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Performance- and cost-benefit analysis of an influenza point-of-care test compared to laboratory-based multiplex RT-PCR in the emergency department.

Am J Infect Control 2021 May 10. Epub 2021 May 10.

Department of Epidemiology and Infection Prevention, Regional Public Health Laboratory Kennemerland, Haarlem, the Netherlands.. Electronic address:

Introduction: Influenza poses a heavy burden on emergency departments (ED) and hospital wards. Fast and reliable bedside tests are invaluable in obtaining indications for (cohort) droplet isolation precautions and improving patient flow. We performed a cost-benefit analysis comparing influenza point-of-care testing (POCT) to laboratory-based multiplex ligation-dependent probe amplification (MLPA). Read More

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Epidemiology of Heart Failure: A Contemporary Perspective.

Circ Res 2021 May 13;128(10):1421-1434. Epub 2021 May 13.

Department of Quantitative Health Sciences and Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN. Now at Division of Intramural Research, National Heart, Lung and Blood Institute, National Institutes of Health. Véronique L Roger, MD, MPH is now at Chief, Epidemiology and Community Health Branch National Heart, Lung and Blood Institute, National Institutes of Health.

Designated as an emerging epidemic in 1997, heart failure (HF) remains a major clinical and public health problem. This review focuses on the most recent studies identified by searching the Medline database for publications with the subject headings HF, epidemiology, prevalence, incidence, trends between 2010 and present. Publications relevant to epidemiology and population sciences were retained for discussion in this review after reviewing abstracts for relevance to these topics. Read More

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Embedding interactive, three-dimensional content in portable document format (PDF) to deliver gross anatomy information and knowledge.

Authors:
Jon Jatsu Azkue

Clin Anat 2021 May 12. Epub 2021 May 12.

Department of Neurosciences, School of Medicine and Nursery, University of the Basque Country, UPV/EHU, Leioa, Bizkaia, Spain.

Introduction: The Portable Document Format (PDF) is likely the most widely used digital file format for scholarly and scientific electronic publishing. Since format specification version 1.6, three-dimensional (3D) models in Universal 3D (U3D) format can be embedded into PDF files. Read More

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NMD inhibition by 5-azacytidine augments presentation of immunogenic frameshift-derived neoepitopes.

iScience 2021 Apr 1;24(4):102389. Epub 2021 Apr 1.

Molecular Medicine Partnership Unit (MMPU), Heidelberg University, 69120 Heidelberg, Germany.

Frameshifted protein sequences elicit tumor-specific T cell-mediated immune responses in microsatellite-unstable (MSI) cancers if presented by HLA class I molecules. However, their expression and presentation are limited by nonsense-mediated RNA decay (NMD). We employed an unbiased immunopeptidomics workflow to analyze MSI HCT-116 cells and identified >10,000 HLA class I-presented peptides including five frameshift-derived InDel neoepitopes. Read More

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Fundus albipunctatus photoreceptor microstructure revealed using adaptive optics scanning light ophthalmoscopy.

Am J Ophthalmol Case Rep 2021 Jun 16;22:101090. Epub 2021 Apr 16.

Icahn School of Medicine at Mount Sinai and New York Eye and Ear Infirmary of Mount Sinai, Department of Ophthalmology, New York, NY, USA.

Purpose: Fundus albipunctatus is an inherited cause of congenital stationary night blindness. The objective of this report is to describe structural changes occurring in a macular phenotype of a novel RDH5 mutation producing fundus albipunctatus using high-resolution imaging. A 62-year-old male with longstanding night blindness underwent imaging and genetic evaluation. Read More

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Successful Treatment of Ventriculitis Caused by MDR/XDR Gram-Negative Bacillus Using Ceftazidime/Avibactam: Case Series and Literature Review.

Infect Drug Resist 2021 5;14:1691-1701. Epub 2021 May 5.

Department of Neurosurgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, 310003, People's Republic of China.

