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Successful emergency evacuation from a hospital within a 5-km radius of Fukushima Daiichi Nuclear Power Plant: the importance of cooperation with an external body.

J Radiat Res 2021 May;62(Supplement_1):i122-i128

Department of Radiation Health Management, Fukushima Medical University School of Medicine, Fukushima, Japan.

Emergency evacuation during a disaster may have serious health implications in vulnerable populations. After the accident at the Fukushima Daiichi Nuclear Power Plant (FDNPP) in March 2011, the Japanese central government immediately issued an evacuation order for residents living near the plant. There is limited information on the process of evacuation from medical institutions within the evacuation zone and the challenges faced. Read More

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Impact of Eliminating Local Anesthesia on Immediate Postoperative Analgesia in Pediatric Ambulatory Adenotonsillectomy.

Pediatr Qual Saf 2021 May-Jun;6(3):e405. Epub 2021 May 5.

Department of Otolaryngology - Head and Neck Surgery, University of Washington School of Medicine, Seattle, Wash.

Our goal was to standardize intraoperative analgesic regimens for pediatric ambulatory tonsillectomy by eliminating local anesthetic use and to determine its impact on postoperative pain measures, while controlling for other factors.

Methods: We assembled a quality improvement team at an ambulatory surgery center. They introduced a standardized anesthetic protocol, involving American Society of Anesthesiologists Classification 1 and 2 patients undergoing adenotonsillectomy. Read More

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Availability of Emergency Department Wait Times Information: A Patient-Centered Needs Assessment.

Emerg Med Int 2021 22;2021:8883933. Epub 2021 Apr 22.

Department of Emergency Medicine, University of Ottawa, Ottawa, Ontario, Canada.

Introduction: Many Emergency Departments (ED) publish wait times; however, the patient perspective in what information is requested and the quantity of information to post is limited.

Methods: We conducted a mixed-methods study at a tertiary care academic center. First, we conducted focus groups of 7 patients. Read More

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Engagement With a Health Information Technology-Augmented Self-Management Support Program in a Population With Limited English Proficiency: Observational Study.

JMIR Mhealth Uhealth 2021 May 11;9(5):e24520. Epub 2021 May 11.

University of California, San Francisco, San Francisco, CA, United States.

Background: Limited English proficiency (LEP) is an important driver of health disparities. Many successful patient-level interventions to prevent chronic disease progression and complications have used automated telephone self-management support, which relies on patient activation and communication to achieve improved health outcomes. It is not clear whether these interventions are similarly applicable to patients with LEP compared to patients with English proficiency. Read More

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Revascularization decisions in patients with chronic coronary syndromes: Results of the second international survey on interventional strategy (ISIS-2).

Int J Cardiol 2021 May 7. Epub 2021 May 7.

Division of Cardiology, Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy; Cardiovascular Research Center Aalst, OLV-Clinic Aalst, Aalst, Belgium.

Background: In chronic coronary syndromes, guidelines mandate invasive functional guidance of revascularization whenever non-invasive proof of ischemia is missing. ISIS-2 survey aimed to evaluate how the adoption of guideline recommendation on ischemia-guided revascularization has evolved over the last 5-7 years.

Methods: In ISIS-2 participants assessed five complete angiograms, presenting only intermediate stenoses without information on non-invasive pre-testing. Read More

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Otorhinolaryngologists/head and neck surgeons' knowledge, attitudes, and practices regarding fertility preservation in young cancer patients treated with chemotherapy: an anonymous questionnaire survey.

Int J Clin Oncol 2021 May 6. Epub 2021 May 6.

Department of Otolaryngology-Head and Neck Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1, Shikada-cho, Kita-ku, Okayama City, Okayama, 700-8558, Japan.

Background: It is well known that chemotherapy for adolescent and young adult (AYA) patients with cancer can reduce fertility regardless of the regimen. A decline in fertility greatly affects the quality of life of cancer survivors in the AYA age group; however, few patients are thought to be receiving fertility preservation measures.

Methods: A questionnaire survey was conducted to assess the current understanding and consideration of fertility among otorhinolaryngologists/head and neck surgeons who treat AYA patients with cancer, and to inform them of the guidelines for fertility preservation. Read More

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Dermatologic Support for Oncology: Quantifying the consultative services received by hospitalized oncology patients.

