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The new services that opioid treatment programs have adopted in response to COVID-19.

J Subst Abuse Treat 2021 Apr 9;130:108393. Epub 2021 Apr 9.

Department of Public Administration, University of Illinois at Chicago, 412 S. Peoria St., 136, Chicago, IL 60607 (MC 278), USA. Electronic address:

COVID-19 has exacerbated the opioid epidemic and transformed how programs treat opioid use disorder. In response to the pandemic, the federal government modified guidelines to allow opioid treatment programs (OTPs) greater flexibility in the provision of medication for opioid use disorder. We conducted a telephone survey of 31. Read More

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Illness stage and predominant polarity in bipolar disorder: Correlation with burden of illness and moderation of treatment outcome.

J Psychiatr Res 2021 Jun 2;140:205-213. Epub 2021 Jun 2.

Dauten Family Center for Bipolar Treatment Innovation, Department of Psychiatry, Massachusetts General Hospital, 50 Staniford Street, Suite 580, Boston, MA, 02114, United States; Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115, United States. Electronic address:

Bipolar disorder often follows a set progression best described in stages where advanced stages are associated with poorer outcomes. Bipolar disorder is also often characterized by a predominance of episode polarity, where some individuals experience more depressive episodes (termed predominant depressive polarity) while others experience more hypo/manic episodes (termed predominant hypo/manic polarity). We examined the associations between staging and predominant polarity with measures of illness burden and treatment outcome utilizing data from a six-month comparative effectiveness trial of lithium and quetiapine in bipolar disorder (Bipolar CHOICE). Read More

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Root cause determination of intraperitoneal catheter obstructions: Insulin amyloid aggregates vs foreign body reaction.

J Control Release 2021 Jun 9. Epub 2021 Jun 9.

Department of Pharmaceutical Sciences, University of Connecticut, 69 N Eagleville Road U3092, Storrs, CT 06269, USA. Electronic address:

Continuous intraperitoneal insulin infusion, from an implanted insulin pump connected to a catheter that delivers insulin directly to the peritoneal cavity has many clinical advantages for patients with Type 1 diabetes. However, the ongoing incidence of catheter obstructions remains a barrier to the widespread use of this therapy. To date, the root cause of these obstructions remains unknown. Read More

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Arteriovenous Access Type and Risk of Mortality, Hospitalization, and Sepsis Among Elderly Hemodialysis Patients: A Target Trial Emulation Approach.

Am J Kidney Dis 2021 Jun 9. Epub 2021 Jun 9.

Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health; Madison, Wisconsin; Department of Medicine, University of Wisconsin School of Medicine and Public Health; Madison, Wisconsin. Electronic address:

Rationale & Objective: Evidence is mixed regarding the optimal choice of the first permanent vascular access for elderly patients on hemodialysis (HD). Lacking data from randomized controlled trials (RCT), we used a target trial emulation approach to compare arteriovenous fistula (AVF) versus arteriovenous graft (AVG) placement among elderly patients on HD.

Study Design: Retrospective cohort study. Read More

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Medial or lateral orbitofrontal cortex activation during fear extinction differentially regulates fear renewal.

Behav Brain Res 2021 Jun 9:113412. Epub 2021 Jun 9.

Institute of Systems Neuroscience, Taiwan; Brain Research Center, National Tsing Hua University, Hsinchu, 30013, Taiwan. Electronic address:

Some anxiety-related disorders, such as panic disorder, specific phobia, post-traumatic stress disorder (PTSD), and obsessive-compulsive disorder (OCD), develop because of the poor regulation and inappropriate expression of fear-related behavior at the wrong place and wrong time. In clinical settings, exposure therapy, which consists of repeated presentation of trauma-related stimuli without real threats in the therapeutic context, is commonly used to treat these disorders. However, 30-50% of patients suffer from the recurrence of anxiety symptoms after they leave the therapeutic context. Read More

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Prepancreatic common hepatic artery arising from superior mesenteric artery: an exceptional but important finding during pancreaticoduodenectomy.

Surg Radiol Anat 2021 Jun 12. Epub 2021 Jun 12.

