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Inflammatory Stratification in Primary Sjögren's Syndrome Reveals Novel Immune Cell Alterations in Patients' Minor Salivary Glands.

Front Immunol 2021 12;12:701581. Epub 2021 Jul 12.

Gade Laboratory for Pathology, Department of Clinical Medicine, University of Bergen, Bergen, Norway.

There is a critical need to deconvolute the heterogeneity displayed by the minor salivary glands of primary Sjögren's syndrome (pSS) patients. This is challenging primarily because the disease etiology remains unknown. The hypothesis includes that initial events in the disease pathogenesis target the salivary glands, thereby triggering the development of focal infiltrates (≥50 mononuclear cells) and finally germinal center-like structures. Read More

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Assessment of Caregiving Burden of Family Caregivers of Advanced Cancer Patients and Their Satisfaction with the Dedicated Inpatient Palliative Care Provided to Their Patients: A Cross-Sectional Study from a Tertiary Care Centre in South Asia.

Asian Pac J Cancer Prev 2021 Jul 1;22(7):2109-2115. Epub 2021 Jul 1.

Department of Pharmacology, All India institute of medical sciences, Jodhpur, Rajasthan, India.

Background And Objectives: Family Caregivers (FCs) of advanced cancer patients often suffer from caregiving burden due to stress arising from the responsibility of caregiving. During the course of their patients palliative therapy, FCs quality of life seems to be influenced by their satisfaction with the quality of patient care. In this study, caregiving burden of FCs and their satisfaction with dedicate Inpatient palliative care (IPC) services provided to their patients  were studied. Read More

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Type V Collagen Regulates the Structure and Biomechanics of TMJ Condylar Cartilage: A Fibrous-Hyaline Hybrid.

Matrix Biol 2021 Jul 24. Epub 2021 Jul 24.

School of Biomedical Engineering, Science and Health Systems, Drexel University, Philadelphia, PA 19104, United States. Electronic address:

This study queried the role of type V collagen in the post-natal growth of temporomandibular joint (TMJ) condylar cartilage, a hybrid tissue with a fibrocartilage layer covering a secondary hyaline cartilage layer. Integrating outcomes from histology, immunofluorescence imaging, electron microscopy and atomic force microscopy-based nanomechanical tests, we elucidated the impact of type V collagen reduction on TMJ condylar cartilage growth in the type V collagen haploinsufficiency and inducible knockout mice. Reduction of type V collagen led to significantly thickened collagen fibrils, decreased tissue modulus, reduced cell density and aberrant cell clustering in both the fibrous and hyaline layers. Read More

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Population pharmacokinetics of diethylcarbamazine in patients with lymphatic filariasis and healthy individuals.

Antimicrob Agents Chemother 2021 Jul 26:AAC0031721. Epub 2021 Jul 26.

Clinical Pharmacology Laboratory, Dept of Pharmacy Practice and Science, University of Nebraska Medical Center, Omaha, NE 68198, United States.

Diethylcarbamazine (DEC) is a drug of choice to treat lymphatic filariasis (LF) either used alone or in combination as mass drug administration (MDA) preventive strategies. The objective of this study was to develop a population pharmacokinetic model for DEC in subjects infected with lymphatic filariasis (LF) compared to healthy individuals, and to evaluate the effect of covariates on the volume of distribution (V/F) and oral clearance (CL/F) of DEC. This was an open-label cohort study of treatment naïve -infected (n=32) and uninfected (n=24) adults residing in the Agboville district of Côte d'Ivoire. Read More

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Genetic architecture of type 1 diabetes with low genetic risk score informed by 41 unreported loci.

Commun Biol 2021 Jul 23;4(1):908. Epub 2021 Jul 23.

The Center for Applied Genomics, Children's Hospital of Philadelphia, Philadelphia, PA, USA.

Type 1 diabetes (T1D) patients with low genetic risk scores (GRS) may be non-autoimmune or autoimmune mediated by other genetic loci. The T1D-GRS2 provides us an opportunity to look into the genetic architecture of these patients. A total of 18,949 European individuals were included in this study, including 6599 T1D cases and 12,323 controls. Read More

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Socioeconomic status and ethnic variation associated with type 2 diabetes mellitus in patients with uncontrolled hypertension in Singapore.

