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Psychiatric understanding and treatment of patients with amputations.

Yeungnam Univ J Med 2021 May 11. Epub 2021 May 11.

Department of Psychiatry, Yeungnam University Hospital, Daegu, Korea.

Amputation changes the lives of patients and their families. Consequently, the patient must adapt to altered body function and image. During this adaptation process, psychological problems, such as depression, anxiety, and posttraumatic stress disorder, can occur. Read More

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Doubling Recruitment of Pediatric Low-grade Glioma within Two Decades does not change Outcome - Report from the German LGG Studies.

Klin Padiatr 2021 May 10;233(3):107-122. Epub 2021 May 10.

Division of Childhood Cancer Epidemiology, Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Centre of the Johannes Gutenberg University Mainz, Mainz, Germany.

Background: Successive multicenter studies for pediatric low-grade glioma (LGG) in Germany were accompanied by a doubling of annual recruitment over 2 decades. We investigated whether this increase conveyed a change of epidemiologic characteristics or survival.

Methods And Results: Participating centers reported 4634 patients with the radiologic/histologic diagnosis of LGG (1996-2018), rising from 109 to 278/year. Read More

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[Antibacterial Prophylaxis in Children and Adolescents Undergoing Therapy for Cancer - Statement of the Society of Pediatric Oncology and Hematology (GPOH) and of the German Society for Pediatric Infectious Diseases (DGPI) on Two Current International Guidelines].

Klin Padiatr 2021 May 10;233(3):101-106. Epub 2021 May 10.

Infectious Disease Research Program, Center for Bone Marrow Transplantation, Department of Pediatric Hematology/Oncology, University Children's Hospital, Muenster, Muenster, Germany.

Immunocompromised children and adolescents receiving treatment for cancer have an increased risk for potentially life-threatening infectious complications such as blood stream infections with Gram-positive and Gram-negative pathogens. Therefore, several centers for Pediatric Hematology and Oncology administer antibacterial prophylaxis to these patients to lower morbidity and mortality. Two pediatric specific guidelines on antibacterial prophylaxis were recently published. Read More

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[Plastic-surgical coverage of an extended defect on the scalp using a bipedicled vascularised flap after removal of two cutaneous squamous epithelial carcinomas].

Handchir Mikrochir Plast Chir 2021 May 10. Epub 2021 May 10.

Uniklinik Bonn; Abteilung für Mund-, Kiefer und Plastische Gesichtschirurgie.

Covering huge scalp defects is often a great challenge. Different aspects play a major role in planing and performing the covering of vast defects. We present the case of a patient with a squamous cell carcinoma of the scalp, measuring 8 × 9 centimeters. Read More

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Community-Onset Venous Thromboembolism in Children: Pediatric Emergency Medicine Perspectives.

Semin Thromb Hemost 2021 May 10. Epub 2021 May 10.

Division of Hematology, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland.

Pediatric venous thromboembolism (VTE) is a condition increasingly encountered by emergency medicine physicians. Unfortunately, despite increased incidence, the diagnosis of pediatric VTE relies on a high index of suspicion from clinicians. Delays in diagnosis and initiation of treatment can lead to poor outcomes in children, including an increased risk of mortality from pulmonary embolism, increased risk of VTE recurrence, and the development of the post-thrombotic syndrome. Read More

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Profile of Patients with Isolated Distal Deep Vein Thrombosis versus Proximal Deep Vein Thrombosis or Pulmonary Embolism: RE-COVERY DVT/PE Study.

Semin Thromb Hemost 2021 May 10. Epub 2021 May 10.

Division of Cardiovascular Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.

Isolated distal deep vein thrombosis (IDDVT) is presumed to be more benign than proximal DVT (PDVT) or pulmonary embolism (PE), suggesting a need for different management approaches. This subgroup analysis of the RE-COVERY DVT/PE global, observational study investigated patient characteristics, hospitalization details, and anticoagulant therapy in patients with IDDVT in real-world settings in 34 countries enrolled from January 2016 to May 2017. Data were analyzed descriptively according to the type and location of the index venous thromboembolism (VTE): IDDVT, PDVT ± distal DVT (DDVT), and PE ± DVT. Read More

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Risk of Bleeding during Implant Surgery in Patients Taking Antithrombotics: A Systematic Review.