HPB Unit, Digestive Surgery Department, Nouvel Hopital Civil, University of Strasbourg, 1 Place de l'Hôpital, 67091, Strasbourg, France.

Purpose: The hepato-mesenteric trunk is an extremely rare condition in which the common hepatic artery (CHA) originates from the superior mesenteric artery (SMA). Usually, CHA passes behind the head of the pancreas. A systematic review was performed to provide guidelines for the perioperative management of patients with this anatomical variation who underwent a pancreaticoduodenectomy (PD). Read More

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An innovative adjustable prone positioning frame for treatment of severe kyphosis secondary to ankylosing spondylitis with two-level osteotomy.

Eur Spine J 2021 Jun 12. Epub 2021 Jun 12.

Mercy Medical Center, Trinity Health of New England, 271 Carew Street, Springfield, MA, 01104, USA.

Purpose: This study aims to introduce an innovative adjustable prone positioning frame (APPF) and explore its feasibility and safety for treatment of severe kyphosis secondary to ankylosing spondylitis (AS) with two-level osteotomy.

Methods: A retrospective, non-controlled study was conducted to illustrate the process where 13 patients diagnosed with severe kyphosis secondary to AS received operations on the APPF. Parameters of chin brow vertical angle (CBVA), global kyphosis (GK), thoracolumbar kyphosis (TLK), lumbar lordosis (LL) and sagittal vertical axis (SVA) were measured. 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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[Evaluation of the presence of an advanced practice nurse in the care of kidney transplant patients].

Nephrol Ther 2021 Jun 8. Epub 2021 Jun 8.

Service de néphrologie-transplantation, CHU Henri-Mondor, 1, rue Gustave-Eiffel, 94000 Créteil, France; UPEC, Unité Inserm 955, 8, rue du Général-Sarrail, 94010 Créteil, France.

The establishment of a new profession requires anticipating its added value and defining its field of intervention. This article explores the needs of a model of care in kidney transplantation through the study of epidemiological data and an exploratory survey within a university hospital center in Île-de-France. The results define the limits of current care and assert the place of the advanced practice nurse in the renal transplantation sector. Read More

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[Modern Treatment Options for Postoperative Chylothorax: a Systematic Review].

Pneumologie 2021 Jun 11;75(6):439-446. Epub 2021 Jun 11.

Klinik für Thoraxchirurgie, Regiomed Kliniken GmbH, Sonneberg/Coburg.

Background:  Chylothorax is a multifactorial complication, usually caused by surgery or traumatic injury, and more rarely by malignant disease. Because of the lack of prospective, randomised trials, the evidence-based treatment rests upon personal experience, but ideally taking into account retrospective analysis.

Material And Methods:  The aim of this review is to provide a comprehensive overview of the currently available modern treatment options. Read More

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Assessment of Morbidity and Mortality after Periprosthetic Hip Fracture. Influence of Vancouver Stage in a Retrospective Single-Centre Study of 88 Patients.

Orthop Traumatol Surg Res 2021 Jun 8:102985. Epub 2021 Jun 8.

Service de Chirurgie de l'Arthrose et du Sport, Urgences Traumatiques des Membres. CHU de Grenoble-Alpes, Hôpital Sud, Avenue de Kimberley, BP 338, 38434 Echirolles Cedex, France.

Background: Peri-prosthetic hip fractures (PPHFs) are serious complications whose treatment is generally difficult due to their predominance in elderly patients with bone frailty and other comorbidities. The Vancouver classification is the most widely used and is helpful for assisting treatment decisions. However, its value for predicting morbidity and mortality has not been assessed. Read More

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Revision of failed trapeziometacarpal prothesis by CMI pyrocarbon implant: Retrospective study of 28 patients with a mean follow-up of 7.5 years.

Orthop Traumatol Surg Res 2021 Jun 8:102984. Epub 2021 Jun 8.

Orthopôle, 53 bis Avenue Maryse Bastié, 33520, Bruges, France.