Background: Central nervous system (CNS) infections caused by multidrug-resistant (MDR) and extensively drug-resistant (XDR) Gram-negative bacillus, including carbapenem-resistant Enterobacteriaceae (CRE) and are associated with high mortality rates. Clinical trials of ceftazidime/avibactam (CAZ/AVI) on infections of other systems indicate that they are effective against these infections. However, clinical studies on the efficacies of CAZ/AVI in the treatment of CNS infections have not been done. Read More

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DNGR-1 limits Flt3L-mediated antitumor immunity by restraining tumor-infiltrating type I conventional dendritic cells.

J Immunother Cancer 2021 May;9(5)

Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain

Background: Conventional type 1 dendritic cells (cDC1s) are central to antitumor immunity and their presence in the tumor microenvironment associates with improved outcomes in patients with cancer. DNGR-1 (CLEC9A) is a dead cell-sensing receptor highly restricted to cDC1s. DNGR-1 has been involved in both cross-presentation of dead cell-associated antigens and processes of disease tolerance, but its role in antitumor immunity has not been clarified yet. Read More

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Ozone therapy as an alternative method for the treatment of diabetic foot ulcer: a case report.

J Med Case Rep 2021 May 13;15(1):234. Epub 2021 May 13.

Department of Medical-Surgical Nursing, Nursing and Midwifery Faculty, School of Nursing and Midwifery, Urmia University of Medical Sciences, Campus Nazlu, 11 KM Road Seru, 575611-5111, Urmia, West Azerbaijan, Iran.

Background: Diabetic foot ulcer (DFU) is one of the most important complications of diabetes that can lead to amputation. Treatment of DFUs is a major challenge and places a heavy economic and social burden on patients and their families.

Case Presentation: The present case report is of a 52-year-old kurdish male patient with a 7-year history of type 2 diabetes. Read More

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Children with medical complexity and paediatric palliative care: a retrospective cross-sectional survey of prevalence and needs.

Ital J Pediatr 2021 May 12;47(1):110. Epub 2021 May 12.

Bioethics Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy.

Background: Children with medical complexity (CMC) have been defined (Cohen et al., Pediatrics 127: 529-538, 2011.) as an emerging population potentially eligible for PPC. Read More

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A preparedness model for the provision of oral health care during unfolding threats: the case of the covid-19 pandemic.

BMC Oral Health 2021 05 12;21(1):254. Epub 2021 May 12.

Director - Community Engagement; Department of Oral Health and Biomedical Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, Canada.

Background: The aim of this study was to appraise a recently developed preparedness model for the provision of oral health care during a threat such as the COVID-19 pandemic from the perspectives of oral health care providers, administrators/staff, and patients.

Methods: An exploratory qualitative inquiry via at-a-distance semi-structured interviews and group discussions engaged a purposefully selected sample of oral health care workers and patients in British Columbia (BC), Canada. Participants were asked to appraise a preparedness model by considering how to prepare for oral care during a pandemic, while answering open-ended questions about the model content and visual presentation. Read More

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Evolution of Disparities in Prostate Cancer Treatment: Is This a New Normal?

Am Soc Clin Oncol Educ Book 2021 Mar;41:1-12

Winship Cancer Institute, Emory University, Atlanta, GA.

Despite notable screening, diagnostic, and therapeutic advances, disparities in prostate cancer incidence and outcomes remain prevalent. Although commonly discussed in the context of men of African descent, disparities also exist based on socioeconomic level, education level, and geographic location. The factors in these disparities span systemic access issues affecting availability of care, provider awareness, and personal patient views and mistrust. Read More

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The first non-radiographic axial spondyloarthrits with COVID-19.

Immun Inflamm Dis 2021 May 12. Epub 2021 May 12.

The Rheumatology Group, South Charleston, West Virginia, USA.

Background: Case report of a 21-year-old female developing non-radiographic axialspondyloarthritis in the setting of a preceding severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. We felt this was a unique case as some cases of psoriatic arthropathy and reactive arthropathy but none, to our knowledge of non-radiographic axial spondyloarthritis.

Case Presentation: Twenty one-year-old female presented in June 2020 with inflammatory symptoms with general work-up per primary care provider being negative. Read More

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Impact of Patient Socioeconomic Disparities on Time to Tympanostomy Tube Placement.