Semin Thromb Hemost 2021 May 10. Epub 2021 May 10.

Department of Oral Implantology, Dental School, University of Santo Amaro, São Paulo, Brazil.

The objective of this systematic review is to assess the risk of postoperative bleeding in oral surgery for implant placement in individuals taking antithrombotics (i.e., anticoagulants and/or antiplatelet agents). Read More

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Physicians' Opinions on Anticoagulant Therapy in Patients with a Limited Life Expectancy.

Semin Thromb Hemost 2021 May 10. Epub 2021 May 10.

Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands.

Patients with a limited life expectancy have an increased risk of thromboembolic and bleeding complications. Anticoagulants are often continued until death, independent of their original indication. We aimed to identify the opinions of physicians about the use of anticoagulants at the end of life. Read More

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Efficacy and Safety of Non-Vitamin K Antagonist Oral Anticoagulants in Pediatric Venous Thromboembolism Treatment and Thromboprophylaxis: A Systematic Review of the Literature.

Semin Thromb Hemost 2021 May 10. Epub 2021 May 10.

Johns Hopkins All Children's Institute for Clinical and Translational Research, St. Petersburg, Florida.

Venous thromboembolism (VTE) in children can lead to significant morbidity and mortality. Traditionally, treatment for thrombotic events in pediatric patients has been limited mainly to unfractionated heparin, low-molecular-weight heparin (LMWH), or vitamin K antagonists. Since the first non-vitamin K antagonist oral anticoagulant (NOAC) was approved for adult use, these agents have gained popularity for a variety of indications. Read More

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Arterial Thrombosis in Patients with Antiphospholipid Syndrome: A Review and Meta-Analysis.

Semin Thromb Hemost 2021 May 10. Epub 2021 May 10.

Department of Medicine, Thrombosis and Atherosclerosis Research Institute, McMaster University, Hamilton, Ontario, Canada.

There is a scarcity of high-quality randomized controlled trials (RCTs) comparing antithrombotic regimens for secondary prevention of arterial thrombosis (AT) in antiphospholipid syndrome (APS). We reviewed different antithrombotic regimens used for this purpose. We searched for studies on management of AT in APS on PubMed and Web of Science. Read More

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[Frequency Distribution and Risk Factors for Latent Tuberculosis in Contact Persons: Cologne 2012-2016].

Pneumologie 2021 May 10. Epub 2021 May 10.

Gesundheitsamt der Stadt Köln, Abteilung Infektions- und Umwelthygiene, Tuberkulose-Beratungsstelle.

Background:  As part of tuberculosis control and the WHO end-TB strategy, contact persons of tuberculosis patients in Germany are examined for a possible infection with latent tuberculosis (LTBI). Activation of LTBI contributes a considerable proportion of newly reported tuberculosis cases in low-incidence countries such as Germany. Therefore, the aim is to detect cases of LTBI and, through chemopreventive treatment of these cases, prevent future, post-primary, active tuberculosis. Read More

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Parent Perception of Child Safety following Admission to a Neonatal Unit.

Am J Perinatol 2021 May 10. Epub 2021 May 10.

Neonatology Department, Gregorio Marañón University Hospital, Madrid, Spain.

Objective:  Parent partnership is a key aspect of neonatal hospital care. However, there is a lack of information regarding parents' perception of neonatal safety. This study explores parents' opinions on safety during their child's hospitalization to identify points for improvement. Read More

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Pan-cancer application of a lung-adenocarcinoma-derived gene-expression-based prognostic predictor.

Brief Bioinform 2021 May 10. Epub 2021 May 10.

Lund University, Sweden.