Introduction: There is no consensus on the best salvage option after a failed trapeziometacarpal prothesis. Conserving the trapezium and inserting a pyrocarbon hemiarthroplasty implant will prevent thumb shortening and preserve the thumb's motion. The aim of this study was to evaluate the clinical and radiological outcomes in the medium term of trapeziometacarpal prothesis revisions done using the CMI pyrocarbon implant. Read More

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Roles of the ventral hippocampus and medial prefrontal cortex in spatial reversal learning and attentional set-shifting.

Neurobiol Learn Mem 2021 Jun 8:107477. Epub 2021 Jun 8.

Laboratory of the Neurophysiology of Memory, Institute of Physiology of the Czech Academy of Science, Prague, Czech Republic. Electronic address:

Neural components enabling flexible cognition and behavior are well-established, and depend mostly on proper intercommunication within the prefrontal cortex (PFC) and striatum. However, dense projections from the ventral hippocampus (vHPC) alter the functioning of the medial PFC (mPFC). Dysfunctional hippocampo-prefrontal connectivity negatively affects the integrity of flexible cognition, especially in patients with schizophrenia. Read More

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Patient Reported Outcomes in a Randomized Trial of Closed-Loop Control: The Pivotal International Diabetes Closed Loop Trial.

Diabetes Technol Ther 2021 Jun 11. Epub 2021 Jun 11.

University of Virginia, Psychiatry and Neurobehavioral Sciences, Charlottesville, Virginia, United States;

Background: Closed-Loop Control (CLC) has been shown to improve glucose time in range and other glucose metrics; however, randomized trials longer than 3 months comparing CLC with sensor-augmented pump (SAP) therapy are limited. We recently reported glucose control outcomes from the 6-month international Diabetes Closed Loop (iDCL) trial; we now report patient-reported outcomes (PROs) in this iDCL trial.

Methods: Participants were randomized 2:1 to CLC (N=112) versus SAP (N=56) and completed questionnaires including Hypoglycemia Fear Survey, Diabetes Distress Scale (DDS), Hypoglycemia Awareness, Hypoglycemia Confidence, Hyperglycemia Avoidance, and Positive Expectancies of CLC (INSPIRE) at baseline, 3, and 6 months. Read More

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Persistent visual dysfunction following PRES due to COVID-19: Case series and literature review.

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

Department of Ophthalmology, Colorado University School of Medicine, 1675 North Aurora Ct. F731, Aurora, CO, 80045, USA.

Background: The full spectrum of neurological sequelae in COVID-19 is beginning to emerge. SARS-CoV-2 has the potential to cause both direct and indirect brain vascular endothelial damage through infection and inflammation that may result in long-term neurological signs and symptoms. We sought to illuminate persistent neuro-ophthalmological deficits that may be seen following posterior reversible encephalopathy syndrome (PRES) due to COVID-19. Read More

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Clinical and radiographic performance of self-locking conical connection implants in the posterior mandible: five-year results of a two-centre prospective study.

Clin Oral Implants Res 2021 Jun 11. Epub 2021 Jun 11.

Department of Oral and Maxillofacial Surgery, Johannes Gutenberg-University, Medical Centre, Augustusplatz 2, D-55131, Mainz, Germany.

Objective: This prospective study aims to assess the 5-year clinical performance of implants with internal conical connection and platform-switched abutments in the posterior mandible.

Material And Methods: Healthy adults missing at least two teeth in the posterior mandible and with a natural tooth mesial to the implant site received two or three adjacent implants. After a transmucosal healing period single crown restorations were cemented on platform-switched abutments. Read More

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Trends in Endotracheal Intubation During In-Hospital Cardiac Arrests: 2001-2018.

Crit Care Med 2021 Jun 9. Epub 2021 Jun 9.

Division of Pulmonary and Critical Care Medicine, David Geffen School of Medicine at the University of California, Los Angeles, CA. Center for the Study of Healthcare Innovation, Implementation, and Policy, Health Services Research and Development, Greater Los Angeles Veterans Affairs Healthcare System, Los Angeles, CA. Center for Resuscitation Science, Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA. Division of Hospital Medicine, David Geffen School of Medicine at the University of California, Los Angeles, CA. Division of Pulmonary, Critical Care Medicine, and Sleep Medicine Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.