BMJ Open Diabetes Res Care 2021 Jul;9(1)

Program in Health Services and Systems Research, Duke-NUS Medical School, Singapore

Introduction: The burden of type 2 diabetes mellitus (T2DM) and related vascular complications is particularly high in Asians and ethnic minorities living in the West. However, the association of T2DM with socioeconomic status (SES) and ethnicity has not been widely studied in populations living in Asia. Therefore, we investigated these associations among the multiethnic population with uncontrolled hypertension in Singapore. Read More

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The Genomic Landscape of a Restricted ALL Cohort from Patients Residing on the U.S./Mexico Border.

Int J Environ Res Public Health 2021 Jul 9;18(14). Epub 2021 Jul 9.

Department of Biological Sciences, College of Science, The University of Texas at El Paso, El Paso, TX 79968, USA.

Next-generation sequencing (NGS) has identified unique biomarkers yielding new strategies in precision medicine for the treatment of Acute lymphoblastic leukemia (ALL). Hispanics show marked health disparities in ALL, often absent in clinical trials or cancer research. Thus, it is unknown whether Hispanics would benefit equally from curated data currently guiding precision oncology. Read More

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Elevated levels of perfluoroalkyl substances in breast cancer patients within the Greater Manila Area.

Chemosphere 2021 Jul 12;286(Pt 1):131545. Epub 2021 Jul 12.

Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco, San Francisco, CA, USA.

Several studies have reported exposure of humans to various endocrine disrupting chemicals (EDCs) worldwide. However, there is a lack of data regarding EDC exposures in humans living in Southeast Asian countries, such as the Philippines. Hence, this study measured levels of 41 EDCs in women residing in the Greater Manila Area, home to the second largest city in Southeast Asia. Read More

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The role of Acanthamoeba spp. in biofilm communities: a systematic review.

Parasitol Res 2021 Jul 22. Epub 2021 Jul 22.

Department of Ophthalmology and Visual Sciences, Paulista School of Medicine, São Paulo Hospital, Federal University of São Paulo, UNIFESP, Rua Pedro de Toledo, 669 - Vila Clementino, São Paulo, SP, 04039-032, Brazil.

Acanthamoeba spp. have always caused disease in immunosuppressed patients, but since 1986, they have become a worldwide public health issue by causing infection in healthy contact lens wearers. Amoebae of the Acanthamoeba genus are broadly distributed in nature, living either freely or as parasites, and are frequently associated with biofilms throughout the environment. Read More

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Psychosocial and mental health disorders among a population-based, case-control cohort of patients with congenital upper eyelid ptosis.

Br J Ophthalmol 2021 Jul 19. Epub 2021 Jul 19.

Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota, USA

Background/aim: Recent studies have demonstrated adverse psychosocial and mental health disorders among children with ocular disorders. The mental health burden of children with simple congenital ptosis, however, is unknown. The purpose of this study was to compare the psychosocial and mental health findings of children with simple congenital ptosis with controls. Read More

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COVID-19 Precautionary Measures and Type 1 Diabetes Patients in Saudi Arabia.

Prim Care Diabetes 2021 Jul 15. Epub 2021 Jul 15.

Division of Endocrinology, College of Medicine, King Saud University, Riyadh, Saudi Arabia. Electronic address:

Aim: To minimize the spread of COVID-19, the Kingdom of Saudi Arabia (KSA) enforced a nationwide lockdown. We aimed to explore whether the manner in which Saudi patients with type 1 diabetes (T1D) manage their disease has changed during this unparalleled lockdown.

Methods: An online survey exploring the effect of lockdown on T1D outcomes was distributed among T1D patients residing in KSA during lockdown. Read More

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Serum 25-hydroxyvitamin D values and risk of incident cardiovascular disease: A population-based retrospective cohort study.

J Steroid Biochem Mol Biol 2021 Jul 15;213:105953. Epub 2021 Jul 15.

Department of Family Medicine, Mayo Clinic, Rochester, MN, USA.

Background: Concentrations of serum 25-hydroxyvitamin D [25(OH)D] below 20 ng/mL and above 50 ng/mL have been associated with chronic adverse events including cardiovascular disease.

Objective: To conduct a comprehensive population-based study in the United States of the relationship of low and high serum 25(OH)D levels with cardiovascular disease.