Gene-expression profiling can be used to classify human tumors into molecular subtypes or risk groups, representing potential future clinical tools for treatment prediction and prognostication. However, it is less well-known how prognostic gene signatures derived in one malignancy perform in a pan-cancer context. In this study, a gene-rule-based single sample predictor (SSP) called classifier for lung adenocarcinoma molecular subtypes (CLAMS) associated with proliferation was tested in almost 15 000 samples from 32 cancer types to classify samples into better or worse prognosis. Read More

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Integration and interplay of machine learning and bioinformatics approach to identify genetic interaction related to ovarian cancer chemoresistance.

Brief Bioinform 2021 May 10. Epub 2021 May 10.

School of Public health and Community Medicine, University of New South Wales, 2052, Sydney, Australia.

Although chemotherapy is the first-line treatment for ovarian cancer (OCa) patients, chemoresistance (CR) decreases their progression-free survival. This paper investigates the genetic interaction (GI) related to OCa-CR. To decrease the complexity of establishing gene networks, individual signature genes related to OCa-CR are identified using a gradient boosting decision tree algorithm. Read More

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Risk of Infection after Deep Brain Stimulation Surgery with Externalization and Local-Field Potential Recordings: Twelve-Year Experience from a Single Institution.

Stereotact Funct Neurosurg 2021 May 10:1-9. Epub 2021 May 10.

Department of Neurology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.

Introduction: Deep brain stimulation (DBS) has been an established surgical procedure in the field of functional neurosurgery for many years. The experimental electrophysiological method of local field potential (LFP) recordings in postsurgically externalized patients has made substantial contributions to the better understanding of pathophysiologies underlying movement disorders. As interest in LFP recordings for the development of improved stimulation strategies increases, this study's aim was to provide evidence concerning safety of this research method, in a major DBS center. Read More

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Early Experience with Comaneci, a Newly FDA-Approved Controllable Assist Device for Wide-Necked Intracranial Aneurysm Coiling.

Cerebrovasc Dis 2021 May 10:1-8. Epub 2021 May 10.

Department of Neurosurgery, NYU Langone Health, New York, New York, USA.

Background: Comaneci (Rapid Medical) is a compliant, adjustable mesh that provides temporary scaffolding during coiling of wide-necked intracranial aneurysms (WNAs) that preserves antegrade flow. We report our early multi-institutional experience with the Comaneci device in the USA.

Method: We reviewed all patients with WNAs that were treated using the Comaneci device for coil remodeling of ruptured and unruptured aneurysms at 4 institutions between July 2019 and May 2020. Read More

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Patient Experiences of Postinfectious Olfactory Dysfunction.

ORL J Otorhinolaryngol Relat Spec 2021 May 10:1-5. Epub 2021 May 10.

Fifth Sense, Phoenix Business Centre, Unit 8, Barrow-in-Furness, United Kingdom.

Introduction: To highlight the importance of the need for new treatment modalities, this study aimed to characterise the experience of patients with postinfectious olfactory dysfunction (PIOD) in terms of the treatment they received.

Methods: An online survey was hosted by the Norwich Clinical Trials Unit on the secure REDCap server. Members of the charity Fifth Sense (the UK charity that represents and supports people affected by smell and taste disorders) were invited to participate. Read More

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Survival Outcomes of Hemoperfusion and Hemodialysis versus Hemodialysis in Patients with End-Stage Renal Disease: A Systematic Review and Meta-Analysis.

Blood Purif 2021 May 10:1-13. Epub 2021 May 10.

Department of Nephrology, Dialysis and Transplantation, International Renal Research Institute (IRRIV), San Bortolo Hospital, Vicenza, Italy.

Background: The maintenance treatment of ESRD puts a great burden on individual patients, society, and the country of China as a whole. Hemoperfusion plus hemodialysis (HP + HD) in ESRD patients can yield modified outcomes such as prolonged life expectancy and improved dialysis quality and quality of life. This study aimed to systematically analyze the effect of HP + HD on the overall survival (OS) rates of ESRD patients and to provide support for clinical decision-making. Read More

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Risk of Vaccine-Preventable Infections in Swiss Adults with Inflammatory Bowel Disease.