Ann Otol Rhinol Laryngol 2021 May 12:34894211015741. Epub 2021 May 12.

UPMC Children's Hospital of Pittsburgh, Division of Pediatric Otolaryngology, Pittsburgh, PA, USA.

Objectives: Extensive literature exists documenting disparities in access to healthcare for patients with lower socioeconomic status (SES). The objective of this study was to examine access disparities and differences in surgical wait times in children with the most common pediatric otolaryngologic surgery, tympanostomy tubes (TT).

Methods: A retrospective cohort study was performed at a tertiary children's hospital. Read More

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Incidence and Clinical Characteristics of Paediatric-onset Type 2 Diabetes in Hong Kong: The Hong Kong Childhood Diabetes Registry 2008 to 2017.

Pediatr Diabetes 2021 May 12. Epub 2021 May 12.

Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong.

With increasing prevalence of childhood obesity worldwide, the incidence of pediatric-onset type 2 diabetes (T2D) is also increasing in many countries. We aim to analyze the time trend and incidence of T2D in children in Hong Kong from 2008 to 2017, and to characterize clinical characteristics at diagnosis. Data were retrieved from the Hong Kong Childhood Diabetes Registry. Read More

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Recent developments in the diagnosis and treatment of extrapulmonary non-tuberculous mycobacterial diseases.

Int J Tuberc Lung Dis 2021 May;25(5):340-349

Department of Clinical Research, ICMR, NIRT, Chennai, India.

Diseases due to pathogenic mycobacteria cause significant health and economic impact on humans worldwide. Although mycobacterial diseases primarily affect the lungs, the involvement of extrapulmonary organs has also gained ground, particularly among individuals with co-existing medical conditions. Besides complex organisms, non-tuberculous mycobacteria (NTM) are also known to cause pulmonary and extrapulmonary diseases. Read More

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Gerodontology in the dental school curriculum: A scoping review.

Gerodontology 2021 May 11. Epub 2021 May 11.

James Cook University, Townsville, QLD, Australia.

Objective: To explore the current status of gerodontology in the undergraduate dental curriculum.

Background: Internationally, there is recognition for the need to include gerodontology in dental education due to accelerating numbers of older dentate people. There is wide variation in the content and method of delivery of gerodontology in undergraduate curricula of dental schools. Read More

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High resolution structural and functional MRI of the hippocampus in young adults with Down syndrome.

Brain Commun 2021 19;3(2):fcab088. Epub 2021 Apr 19.

Department of Pediatrics, Case Western Reserve University, Cleveland, OH 44106, USA.

Down syndrome is the phenotypic consequence of trisomy 21, with clinical presentation including both neurodevelopmental and neurodegenerative components. Although the intellectual disability typically displayed by individuals with Down syndrome is generally global, it also involves disproportionate deficits in hippocampally-mediated cognitive processes. Hippocampal dysfunction may also relate to Alzheimer's disease-type pathology, which can appear in as early as the first decade of life and becomes universal by age 40. Read More

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Rare case of immunoglobulin G4-related disease arising in gonadal glands with long-term remission without steroid treatment: Discussion and literature review.

IJU Case Rep 2021 May 15;4(3):188-191. Epub 2021 Mar 15.

Department of Nephro-Urology Graduate School of Medical Sciences Nagoya City University Nagoya Japan.

Introduction: Immunoglobulin G4-related disease embraces a wide range of extra-pancreatic manifestations. However, localized pathogenesis in gonadal glands, including testes or seminal vesicles, is rare. The clinical course and therapeutic strategy for this disease have not been clearly characterized. Read More

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Clinical and Intestinal Histopathological Findings in SARS-CoV-2/COVID-19 Patients with Hematochezia.

Case Rep Gastroenterol 2021 Jan-Apr;15(1):408-417. Epub 2021 Mar 22.

