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US estimates for dog bite injuries presenting to emergency departments.

S Ramgopal M L Macy

Public Health 2021 Jun 9;196:1-3. Epub 2021 Jun 9.

Division of Emergency Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL, USA; Mary Ann & J. Milburn Smith Child Health Outcomes, Research, and Evaluation Center, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.

Objectives: Dog bites are a frequent source of injury requiring emergency department (ED) management. We sought to evaluate the longitudinal burden of dog bites presenting to US EDs.

Study Design: Cross-sectional study of a complex survey. Read More

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Anticoagulant-induced hemorrhagic cholecystitis with hemobilia after deceased donor kidney transplant and literature review.

Int J Surg Case Rep 2021 May 26;84:106027. Epub 2021 May 26.

Augusta University, Department of Surgery, United States of America. Electronic address:

Introduction And Importance: Hemobilia and hemorrhagic cholecystitis are uncommon causes of right upper quadrant abdominal pain. The development of intra-gallbladder and biliary bleeding has been primarily associated with abdominal trauma, malignancy, liver transplant, and iatrogenic injury to the biliary tree and vasculature. Spontaneous anticoagulant induced hemorrhagic cholecystitis and hemobilia are incredibly rare events and have only been documented by a handful of case reports. Read More

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Open Reduction on very late-presenting unreduced posterior elbow dislocation: Still promising treatment option.

Int J Surg Case Rep 2021 Jun 2;84:106056. Epub 2021 Jun 2.

Department of Orthopaedics and Traumatology - Faculty of Medicine - University Padjadjaran - Indonesia.

Background: Neglected dislocation of the elbow is associated with instability, pain, and limitation of elbow function. In developing countries, neglected dislocations of the elbow are quite common, and most patients initially go to local bonesetters, which only aggravates the problem.

Presentation Of Case: Two patients with a history of unreduced posterior elbow dislocation for more than 1 year and were treated by a traditional bonesetter were included in this case study. Read More

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Subacute duodenal obstruction caused by Common Celiaco-Mesenteric Trunk anomaly-A case report.

Int J Surg Case Rep 2021 May 26;83:106043. Epub 2021 May 26.

Department of General Surgery, Grant Government Medical College and Sir J&J Group of Hospitals, Mumbai, India.

Introduction And Importance: The origin of the mesenteric vasculature is highly variable. One such variation is the common celiaco-mesenteric trunk (CMT). To our knowledge, this is the first reported case of subacute duodenal obstruction caused by common CMT. Read More

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Nasogastric Tube Insertion in intubated patients with the guide of Wire rope: A Prospective Randomized Controlled Study.

Int J Clin Pract 2021 Jun 12:e14508. Epub 2021 Jun 12.

Department of Anesthesiology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Introduction: Nasogastric tube (NGT) insertion is sometimes required in intubated patients. NGTs are prone to kink and coil during blind insertion. We hypothesized that Wire rope guide-assisted NGT insertion with chin lift can significantly improve the first-attempt success rate over the conventional technique during its insertion in intubated patients. Read More

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Human papillomavirus in Italy: retrospective cohort analysis and preliminary vaccination effect from real-world data.

Eur J Health Econ 2021 Jun 12. Epub 2021 Jun 12.

Institute for Leadership and Management in Health, Kingston University London, London, UK.

Introduction: The objective of this study was to estimate the lifetime risk of hospitalization associated with all major human papillomavirus (HPV)-related diseases in Italy. Moreover, a preliminary vaccination effect was also performed.

Methods: A retrospective, nonrandomized, observational study was developed based on patients hospitalized between 2006 and 2018 in Italy. Read More

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Feeling better on hemodialysis: user-centered design requirements for promoting patient involvement in the prevention of treatment complications.

J Am Med Inform Assoc 2021 Jun 12. Epub 2021 Jun 12.

School of Information, University of Michigan, Ann Arbor, Michigan, USA.

Objective: Hemodialysis patients frequently experience dialysis therapy sessions complicated by intradialytic hypotension (IDH), a major patient safety concern. We investigate user-centered design requirements for a theory-informed, peer mentoring-based, informatics intervention to activate patients toward IDH prevention.

Methods: We conducted observations (156 hours) and interviews (n = 28) with patients in 3 hemodialysis clinics, followed by 9 focus groups (including participatory design activities) with patients (n = 17). Read More

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Is there an association of socioeconomic deprivation with acute primary angle closure?

Eye (Lond) 2021 Jun 11. Epub 2021 Jun 11.

Princess Alexandra Eye Pavilion, Edinburgh, UK.

