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Comparison of Different Nutritional and Lifestyle Factors between Glaucoma Patients and an Age-Matched Normal Population.

Klin Monbl Augenheilkd 2021 Apr 14. Epub 2021 Apr 14.

Department of Ophthalmology, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany.

Purpose: To compare nutritional and lifestyle factors between glaucoma patients and an age-matched control group.

Methods: One hundred and ninety (190) glaucoma patients were enrolled in this study. The control group comprised 97 age-matched participants. Read More

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Large-Diameter Penetrating Keratoplasties are Mostly Due to Very Severe Infectious Keratitis and Cannot Always Prevent Secondary Enucleation.

Klin Monbl Augenheilkd 2021 Apr 14. Epub 2021 Apr 14.

Augenheilkunde, Universitätsklinikum des Saarlandes und Medizinische Fakultät der Universität des Saarlandes, Homburg (Saar), Germany.

Purpose: To report the indications and outcomes of penetrating keratoplasties with a graft diameter > 8.5 mm in severe corneal diseases at the Department of Ophthalmology at Saarland University Medical Centre.

Study Design: Retrospective (6 years), descriptive, and observational. Read More

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Bioabsorbable Implant for Treatment of Nasal Valve Collapse with or without Concomitant Procedures.

Facial Plast Surg 2021 Apr 14. Epub 2021 Apr 14.

Madison ENT and Facial Plastic Surgery, New York, New York.

The aim of the study is to report outcomes after treatment of nasal valve collapse with a bioabsorbable nasal implant. It involves two prospective, multicenter, post-market studies evaluating long-term effectiveness of the LATERA implant for severe to extreme nasal obstruction. Participants underwent implant alone or with concomitant inferior turbinate reduction (ITR) and/or septoplasty. Read More

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Teprotumumab: The Dawn of Therapies in Moderate-to-Severe Thyroid-Associated Ophthalmopathy.

Horm Metab Res 2021 Apr 14;53(4):211-218. Epub 2021 Apr 14.

Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, Tianjin, China.

Thyroid-associated ophthalmopathy (TAO) is a potentially sight-threatening ocular disease. About 3-5% of patients with TAO have severe disease with intense pain, inflammation, and sight-threatening corneal ulceration or compressive optic neuropathy. The current treatments of TAO are often suboptimal, mainly because the existing therapies do not target the pathogenesis of the disease. Read More

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Supplementary Bovine Colostrum Feedings to Formula-Fed Preterm Pigs Improve Gut Function and Reduce Necrotizing Enterocolitis.

J Pediatr Gastroenterol Nutr 2021 Apr 12. Epub 2021 Apr 12.

Comparative Pediatrics and Nutrition, Department of Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Neonatology, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, Guangdong, China; Department of Neonatology, Rigshospitalet, Copenhagen, Denmark; Hans Christian Andersen Children's Hospital, Odense, Denmark.

Objectives: Exclusive feeding with bovine colostrum (BC) protects preterm pigs against necrotizing enterocolitis (NEC) and BC has recently been tested as a supplement to mother's own milk or formula (FOR) for very preterm infants. Using preterm pigs as model for infants, we investigated if BC has gut- and NEC-protective effects at different proportions of the daily enteral intake given as BC.

Methods: Sixty-eight caesarean-delivered preterm piglets (90% gestation) were allocated into four groups with increasing proportions of eight daily bolus feedings as BC: BC00 (only FOR feeding), BC25 (25% BC), BC50 (50% BC), or BC75 (75% BC). Read More

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COVID-19: Clinical Presentation and Prognostic Factors of Severe Disease and Mortality in the Oldest-Old Population: A Cohort Study.

Gerontology 2021 Apr 14:1-14. Epub 2021 Apr 14.

Research Area, Consorci Sanitari de l'Alt Penedès i Garraf (CSAPG), Sant Pere de Ribes, Barcelona, Spain.

