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Disconnected pancreatic duct syndrome and outcomes of endoscopic ultrasound-guided treatment of pancreatic fluid collections: A systematic review and meta-analysis.

Dig Endosc 2021 Sep 20. Epub 2021 Sep 20.

Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.

Background: Disconnected pancreatic duct syndrome (DPDS) frequently occurs in patients with acute necrotizing pancreatitis and resultant pancreatic fluid collection (PFC). We performed a systematic review and meta-analysis to evaluate outcomes of endoscopic ultrasound-guided treatment of PFCs according to the presence of DPDS.

Methods: Using PubMed, Embase, and the Cochrane database, we identified clinical studies published until January 2021 with data comparing outcomes of endoscopic ultrasound-guided drainage of PFCs between DPDS and non-DPDS patients. Read More

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September 2021

[Living wills of residents in nursing homes - which treatment situations and treatment measures are decreed?]

Dtsch Med Wochenschr 2021 Sep 20. Epub 2021 Sep 20.

Institut für Angewandte Sozialwissenschaften (IFAS), Hochschule für angewandte Wissenschaften Würzburg-Schweinfurt.

Background:  The possibility of using a living will to influence later treatment in the event of incapacity to consent is nowadays an important element in safeguarding patients' autonomy at the end of life. Refusing or consenting treatment measures in advance of treatment is of particular importance for nursing home residents, not only against the background of the COVID-19 pandemic.

Methods:  We conducted a survey of all resident-documents in 13 nursing homes of different sizes and service providers in the city and district of Wuerzburg. Read More

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September 2021

The Effect of Betamethasone Dosing Interval on Perinatal Outcomes: 12 Hours or 24 Hours Apart.

Am J Perinatol 2021 Sep 20. Epub 2021 Sep 20.

Department of Obstetrics and Gynecology, Istanbul Medipol University, Istanbul, Turkey.

Objective:  Antenatal steroids are commonly used to stimulate fetal lung maturation, particularly in pregnancies at risk of early preterm labor. This study aimed to compare the effects of administering betamethasone at a 12- versus 24-hour interval on perinatal outcomes.

Study Design:  This retrospective study included 423 early preterm births from 26 to 33 weeks of gestation. Read More

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September 2021

Optimizing Fluid Resuscitation and Preventing Fluid Overload in Patients with Septic Shock.

Semin Respir Crit Care Med 2021 Oct 20;42(5):698-705. Epub 2021 Sep 20.

Department of Anesthesiology, University of Nebraska Medical Center, Omaha, Nebraska.

Intravenous fluid administration remains an important component in the care of patients with septic shock. A common error in the treatment of septic shock is the use of excessive fluid in an effort to overcome hypovolemia and vasoplegia. While fluids are necessary to help correct the intravascular depletion, vasopressors should be concomitantly administered to address vasoplegia. Read More

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October 2021

In-office Endonasal Minor Revision Rhinoplasty.

Facial Plast Surg 2021 Sep 20. Epub 2021 Sep 20.

Section of Otolaryngology - Head and Neck Surgery, Department of Surgery, University of Chicago Medical Center, Chicago, Illinois.

The revision rhinoplasty presents many unique challenges to the facial plastic surgeon. While many cases will require a full revision in the operating room, there are several isolated deformities which may be repaired in the office via an endonasal approach. This provides many benefits to the patient and surgeon including decreased cost, shorter recovery time, avoidance of general anesthesia, and less discomfort. Read More

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September 2021

Impact of correlation of angle α with ocular biometry variables.

J Cataract Refract Surg 2021 Oct;47(10):1279-1284

From the Anterior Segment Surgery Department, Asociación para Evitar la Ceguera en México I.A.P., Mexico City, Mexico.

Purpose: To analyze the association between angle α and ocular biometry in the general population at a third-level ophthalmology hospital.

Setting: Anterior Segment Surgery Department, Asociación para Evitar la Ceguera en México I.A. Read More

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October 2021

Comparison of Outcomes between Percutaneous and Surgical Placement of Peritoneal Dialysis Catheters in Uremic Patients: A Meta-Analysis.