Background: Socioeconomic deprivation is known to increase the risk of late presentation of many diseases. This is the largest study in United Kingdom investigating the relationship between socioeconomic deprivation and acute primary angle closure (APAC).

Methods: A retrospective review of case notes was conducted of 718 consecutive patients who underwent laser peripheral iridotomy (LPI) in Edinburgh (Princess Alexandra Eye Pavilion) and Fife (Queen Margaret Hospital) between 2015 and 2019. Read More

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Chemoenzymatic modular assembly of O-GalNAc glycans for functional glycomics.

Nat Commun 2021 Jun 11;12(1):3573. Epub 2021 Jun 11.

Department of Chemistry, Georgia State University, Atlanta, GA, 30303, USA.

O-GalNAc glycans (or mucin O-glycans) play pivotal roles in diverse biological and pathological processes, including tumor growth and progression. Structurally defined O-GalNAc glycans are essential for functional studies but synthetic challenges and their inherent structural diversity and complexity have limited access to these compounds. Herein, we report an efficient and robust chemoenzymatic modular assembly (CEMA) strategy to construct structurally diverse O-GalNAc glycans. Read More

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Gastrointestinal Perspective of COVID-19 in Children - an Updated Review.

J Pediatr Gastroenterol Nutr 2021 Jun 10. Epub 2021 Jun 10.

Department of Paediatrics, Assuta Ashdod University Hospital, Ashdod, Israel Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel Department of Paediatrics, Emma Children's Hospital, Amsterdam University Medical Center, Amsterdam, The Netherlands Division of Neurogastroenterology & Motility, Department of Paediatric Gastroenterology, Great Ormond Street Hospital, London, UK Department of Paediatrics, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany Hospital Sant Joan de Déu, Barcelona, Spain Department of Paediatrics, Woman's & Child's University Hospital of Verona, Italy Department of pediatrics, University Medical Center Maribor, Ljubljanska 5, 2000 Maribor, Slovenia Unité de Gastroentérologie, Hépatologie, Nutrition et Maladies Héréditaires du Métabolisme, Hôpital des Enfants, and IRSD, Université de Toulouse, INSERM, INRAE, ENVT, UPS, Toulouse, France Department of Translational Medical Science, Section of Pediatrics, University of Naples "Federico II", Naples, Italy Centre for Paediatric Gastroenterology, Sheffield Children's Hospital NHS Foundation Trust, Weston Bank, Sheffield, S10 TH, UK Paediatric Gastroenterology Department, Al Jalila Children's Specialty Hospital, Dubai, UAE.

Abstract: Gastrointestinal symptoms are common findings in children with SARS-CoV-2 infection, including vomiting, diarrhoea, abdominal pain, and difficulty in feeding, although these symptoms tend to be mild. The hepato-biliary system and the pancreas may also be involved, usually with a mild elevation of transaminases and, rarely, pancreatitis. In contrast, a late hyper-inflammatory phenomenon, termed multisystem inflammatory syndrome (MIS-C), is characterized by more frequent gastrointestinal manifestations with greater severity, sometimes presenting as peritonitis. Read More

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Clinical Outcomes of New Monofocal Intraocular Lenses with Enhanced Intermediate Function Compared with Extended Depth of Focus Intraocular Lenses.

J Cataract Refract Surg 2021 Jun 7. Epub 2021 Jun 7.

Department of Ophthalmology, HanGil Eye Hospital, Incheon, South Korea. Department of Ophthalmology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea Department of Ophthalmology, Dankook University Hospital, Dankook University College of Medicine, Cheonan, South Korea.

Purpose: To compare clinical outcomes of a new monofocal intraocular lens (IOL) with enhanced intermediate function and an extended-depth-of-focus (EDOF) IOL.

Setting: Asan Medical Center, Seoul, Korea.

Design: Nonrandomized prospective comparative case series. Read More

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Pediatric Trigger Digit Presenting in the Setting of Trauma.

Ann Plast Surg 2021 Jun 10. Epub 2021 Jun 10.

From the Division of Plastic Surgery, Saint Louis University School of Medicine SSM Health Cardinal Glennon Children's Hospital at SLU, St Louis, MO.

Background: Pediatric trigger digit is a relatively rare condition with incompletely understood etiology. In our practice, we noted a series of children presenting with pediatric trigger digit after an associated local trauma to the hand, which has not been previously described. The aim of this study was to analyze the nature of presentation of trigger digits, the accuracy of initial diagnosis, and the impact on treatment strategies used. Read More

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Assessing Back Pain in Patients Presenting to the ED.