Introduction: The oldest-old population (80 years or older) has the highest lethality from COVID-19. There is little information on the clinical presentation and specific prognostic factors for this group. This trial evaluated the clinical presentation and prognostic factors of severe disease and mortality in the oldest-old population. Read More

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Hyposmia Is Associated with Reduced Cognitive Function in COVID-19: First Preliminary Results.

Dement Geriatr Cogn Disord 2021 Apr 14:1-6. Epub 2021 Apr 14.

Department of Neurology, Clinic Hietzing, Vienna, Austria.

Background: Hyposmia is frequently reported as an initial symptom in coronavirus disease 2019 (COVID-19).

Objective: As hyposmia accompanies cognitive impairment in several neurological disorders, we aimed to study whether hyposmia represents a clinical biomarker for both neurological involvement and cognitive impairment in mild CO-VID-19. We aimed to study whether olfactory dysfunction (OD) represents a clinical biomarker for both neurological involvement and cognitive impairment in mild COVID-19. Read More

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A Survey of Hospitalized Trauma Patients in Hemorrhage Control Education: Are Trauma Victims Willing to Stop the Bleed?

J Surg Res 2021 Apr 11;264:469-473. Epub 2021 Apr 11.

Division of Acute Care Surgery, Department of Surgery, Baltimore, Maryland, USA; Department of Anesthesiology and Critical Care Medicine, Baltimore, Maryland, USA; Department of Emergency Medicine, Baltimore, Maryland, USA; The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; The Armstrong Institute for Patient Safety and Quality, Johns Hopkins Medicine, Baltimore, Maryland, USA; Department of Health Policy and Management, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA. Electronic address:

Background: The Stop the Bleed (STB) campaign was developed in part to educate the lay public about hemorrhage control techniques aimed at reducing preventable trauma deaths. Studies have shown this training increases bystanders' confidence and willingness to provide aid. One high-risk group might be better solicited to take the course: individuals who have been a victim of previous trauma, as high rates of recidivism after trauma are well-established. Read More

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[Basic aspects of COVID-19 for management from primary care].

Aten Primaria 2020 Dec 26;53(6):101966. Epub 2020 Dec 26.

CS Ramón y Cajal, DA OESTE (SERMAS), Grupo de trabajo de enfermedades infecciosas de SoMaMFyC, Alcorcón, España.

SARS-CoV-2 is transmitted from person to person by inhalation or contact with respiratory droplets and aerosols. The median incubation period is 5.1 days. Read More

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December 2020

Fungal and bacterial coinfections increase mortality of severely ill COVID-19 patients.

J Hosp Infect 2021 Apr 11. Epub 2021 Apr 11.

Department of Microbiology, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil. Electronic address:

Background: SARS-CoV-2 predisposes patients to secondary infections; however, a better understanding of the impact of coinfections on the outcome of hospitalized COVID-19 patients is still necessary.

Aim: To analyse death risk due to coinfections in COVID-19 patients.

Methods: We evaluated the Odds of death of 212 severely ill COVID-19 patients, with detailed focus on the risks for each pathogen, site of infection, comorbidities and length of hospitalization. Read More

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C5aR inhibition of non-immune cells suppresses inflammation and maintains epithelial integrity in SARS-CoV-2-infected primary human airway epithelia.

J Allergy Clin Immunol 2021 Apr 11. Epub 2021 Apr 11.

Institute of Hygiene and Medical Microbiology, Medical University of Innsbruck, Austria. Electronic address:

Background: Excessive inflammation triggered by a hitherto undescribed mechanism is a hallmark of severe SARS-CoV-2 infections and is associated with enhanced pathogenicity and mortality.

Objective: Complement hyper activation promotes lung injury and was observed in patients suffering from MERS-CoV, SARS-CoV-1 and SARS-CoV-2 infections. Therefore, we investigated the very first interactions of primary human airway epithelial cells upon exposure to SARS-CoV-2 in terms of complement C3-mediated effects. Read More

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A randomized trial of Mycobacterium w in severe presumed Gram-negative sepsis (MIST).