Blood Purif 2021 Sep 20:1-17. Epub 2021 Sep 20.

Division of Nephrology, Kidney Institute of CPLA, Changzheng Hospital, Second Military Medical University, Shanghai, China.

Background: The optimal technique for inserting peritoneal dialysis catheters in uremic patients remains debated. This meta-analysis aimed to summarize the current evidence evaluating the efficacy and safety of percutaneous insertion methods compared to surgical methods.

Method: A literature search was performed in the PubMed, EMBASE, Cochrane, and Web of Science databases. Read More

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September 2021

Uniform versus non-uniform dose prescription for proton stereotactic body radiotherapy of liver tumors investigated by extensive motion-including treatment simulations.

Phys Med Biol 2021 Sep 20. Epub 2021 Sep 20.

Department of Clinical Medicine, Aarhus University, Aarhus, DENMARK.

Compared to x-ray-based stereotactic body radiotherapy (SBRT) of liver cancer, proton SBRT may reduce the normal liver tissue dose. For optimal trade-off between target and liver dose, a non-uniform dose prescription is often applied in x-ray SBRT, but lacks investigation for proton SBRT. Also, proton SBRT is prone to breathing-induced motion-uncertainties causing target mishit or dose alterations by interplay with the proton delivery. Read More

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September 2021

Increased Detection of Mycobacterium tuberculosis Disease Using a Tissue-Based Laboratory-Developed Polymerase Chain Reaction Assay Compared to Standard Diagnostics.

Am J Trop Med Hyg 2021 Sep 20. Epub 2021 Sep 20.

Section of Infectious Diseases, Yale University School of Medicine, New Haven, Connecticut.

Standard diagnostics for Mycobacterium tuberculosis (MTB) including acid-fast bacilli (AFB) smear and culture, and Xpert™ MTB/RIF real-time Polymerase Chain Reaction (RT-PCR; Xpert) have variable sensitivity and/or long turnaround times. We describe the clinical performance of a laboratory-developed tissue-based MTB PCR compared with AFB culture and Xpert using a composite reference standard (CRS). Over an 8-year period, MTB PCR was performed on pulmonary, pleural, or lymph node specimens for 36 patients. Read More

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September 2021

Neural mapping of anhedonia across psychiatric diagnoses: A transdiagnostic neuroimaging analysis.

Neuroimage Clin 2021 Sep 16;32:102825. Epub 2021 Sep 16.

University of Basel, Department of Psychiatry (UPK), Basel, Switzerland. Electronic address:

Anhedonia has been associated with abnormal reward-related striatal dopamine functioning in patients with different psychiatric disorders. Here, we tested whether anhedonia expression mapped onto striatal volume across several psychiatric diagnoses. T1-weighted images from 313 participants including 89 healthy controls (HC), 22 patients with opioid use disorder (OUD), 50 patients with major depressive disorder (MDD), 45 patients with borderline personality disorder (BPD), 49 patients with first-episode psychosis (FEP), 43 patients with cocaine use disorder (CUD) and 15 patients with schizophrenia (SZ) were included. Read More

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September 2021

Knee proprioceptive function and physical performance of patients with patellofemoral pain: A matched case-control study.

Knee 2021 Sep 17;33:49-57. Epub 2021 Sep 17.

Rehabilitation Science Postgraduation Progam - Augusto Motta University Centre (UNISUAM), Rio de Janeiro, Brazil; Physiotherapy Department - Federal Institute of Rio de Janeiro (IFRJ), Rio de Janeiro, Brazil. Electronic address:

Background: Patients with patellofemoral pain (PFP) present pain, functional limitation, and alteration in knee proprioception.

Purpose: To compare the knee joint position sense and lower extremity functionality between patients with PFP and controls. Secondarily, investigate the relationship between proprioceptive acuity and physical performance. Read More

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September 2021

Increased LPS levels coexist with systemic inflammation and result in monocyte activation in severe COVID-19 patients.