Am J Nurs 2021 Jun 10. Epub 2021 Jun 10.

Margaret J. Carman is an associate professor in the School of Nursing, University of North Carolina at Chapel Hill. Contact author: The author and planners have disclosed no potential conflicts of interest, financial or otherwise. A podcast with the author is available at www.ajnonline.com.

Abstract: Although back pain is common, most often benign, and generally resolves in a few days with self-care, nonspecific low back pain that does not resolve with self-care and prompts patients to seek treatment in an ED may result from a serious underlying pathology. In this article, the first in a series on clinical red flags-indicators that can be used in the clinical setting to screen for an elevated risk of severe underlying conditions-the author considers back pain manifestations that may signal the presence of a debilitating or even fatal disease process. Detecting such red flags and communicating their presence to the attending provider can facilitate appropriate diagnosis and management. Read More

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Novel selection paradigms for endovascular stroke treatment in the extended time window.

J Neurol Neurosurg Psychiatry 2021 Jun 11. Epub 2021 Jun 11.

Neurology, Emory University, Atlanta, Georgia, USA

Background And Purpose: The optimal selection methodology for stroke thrombectomy beyond 6 hours remains to be established.

Methods: Review of a prospectively collected database of thrombectomy patients with anterior circulation strokes, adequate CT perfusion (CTP) maps, National Institute of Health Stroke Scale (NIHSS)≥10 and presenting beyond 6 hours from January 2014 to October 2018. Patients were categorised according to five selection paradigms: DAWN clinical-core mismatch (DAWN-CCM): between age-adjusted NIHSS and CTP core, DEFUSE 3 perfusion imaging mismatch (DEFUSE-3-PIM): between CTP-derived perfusion defect (Tmax >6 s lesion) and ischaemic core volumes and three non-contrast CT Alberta Stroke Program Early CT Score (ASPECTS)-based criteria: age-adjusted clinical-ASPECTS mismatch (aCAM): between age-adjusted NIHSS and ASPECTS, eloquence-adjusted clinical ASPECTS mismatch (eCAM): ASPECTS 6-10 and non-involvement of the right M6 and left M4 areas and standard clinical ASPECTS mismatch (sCAM): ASPECTS 6-10. Read More

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Unusual source of recurrent Corynebacterium bacteraemia in an immunocompromised patient.

BMJ Case Rep 2021 Jun 11;14(6). Epub 2021 Jun 11.

Respiratory Medicine, Prince Philip Hospital, Llanelli, UK.

We describe a unique case of a patient with acute myeloid leukaemia (AML), with recurring infections during chemotherapy from chronic nasal carriage of non-diphtherial Corynebacterium, who was eventually diagnosed as she presented with neutropaenic sepsis. Identifying (often multiple) sources of infection in immunocompromised patients is crucial but deciding whether multiple organisms, which in health are considered as commensals, are actually pathogenic during vulnerable states-can be clinically difficult. Our case highlights the efforts to correctly identify the actual source of this rare organism and the recognition of its pathogenic potential when other illnesses present. Read More

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Cost-effectiveness analysis of resorbable biosynthetic mesh in contaminated ventral hernia repair.

J Visc Surg 2021 Jun 8. Epub 2021 Jun 8.

Clinical Epidemiology Unit, Clinical Investigation Center, INSERM, CIC1432, Dijon University Hospital; INSERM, LNC UMR1231, University Bourgogne Franche-Comté, Dijon, France.

Background: The aim of this study was to compare, in terms of cost and serious complications, the use of biosynthetic resorbable parietal mesh with biologic mesh in patients undergoing contaminated ventral hernia repair (modified Ventral Hernia Working Group grade 3). Poly-4-hydroxy-butyrate (P4HB) biosynthetic mesh has rarely been the subject of comparative studies in the context of contamination. Data are required to confirm the effects of a transition from biological mesh to biosynthetic resorbable mesh. Read More

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[Radiation therapy of hepatic haemangiomas: Review from a case report].

Cancer Radiother 2021 Jun 8. Epub 2021 Jun 8.

Université Claude-Bernard Lyon 1, Lyon, France; Département d'hépatologie, groupement hospitalier Lyon Nord, Hospices civils de Lyon, Lyon, France.

Haemangioma is the most frequent benign hepatic tumour. Haemangioma is generally asymptomatic but it can sometimes cause disabling symptoms depending on its size and location. Surgery and interventional radiology are the cornerstone of the treatment in this situation. Read More

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Bioactive glass S53P4 to fill-up large cavitary bone defect after acute and chronic osteomyelitis treated with antibiotic-loaded cement beads: A prospective case series with a minimum 2-year follow-up.