Chest 2021 Apr 11. Epub 2021 Apr 11.

Professor, Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India. Electronic address:

Background: Mycobacterium w (Mw), an immunomodulator, has been shown to resolve early organ failure in severe sepsis.

Research Question: Does Mw improve survival in subjects with severe presumed Gram-negative sepsis?

Study Design: and methods: This was a randomized, double-blind, placebo-controlled, parallel-group study conducted in intensive care units (ICUs) of five tertiary care centers in India. We included consecutive subjects (aged ≥18 years) with presumed Gram-negative sepsis in the study within 48 hours of the first organ dysfunction. Read More

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Laparoscopic versus EUS-guided gastroenterostomy for gastric outlet obstruction: an international multicenter propensity score-matched comparison (with video).

Gastrointest Endosc 2021 Apr 11. Epub 2021 Apr 11.

Department of Gastroenterology and Hepatology, University Hospitals Gasthuisberg, University of Leuven, Leuven, Belgium.

Background And Aims: In the management of gastric outlet obstruction (GOO), EUS-guided gastroenterostomy (EUS-GE) seems safe and more effective than enteral stent placement. However, comparisons with laparoscopic gastroenterostomy (L-GE) are scarce. Our aim was to perform a propensity score-matched comparison between EUS-GE and L-GE. Read More

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Human Pluripotent Stem Cell-Derived Intestinal Organoids Model SARS-CoV-2 Infection Revealing a Common Epithelial Inflammatory Response.

Stem Cell Reports 2021 Apr;16(4):940-953

Center for Regenerative Medicine of Boston University and Boston Medical Center, Boston, MA 02118, USA; Department of Microbiology, Boston University School of Medicine, Boston, MA 02118, USA; Section of Gastroenterology, Department of Medicine, Boston University School of Medicine, Boston, MA 02218, USA. Electronic address:

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection leading to coronavirus disease 2019 (COVID-19) usually results in respiratory disease, but extrapulmonary manifestations are of major clinical interest. Intestinal symptoms of COVID-19 are present in a significant number of patients, and include nausea, diarrhea, and viral RNA shedding in feces. Human induced pluripotent stem cell-derived intestinal organoids (HIOs) represent an inexhaustible cellular resource that could serve as a valuable tool to study SARS-CoV-2 as well as other enteric viruses that infect the intestinal epithelium. Read More

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High-dimensional profiling clusters asthma severity by lymphoid and non-lymphoid status.

Cell Rep 2021 Apr;35(2):108974

Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA; Department of Immunology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA. Electronic address:

Clinical definitions of asthma fail to capture the heterogeneity of immune dysfunction in severe, treatment-refractory disease. Applying mass cytometry and machine learning to bronchoalveolar lavage (BAL) cells, we find that corticosteroid-resistant asthma patients cluster largely into two groups: one enriched in interleukin (IL)-4 innate immune cells and another dominated by interferon (IFN)-γ T cells, including tissue-resident memory cells. In contrast, BAL cells of a healthier population are enriched in IL-10 macrophages. Read More

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Lifestle and rehabilitation during the COVID-19 pandemic: guidance for health professionals and support for exercise and rehabilitation programs.

Expert Rev Anti Infect Ther 2021 Apr 14. Epub 2021 Apr 14.

Cardiopulmonary Physiotherapy Laboratory, Physiotherapy Department, Universidade Federal de Sao Carlos, UFSCar, Rod Washington Luis, KM 235, Monjolinho, CEP: 13565-905, Sao Carlos, SP, Brazil.

Introduction: The coronavirus disease 2019 (COVID-19) is a highly contagious respiratory viral disease for both the general population and health care professionals caring for infected patients. Of particular concern is the potential for significant respiratory, cardiovascular, physical, and psychological dysfunctions.