Objectives: Airway management during in-hospital cardiac arrest represents a fundamental component of resuscitative efforts, yet little is known about temporal trends in intubation during in-hospital cardiac arrest. Our objective was to investigate changes in in-hospital cardiac arrest airway management over time and in response to national guideline updates.

Design: Observational cohort study of a prospectively collected database. Read More

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Wire countertraction for sheath placement through stenotic and tortuous veins: The "body flossing" technique.

Heart Rhythm O2 2020 Apr 27;1(1):21-26. Epub 2020 Apr 27.

Section of Cardiac Electrophysiology, Cardiovascular Division, Department of Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.

Background: Innominate vein stenosis and venous tortuosity are common findings during cardiac implantable electronic device upgrades or replacements and present a challenge to the implanting physician. Various techniques have been described to facilitate lead placement, including serial dilation, balloon venoplasty, and percutaneous access medial to the stenosis, each with its own benefits and risks.

Objective: The purpose of this study was to assess the feasibility, safety, and efficacy of the wire countertraction ("body flossing") technique to facilitate sheath placement through tortuous and stenotic vessels. Read More

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Enface vitreous OCT 'worm holes': A novel finding in a patient with diffuse unilateral subacute neuroretinitis (DUSN).

Am J Ophthalmol Case Rep 2021 Sep 12;23:101112. Epub 2021 May 12.

Vitreous Retina Macula Specialists of Toronto, 3280 Bloor St. West, Suite 310, Etobicoke, ON, Canada.

Purpose: To describe a case of diffuse unilateral subacute neuroretinitis (DUSN), a rare condition that causes progressive vision loss following infection by a nematode using enface vitreous imaging.

Observations: We present the clinical findings of a 37-year-old female, clinically diagnosed with DUSN after a non-invasive multimodal imaging approach that included MultiColor scanning laser imaging and enface vitreous OCT, which revealed the nematode body and lacunae created by worm migration, respectively.

Conclusion And Importance: To our knowledge, this is the first reported case of lacunae visualized using enface vitreous optical coherence tomography (OCT), potentially marking the migration path of the nematode. Read More

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September 2021

Recent trend in gastric cancer treatment in the USA.

J Cancer Metastasis Treat 2018 Apr 26;4. Epub 2018 Apr 26.

Department of Gastrointestinal Medical Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX 77030, USA.

Gastric adenocarcinoma (GAC) is estimated as the fifteenth most common cancer in the USA. Incidence rate has been gradually decreasing, but prognosis remains dismal. For patients with locally advanced GAC (stage > T1B and < T4B), multimodality therapies, such as surgery, chemotherapy, and radiation therapy, are needed. Read More

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When the Good Syndrome Goes Bad: A Systematic Literature Review.

Yiyun Shi Chen Wang

Front Immunol 2021 25;12:679556. Epub 2021 May 25.

Department of Internal Medicine, Morsani College of Medicine, University of South Florida, Tampa, FL, United States.

Background: Good syndrome is a rare adult-onset immunodeficiency characterized by thymoma and hypogammaglobulinemia. Its clinical manifestations are highly heterogeneous, ranging from various infections to autoimmunity.

Objective: This study was to summarize patient characteristics, identify prognostic factors and define clinical subgroups of Good syndrome. Read More

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Perceived Stress of Quarantine and Isolation During COVID-19 Pandemic: A Global Survey.


Front Psychiatry 2021 25;12:656664. Epub 2021 May 25.

Understanding of the perceived stress and coping strategies adopted by people is important for contemplating the consequences of a pandemic on mental health of people globally. In this study, we intended to assess the perceived stress status under quarantine/isolation globally during the COVID-19 pandemic. This is a multicentre, multinational cross-sectional study that recruited isolated/quarantined individuals suspected or confirmed to have COVID-19 to assess the psychological impact of the quarantine/isolation experience by answering a survey distributed online. Read More

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Cost of Illness of Epilepsy and Associated Factors in Patients Attending Adult Outpatient Department of University of Gondar Referral Hospital, Northwest Ethiopia.

