNF) and BDNF concentrations with depressive state in community-dwelling elderly people.

Psychogeriatrics 2021 Apr 20. Epub 2021 Apr 20.

Department of Psychiatry, Faculty of Medicine, Saga University, Saga, Japan.

Background: Brain-derived neurotrophic factor (BDNF) is involved in emotional and cognitive function. Low-BDNF levels occur in patients with depression, while proBDNF, a precursor of BDNF with the opposite physiological function, increases in major depression. However, it is unclear whether BDNF and proBDNF are associated with depression in the elderly. Read More

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Tranexamic Acid Treatment for Trauma Victims.

Semin Thromb Hemost 2021 Apr 20. Epub 2021 Apr 20.

Department of Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom.

Worldwide, traumatic injury is responsible for over 5 million deaths per year, the majority due to exsanguination and head injury. The antifibrinolytic drug tranexamic acid is the only drug proven to reduce deaths after traumatic injury. Several large randomized controlled trials have provided high-quality evidence of its effectiveness and safety in trauma patients. Read More

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A Randomized Controlled Trial on the Effect of Standardized Video Education on Prenatal Genetic Testing Choices: Uptake of Genetic Testing.

Am J Perinatol 2021 Apr 20. Epub 2021 Apr 20.

Department of Obstetrics and Gynecology, Naval Medical Center San Diego, San Diego, California.

Objective:  This study aimed to assess the use of a standardized prenatal genetic testing educational video and its effects on patient uptake of prenatal testing, patient knowledge, decisional conflict, and decisional regret.

Study Design:  This was an IRB-approved randomized controlled trial. Patients were randomized to intervention (standardized video education) or control (no video education). Read More

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Improving Postpartum Attendance among Women with Gestational Diabetes Using the Medical Home Model of Care.

Am J Perinatol 2021 Apr 20. Epub 2021 Apr 20.

Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, New York.

Objective:  Poor attendance at the 6-week postpartum (PP) visit has been well reported. Attendance at this visit is crucial to identify women who have persistent diabetes mellitus (DM) following pregnancies affected by gestational DM (GDM). The medical home model has eliminated barriers to care in various other settings. Read More

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Effects of Different Onset Times of Early Caffeine Treatment on Mesenteric Tissue Oxygenation and Necrotizing Enterocolitis: A Prospective, Randomized Study.

Am J Perinatol 2021 Apr 20. Epub 2021 Apr 20.

Division of Neonatology, Department of Pediatrics, Bursa Uludag University Faculty of Medicine, Bursa, Turkey.

Objective:  Caffeine treatment is routinely used in premature infants to prevent development of apnea and bronchopulmonary dysplasia. Although a limited number of studies have reported that early caffeine treatment may cause development of necrotizing enterocolitis (NEC) by reducing mesenteric blood flow, this issue is still under discussion. The aim of this study is to investigate the possible effect of different onset times of early caffeine treatment on mesenteric tissue oxygen saturation and NEC development in premature infants. Read More

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The Effect of Prandial Insulin Applied for Fat Protein Units on Postprandial Glucose Excursions in Type 1 Diabetes Patients with Insulin Pump Therapy: Results of a Randomized, Controlled, Cross-Over Study.

Exp Clin Endocrinol Diabetes 2021 Apr 20. Epub 2021 Apr 20.

FIDAM - Research Institute Diabetes Academy, Mergentheim, Gemany.

Objective: This randomized cross-over study aimed to compare different algorithms for calculating prandial insulin considering the fat and protein content of a standardized meal in type 1 diabetes patients using insulin pump therapy (CSII).

Methods: Twenty-six patients received a standardized evening meal for three consecutive days using different algorithms for insulin dose adjustment: A) exclusive consideration of carbohydrate content without considering fat-protein content, B) high-dose algorithm considering additional insulin for fat protein units (FPUs) with the same factor as for carbohydrates, and C) low-dose algorithm considering additional insulin for FPUs with half the factor as for carbohydrates. The primary outcome was the proportion of interstitial glucose values in the target range (≥ 70 to ≤ 180 mg/dl) during the post-prandial 12-hour follow-up period. Read More

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Assessment of perinodular stiffness in differentiating malignant from benign thyroid nodules.