Areas Covered: In this context, the current review will focus on the following areas: 1) staying physically active during the COVID-19 pandemic; 2) highlighting the importance of understanding COVID-19 mechanisms; 3) preventing infections for healthcare workers by using personal protective equipment; 4) highlighting importance of respiratory care and physical therapy during hospitalization in patients with COVID-19; and 5) facilitating referral to a rehabilitation program in patients recovering from COVID-19. Read More

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Trial of Psilocybin versus Escitalopram for Depression.

N Engl J Med 2021 Apr;384(15):1402-1411

From the Centre for Psychedelic Research, Department of Brain Sciences, Faculty of Medicine, Imperial College London, London.

Background: Psilocybin may have antidepressant properties, but direct comparisons between psilocybin and established treatments for depression are lacking.

Methods: In a phase 2, double-blind, randomized, controlled trial involving patients with long-standing, moderate-to-severe major depressive disorder, we compared psilocybin with escitalopram, a selective serotonin-reuptake inhibitor, over a 6-week period. Patients were assigned in a 1:1 ratio to receive two separate doses of 25 mg of psilocybin 3 weeks apart plus 6 weeks of daily placebo (psilocybin group) or two separate doses of 1 mg of psilocybin 3 weeks apart plus 6 weeks of daily oral escitalopram (escitalopram group); all the patients received psychological support. Read More

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Clinical features and follow-up of pediatric patients hospitalized for COVID-19.

Pediatr Pulmonol 2021 Apr 14. Epub 2021 Apr 14.

Medicine Research Center, Ningbo City First Hospital, Ningbo, Zhejiang Province, China.

Objective: This report summarizes the clinical features and 1-month follow-up observations for pediatric patients who were hospitalized with coronavirus disease 2019 (COVID-19) in Wuhan Women and Children's Hospital.

Methods: The 1-month follow-up data included clinical manifestations and results from serum severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) IgG and IgM tests, reverse-transcription polymerase chain reaction (RT-PCR) for SARS-CoV-2, lung computed tomography (CT) scans, and laboratory tests.

Results: Between January 20 and March 15, 2020, 127 patients aged 0-15 years were hospitalized for COVID-19 treatment, including 3 severe cases and 124 mild or moderate cases. Read More

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A novel c.671_682del NCSTN variant in a family with Hidradenitis Suppurativa: a pilot study.

Clin Exp Dermatol 2021 Apr 14. Epub 2021 Apr 14.

Centre for Molecular Medicine and Biobanking, Faculty of Medicine and Surgery, University of Malta, Malta.

The proband, a 21-year-old male and his 45-year-old mother were being seen at the dermatology department in view of hidradenitis suppurativa (HS). Both patients had Hurley Stage IIIa HS and shared a follicular, Latent Class 2 phenotype, necessitating treatment with multiple courses of antibiotics, surgery and biological agents. Despite their phenotypic similarities (including involvement of atypical locations such as the neck), the proband (asthenic and a non-smoker) presented with an earlier-onset disease and a more severe phenotype than his mother (Figure 1). Read More

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Antimicrobial treatment of Erysipelatoclostridium ramosum invasive infections: a systematic review.

Rev Inst Med Trop Sao Paulo 2021 12;63:e30. Epub 2021 Apr 12.

University of Kragujevac, Faculty of Medical Sciences, Department of Pharmacy, Kragujevac, Serbia.

The aim of this systematic review was to determine the causal role of Erysipelatoclostridium ramosum in specific invasive infections in humans, and to assess the clinical outcome of antibiotic therapy used to treat them. Several electronic databases were systematically searched for clinical trials, observational studies or individual cases on patients of any age and gender with a systemic inflammatory response syndrome (SIRS) due to E. ramosum isolated from body fluids or tissues in which it is not normally present. Read More

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Renin-Angiotensin-Aldosterone System Inhibitors in COVID-19: A Review.

Clinics (Sao Paulo) 2021 9;76:e2342. Epub 2021 Apr 9.