Int Immunopharmacol 2021 Sep 9;100:108125. Epub 2021 Sep 9.

Laboratory of Cellular and Molecular Immunology, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil; Graduate Program in Health Sciences, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil; Graduate Program in Biosciences, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil. Electronic address:

Mucosal barrier alterations may play a role in the pathogenesis of several diseases, including COVID-19. In this study we evaluate the association between bacterial translocation markers and systemic inflammation at the earliest time-point after hospitalization and at the last 72 h of hospitalization in survivors and non-survivors COVID-19 patients. Sixty-six SARS-CoV-2 RT-PCR positive patients and nine non-COVID-19 pneumonia controls were admitted in this study. Read More

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September 2021

Two cases of primary leiomyosarcoma of sigmoid colon treated with laparoscopic surgery: A case report and a review of literature.

Int J Surg Case Rep 2021 Sep 16;87:106420. Epub 2021 Sep 16.

Colorectal Research Center, Department of Surgery, Shiraz University of Medical Sciences, Shiraz, Iran. Electronic address:

Introduction And Importance: Leiomyosarcoma (LMS) of the colon is an extremely rare and highly invasive tumor arising from the muscularis propria of the gastrointestinal tract. After the introduction of oncogenic role of KIT by immunohistochemistry (IHC), the reported cases of gastrointestinal leiomyosarcoma were highly limited. True LMS of the colon is such a rare disorder that there isn't much description of its nature. Read More

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September 2021

Penalty weighted glucose prediction models could lead to better clinically usage.

Comput Biol Med 2021 Sep 15;138:104865. Epub 2021 Sep 15.

Department of Health Science and Technology, Aalborg University, Denmark.

Background And Objective: Numerous attempts to predict glucose value from continuous glucose monitors (CGM) have been published. However, there is a lack of proper analysis and modeling of penalty for errors in different glycemic ranges. The aim of this study was to investigate the potential for developing glucose prediction models with focus on the clinical aspects. Read More

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September 2021

First-in-child phase I/II study of the dual mTORC1/2 inhibitor vistusertib (AZD2014) as monotherapy and in combination with topotecan-temozolomide in children with advanced malignancies: arms E and F of the AcSé-ESMART trial.

Eur J Cancer 2021 Sep 17;157:268-277. Epub 2021 Sep 17.

Gustave Roussy Cancer Campus, Department of Paediatric and Adolescent Oncology, Villejuif, France; INSERM U1015, Gustave Roussy Cancer Campus, Université Paris-Saclay, Villejuif, France. Electronic address:

Aim: Arms E and F of the AcSé-ESMART phase I/II platform trial aimed to define the recommended dose and preliminary activity of the dual mTORC1/2 inhibitor vistusertib as monotherapy and with topotecan-temozolomide in a molecularly enriched population of paediatric patients with relapsed/refractory malignancies. In addition, we evaluated genetic phosphatidylinositol 3-kinase (PI3K)/AKT/ mammalian (or mechanistic) target of rapamycin (mTOR) pathway alterations across the Molecular Profiling for Paediatric and Young Adult Cancer Treatment Stratification (MAPPYACTS) trial (NCT02613962).

Experimental Design And Results: Four patients were treated in arm E and 10 in arm F with a median age of 14. Read More

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September 2021

Osimertinib plus platinum-pemetrexed in newly diagnosed epidermal growth factor receptor mutation-positive advanced/metastatic non-small-cell lung cancer: safety run-in results from the FLAURA2 study.

ESMO Open 2021 Sep 17;6(5):100271. Epub 2021 Sep 17.

Department of Respiratory Medicine, Saitama Medical School International Medical Center, Saitama, Japan.

Background: The phase III FLAURA2 (NCT04035486) study will evaluate efficacy and safety of first-line osimertinib with platinum-pemetrexed chemotherapy versus osimertinib monotherapy in epidermal growth factor receptor mutation-positive (EGFRm) advanced/metastatic non-small-cell lung cancer (NSCLC). The safety run-in, reported here, assessed the safety and tolerability of osimertinib with chemotherapy prior to the randomized phase III evaluation.