J Am Acad Dermatol 2021 May 2. Epub 2021 May 2.

Department of Dermatology, Hospital of the University of Pennsylvania, Philadelphia, PA. Electronic address:

Dermatology was the fifth most utilized consultative service by Oncology when compared to the 101 other inpatient consultative services. Patients receiving dermatology consults had longer lengths of stay. Previous work has demonstrated the impact of dermatology consultations, showing that dermatology consults changed the final diagnosis in 71% of consult requests, and another tudy demonstrated that 23% of dermatology consultations came from the primary hematology or bone marrow transplant services. Read More

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From cataract to syndrome diagnosis: Revaluation of Warburg-Micro syndrome Type 1 patients.

Am J Med Genet A 2021 May 5. Epub 2021 May 5.

Department of Medical Genetics, Pamukkale University, Denizli, Turkey.

Warburg-Micro syndrome (WARBM) is a rare autosomal recessively inherited neuro-ophthalmologic syndrome. Although WARBM shows genetic heterogeneity, the pathogenic variants in RAB3GAP1 were the most common cause of WARBM. In this study, we aimed to evaluate the detailed clinical and dysmorphic features of seven WARBM1 patients and overview the variant spectrum of RAB3GAP1 in comparison with the literature who were referred due to congenital cataracts. Read More

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Mobile-phone-based e-diary derived patient reported outcomes: Association with clinical disease activity, psychological status and quality of life of patients with multiple sclerosis.

PLoS One 2021 5;16(5):e0250647. Epub 2021 May 5.

Multiple Sclerosis Center & Department of Neurology, Lady Davis Carmel Medical Center, Haifa, Israel.

Background: The applicability of mobile digital technology to promote clinical care of people with multiple sclerosis (pwMS) is gaining increased interest as part of the implementation of patient-centered approaches. We aimed at assessing adherence to a smartphone-based e-diary, which was designed to collect patient-reported outcomes (PROs). Secondary objectives were to evaluate the construct and predictive validity of e-diary derived PROs and to explore the various factors that were associated with changes in PROs over time. Read More

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Trauma Tertiary Survey: Trauma Service Medical Officers and Trauma Nurses Detect Similar Rates of Missed Injuries.

J Trauma Nurs 2021 May-Jun 01;28(3):166-172

Trauma Service (Mss Williamson and Grant and Mr Handy) and Jamieson Trauma Institute (Mss Williamson and Warren and Mr Handy), Royal Brisbane and Women's Hospital, Metro North Hospital and Health Service, Herston, Queensland, Australia; and Faculty of Medicine, The University of Queensland, Herston, Queensland, Australia (Ms Williamson).

Background: Trauma tertiary surveys (TTSs) can improve patient outcomes by identifying missed injuries following initial trauma reception and resuscitation. Most TTSs are conducted by medical officers despite the multidisciplinary team approach of modern trauma care.

Objective: The study aim was to assess the accuracy of detecting missed injuries when the TTS was performed by specialist trauma nursing staff, rather than trauma service medical officers (TSMOs). Read More

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Tarsal tunnel syndrome: Clinical-imaging analysis of a case series.

Rev Esp Cir Ortop Traumatol 2021 May 1. Epub 2021 May 1.

Equipo Tobillo y Pie, Clínica Santa María, Santiago, Chile.

Background: Retrospective review of patients with a diagnosis of Tarsal Tunnel Syndrome (TTS) treated surgically.

Methods: Retrospective series of patients with diagnosis of TTS operated between 2005 and 2020 in the same center. Variables such as age, sex, side, affected nerve or branch, classification, type of imaging study, biopsy result, infection rate, recurrence rate, sequelae, among others, were analyzed. Read More

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Outcome of selective CT vs. pan-CT scan in elderly trauma patients: A retrospective cohort study in a level 1 trauma center.

Chin J Traumatol 2021 Apr 25. Epub 2021 Apr 25.

Department of Trauma and Orthopaedics, Princess Alexandra Hospital NHS Foundation Trust, London, United Kingdom.

Purpose: There are currently no clear guidelines for use of pan- or selective CT in elderly trauma patients and this subject matter remains controversial. The aim of this study is to compare the outcome of elderly trauma patients in a level 1 trauma centre who required a pan- or selective CT scan on admission.