Programa de Pos-Graduacao em Cardiologia e Ciencias Cardiovasculares, Hospital de Clinicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, BR.

Among the multiple uncertainties surrounding the novel coronavirus disease (COVID-19) pandemic, a research letter published in The Lancet implicated drugs that antagonize the renin-angiotensin-aldosterone system (RAAS) in an unfavorable prognosis of COVID-19. This report prompted investigations to identify mechanisms by which blocking angiotensin-converting enzyme 2 (ACE2) could lead to serious consequences in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The possible association between RAAS inhibitors use and unfavorable prognosis in this disease may have been biased by the presence of underlying cardiovascular diseases. Read More

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Functional plasticity in lateral hypothalamus and its prediction of cognitive impairment in patients with diffuse axonal injury: evidence from a resting-state functional connectivity study.

Neuroreport 2021 Apr 12. Epub 2021 Apr 12.

Department of Radiology, The First Affiliated Hospital, Nanchang University Neuroimaging Lab, Jiangxi Province Medical Imaging Research Institute Department of Neurosurgery, The First Affiliated Hospital, Nanchang University, Nanchang, People's Republic of China.

Objective: Diffuse axonal injury (DAI) is a common pathological process after traumatic brain injury, which may cause survivors severe functional disorders, including cognitive impairment and physical disability. Recent literature indicated lateral hypothalamus and medial hypothalamus damage during DAI. Thus, we aim to investigate whether there is imaging evidence of hypothalamic injury in patients with DAI and its clinical association. Read More

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How do we identify the crashing traumatic brain injury patient - the intensivist's view.

Curr Opin Crit Care 2021 Apr 14. Epub 2021 Apr 14.

Interdepartmental Division of Critical Care Medicine, University of Toronto Toronto Western Hospital, University Health Network Krembil Research Institute, Toronto Western Hospital Department of Critical Care Medicine, Sunnybrook Health Sciences Centre Department of Critical Care, St. Michael's Hospital Toronto, University of Toronto Department of Anesthesia, Keenan Research Centre for Biomedical Science, St. Michael's Hospital Toronto, University of Toronto, Toronto, Ontario, Canada.

Purpose Of Review: Over 40% of patients with severe traumatic brain injury (TBI) show clinically significant neurological worsening within the acute admission period. This review addresses the importance of identifying the crashing TBI patient, the difficulties appreciating clinical neurological deterioration in the comatose patient and how neuromonitoring may provide continuous real-time ancillary information to detect physiologic worsening.

Recent Findings: The latest editions of the Brain Trauma Foundation's Guidelines omitted management algorithms for adult patients with severe TBI. Read More

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Stroke Risk Scores as Predictors of Severe Outcomes in Atrial Fibrillation: A Comprehensive Review.

Am J Ther 2021 Apr 7. Epub 2021 Apr 7.

Carol Davila University of Medicine and Pharmacy, Department of Internal Medicine, Bucharest, Romania; and Cardiology Department, Colentina University Hospital, Bucharest, Romania.

Background: Atrial fibrillation (AF) is the most frequent sustained arrhythmia. It increases the risk of stroke, heart failure, death, hospitalizations, and costs.

Area Of Uncertainty: Several scores were introduced to stratify the stroke risk and need for anticoagulation in patients (pts) with AF . Read More

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Diagnostic Performance of Hemophagocytic Lymphohistiocytosis Criteria and HScore in Critically Ill Patients With Severe Hemophagocytic Syndrome.

Crit Care Med 2021 Apr 12. Epub 2021 Apr 12.

Medical ICU, Saint-Louis University Hospital, AP-HP, Paris, France. Faculté de Médecine, Université Paris 7, Paris-Diderot, France. ECSTRA Team, Biostatistics and Clinical Epidemiology, UMR 1153 (Center of Epidemiology and Biostatistic Sorbonne Paris Cité, CRESS), INSERM, Paris, France.