Digestion 2021 May 10:1-9. Epub 2021 May 10.

Department of Pediatrics, Pediatric Infectious Disease Unit, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland.

Background: Patients with inflammatory bowel disease (IBD) have a higher risk of infection and are frequently not up to date with their immunizations.

Objectives: This study aims to review vaccination status and evaluate whether age, disease type, or treatment regimen could predict the absence of seroprotection against selected vaccine-preventable infection in adults with IBD.

Methods: Cross-sectional study using questionnaire, immunization records review, and assessment of tetanus-specific, varicella-specific, and measles-specific immunoglobulin G concentrations. Read More

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Comparisons of Efficacy and Safety between Triple (Inhaled Corticosteroid/Long-Acting Muscarinic Antagonist/Long-Acting Beta-Agonist) Therapies in Chronic Obstructive Pulmonary Disease: Systematic Review and Bayesian Network Meta-Analysis.

Respiration 2021 May 10:1-13. Epub 2021 May 10.

Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Hospital, Jongno-Gu, Seoul, Republic of Korea.

Background: Various combinations of inhaled corticosteroid (ICS), long-acting muscarinic antagonist (LAMA), and long-acting beta-agonist (LABA) have been used as triple therapy for stable chronic obstructive pulmonary disease (COPD).

Objective: Our study was conducted to answer whether there were significant differences among various combinations in efficacy, for reducing exacerbation or mortality, and in safety, for increasing cardiovascular events or pneumonia.

Method: We searched parallel-group randomized controlled trials (RCTs) comparing ICS/LAMA/LABA with other inhaled drugs in patients with stable COPD for at least 12 weeks in PubMed, EMBASE, the Cochrane Library, and clinical trial registries from inception to December 31, 2019. Read More

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Why is radiological protection different in medicine?

Eliseo Vano

J Radiol Prot 2021 May 10. Epub 2021 May 10.

Radiology Department, Universidad Complutense de Madrid, Madrid, SPAIN.

There are many aspects of radiological protection in medicine that are different than in other areas of activity using ionising radiations. In this paper, we present and justify some of these differences and highlight the reasons and benefits of this consideration for the medical field. It is important to understand the differences as we are all likely to be patients at some point in our lives and be exposed to ionising radiation for imaging procedures several times and, in some cases, for therapeutic indications. Read More

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Ventilation improvement after pneumonia treatment evaluated with electrical impedance tomography: an observational study.

Physiol Meas 2021 May 10. Epub 2021 May 10.

Department of Biomedical Engineering, Fourth Military Medical University, Xi'an, 710032, CHINA.

Objective: Due to radiation exposures, not all patients with pneumonia would receive chest x-ray or CT measurements to confirm treatment effectiveness. The aim of the study was to examine the ability of using electrical impedance tomography (EIT) to evaluate the treatment effectiveness in such patient group.

Methods: A total of 35 consecutive patients with non-severe pneumonia was included in this prospective study. Read More

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Morphology-based radiomics signature: a novel determinant to identify multiple intracranial aneurysms rupture.

Aging (Albany NY) 2021 May 10;13. Epub 2021 May 10.

Department of Neurosurgery, Beijing Hospital, National Center of Gerontology, Graduate School of Peking Union Medical College, Beijing, China.

We aimed to develop and validate a morphology-based radiomics signature nomogram for assessing the risk of intracranial aneurysm (IA) rupture. A total of 254 aneurysms in 105 patients with subarachnoid hemorrhage and multiple intracranial aneurysms from three centers were retrospectively reviewed and randomly divided into the derivation and validation cohorts. Radiomics morphological features were automatically extracted from digital subtraction angiography and selected by the least absolute shrinkage and selection operator algorithm to develop a radiomics signature. Read More

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Neutrophil extracellular traps, released from neutrophil, promote microglia inflammation and contribute to poor outcome in subarachnoid hemorrhage.

Aging (Albany NY) 2021 May 8;13. Epub 2021 May 8.