Patients And Methods: Patients (≥18 years; Japan: ≥20 years) with EGFRm locally advanced/metastatic NSCLC received oral osimertinib 80 mg once daily (QD), with either intravenous (IV) cisplatin 75 mg/m or IV carboplatin target area under the curve 5, plus pemetrexed 500 mg/m every 3 weeks (Q3W) for four cycles. Read More

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September 2021

The impact of radiological assessment schedules on progression-free survival in metastatic breast cancer: A systemic review and meta-analysis.

Cancer Treat Rev 2021 Sep 13;100:102293. Epub 2021 Sep 13.

Oncology Institute, Shaare Zedek Medical Center, and the Hebrew University Faculty of Medicine, Jerusalem, Israel. Electronic address:

Background: The impact of interval of restaging on the observed magnitude of benefit of progression-free survival (PFS) is undefined.

Materials And Methods: Phase 3 randomized controlled trials (RCTs) investigating anti-neoplastic drugs for metastatic breast cancer which reported the restaging interval and hazard ratio (HR) for PFS were included. Data on study design and study population were collected. Read More

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September 2021

Peripheral nervous system electrodiagnostic abnormalities in predominantly Hispanic Multiple Sclerosis patients.

Mult Scler Relat Disord 2021 Sep 4;56:103254. Epub 2021 Sep 4.

Department of Neurology, University of Miami, Miami, FL, USA, 1120 NW 14(th) Street, 13th Floor, Miami FL 33136, USA.

Background: Peripheral nervous system (PNS) abnormalities in Multiple Sclerosis (MS) have been reported in case reports and small case series over the past several decades. Little is known, however, about the prevalence of electrodiagnostic abnormalities in patients with MS, including not only demyelinating neuropathies such as chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) but also axonal peripheral neuropathy and sympathetic dysfunction.

Methods: This is an observational, cross-sectional study with the objective of identifying the prevalence of the electrodiagnostic abnormalities in predominantly Hispanic MS patients in Miami, Florida. Read More

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September 2021

Longitudinal associations between cancer history and cognitive functioning among older adults.

Arch Gerontol Geriatr 2021 Sep 11;97:104521. Epub 2021 Sep 11.

School of Social Work, New York University, New York, NY 11220, USA.

Objectives: This study aimed to examine (1) whether cancer history accelerates older adults' rates of cognitive decline over time and (2) whether chemotherapy increases older cancer patients'/ survivors' rates of cognitive decline over time.

Methods: This longitudinal study drew a subsample of 8811 adults aged 65 or older from Wave 6 of the Health and Retirement Study in 2002 and followed biennually until Wave 13 in 2016. Linear mixed-effects models were performed to test whether cancer history and chemotherapy were associated with accelerated rates of cognitive decline over time among older adults in different age groups. Read More

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September 2021

ADIPOSE TISSUE DYSFUNCTION AND MAFLD IN OBESITY ON THE SCENE OF COVID-19.

Clin Res Hepatol Gastroenterol 2021 Sep 17:101807. Epub 2021 Sep 17.

Department of Social Applied Nutrition, Micronutrients Research Center (NPqM), Institute of Nutrition, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil.

Obesity is a known risk factor for respiratory infection and many other chronic diseases, including metabolic dysfunction-associated fatty liver disease (MAFLD), previously known as nonalcoholic fatty liver disease (NAFLD). Recently, it has been considered an important and independent predictor for coronavirus disease 2019 (COVID-19) complications in adults, especially cardiopulmonary, presenting in a great number of individuals in critical care. In obesity, adipose tissue (AT) undergoes expansion via several processes: expansion of adipocytes and insufficient vascularization lead to hypoxia; adipocyte apoptosis/necrosis; irregular fatty acid flux; and enhanced secretion of inflammatory adipokines, cytokines, and chemokines. Read More

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September 2021

Medialized versus Lateralized Humeral Implant in Reverse Total Shoulder Arthroplasty: The Comparison of Outcomes in Pseudoparalysis with Massive Rotator Cuff Tear.