Objectives: To assess whether critically ill hematologic patients without diagnosis of hemophagocytic lymphohistiocytosis may have features mimicking hemophagocytic lymphohistiocytosis according to both diagnostic scores.

Design: A retrospective case-control study.

Setting: Hemophagocytic syndrome diagnosis was standardized and based on a consensual diagnosis by at least two experts of a university hospital which is a reference center for hemophagocytic syndrome. Read More

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Four-Week Daily Calcipotriene/Betamethasone Dipropionate Foam Is Highly Efficacious in Patients With Psoriasis (PSO-LONG Lead-in Phase).

J Drugs Dermatol 2021 Apr;20(4):436-441

Background: Psoriasis is a chronic disease requiring long-term treatment strategies. Optimal strategies should include initial rapid relief of symptoms followed by long-term management to maintain remission. This 4-week open-label phase of a long-term proactive management phase 3 trial aimed to select responders to once daily, fixed-dose combination calcipotriene 0. Read More

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A Phase 3, Randomized Trial Demonstrating the Improved Efficacy and Patient Acceptability of Fixed Dose Calcipotriene and Betamethasone Dipropionate Cream.

J Drugs Dermatol 2021 Apr;20(4):420-425

Background: The fixed dose combination of calcipotriene and betamethasone dipropionate (CAL/BDP) is a well-established, efficacious, and safe topical treatment of psoriasis.

Method: A Phase 3, multicenter, randomized, investigator-blind, active, and vehicle-controlled trial enrolling 796 patients with moderate to severe psoriasis according to the Physician Global Assessment (PGA) scale. Products were applied once daily for 8 weeks. Read More

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Effect of Ixekizumab on Patient Reported Outcomes and Quality of Life in Patients With Moderate-to-Severe Plaque Psoriasis: 5-Year Results from the UNCOVER-1 and -2 Studies.

J Drugs Dermatol 2021 Apr;20(4):394-401

Objective: We describe patient-reported outcomes and quality of life through 5 years of treatment in patients with moderate-to-severe plaque psoriasis in the UNCOVER-1 and -2 studies.

Methods: This analysis included patients who were randomized to ixekizumab every 2 weeks then received ixekizumab every 4 weeks during the maintenance period, and who achieved static physician global assessment (0,1) at week 12, completed week 60, and entered the long-term extension period (weeks 60–264). Outcomes measures included responses in itch numeric rating scale (NRS), skin pain visual analog scale (VAS), and dermatology life quality index (DLQI) (0,1), and mean change from baseline in short form health survey (SF-36) mental (MCS) and physical component summaries (PCS), psoriasis skin appearance bothersomeness (PSAB), and work productivity activity impairment (WPAI). Read More

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A Retrospective Review of Patients' Response to Biologic Therapy for Psoriasis.

J Drugs Dermatol 2021 Apr;20(4):442-449

Background: Biologic treatments have taken the forefront in treating moderate-to-severe psoriasis. Although numerous randomized, controlled trials have demonstrated the efficacy of these agents, there is limited data suggesting that clinical trial outcomes are reproducible in real-world patients.

Objective: Obtain real-world evidence for the use of biologics that target different segments of the immune system in patients with moderate-to-severe psoriasis. Read More

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[Lithium sulfate poisoning treated with hemodialysis in a patient with normal renal function: a case report].

G Ital Nefrol 2021 Apr 14;38(2). Epub 2021 Apr 14.

UOC Diagnostica per immagini, A.O. Rummo, Benevento, Italia.

Lithium is the milestone of psychiatric patients' therapy, in particular in bipolar disorder. Despite its high therapeutic efficacy, there are several side effects (renal, thyroid, parathyroid, dermatological) and management problems linked to its narrow therapeutic range, which exposes patients to a high risk of toxicity. We describe the case of a male patient with bipolar disorder in therapy with lithium sulfate who developed a severe acute-on-chronic intoxication. Read More

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