Methods: The Trauma Audit Research Network database was reviewed to identify eligible patients (65 years old and older) over a one-year period, from January 2018 to January 2019. Read More

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Is there a role for doravirine in African HIV treatment programmes? A large observational resistance study in South Africa.

J Int AIDS Soc 2021 May;24(5):e25706

Department of Molecular Medicine and Haematology, National Health Laboratory Services, Johannesburg, South Africa.

Introduction: Dolutegravir has replaced efavirenz in most low- and middle-income countries, due to better tolerability and formidable resistance profile, but dolutegravir side effects suggest alternatives are needed. We evaluated doravirine resistance in South Africa as a first step to assess whether doravirine may replace dolutegravir.

Methods: A retrospective dataset was analysed for predicted doravirine susceptibility, including sequences obtained from three patient groups. Read More

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Urinary incontinence as a marker of temporality in women: a qualitative study.

Climacteric 2021 May 4:1-7. Epub 2021 May 4.

Department of Obstetrics and Gynecology, Saint-Roch Polyclinic, Montpellier, France.

Background: Urinary incontinence (UI) is prevalent in postmenopausal women. To manage UI, it necessary to improve UI screening. We aimed to analyze and understand the experience of women with UI. Read More

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Exploring Quality of Life and Satisfaction with Treatment in Asthmatic Patients Receiving Dry Powder Inhalers: A Multinational Survey.

J Asthma 2021 May 3:1-15. Epub 2021 May 3.

Department of Internal Medicine (DiMI), Respiratory Unit for Continuity of Care, IRCCS, Ospedale Policlinico San Martino, University of Genova, Genova, Italy.

The quality of life (QoL) and device needs have not been characterized in asthmatic patients treated via dry powder inhalers (DPIs). The aim of this study was to assess the impact of asthma on health-related QoL, device satisfaction and preference in adult asthmatic patients using DPI devices, and to identify any DPI-associated unmet needs. An online survey was conducted between November and December 2019 on eligible patients from the Cint consumer panel across Europe. Read More

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Family medicine provision of online medication abortion in three US states during COVID-19.

Contraception 2021 Apr 30. Epub 2021 Apr 30.

Women on Web/Aid Access, Amsterdam, the Netherlands.

Objective: To examine provision of direct-to-patient medication abortion during COVID-19 by United States family physicians through a clinician-supported, asynchronous online service, Aid Access.

Study Design: We analyzed data from United States residents in New Jersey, New York, and Washington who requested medication abortion from 3 family physicians using the online service from Aid Access between April and November 2020. This study seeks to examine individual characteristics, motivations, and geographic locations of patients receiving abortion care through the Aid Access platform. Read More

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Telehealth for Upper Extremity Conditions: Perceptions of the Patient and Provider.

J Am Acad Orthop Surg Glob Res Rev 2020 09;4(9):e2000127-13

From the Division of Hand Surgery, Rothman Orthopaedic Institute (Dr. Katt, Dr. Fletcher, Dr. Aita, Dr. Nakashian, Dr. Kwok, Dr. Beredjiklian), Philadelphia, PA, and the Rutgers Robert Wood Johnson Medical School (Mr. Imbregamo), New Brunswick, NJ.

The recent coronavirus pandemic has prompted providers to adopt telehealth as a way to maintain contact with their patients on an unprecedented scale. The purpose of this study was to evaluate the perception of care for both patients and physicians using telehealth visits for the management of upper extremity orthopaedic conditions. This study consisted of the analysis of surveys sent to both physicians and patients immediately after the completion of a telehealth visit for an upper extremity condition. Read More

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September 2020

Value of skin tests for managing allergic hypersensitivity reactions to platinum compounds.

Int J Clin Pharm 2021 May 2. Epub 2021 May 2.

Servicio de Farmacia, IBSAL-Hospital Universitario de Salamanca, Paseo San Vicente 58, 37007, Salamanca, Spain.

Background Platinum-based therapy continues to be one of the pillars of the treatment of different types of cancer. However, many times the responsible clinician renounces its use after the appearance of a hypersensitivity reaction. Objective To assess the value of skin tests (ST) in clinical practice to address the treatment of patients with suspicion of immediate hypersensitivity reactions (HSRs) to platinum compounds. Read More

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First-Time Users of ADHD Medication Among Children and Adolescents in Germany: An Evaluation of Adherence to Prescribing Guidelines Based on Claims Data.