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

Gastrointestinal (GI) symptoms of SARS-CoV-2/COVID-19 in the form of anorexia, nausea, vomiting, abdominal pain and diarrhea are usually preceded by respiratory manifestations and are associated with a poor prognosis. Hematochezia is an uncommon clinical presentation of COVID-19, and we hypothesize that older patients with significant comorbidities (obesity and cardiovascular) and prolonged hospitalization are susceptible to ischemic injury to the bowel. We reviewed the clinical course, key laboratory data including acute-phase reactants, and drug/medication history in 2 elderly male patients admitted for COVID-19 respiratory failure. Read More

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Combined Liposuction and Physiologic Treatment Achieves Durable Limb Volume Normalization in Class II-III Lymphedema: A Treatment Algorithm to Optimize Outcomes.

Ann Plast Surg 2021 May;86(5S Suppl 3):S384-S389

From the Division of Plastic and Reconstructive Surgery, Stanford University, Palo Alto, CA.

Introduction: Outcomes of surgical lymphedema treatment are currently suboptimal. Physiologic procedures including lymphovenous anastomosis (LVA) and vascularized lymph node transfer (VLNT) reestablish lymphatic flow but cannot correct fibroadipose deposition, whereas liposuction alone cannot prevent disease progression. We propose a treatment algorithm combining liposuction with LVA or VLNT that can achieve normal limb volumes and prevent disease progression in stage II-III lymphedema. Read More

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The DnaK/DnaJ Chaperone System Enables RNA Polymerase-DksA Complex Formation in Salmonella Experiencing Oxidative Stress.

mBio 2021 May 11;12(3). Epub 2021 May 11.

University of Colorado School of Medicine, Department of Immunology & Microbiology, Aurora, Colorado, USA

Our previous biochemical approaches showed that the oxidoreductase activity of the DnaJ protein facilitates the interaction of oxidized DksA with RNA polymerase. Investigations herein demonstrate that under biologically relevant conditions the DnaJ- and DksA-codependent activation of the stringent response in undergoing oxidative stress involves the DnaK chaperone. Oxidation of DksA cysteine residues stimulates redox-based and holdase interactions with zinc-binding and C-terminal domains of DnaJ. Read More

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Severe cutaneous presentation of hydralazine-induced ANCA vasculitis without renal or pulmonary involvement, complicated by DIC.

BMJ Case Rep 2021 May 11;14(5). Epub 2021 May 11.

Internal Medicine, Albany Medical Center, Albany, New York, USA.

Hydralazine is a common arterial vasodilator used in the management of congestive heart failure and hypertension. It can be associated with drug-induced lupus and less commonly antineutrophil cytoplasmic antibody (ANCA) associated vasculitis (AAV). Drug-induced AAV typically has a favourable long-term prognosis. Read More

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Cerebral Venous Thrombosis Associated with COVID-19 Infection: An Observational, Multicenter Study.

Cerebrovasc Dis Extra 2021 May 11;11(2):55-60. Epub 2021 May 11.

Rashid Hospital, Dubai, United Arab Emirates.

Background And Purpose: Coronavirus disease 2019 (CO-VID-19) has an increased propensity for systemic hypercoagulability and thromboembolism. An association with cerebrovascular diseases, especially cerebral venous thrombosis (CVT), has been reported among these patients. The objective of the present study was to identify risk factors for CVT as well as its presentation and outcome in COVID-19 patients. Read More

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Early recurrence of mandibular torus following surgical resection: A case report.

Int J Surg Case Rep 2021 Apr 30;83:105942. Epub 2021 Apr 30.

Department of Maxillofacial and Oral Surgery, University Hospital of Burgundy, 2 boulevard du Maréchal de Lattre de Tassigny, BP 77908, 21079 Dijon cedex, France.

Introduction And Importance: Tori are benign bony outgrowths that occur in different locations along the mandible and maxilla. Their origin is still uncertain; however, various hypotheses have been put forward, including male gender or mechanical overload. Recurrence of a torus after surgical resection is rarely described, and even less rapidly after a procedure. Read More

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Complex nasal reconstruction for skin cancer and posttraumatic deformity using a modified frontonasal flap - Case report.