Endocr Connect 2021 Apr 1. Epub 2021 Apr 1.

N He, Department of Ultrasound, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, , USTC, Hefei, China.

Objective: We evaluated the diagnostic accuracy of perinodular stiffness, four risk stratification systems (RSSs) (KWAK-TIRADS, ACR-TIRADS, EU-TIRADS, and C-TIRADS), and the combination of perinodular stiffness and these four RSSs in differentiating malignant from benign thyroid nodules (TNs).

Methods: A total of 788 TNs in 726 patients were examined with conventional ultrasound (US) examination and sound touch elastography (STE). All TNs were classified by each of the four RSSs. Read More

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Relation of kidney function and homocysteine in patients with hypothyroidism.

Endocr Connect 2021 Apr 1. Epub 2021 Apr 1.

G Wang, Department of Endocrinology, Beijing Chao-Yang Hospital, Beijing, 100020, China.

Objective: It has been found that both serum homocysteine (Hcy) and serum creatinine levels were increased in hypothyroidism patients. The aim of this study was to investigate the correlation between serum Hcy and kidney function in patients with subclinical hypothyroidism or hypothyroidism.

Methods: A total of 448 subjects were enrolled and divided into three groups: hypothyroidism (n=129), subclinical hypothyroidism (n=141), and control group (n=168). Read More

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Early and Midtreatment Mortality in Palliative Radiotherapy: Emphasizing Patient Selection in High-Quality End-of-Life Care.

J Natl Compr Canc Netw 2021 Apr 20:1-9. Epub 2021 Apr 20.

1Department of Radiation Oncology, and.

Background: Palliative radiotherapy (RT) is effective, but some patients die during treatment or too soon afterward to experience benefit. This study investigates end-of-life RT patterns to inform shared decision-making and facilitate treatment consistent with palliative goals.

Materials And Methods: All patients who died ≤6 months after initiating palliative RT at an academic cancer center between 2015 and 2018 were identified. Read More

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Tuberculosis in Myasthenia Gravis patients on immunosuppressive therapy in a high-risk area: Implications for preventative therapy.

J Neurol Sci 2021 Apr 17;425:117447. Epub 2021 Apr 17.

Division of Neurology, Department of Medicine, University of Cape Town, Cape Town, South Africa; Neurology Research Group, UCT Neuroscience Institute, University of Cape Town, Cape Town, South Africa. Electronic address:

Data regarding the risk of tuberculosis (TB) in myasthenia gravis (MG) patients receiving immunosuppressive therapy is limited, and the benefit of TB preventative therapy in these patients is uncertain. We audited observational data collected at an MG clinic in South Africa over a ~ 10-year period, of cases who received immunosuppressive therapy. The total time that the cohort was at risk (patient-years) was used as the denominator to calculate TB incidence after immunosuppressive therapy initiation. Read More

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Real-world analysis of botulinum toxin (BoNT) injections in post-stroke spasticity: Higher doses of BoNT and longer intervals in the early-start group.

J Neurol Sci 2021 Apr 17;425:117449. Epub 2021 Apr 17.

Department of Physical Medicine and Rehabilitation, University of Texas Health Science Center McGovern Medical School and the NeuroRecovery Research Center, TIRR Memorial Hermann, Houston, TX, United States of America. Electronic address:

Our primary objective was to compare early-start vs. late-start Botulinum toxin (BoNT) injections in post-stroke spasticity management. This is an IRB approved retrospective chart review of patients who were admitted for inpatient rehabilitation within 6 months after first-ever stroke between January 2014 and December 2018 and received BoNT injections within 15 months. Read More

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Intrauterine administration of peripheral blood mononuclear cells activated by human chorionic gonadotropin in patients with repeated implantation failure: A meta-analysis.

J Reprod Immunol 2021 Apr 15;145:103323. Epub 2021 Apr 15.