J Shoulder Elbow Surg 2021 Sep 17. Epub 2021 Sep 17.

Department of Orthopaedic Surgery, Myongji Hospital, 697-24 Hwajung-dong, Deokyang-gu, Goyang-si, Gyeonggi-do 412-270, Republic of Korea. Electronic address:

Background: With the increasing use of the lateralized humeral implants in reverse total shoulder arthroplasty (RTSA), it is still unclear whether or not this design will be as advantageous as the medialized humeral implants in the setting of pseudoparalysis (PP).

Methods: A total of 51 eligible RTSA cases for PP signs due to massive rotator cuff deficiency were selected for the retrospective review. Twenty-five patients were allocated to Group L in which the isolated humeral side lateralization was performed (neck-shaft angle of 145°), and 26 patients were allocated to Group M (neck-shaft angle of 155°). Read More

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September 2021

Lateralized Glenosphere Reverse Shoulder Arthroplasty: Inlay and Onlay Designs have Similar Clinical Outcomes in Patients with Glenohumeral Osteoarthritis.

J Shoulder Elbow Surg 2021 Sep 17. Epub 2021 Sep 17.

Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, MD, USA. Electronic address:

Background: Whether or how the position of the humeral tray (inlay or onlay) in reverse shoulder arthroplasty (RSA) affects outcomes is unclear. Our goal was to compare the clinical and radiographic results of RSA systems with inlay versus onlay designs but with similar neck shaft angles (NSAs) and lateralized glenospheres.

Methods: We screened the institutional database at our tertiary academic center for patients who underwent primary RSA (with a lateralized glenosphere and a 135° NSA) from 2009 through 2017. Read More

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September 2021

Using fiber tractography and diffusion kurtosis imaging to evaluate neuroimaging changes in patients with cerebrotendinous xanthomatosis after stopping chenodeoxycholic acid treatment for three years.

Biomed J 2021 Sep 17. Epub 2021 Sep 17.

Department of Neurology, Chang-Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan. Electronic address:

Background: The aim of this study was to use tractography and diffusion kurtosis imaging (DKI) to evaluate cerebral white matter (WM) changes in patients with cerebrotendinous xanthomatosis (CTX) after stopping chenodeoxycholic acid (CDCA) treatment.

Material And Methods: Two siblings with CTX aged 40 and 38 years, respectively, who had been diagnosed with CTX for 16 years were enrolled. They had received CDCA treatment from 2005 until 2015, after which CDCA was no longer available in Taiwan. Read More

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September 2021

Post-clozapine in a clinical setting: A retrospective case note review in Kumamoto, Japan (2009-2019).

Asian J Psychiatr 2021 Sep 7;65:102845. Epub 2021 Sep 7.

Meisei-Hospital, Okubo, Kumamoto, Japan.

Clozapine is commonly prescribed in dopamine supersensitivity psychosis (DSP) cases in Japan. However, limited knowledge on treatment post-clozapine discontinuation use exists. We investigated antipsychotic medications, patient status, and DSP episodes before, during, and after clozapine treatment using medical records of 30 schizophrenia patients (mean age, 51 years; mean illness duration before clozapine treatment, 24 years; mean clozapine treatment duration, 1. Read More

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September 2021

Inflammatory Bowel Disease: The role of commensal microbiome in immune regulation.

Gastroenterol Hepatol 2021 Sep 17. Epub 2021 Sep 17.

División de Gastroenterología y Hepatología, Hospital Universitario "Dr. José E. González" Monterrey, NL, México.

The incidence of inflammatory bowel disease (IBD) is increasing. Microbiome is one of the most important factors in its development and affects the different clinical outcomes of IBD patients depending on its composition and different alterations. We conducted a systematic review to discuss the association between microbiome and IBD in terms of immune regulation, and therapies that can modify microbiota. Read More

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September 2021

Periprosthetic Joint Infection Prediction via Machine Learning: Comprehensible Personalized Decision Support for Diagnosis.