Front Psychiatry 2021 15;12:653093. Epub 2021 Apr 15.

Department of Child & Adolescent Psychiatry, University Hospital Ulm, Ulm, Germany.

Drug utilization studies based on real-world data are vital for the identification of potentially needed improvements to rational prescribing. This is particularly important for the pharmacological treatment of children and adolescents with attention-deficit hyperactivity disorder (ADHD) due to the associated potential side effects and the frequent use. Whereas prevalent use is well-characterized, studies on first-time use of ADHD medication are scarce. Read More

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Prediction of Relapse After Anti-Tumor Necrosis Factor Cessation in Crohn's Disease: Individual Participant Data Meta-Analysis of 1317 Patients From 14 Studies.

Clin Gastroenterol Hepatol 2021 Apr 29. Epub 2021 Apr 29.

Department of Gastroenterology and Hepatology. Electronic address:

Background & Aims: Tools for stratification of relapse risk of Crohn's disease (CD) after anti-tumor necrosis factor (TNF) therapy cessation are needed. We aimed to validate a previously developed prediction model from the diSconTinuation in CrOhn's disease patients in stable Remission on combined therapy with Immunosuppressants (STORI) trial, and to develop an updated model.

Methods: Cohort studies were selected that reported on anti-TNF cessation in 30 or more CD patients in remission. Read More

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Could Low Doses Acetylsalicylic Acid Prevent Thrombotic Complications in COVID-19 Patients?

Clin Appl Thromb Hemost 2021 Jan-Dec;27:10760296211014592

Department of Cardiology and Coronary Intensive Care Unit, "V. Monaldi" Hospital, Naples, Italy.

Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2) can induce inflammatory and thrombotic complications of pulmonary district (interstitial pneumonia), sometimes evolving toward acute respiratory failure. In adults, Acetylsalicylic Acid (ASA) is widely employed at low doses for primary and secondary prevention of cardiovascular diseases (CVD). Apart their anti-thrombotic effect, low ASA doses also exert an anti-inflammatory action. Read More

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Home mobile radiography service in the COVID-19 era.

Eur Rev Med Pharmacol Sci 2021 Apr;25(8):3338-3341

Radiology Division, "Istituto Nazionale Tumori - IRCCS - Fondazione G. Pascale", Naples, Italy.

Demographic changes in the Western world linked to the increase in the elderly population, life expectancy and above all cancer patients and chronically ill patients, often entrusted to home care or in healthcare residences, highlight an exponential increase in requests for diagnostic tests at home. Conventional radiographic examinations, such as thoracic, musculoskeletal and abdominal images are the most requested and are important first level diagnostic tests. To date and, in particular, in times of COVID-19 emergency, these patients need to be transferred to the hospital to perform radiological examinations which involve an increase in costs for the health system and an increased risk for the health of these patients, already often debilitated and immunocompromised. Read More

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Management Guidelines for Infection After ACL Reconstruction: Expert Opinion Statement Based on the Modified Delphi Survey of Indian Arthroscopy Surgeons.

Indian J Orthop 2021 Apr 1;55(2):342-351. Epub 2021 Feb 1.

Department of Orthopaedics, Maulana Azad Medical College, New Delhi, 110002 India.

Aim: Infection after anterior cruciate ligament (ACL) reconstruction, though rare, is a potentially devastating complication and the evidence-based recommendation on the various topics in its management is limited. The purpose of this study was to develop recommendations for the prevention and management of infections in ACL reconstruction surgery by performing a structured expert consensus survey using Delphi methodology.

Materials And Methods: 22 topics of relevance in the prevention and management of infection following ACL reconstruction were chosen from an extensive literature review. Read More

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Utility of icteric index in clinical laboratories: more than a preanalytical indicator.

Biochem Med (Zagreb) 2021 Jun 15;31(2):020703. Epub 2021 Apr 15.

UGC Laboratory, Puerto Real University Hospital, Cádiz, Spain.

Introduction: Total bilirubin tests are highly demanded in clinical laboratories. Since icteric index (I-index) has zero cost, we aimed to evaluate its clinical utility and cost-effectiveness to determine if total bilirubin is necessary to be tested. We took into account if haemolysis could interfere to icteric index determination. Read More

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Decision support system through automatic algorithms and electronic request in diagnosis of anaemia for primary care patients.