Jinxin Research Institute for Reproductive Medicine and Genetics, Chengdu Jinjiang Hospital for Maternal and Child Health Care, Chengdu, China. Electronic address:

The purpose of this study was to assess whether intrauterine administration of peripheral blood mononuclear cells (PBMCs) activated by human chorionic gonadotropin (hCG) could improve the pregnancy and live birth rates in women with repeated implantation failure (RIF), and whether the parameters of co-culture of hCG and PBMCs would affect the clinical outcomes. Six databases (PubMed, Ovid, Medline, NCBI, Cqvip and Wanfang) were searched up to October 2020 by two independent reviewers. Seven studies were included according to specific inclusion and exclusion criteria. Read More

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ACOSOG Z-0011 criteria impact on axillary surgery for early breast cancer in clinical practice: Evaluation in a retrospective cohort of 1900 patients.

Eur J Obstet Gynecol Reprod Biol 2021 Apr 9;261:41-45. Epub 2021 Apr 9.

Surgery Department, Institut Cancérologie de L'ouest, Nantes, Saint Herblain, France.

Background: There is a trend towards de-escalation in early breast cancer axillary surgery. In the American College of Surgeons Oncology Group (ACOSOG) Z-0011 trial, observation was shown to be non-inferior in terms of overall survival to complementary axillary lymph node dissection (cALND) in patients with up to two sentinel lymph node (SLN) metastases. The study included patients with T1-T2 invasive breast cancer, clinically node negative, undergoing breast-conserving surgery with SLN biopsy, followed by systemic therapy and radiotherapy. Read More

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Identification and validation of autophagy-related prognostic signature for head and neck squamous cell carcinoma.

Transl Oncol 2021 Apr 17;14(7):101094. Epub 2021 Apr 17.

Department of Otorhinolaryngology-Head and Neck Surgery, Zhongnan Hospital of Wuhan University, Wuhan 430000, China. Electronic address:

Background: Many studies have demonstrated that autophagy plays a significant role in regulating tumor growth and progression. However, the effect of autophagy-related genes (ARGs) on the prognosis have rarely been analyzed in head and neck squamous cell carcinoma (HNSCC).

Methods: We obtained differentially expressed ARGs from HNSCC mRNA data in The Cancer Genome Atlas (TCGA) database. Read More

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The gut microbiota is associated with clinical response to statin treatment in patients with coronary artery disease.

Atherosclerosis 2021 Mar 29;325:16-23. Epub 2021 Mar 29.

Department of Cardiology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China. Electronic address:

Background: The structure and composition of the gut microbiota influence patients' response to therapeutic interventions. It is also known that the response to statin treatment can vary greatly from one patient to another, suggesting a possible connection between microbiome composition and response to statins. In the present study, we aim to explore the influence of the microbiome composition on the response to statin treatment among patients with coronary artery disease (CAD). Read More

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Shifting trends in modes of death in the Intensive Care Unit.

J Crit Care 2021 Apr 17;64:131-138. Epub 2021 Apr 17.

Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain; Paediatric Critical, Intermediate and Palliative Care Section, Paediatric Area, University Clinic Hospital of Santiago de Compostela (CHUS), Galician Public Health System (SERGAS), Santiago de Compostela, Spain.

Purpose: To describe the way patients die in a Spanish ICU, and how the modes of death have changed in the last 10 years.

Materials And Methods: Retrospective observational study evaluating all patients who died in a Spanish tertiary ICU over a 10-year period. Modes of death were classified as death despite maximal support (D-MS), brain death (BD), and death following life-sustaining treatment limitation (D-LSTL). Read More

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Continuous renal replacement therapy in intensive care patients with COVID-19; survival and renal recovery.

J Crit Care 2021 Apr 16;64:125-130. Epub 2021 Apr 16.

Dept of Perioperative Medicine and Intensive Care, Karolinska University Hospital, 171 76, Stockholm, Sweden. Electronic address:

Background: Outcome for critically ill patients with COVID-19 treated with continuous renal replacement therapy (CRRT) is largely unknown. We describe mortality and renal outcome in this group.

Methods: This observational study was conducted at a university hospital in Sweden. Read More

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Using Computational Modelling to Capture Schizophrenia-Specific Reinforcement Learning Differences and Their Implications on Patient Classification.

Biol Psychiatry Cogn Neurosci Neuroimaging 2021 Apr 17. Epub 2021 Apr 17.

Background: Psychiatric diagnosis and treatment have historically taken a symptom-based approach, with less attention on identifying underlying symptom-producing mechanisms. Recent efforts have illuminated the extent to which different underlying circuitry can produce phenotypically similar symptomatology (e.g. Read More

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Association of Adenoma Detection Rate and Adenoma Characteristics with Colorectal Cancer Mortality after screening colonoscopy.