Risk Manag Healthc Policy 2021 4;14:2385-2394. Epub 2021 Jun 4.

Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.

Background: Epilepsy has significant economic implications on health care needs, premature death, and lost work productivity. Therefore, this study aimed to assess the cost of illness of epilepsy and its associated factors in the Outpatient Department of University of Gondar Referral Hospital, Northwest Ethiopia.

Methods: We conducted an institution-based cross-sectional study from March 2018 to April 2018. Read More

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An Ethical Risk Management Approach for Medical Devices.

Risk Manag Healthc Policy 2021 3;14:2311-2318. Epub 2021 Jun 3.

Technology Project Management Program, College of Technology, University of Houston, Houston, Texas, 77204-4023, USA.

Introduction: The Food and Drug Administration (FDA) audits and validates devices before mass production to ensure high standards, safety, and quality of medical devices being marketed. Despite those measures in place, consumers' trusts in medical devices are still dwindling based on safety and privacy risks that eventually influence the health of patients.

Methods: The method employed in this study is conceptual and includes a selection of a company that develops medical devices to use as an example organization to apply the hybrid risk management framework, defined herein in the results and discussion section. Read More

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Feelings and Emotions of Nurses Related to Dying and Death of Patients - A Pilot Study.

Psychol Res Behav Manag 2021 4;14:705-717. Epub 2021 Jun 4.

Department of Clinical Nursing, Faculty of Health Sciences, Wroclaw Medical University, Wroclaw, Poland.

Introduction: The aim of the study, conducted in selected inpatient units, was to evaluate and analyse the feelings and emotions which accompany nurses during their work when they face the death of patients.

Material And Methods: A total of 160 nurses were invited to participate in the study. The study group consisted of 40 nurses from each of the four departments of a municipal hospital: a surgery unit, an internal medicine unit, a hospital emergency department (ER) and an intensive care unit (ICU). Read More

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Implementation strategies in the context of medication reconciliation: a qualitative study.

Implement Sci Commun 2021 Jun 10;2(1):63. Epub 2021 Jun 10.

Center for Clinical Quality and Implementation Research, Vanderbilt University Medical Center, 2525 West End Ave, Suite 1200, Nashville, TN, 37203, USA.

Background: Medication reconciliation (MedRec) is an important patient safety initiative that aims to prevent patient harm from medication errors. Yet, the implementation and sustainability of MedRec interventions have been challenging due to contextual barriers like the lack of interprofessional communication (among pharmacists, nurses, and providers) and limited organizational capacity. How to best implement MedRec interventions remains unclear. Read More

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Access to care and worsening eating disorder symptomatology in youth during the COVID-19 pandemic.

J Eat Disord 2021 Jun 10;9(1):69. Epub 2021 Jun 10.

Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, 300 Longwood Ave, Boston, MA, 02115, USA.

Background: Shelter-in-place orders and social distancing guidelines, in response to the COVID-19 pandemic, have limited traditional face-to-face interactions and led to many clinical providers transitioning to the use of videoconferencing platforms. The present study aims to assess how the COVID-19 pandemic has impacted adolescents'/young adults' (AYA) eating disorder (ED)-related care, and how access to, changes in, perceived disruptions to, and quality of care are associated with ED thoughts and behaviors.

Methods: AYA enrolled in the RECOVERY study, a pre-existing web-based longitudinal study, and completed a COVID-19-specific survey (n = 89). Read More

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Guidelines on analgosedation, monitoring, and recovery time for flexible bronchoscopy: a systematic review.

BMC Pulm Med 2021 Jun 10;21(1):198. Epub 2021 Jun 10.

Lung Clinic Cologne-Merheim, Thoracic Surgery, Hospital of Cologne, University of Witten/Herdecke, Ostmerheimer Str. 200, 51109, Cologne, Germany.

Background: Patients undergoing bronchoscopy in spontaneous breathing are prone to hypoxaemia and hypercapnia. Sedation, airway obstruction, and lung diseases impair respiration and gas exchange. The restitution of normal respiration takes place in the recovery room. Read More

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