Injury 2021 Jun 1. Epub 2021 Jun 1.

Trauma Service, Instituto de Ortopedia e Traumatologia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, SP, Brazil.

Introduction: Bioactive glass S53P4 (BAG-S53P4) has been used in the treatment of osteomyelitis with excellent results. The aim of this study was to evaluate the clinical and radiographic results of patients treated with use of antibiotic-loaded cement beads, followed by bone defects filling using bioglass.

Methods: We treated a prospective series of patients presenting with acute or chronic osteomyelitis of a long bone of the upper or lower limb. Read More

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[Papular mycosis fungoides in elderly: Report of two cases].

Rev Esp Geriatr Gerontol 2021 Jun 8. Epub 2021 Jun 8.

Servicio de Dermatología, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España.

Papular mycosis fungoides (MF) is an uncommon clinical variant of early MF without prognostic implications that follows an indolent course over years. It is characterized by the presence of multiple, small, pruritic, flat-topped, erythematous papules, often presenting as a nonspecific papular eruption which makes early diagnosis difficult. We describe two cases of elderly patients with papular MF, a probably underdiagnosed entity, which causes a significant deterioration in quality of life of patients who may benefit from specific treatments such as phototherapy. Read More

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Anomalous Aortic Origin of the Coronary Arteries - State of the Art Management and Surgical Techniques.

Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 2021 ;24:85-94

Coronary Artery Anomalies Program, Texas Children's Hospital; Houston, Texas; Division of Congenital Heart Surgery, Michael E. DeBakey Department of Surgery, Texas Children's Hospital, Baylor College of Medicine; Houston, Texas. Electronic address:

Anomalous aortic origin of a coronary artery (AAOCA) can be associated with myocardial ischemia and sudden cardiac arrest. We describe and compare the management and surgical techniques for patients with AAOCA. Patients presenting to the Coronary Artery Anomalies Program are evaluated and managed following a standardized approach. Read More

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January 2021

Neonatal Lymphopenia Screening Is Important For Early Diagnosis of Severe Combined Immunodeficiency.

Am J Perinatol 2021 Jun 11. Epub 2021 Jun 11.

Division of Hematology and Oncology, Immunology, Department of Pediatrics, Erciyes University, School of Medicine, Kayseri, Turkey.

Objective:  T-cell receptor excision circles are expensive for neonatal severe combined immunodeficiency screening in developing countries. We aimed to detect immunodeficiencies presenting with lymphopenia to enable screening in the general population and to improve awareness regarding lymphopenia among clinicians.

Study Design:  This study was conducted prospectively. Read More

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Pediatric Ocular Injury Due to Hand Sanitizer Exposure An Emerging Hazard.

Pediatr Emerg Care 2021 Jun 11. Epub 2021 Jun 11.

From the Department of Ophthalmology, Shaare Zedek Medical Center, Jerusalem Edmond and Lily Safra Children's Hospital, Chaim Sheba Medical Center, Tel Hashomer Pediatric Emergency Medicine, Shaare Zedek Medical Center, Jerusalem, Israel.

Objectives: The objective of this study was to describe the incidence and severity of ocular exposure to alcohol-based hand rub (ABHR) in children presenting to a tertiary medical center during the severe acute respiratory syndrome coronavirus 2 pandemic.

Methods: A retrospective single-center observational study conducted from February 21, 2020, to October 11, 2020. Subjects 10 years or younger who presented with ABHR-induced ocular injury were included. Read More

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Radiosurgery as a microsurgical adjunct: outcomes after microsurgical resection of intracranial arteriovenous malformations previously treated with stereotactic radiosurgery.

J Neurosurg 2021 Jun 11:1-12. Epub 2021 Jun 11.

1Department of Neurosurgery and Stanford Stroke Center, Stanford University Medical Center, Stanford.

Objective: Microsurgical resection of arteriovenous malformations (AVMs) can be aided by staged treatment consisting of stereotactic radiosurgery followed by resection in a delayed fashion. This approach is particularly useful for high Spetzler-Martin (SM) grade lesions because radiosurgery can reduce flow through the AVM, downgrade the SM rating, and induce histopathological changes that additively render the AVM more manageable for resection. The authors present their 28-year experience in managing AVMs with adjunctive radiosurgery followed by resection. Read More

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Prevalence of acute dizziness and vertigo in cortical stroke.

Eur J Neurol 2021 Jun 11. Epub 2021 Jun 11.