Biochem Med (Zagreb) 2021 Jun 15;31(2):020702. Epub 2021 Apr 15.

Laboratory of Biochemistry, Valencia University Clinic Hospital, Valencia, Spain.

Introduction: An appropriate management of anaemia laboratory tests is crucial for a correct diagnosis and treatment. A non-sequential "shotgun" approach (where every anaemia related test is ordered) causes workload and cost increases and could be potentially harmful. We have implemented a Decision Support System through our laboratory information system (LIMS) based on reflexive algorithms and automatic generation of interpretative reports specifically in diagnosis of anaemia for primary care patients. Read More

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Screening for distress, related problems and perceived need for psycho-oncological support in head and neck squamous cell carcinoma (HNSCC) patients: a retrospective cohort study.

BMC Cancer 2021 Apr 30;21(1):478. Epub 2021 Apr 30.

Department of Otolaryngology, Head and Neck Surgery, University Medical Center Leipzig, Leipzig, Germany.

Background: In different cancer entities, several studies have shown the adverse effects of cancer on mental health, psychological well-being and the increased risk of high emotional distress in cancer patients. This study aims to analyze psychosocial distress levels and their relationship between sociodemographic parameters and selected items on the Distress Thermometer (DT) Problem List in head and neck squamous cell carcinoma (HNSCC) patients.

Patients And Methods: We assessed a total of 120 HNSCC patients using the Distress Thermometer (DT) Problem List. Read More

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Long-Acting Reversible Contraception: Placement, Continuation, and Removal Rates at an Inner-City Academic Medical Center Clinic.

J Clin Med 2021 Apr 28;10(9). Epub 2021 Apr 28.

NIH-Women's Reproductive Health Research (WRHR) Scholar, Department of Obstetrics and Gynecology, Wayne State University, Detroit, MI 48202, USA.

Long-Acting Reversible Contraception (LARCs) has the potential to decrease unintended pregnancies but only if women can easily access a requested method. Retrospective electronic chart review identified women desiring LARC placement over a one-year period ending 31 December 2016. Most of the 311 insertions were for family planning, with 220 new insertions and 60 replacements. Read More

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Diagnostic and Interventional Radiology Management of Ureteral Iatrogenic Leakage after Gynecologic Surgery.

Diagnostics (Basel) 2021 Apr 22;11(5). Epub 2021 Apr 22.

Diagnostic and Interventional Radiology Department, Ospedale Di Circolo, ASST dei Sette Laghi, 21100 Varese, Italy.

Objective: To report safety and efficacy of interventional radiology procedures in the treatment of gynecologic iatrogenic urinary leaks.

Methods: A retrospective analysis of iatrogenic ureteral lesions treated between November 2009 to April 2019 was performed. Under ultrasound (US) and fluoroscopy guidance, an attempt to place a ureteral stent and nephrostomy was carried out in the same session using an anterograde percutaneous approach. Read More

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The Screen Project: Guided Direct-To-Consumer Genetic Testing for Breast Cancer Susceptibility in Canada.

Cancers (Basel) 2021 Apr 15;13(8). Epub 2021 Apr 15.

Women's College Research Institute, Women's College Hospital, Toronto, ON M5S 1B2, Canada.

There is limited information of the outcomes of direct-to-consumer testing for BRCA1 and BRCA2 mutations. The Screen Project was initiated in 2017 to offer BRCA1 and BRCA2 genetic screening to all Canadians over the age of 18 who wish to know their mutation status. Patients enrolled in the study from 2017 to 2019 and were followed for one year after the receipt of a genetic test result. Read More

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Screening for TB in Hospitalised Patients with Inflammatory Bowel Disease before Anti-TNF Therapy: Is QuantiFERON Gold Testing Useful?

J Clin Med 2021 Apr 21;10(9). Epub 2021 Apr 21.

Gastroenterology, Leeds Teaching Hospitals NHS Trust, Leeds LS1 3EX, UK.

Background-Tumour necrosis factor alpha (TNFα) plays an important role in the pathogenesis of inflammatory bowel disease (IBD) and in immunity to Patients should be tested for latent tuberculosis infection using interferon-gamma release assays (IGRA/QF) prior to anti-TNFα therapy. Indeterminate QF results can delay anti-TNFα therapy. We sought to investigate factors associated with indeterminate QF results. Read More

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