21,557 results match your criteria presenting institution

A pediatric surgeon's dilemma: does cholecystectomy improve symptoms of biliary dyskinesia?

Pediatr Surg Int 2021 May 11. Epub 2021 May 11.

Ochsner Clinic Foundation, 1514 Jefferson Hwy, New Orleans, LA, 70121, USA.

Background: Biliary dyskinesia (BD) is a well-established gallbladder pathology in adult patients and rates of cholecystectomy for BD continue to rise in the United States. Many pediatric patients with vague abdominal pain of variable duration are evaluated for biliary dyskinesia. It remains unknown which cohort of pediatric patients diagnosed with BD are most likely to have sustained improvement in symptoms following laparoscopic cholecystectomy. Read More

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First case of ductal adenocarcinoma of the prostate with MAP3K1 homozygous deletion.

IJU Case Rep 2021 May 17;4(3):176-179. Epub 2021 Mar 17.

Department of Urology Keio University School of Medicine Tokyo Japan.

Introduction: Ductal adenocarcinoma of the prostate is a rare prostate cancer variant and associated with higher stage and greater risk of mortality. Optimal systemic therapy for metastatic ductal adenocarcinoma is not known.

Case Presentation: A 67-year-old man presented with ductal adenocarcinoma of the prostate accompanied by multiple lung metastases and advanced bone metastases. Read More

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Training the Trainers in Ultrasound-guided Access to Improve Peripheral Intravenous Catheter Placement among Children Presenting for Anesthesia.

Pediatr Qual Saf 2021 May-Jun;6(3):e406. Epub 2021 May 5.

Department of Anesthesiology and Pain Medicine, University of Washington School of Medicine, Seattle Children's Hospital, Seattle, Wash.

Factors predicting difficult peripheral intravenous (PIV) catheter placement in children are known. Ultrasound guidance can decrease the number of attempts required for difficult PIV placement. However, the uptake of this technique among attending anesthesiologists at our institution remained low. Read More

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Conservative versus invasive management of secondary spontaneous pneumothorax: a retrospective cohort study.

Acute Med Surg 2021 Jan-Dec;8(1):e663. Epub 2021 May 7.

Department of Respiratory Medicine Cairns Hospital Cairns QLD Australia.

Aim: Hospitalization, often with intervention, is the recommended management algorithm by multiple international respiratory societies for management of a secondary spontaneous pneumothorax (SSP). Over recent years we adopted a conservative approach to SSPs. We undertook a retrospective cohort study of SSP to establish the safety profile of a conservative approach for these previously unstudied patients. Read More

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Histological evaluation of acute ischemic stroke thrombi may indicate the occurrence of vessel wall injury during mechanical thrombectomy.

J Neurointerv Surg 2021 May 11. Epub 2021 May 11.

Department of Neurology, Grady Memorial Hospital, Atlanta, Georgia, USA.

Background: Several animal studies have demonstrated that mechanical thrombectomy (MT) for acute ischemic stroke (AIS) may cause vessel wall injury (VWI). However, the histological changes in human cerebral arteries following MT are difficult to determine.

Objective: To investigate the occurrence of VWI during MT by histological and immunohistochemical evaluation of AIS clots. Read More

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Criticality index conducted in pediatric emergency department triage.

Am J Emerg Med 2021 May 6;48:209-217. Epub 2021 May 6.

Children's Hospital of Orange County, Orange, CA, United States.

Objective: To develop and analyze the performance of a machine learning model capable of predicting the disposition of patients presenting to a pediatric emergency department (ED) based on triage assessment and historical information mined from electronic health records.

Methods: We retrospectively reviewed data from 585,142 ED visits at a pediatric quaternary care institution between 2013 and 2020. An extreme gradient boosting machine learning model was trained on a randomly selected training data set (50%) to stratify patients into 3 classes: (1) high criticality (patients requiring intensive care unit [ICU] care within 4 h of hospital admission, patients who died within 4 h of admission, and patients who died in the ED); (2) moderate criticality (patients requiring hospitalization without the need for ICU care); and (3) low criticality (patients discharged home). Read More

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A Comparative Analysis of Mucormycosis in Immunosuppressed hosts Including Patients with Uncontrolled Diabetes in the Southwest United States.

Am J Med 2021 May 8. Epub 2021 May 8.

Division of Infectious Diseases, Banner University Medical Center, University of Arizona, Tucson, United States.

Background: Mucormycosis (Zygomycosis) is an invasive fungal infection that carries a high risk of morbidity and mortality. Uncontrolled diabetes mellitus and other immunocompromising conditions are risk factors for Mucormycosis development. We here describe the differences in characteristics and outcomes of Mucormycosis among solid organ transplant, hematological malignancy, and diabetes mellitus groups at our institution. Read More

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Patient and public involvement in care home research: Reflections on the how and why of involving patient and public involvement partners in qualitative data analysis and interpretation.