Centre for Vestibular and Behavioural Neuroscience, Department of Clinical and Movement Neurosciences, Institute of Neurology, University College London, London, WC1N 3BG, UK.

Background: In posterior circulation stroke, vertigo can be a presenting feature. However, whether isolated hemispheric strokes present with vertigo is less clear, despite a few single case-reports in the literature. Here we, a) explored the prevalence of vertigo/dizziness in acute stroke and, b) considered the cortical distribution of these lesions in relation to both the known vestibular cortex and evolution of these symptoms. Read More

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Stereotypy and spontaneous alternation in deer mice and its response to anti-adenosinergic intervention.

J Neurosci Res 2021 Jun 11. Epub 2021 Jun 11.

Center of Excellence for Pharmaceutical Sciences, Department of Pharmacology, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa.

Repetitive behavioral phenotypes are a trait of several neuropsychiatric disorders, including obsessive-compulsive disorder (OCD). Such behaviors are typified by complex interactions between cognitive and neurobiological processes which most likely contribute to the suboptimal treatment responses often observed. To this end, exploration of the adenosinergic system may be useful, since adenosine-receptor modulation has previously shown promise to restore control over voluntary behavior and improve cognition in patients presenting with motor repetition. Read More

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The p16/ki-67 assay is a safe, effective and rapid approach to triage women with mild cervical lesions.

PLoS One 2021 11;16(6):e0253045. Epub 2021 Jun 11.

1st Department of Obstetrics and Gynecology, "Alexandra" Hospital, National and Kapodistrian University of Athens, Athens, Greece.

Objective: The aim of this study was to evaluate the diagnostic accuracy and efficiency of p16/ki-67 dual stain in the identification of CIN2+ lesions, in Greek women with ASCUS or LSIL cytology.

Methods: A total of 200 women, 20 to 60 years old, were enrolled in the study. All samples were cytologically evaluated and performed for p16/ki-67 and high-risk HPV (HR-HPV) test. Read More

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General health of patients with diabetic macular edema-The LIPSIA study.

PLoS One 2021 11;16(6):e0252321. Epub 2021 Jun 11.

Department of Ophthalmology, University Hospital Leipzig, Leipzig, Germany.

Purpose: Cardiovascular risk factors such as hypertension or dyslipidemia can influence the incidence and progression of diabetic retinopathy (DR) and diabetic macular edema (DME). The aim of this study is to describe the comorbidities in patients with DME.

Methods: Prospective, monocentric observational study. Read More

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Utility of Emergency Medical Dispatch (EMD) Telephone Screening in Identifying COVID-19 Positive Patients.

Prehosp Emerg Care 2021 Jun 11:1-14. Epub 2021 Jun 11.

Department of Emergency Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA.

In response to the COVID-19 pandemic, Emergency Medical Services (EMS) systems have received guidelines as part of coordinated response efforts aimed at mitigating exposures and ensuring occupational wellbeing, including recommendations of Personal Protective Equipment (PPE) utilization, and modifications of Emergency Medical Dispatch (EMD) caller queries. The aim of the study was to estimate the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of an EMD telephone screening process for the identification of hospital diagnosed COVID-19 positive patients.A retrospective cohort study was conducted of adult EMS encounters presenting to hospitals within a large health system from March 16-June 30, 2020. Read More

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Comparison of equine synovial sepsis rate following intrasynovial injection in ambulatory versus hospital settings.

Equine Vet J 2021 Jun 11. Epub 2021 Jun 11.

Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, 300 West Drake Road, Fort Collins, Colorado, 80523, USA.

Background: Frequency of synovial sepsis in horses following intrasynovial injection has been reported, but not compared with respect to environment in which the injection was performed.

Objectives: To describe occurrence of synovial sepsis following intrasynovial injections performed in ambulatory versus hospital settings.

Study Design: Retrospective cohort study. Read More

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Efficacy of thromboelastography in the management of anticoagulation for veno-venous extracorporeal membrane oxygenation in a coronavirus disease 2019 patient: A case report.

Medicine (Baltimore) 2021 Jun;100(23):e26313

Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan.

Rationale: In coronavirus disease 2019 (COVID-19) patients with acute respiratory distress syndrome refractory to optimal conventional management, we should consider the indication for veno-venous extracorporeal membrane oxygenation (V-V ECMO). Growing evidence indicates that COVID-19 frequently causes coagulopathy, presenting as hypercoagulation and incidental thrombosis. For these reasons, a multifactorial approach with several anticoagulant markers should be considered in the management of anticoagulation using heparin in COVID-19 patients on V-V ECMO. Read More

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