Department of Neurological Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.

Evidence indicates that neutrophil has promoted inflammation in several central nervous system diseases. However, whether the peripheral blood levels of neutrophils are associated with the functional outcome after subarachnoid hemorrhage and its potential mechanism remain unclear. In this study, we showed that neutrophil levels in peripheral blood were higher in patients with subarachnoid hemorrhage ( < 0. Read More

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Gene expression signatures differentiating major depressive disorder from subsyndromal symptomatic depression.

Aging (Albany NY) 2021 May 8;13. Epub 2021 May 8.

Clinical Research Center, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China.

Subsyndromal symptomatic depression (SSD) and major depressive disorder (MDD) have been classified as distinct diseases, due to their dissimilar gene expression profiles and responses to venlafaxine. To identify specific biomarkers of these two diseases, we conducted a secondary analysis of the gene expression signatures of SSD patients, MDD patients and healthy controls (n=8/group) from the study of Yi et al. Global, individual, specific, enrichment and co-expression analyses were used to compare the transcriptomic profiles of peripheral blood lymphocytes from the three groups. Read More

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Plasma hemoglobin and the risk of death in HIV/AIDS patients treated with antiretroviral therapy.

Aging (Albany NY) 2021 May 7;13. Epub 2021 May 7.

Department of Preventive Medicine, School of Public Health and Management, Wenzhou Medical University, Wenzhou 325035, Zhejiang, China.

Background: Previous studies concerning the effect of plasma hemoglobin (HB) and other factors that may modify the risk of death in people living with HIV/AIDS (PLHIV) treated with antiretroviral therapy (ART) are limited.

Results: Higher HB was independently linked to a lower death risk in PLHIV, with a decrease of 29% (13%, 43%) per standard deviation (SD) increment after adjusting for CD4, VL and other potential factors [hazard ratio (HR): 0.71, 95% confidence interval (CI): 0. Read More

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Early arteriosclerosis and its risk factors in subjects with prediabetes and new-onset diabetes.

Endocr Connect 2021 May 1. Epub 2021 May 1.

Q Lu, Department of Endocrinology, The First Hospital of Qinhuangdao, Qinhuangdao, China.

Background: We aimed to investigate early arteriosclerosis and its risk factors in populations with prediabetes and new-onset diabetes.

Materials And Methods: A total of 148 participants who did not have diabetes mellitus were assigned to three groups through an oral glucose tolerance test: the normal glucose tolerance group; the impaired glucose regulation, also known as prediabetes, group; and the new-onset type 2 diabetes mellitus group. The insulin resistance index was assessed using the Homeostatic Model Assessment of Insulin Resistance. Read More

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Effect of plasma glucose at admission on COVID-19 mortality: experience from a tertiary hospital.

Endocr Connect 2021 May 1. Epub 2021 May 1.

S Misra, Director and Chief Executive Officer, All India Institute of Medical Sciences Jodphur, Jodhpur, India.

Objective: Plasma glucose has been correlated with in-hospital mortality among many diseases including infections. We aimed to study plasma glucose at admission of hospitalized patients with COVID-19 at a tertiary care referral hospital at Jodhpur, India and its relation with mortality.

Design: A hospital-based clinical study of plasma glucose of COVID-19 patients conducted from May 15th to June 30th, 2020 after ethical approval. Read More

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Experiences of responsiveness to exercise in people with chronic whiplash: A qualitative study.

Musculoskelet Sci Pract 2021 Apr 21;54:102380. Epub 2021 Apr 21.

Faculty of Medicine & Health, The University of Sydney, NSW, Australia; John Walsh Centre for Rehabilitation Research, Royal North Shore Hospital, NSW, Australia. Electronic address:

Exercise is recommended in clinical guidelines for the treatment of chronic whiplash associated disorders (WAD). However, randomised controlled trials have shown similar effects for comprehensive exercise programs and advice. To date, there is no clear understanding of why some individuals with WAD appear to respond to exercise whilst others do not. Read More

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