Clin Gastroenterol Hepatol 2021 Apr 17. Epub 2021 Apr 17.

Dept. of Internal Medicine, Div. of Gastroenterology and Hepatology, Medical University of Vienna, Austria; Quality Assurance Working Group, Austrian Society for Gastroenterology and Hepatology, Austria. Electronic address:

Background & Aims: The adenoma detection rate (ADR) and characteristics of previously resected adenomas are associated with colorectal cancer (CRC) incidence and mortality. However, the combined effect of both factors on CRC mortality is unknown.

Patients And Methods: Using data of the Austrian quality assurance program for screening colonoscopy, we evaluated the combined effect of ADR and lesion characteristics on subsequent risk for CRC mortality. Read More

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Thrombectomy using the EmboTrap II Device in Late Treatment Patients in the Real-World Setting.

World Neurosurg 2021 Apr 17. Epub 2021 Apr 17.

Department of Interventional Neuroradiology, CHU Lille, Lille, France. Electronic address:

Objective: We aimed to evaluate the safety and efficacy of endovascular thrombectomy (EVT) using the EmboTrap® Revascularization Device (EmboTrap) in patients with ischemic stroke treated >6-24 hours after stroke onset.

Methods: We performed a retrospective analysis of data from a prospective registry of consecutive stroke patients with anterior circulation large vessel occlusion (LVO) treated by stent-retriever thrombectomy with EmboTrap II in a single stroke center in France from 2016 to 2017. Patients were divided into late treatment window (>6-24 hours after stroke onset) or early treatment window (≤6 hours) groups. Read More

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Effect of Ammonium Chloride in addition to standard of care in outpatients and hospitalized COVID-19 patients: a randomized clinical trial.

Int J Infect Dis 2021 Apr 17. Epub 2021 Apr 17.

Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran; Department of Microbiology, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran. Electronic address:

Objective: The COVID-19 pandemic has called an urgent need for drug repurposing to improve the outcome of the disease. Quaternary ammonium compounds have been demonstrated to have antiviral effects and may be of use against SARS-CoV-2 infections.

Design: In this double-blind, single-center study, we enrolled patients with positive PCR test and/or CT findings for COVID-19. Read More

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Efficacy and safety of interferon α-2b spray for herpangina in children: a randomized, controlled trial.

Int J Infect Dis 2021 Apr 17. Epub 2021 Apr 17.

Department of Infectious Diseases, Children's Hospital of Fudan University, Shanghai, China. Electronic address:

Objectives: The treatment of acute herpangina is inconsistent. We aim to evaluate the effectiveness and safety of interferon α-2b spray versus Ribavirin for the disease.

Methods: A randomized, controlled trial was conducted in eight hospitals in China between 2016 and 2018. Read More

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A novel closed-loop EEG-tDCS approach to promote responsiveness of patients in minimally conscious state: a study protocol.

Behav Brain Res 2021 Apr 17:113311. Epub 2021 Apr 17.

Coma Science Group, GIGA Consciousness, University of Liège, Liège, Belgium; Centre du Cerveau² - Centre intégré pluridisciplinaire de l'étude du cerveau, de la cognition et de la conscience, University Hospital of Liège, Liège, Belgium; Neuromodulation Center, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, USA.

Transcranial direct current stimulation (tDCS) applied over the prefrontal cortex has been shown to improve behavioral responsiveness in patients with disorders of consciousness following severe brain injury, especially those in minimally conscious state (MCS). However, one potential barrier of clinical response to tDCS is the timing of stimulation with regard to the fluctuations of vigilance that characterize this population. Indeed, a previous study showed that the vigilance of MCS patients has periodic average cycles of 70 minutes (range 57-80 minutes), potentially preventing them to be in an optimal neural state to benefit from tDCS when applied randomly. Read More

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Stimulant use in patients presenting with psychocutaneous disorders.

J Am Acad Dermatol 2021 Apr 17. Epub 2021 Apr 17.

Department of Dermatology and Pathology; University of Iowa Hospitals and Clinics and VA Medical Center, Iowa City, Iowa.