Methods: We identified all serum 25(OH)D measurements in adults age 18 years and older residing in Olmsted County, MN between January 1, 2005 and December 31, 2011, using the resources of the Rochester Epidemiology Project. Read More

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Multi-country cross-sectional study of colonization with multidrug-resistant organisms: protocol and methods for the Antibiotic Resistance in Communities and Hospitals (ARCH) studies.

BMC Public Health 2021 Jul 16;21(1):1412. Epub 2021 Jul 16.

Division of Healthcare Quality Promotion, U.S. Centers for Disease Control and Prevention, Office of the Director, 1600 Clifton Rd NE, MS H16-2, Atlanta, GA, 30029, USA.

Background: Antimicrobial resistance is a global health emergency. Persons colonized with multidrug-resistant organisms (MDROs) are at risk for developing subsequent multidrug-resistant infections, as colonization represents an important precursor to invasive infection. Despite reports documenting the worldwide dissemination of MDROs, fundamental questions remain regarding the burden of resistance, metrics to measure prevalence, and determinants of spread. Read More

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Peritoneal Dialysis Catheter Insertion by Nephrologist Using Minilaparotomy: Do Survival and Complications Vary in Obese?

Indian J Nephrol 2021 Mar-Apr;31(2):124-129. Epub 2021 Apr 2.

Department of Nephrology, Military Hospital, Jalandhar, Punjab, India.

Introduction: Peritoneal dialysis catheter (PDC) placement for chronic kidney disease (CKD) amongst overweight and obese patients is difficult owing to deeper operating field. Literature being discordant on survival and complications in this patient subset, we attempted to analyse this research question in Indian population.

Materials And Methods: We retrospectively analysed PDC inserted by nephrologist using surgical minilaparotomy for survivals and complications amongst 'overweight and obese' cohort ('O') at two tertiary care government hospitals in India, and compared results with normo-weight cohort ('N'), with 12-36 months follow-up. Read More

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Patient and Visit Characteristics of Families Accessing Pediatric Urgent Care Telemedicine During the COVID-19 Pandemic.

Telemed J E Health 2021 Jul 15. Epub 2021 Jul 15.

Center for Health Delivery Innovation, Nemours Children's Health, Jacksonville, Florida, USA.

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Is severe COVID-19 a cytokine storm syndrome: a hyperinflammatory debate.

Curr Opin Rheumatol 2021 Jul 15. Epub 2021 Jul 15.

Centre for Inflammation and Tissue Repair, UCL Respiratory, Division of Medicine, University College London Department of Rheumatology, University College London Hospital (UCLH), London, UK Department of Medicine, Division of Translational Medicine and Human Genetics, Center for Cytokine Storm Treatment and Laboratory, Philadelphia, Pennsylvania, USA.

Purpose Of Review: The COVID-19 pandemic is a global public health crisis with considerable mortality and morbidity. A role for cytokine storm and therapeutic immunomodulation in a subgroup of patients with severe COVID-19 was proposed early in the pandemic. The concept of cytokine storm in COVID-19 has been criticised, given the lack of clear definition and relatively modest cytokinaemia (which may be necessary for viral clearance) compared with acute respiratory distress syndrome and bacterial sepsis. Read More

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The changing characteristics of patients with chronic hepatitis C prescribed direct acting antiviral medicines in general practice since listing of the medicines on the Australian Pharmaceutical Benefits Scheme.

JGH Open 2021 Jul 18;5(7):813-819. Epub 2021 Jun 18.

NPS MedicineWise Sydney New South Wales Australia.

Background And Aim: The primary objective of this study was to determine whether the characteristics of patients prescribed direct acting antiviral (DAA) medicines have changed since initial listing of the medicines on the Australian Pharmaceutical Benefits Scheme (PBS).

Methods: A cross-sectional study was conducted using data from MedicineInsight, an Australian database of general practice electronic health records, from March 2016 to August 2018. We compared sociodemographic, comorbidity, and clinical characteristics of patients aged at least 18 years who were prescribed at least one DAA in the first 4 months of PBS listing in 2016 with those prescribed at least one DAA in 2018. Read More

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Epidemiologic Associations Vary Between Tetracycline and Fluoroquinolone Resistant Infections.

Front Public Health 2021 28;9:672473. Epub 2021 Jun 28.