J Arthroplasty 2021 Sep 17. Epub 2021 Sep 17.

College of Computer Science, National Yang Ming Chiao Tung University, Hsinchu, Taiwan; Institute of Biomedical Engineering, National Yang Ming Chiao Tung University, Hsinchu, Taiwan. Electronic address:

Background: The criteria outlined in the International Consensus Meeting (ICM) in 2018, which were prespecified and fixed, have been commonly practiced by clinicians to diagnose periprosthetic joint infection (PJI). We developed a machine learning (ML) system for PJI diagnosis and compared it with the ICM scoring system to verify the feasibility of ML.

Methods: We designed an ensemble meta-learner, which combined five learning algorithms to achieve superior performance by optimizing their synergy. Read More

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September 2021

Mortality following post-operative periprosthetic fracture of the femur after hip replacement in the last decade: Meta-analysis of 35 cohort studies including 4841 patients.

J Arthroplasty 2021 Sep 17. Epub 2021 Sep 17.

Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK.

Introduction: Post-operative periprosthetic fracture of the femur (POPFF) is associated with increased mortality. There is a lack of general estimates of mortality following POPFF and a need for higher-level evidence in this area. The aim of this study was to estimate mortality following POPFF mortality using data reported in cohort studies from the last decade. Read More

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September 2021

CKD Progression From the Time of Estimated GFR-Based Waitlist Eligibility and Racial Disparities in Transplant Access.

Am J Kidney Dis 2021 Sep 17. Epub 2021 Sep 17.

Department of Medicine, University of California, San Francisco, San Francisco, CA; Department of Medicine, Priscilla Chan and Mark Zuckerberg San Francisco General Hospital, San Francisco, CA; Center for Vulnerable Populations, University of California, San Francisco, San Francisco, CA.

Rationale & Objective: eGFR equations that incorporate a term for race assign a higher value to Black individuals compared to non-Black individuals not attributable to sex, age, or serum creatinine. This difference may contribute to racial disparities in kidney transplant access. We sought to 1) compare time from meeting a transplant eligibility threshold of eGFR ≤20 ml/min/1. Read More

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September 2021

Willingness to Randomize Primary Medium Vessel Occlusions for Endovascular Treatment.

J Neuroradiol 2021 Sep 17. Epub 2021 Sep 17.

Department of Clinical Neurosciences, Foothills Medical(1-3) Center, University of Calgary, Calgary, AB, Canada; Department of Diagnostic Imaging, Foothills Medical Center, University of Calgary, Calgary, AB, Canada. Electronic address:

Background And Purpose: Patients with acute ischemic stroke due to medium vessel occlusion (MeVO) make up a substantial part of the acute stroke population, though guidelines currently do not recommend endovascular treatment (EVT) for them. A growing body of evidence suggests that EVT is effective in MeVOs, including observational data but no randomized studies. We aimed to explore willingness of physicians worldwide to randomize MeVO stroke patients into a hypothetical trial comparing EVT in addition to best medical management versus best medical management only. Read More

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September 2021

Physical Resilience in Daily Functioning Among Acutely Ill Hospitalized Older Adults: The Hospital-ADL Study.

J Am Med Dir Assoc 2021 Sep 17. Epub 2021 Sep 17.

Amsterdam UMC, University of Amsterdam, Internal Medicine, Section of Geriatric Medicine, Amsterdam Public Health Research Institute, Amsterdam, Netherlands; ACHIEVE - Centre of Applied Research, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, Netherlands.

Objectives: Insight into older adults' physical resilience is needed to predict functional recovery after hospitalization. We assessed functional trajectories in response to acute illness and subsequent hospitalization and investigated baseline variables and dynamic variables associated with these trajectories.

Design: Prospective observational cohort study (Hospitalization-Associated Disability and impact on daily Life Study). Read More

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September 2021