Int J Surg Case Rep 2021 Apr 30;83:105944. Epub 2021 Apr 30.

Plastic and Aesthetic Surgery, AARE KLINIK, Bern, Switzerland. Electronic address:

Introduction And Importance: Reconstruction of the nasal tip is challenging, especially when large defects are associated with compromised nasal soft tissues and framework. The frontonasal flap is an axial-pattern myocutaneous flap from the glabella and nasal dorsum that allows for various modifications in flap design to cover medium sized defects of the nasal tip.

Case Presentation: A 66-year-old male patient presented with a large and ulcerated squamous cell carcinoma of the nasal tip that was associated with substantial posttraumatic damage of the nasal soft tissue envelope and cartilaginous vault of the dorsum. Read More

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Long-term survival case of esophageal carcinosarcoma coexisting with alcoholic liver cirrhosis successfully treated by staged operation: A case report.

Int J Surg Case Rep 2021 Apr 30;83:105946. Epub 2021 Apr 30.

Department of Surgery, Ota Memorial Hospital, 455-1 Oshima-cho, Ota, Gunma 373-8585, Japan.

Introduction: Patients with esophageal cancers including carcinosarcoma sometimes have underlying liver cirrhosis because of a history of heavy drinking. It is definitely required to determine the appropriate surgical strategy and to manage the patients promptly when performing esophagectomy for the esophageal carcinosarcoma coexisting with alcoholic liver cirrhosis.

Presentation Of Case: A 56-year-old male patient with a history of chest pain and difficulty swallowing was admitted to our hospital. Read More

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Impact of Insurance on Stage of Breast Cancer Presentation for Different Races and Ethnicities.

JCO Oncol Pract 2021 May;17(5):e603-e613

Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA.

Purpose: Survival in breast cancer is largely stage-dependent. Lack of insurance and Medicaid have been associated with later-stage breast cancer, but it is unknown to what degree this association varies by race or ethnicity.

Methods: We conducted a retrospective single-institution cohort analysis of women undergoing breast radiotherapy from 2012 to 2017 (n = 1,019). Read More

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Platelet-Rich Plasma Injection for Quadriceps Tendinopathy: A Case Report.

WMJ 2021 Apr;120(1):78-81

Department of Orthopaedic Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin.

Introduction: Platelet-rich plasma (PRP) is a promising treatment for persistent symptoms caused by various musculoskeletal injuries, including tendinopathies.

Case Presentation: A 47-year-old woman presented with chronic left knee pain following a motor vehicle accident. Magnetic resonance imaging (MRI) revealed distal quadriceps tendinosis and a partial tear of the vastus intermedius tendon. Read More

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Implications of Low-grade Inflammation in SARS-CoV-2 Immunopathology.

MEDICC Rev 2021 Apr 30;23(2):42. Epub 2021 Apr 30.

Immunology Laboratory, National Oncology and Radiobiology Institute (INOR), Havana, Cuba.

Introduction: Advanced age and chronic disease comorbidities are indicators of poor prognosis in COVID-19 clinical progression. Fatal outcomes in patients with these characteristics are due to a dysfunctional immune response. Understanding COVID-19's immunopathogenesis helps in designing strategies to prevent and mitigate complications during treatment. Read More

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[Care of rheumatology patients during the lockdown in early 2020 : Telemedicine, delegation, patient satisfaction and vaccination behavior].

Z Rheumatol 2021 May 11. Epub 2021 May 11.

Klinik für Rheumatologie und Immunologie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland.

Background: Telemedicine was implemented in outpatient care during the lockdown between March and May 2020. The aim of the study was to assess patients from a private practice and the university outpatient department with respect to patient satisfaction with telemedicine, COVID-19 worries and vaccination behavior and to compare the teleconsultation by a medical assistant for rheumatology (RFA) and a physician.

Methods: Patients with rheumatoid arthritis, psoriatric arthropathy or spondylarthritis without treatment modifications since the previous presentation were offered a telemedical replacement appointment within the framework of this study in the case of appointment cancellation by the treating center. Read More

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