Background: Psychocutaneous disorders are often attributed to stimulant medications, yet this relationship has never been fully elucidated. Literature on psychocutaneous disorders largely focuses on clinical presentation and treatment rather than disease etiology or exacerbation.

Objective: To determine if patients presenting with psychocutaneous disorders display high rates of stimulant use and psychiatric comorbidity METHODS: A retrospective cohort study of patients with psychocutaneous disorders presenting to a single center. Read More

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Elastase Activity from Pseudomonas aeruginosa Respiratory Isolates and ICU Mortality.

Chest 2021 Apr 17. Epub 2021 Apr 17.

Acute Lung Injury Center of Excellence, Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA;; Vascular Medicine Institute, University of Pittsburgh, Pittsburgh PA USA. Electronic address:

Background: Pseudomonas aeruginosa (PA) is a common cause of respiratory infection and morbidity. Pseudomonas elastase is an important virulence factor regulated by the lasR gene. Whether PA elastase activity is associated with worse clinical outcomes in ICU patients is unknown. Read More

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A Mobile Health Intervention to Increase Physical Activity in Pulmonary Arterial Hypertension.

Chest 2021 Apr 17. Epub 2021 Apr 17.

Division of Cardiovascular Medicine and Vanderbilt Translational and Clinical Cardiovascular Research Center, Nashville, TN. Electronic address:

Background: Supervised exercise training improves outcomes in patients with pulmonary arterial hypertension (PAH). The effect of an unsupervised activity intervention has not been tested.

Research Question: Can a text-based mobile health intervention increase step counts in patients with PAH?

Study Design And Methods: We performed a randomized, parallel arm, single-blind clinical trial. Read More

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The Fate of Proximal Junctional Vertebral Fractures after Long-Segment Spinal Fixation : Are There Predictable Radiologic Characteristics for Revision surgery?

J Korean Neurosurg Soc 2021 Apr 21. Epub 2021 Apr 21.

Department of Neurosurgery, Gangnam Severance Hospital, Spine and Spinal Cord Institute, Yonsei University College of Medicine, Seoul, Korea.

Objective: To investigate the radiographic characteristics of the uppermost instrumented vertebrae (UIV) and UIV+1 compression fractures that are predictive of revision surgery following long-segment spinal fixation.

Methods: A total 27 patients who presented newly developed compression fracture at UIV, UIV+1 after long segment spinal fixation (minimum 5 vertebral bodies, lowest instrumented vertebra of L5 or distal) were reviewed retrospectively. Patients were divided into two groups according to following management : revisional surgery (group A, n=13) and conservative care (group B, n=14). Read More

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General characteristics, features of cultivation and antibiotic resistance representatives of mycobacterium fortuitum group representatives (review of literature).

Klin Lab Diagn 2021 Apr;66(4):223-228

Samara State Medical University.

Recently, more and more scientific works have been devoted to non-tuberculous mycobacteria, both by domestic and foreign researchers. One of the main reasons for this is the increase in patients with immunosuppression of various origins, improvement of the quality of laboratory and instrumental diagnostics of mycobacteriosis. This article focuses on the representatives of the M. Read More

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Еvaluation of the sensitivity of bacteriophage preparations to Klebsiella pneumoniae strains isolated from the colon microbiota in children with functional gastrointestinal disorders.

Klin Lab Diagn 2021 Apr;66(4):217-222

Scientific Centre for Family Health and Human Reproduction Problems.

The level of sensitivity of Klebsiella pneumoniae strains isolated from children of the first half of life with functional gastrointestinal disorders (FGID) to commercial bacteriophage preparations was assessed. The material was the feces of 67 children of the first half of life with FGID who are breastfed. Culture of K. Read More

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Experiences with health care practitioners among advanced cancer patients and their family caregivers: A longitudinal dyadic study.

Cancer 2021 Apr 20. Epub 2021 Apr 20.

National Cancer Centre, Singapore, Singapore.

Background: Assessing patient and caregiver experiences with care is central to improving care quality. The authors assessed variations in the experiences of advanced cancer patients and their caregivers with physician communication and care coordination by patient and caregiver factors.

Methods: The authors surveyed 600 patients with a stage IV solid malignancy and 346 caregivers every 3 months for more than 2 years. Read More

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