Department of Microbiology and Molecular Genetics, Michigan State University, East Lansing, MI, United States.

is the leading cause of bacterial gastroenteritis and antibiotic resistant are a serious threat to public health. Herein, we sought to evaluate trends in infections, quantify resistance frequencies, and identify epidemiological factors associated with infection. isolates ( = 214) were collected from patients via an active surveillance system at four metropolitan hospitals in Michigan between 2011 and 2014. Read More

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A propensity-matched comparison of long-term disability worsening in patients with multiple sclerosis treated with dimethyl fumarate or fingolimod.

Ther Adv Neurol Disord 2021 30;14:17562864211021177. Epub 2021 Jun 30.

Center for Multiple Sclerosis Treatment and Research, Cleveland Clinic, Cleveland, OH, USA.

Background: Although the aggregate of data among patients with multiple sclerosis (MS) have shown similar efficacy between dimethyl fumarate (DMF) and fingolimod (FTY), most studies have not assessed long-term worsening of disability. We compared long-term disability worsening over 5 years, as assessed by the Patient-Determined Disease Steps (PDDS), among participants with MS treated with DMF or FTY.

Methods: We identified individuals in the North American Research Committee on Multiple Sclerosis (NARCOMS) registry who had relapsing-remitting MS (RRMS), residing in the United States (Spring 2011 to Spring 2018), who initiated treatment with DMF ( = 689) or FTY ( = 565) and had ⩾1 year follow-up on index treatment. Read More

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Rarity of Mutations Outside the Rifampicin Resistance-Determining Region of Isolates from Patients Responding Poorly to First-Line Tuberculosis Regimens in Beijing, China: A Retrospective Study.

Infect Drug Resist 2021 6;14:2607-2612. Epub 2021 Jul 6.

Department of Bacteriology and Immunology, Beijing Key Laboratory on Drug-Resistant Tuberculosis Research, Beijing Chest Hospital, Capital Medical University/Beijing Tuberculosis & Thoracic Tumor Research Institute, Beijing, 101149, People's Republic of China.

Background: Early and accurate diagnosis of rifampicin (RIF)-resistant (MTB) is essential for controlling community spread of drug-resistant tuberculosis (TB). In order to discover mutations residing outside the rifampicin resistance-determining region (RRDR) of the MTB gene, we conducted this retrospective study.

Methods: We retrospectively screened patient records to obtain Xpert MTB/RIF assay results for patients who received care at the Beijing Chest Hospital from 2016 to 2019 in order to identify subjects who met study selection criteria. Read More

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The Impact of NK Cell-Based Therapeutics for the Treatment of Lung Cancer for Biologics: Targets and Therapy.

Biologics 2021 7;15:265-277. Epub 2021 Jul 7.

Department of Vascular Surgery, Medical University of Vienna, Vienna, Austria.

Lung cancer has a dismal prognosis and novel targeted therapies leave still room for major improvements and better outcomes. Immunotherapy targeting immune checkpoint (IC) proteins, either as single agents or in combination with chemotherapy, is active but responders constitute only approximately 10-15% of non-small cell lung cancer (NSCLC) patients. Other effector immune cells such as CAR-T cells or NK cells may help to overcome the limitations of the IC inhibitor therapies for lung cancer. Read More

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Understanding disparities in primary care patient experience.

Can Fam Physician 2021 Jul;67(7):e178-e187

Vice-Chair of Quality and Innovation in the DFCM at the University of Toronto, Associate Professor in the Faculty of Medicine and the Institute of Health Policy, Management and Evaluation at the University of Toronto, Scientist in the MAP Centre for Urban Health Solutions at St Michael's Hospital, a staff physician in the DFCM at St Michael's Hospital, and, at the time of writing, was Embedded Clinician Researcher at Health Quality Ontario (now Ontario Health).

Objective: To understand disparities in primary care patient experience.

Design: A serial cross-sectional study was conducted to understand disparities in patient experience at 2 time points (2014 and 2016). Disparities related to age, gender, neighbourhood income, and self-rated health were explored using 3 analytic approaches: stratification, logistic regression, and relative comparison across multiple demographic variables. Read More

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Experiences of barriers to self-monitoring and medication-management among Indian patients with type 2 diabetes, their primary family-members and physicians.

Chronic Illn 2021 Jul 14:17423953211032251. Epub 2021 Jul 14.

Manchester Centre for Health Psychology, Division of Psychology & Mental Health, University of Manchester, Manchester, UK.

Objectives: This study explored the subjective accounts of the main barriers to self-monitoring of blood-glucose (SMBG) and medication-management among Indian patients with type 2 diabetes (T2DM), their primary family-members (PFMs) and physicians.

Methods: Using convenience sampling, patients with T2DM, their PFMs, and physicians, residing in a South Indian capital city, were recruited for semi-structured, audio-recorded interviews. Thematic analysis was used to analyze the data. Read More

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Evaluation of the Use of Colors and Drawings for Pain Communication for Hmong Patients.

Pain Manag Nurs 2021 Jul 10. Epub 2021 Jul 10.

University of Wisconsin-Madison, School of Medicine and Public Health, Madison, Wisconsin.

Aims: The aim of the present study was to explore: (1) the feasibility of using color and pain drawing to describe pain; (2) the cultural appropriateness of pain body diagram (PBD); and (3) the cultural meaning of colors used in pain expression within one cultural group-the Hmong residing in the United States.

Design: A qualitative-descriptive study.

Methods: Data were collected sequentially in two phases with different Hmong participants from a Midwestern city using (1) focus groups to determine colors used for pain intensity and qualities along with preferences for drawing versus using the PBD; and (2) individual interviews to determine pain-related meanings of colors and cultural appropriateness of PBDs. Read More

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Residual malaria in Jazan region, southwestern Saudi Arabia: the situation, challenges and climatic drivers of autochthonous malaria.

Malar J 2021 Jul 13;20(1):315. Epub 2021 Jul 13.

Saudi Centre for Disease Prevention and Control, Ministry of Health, Jazan, Kingdom of Saudi Arabia.

Background: Saudi Arabia and Yemen are the only two countries in the Arabian Peninsula that are yet to achieve malaria elimination. Over the past two decades, the malaria control programme in Saudi Arabia has successfully reduced the annual number of malaria cases, with the lowest incidence rate across the country reported in 2014. This study aims to investigate the distribution of residual malaria in Jazan region and to identify potential climatic drivers of autochthonous malaria cases in the region. Read More

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Defective complex III mitochondrial respiratory chain due to a novel variant in CYC1 gene masquerades acute demyelinating syndrome or Leber hereditary optic neuropathy.

Mitochondrion 2021 Jul 9;60:12-20. Epub 2021 Jul 9.

Myelin Disorders Clinic, Pediatric Neurology Division, Children's Medical Center, Pediatrics Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran. Electronic address:

Complex III (CIII) is the third out of five mitochondrial respiratory chain complexes residing at the mitochondrial inner membrane. The assembly of 10 subunits encoded by nuclear DNA and one by mitochondrial DNA result in the functional CIII which transfers electrons from ubiquinol to cytochrome c. Deficiencies of CIII are among the least investigated mitochondrial disorders and thus clinical spectrum of patients with mutations in CIII is not well defined. Read More

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Associations between recently diagnosed conditions and hospitalization due to COVID-19 in patients aged 50 years and older- A SHARE-based analysis.

J Gerontol A Biol Sci Med Sci 2021 Jul 12. Epub 2021 Jul 12.

National Research Centre for the Working Environment, Copenhagen, Denmark.

Background: Only a few studies have been carried out with a large sample size on the relationship between chronic conditions and hospitalization for COVID-19, and there is no research examining recently diagnosed conditions. Our purpose was to evaluate this association in a large sample including the older population from Europe and Israel.

Methods: Data from the SHARE COVID-19 Survey, a representative survey of individuals aged 50 or over residing in 27 European countries and Israel, were retrieved. Read More

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Efficacy of Pelvic Peritoneum Closure After Laparoscopic Extralevator Abdominoperineal Excision for Rectal Cancer.

J Gastrointest Surg 2021 Jul 9. Epub 2021 Jul 9.

Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Guo Xue Xiang 37#, Chengdu, Sichuan Province, China.

Background: The descent of the small bowel into the pelvic dead space after extralevator abdominoperineal excision (ELAPE) presents a higher risk for postoperative complications. The aim of the present study was to evaluate the efficacy of pelvic peritoneum closure in preventing the small bowel from descending into the pelvic dead space and the potential consequences of this approach.

Methods: Patients with rectal cancer undergoing laparoscopic ELAPE from March 2014 to January 2019 were retrospectively investigated. Read More

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