Health Expect 2021 May 11. Epub 2021 May 11.

Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK.

Background: There is limited evidence for the impact of involving patients and the public (PPI) in health research. Descriptions of the PPI process are seldom included in publications, particularly data analysis, yet an understanding of processes and impacts of PPI is essential if its contribution to research is to be evaluated.

Objective: To describe the 'how' of PPI in qualitative data analysis and critically reflect on potential impact. Read More

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Subphthalocyanine-Diketopyrrolopyrrole Conjugates: 3D Star-Shaped Systems as Non-Fullerene Acceptors in Polymer Solar Cells with High Open-Circuit Voltage.

Chempluschem 2021 May 11. Epub 2021 May 11.

Instituto de Bioingeniería, Universidad Miguel Hernández, 03202, Elche, Spain.

Four star-shaped electron acceptors (C -OPh, C -OPh, C -Cl and C -Cl) based on a subphthalocyanine core bearing three diketopyrrolopyrrole wings linked by an acetylene bridge have been synthesized. These derivatives feature two different axial substituents (i. e. Read More

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A simple cognitive task intervention to prevent intrusive memories after trauma in patients in the Emergency Department: A randomized controlled trial terminated due to COVID-19.

BMC Res Notes 2021 May 10;14(1):176. Epub 2021 May 10.

Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, 171 77, Stockholm, Sweden.

Objective: This randomised controlled trial (RCT) aimed to investigate the effects of a simple cognitive task intervention on intrusive memories ("flashbacks") and associated symptoms following a traumatic event. Patients presenting to a Swedish emergency department (ED) soon after a traumatic event were randomly allocated (1:1) to the simple cognitive task intervention (memory cue + mental rotation instructions + computer game "Tetris" for at least 20 min) or control (podcast, similar time). We planned follow-ups at one-week, 1-month, and where possible, 3- and 6-months post-trauma. Read More

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Late Effects of Clubfoot Deformity in Adolescent and Young Adult Patients Whose Initial Treatment Was an Extensive Soft-tissue Release: Topic Review and Clinical Case Series.

J Am Acad Orthop Surg Glob Res Rev 2020 May;4(5):e1900126

From the Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, MO (Dr. Johnson, Dr. Klein, Dr. McCormick, Dr. Dobbs, Dr. Gordon, Dr. Schoenecker); the Department of Orthopaedic Surgery, Dartmouth-Hitchcock School of Medicine, New Hampshire, NH (Dr. Fortney); and the Congress Orthopaedic Associates, Arcadia, CA (Dr. Luk).

Children with congenital clubfoot often have residual deformity, pain, and limited function in adolescence and young adulthood. These patients represent a heterogeneous group that often requires an individualized management strategy. This article reviews the available literature on this topic while proposing a descriptive classification system based on a review of patients at our institution who underwent surgery for problems related to previous clubfoot deformity during the period between January 1999 and January 2012. Read More

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A multi-stage stochastic programming approach to epidemic resource allocation with equity considerations.

Health Care Manag Sci 2021 May 10. Epub 2021 May 10.

Department of Mechanical and Industrial Engineering, New Jersey Institute of Technology, Mechanical Engineering Center, 200 Central Ave #204, Newark, NJ, 07114, USA.

Existing compartmental models in epidemiology are limited in terms of optimizing the resource allocation to control an epidemic outbreak under disease growth uncertainty. In this study, we address this core limitation by presenting a multi-stage stochastic programming compartmental model, which integrates the uncertain disease progression and resource allocation to control an infectious disease outbreak. The proposed multi-stage stochastic program involves various disease growth scenarios and optimizes the distribution of treatment centers and resources while minimizing the total expected number of new infections and funerals. Read More

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Neglected sexual dysfunction symptoms amongst chronic patients during routine consultations in rural clinics in the North West province.

Afr J Prim Health Care Fam Med 2021 Apr 28;13(1):e1-e7. Epub 2021 Apr 28.

Division of Family Medicine, School of Clinical Medicine, University of the Witwatersrand, Johannesburg.

Background: Sexual dysfunction contributes to personal feelings of loss and despair and being a cause of exacerbated interpersonal conflict. Erectile dysfunction is also an early biomarker of cardiovascular disease. As doctors hardly ever ask about this problem, it is unknown how many patients presenting for routine consultations in primary care suffer from symptoms of sexual dysfunction. Read More

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Emergency department visits among people with cancer: Frequency, symptoms, and characteristics.

J Am Coll Emerg Physicians Open 2021 Jun 1;2(3):e12438. Epub 2021 May 1.

Division of Cancer Prevention and Control National Center for Chronic Disease Prevention and Health Promotion Centers for Disease Control and Prevention Atlanta Georgia USA.

Objective: People with cancer are increasingly more likely to visit an emergency department for acute care than the general population. They often have long wait times and more exposure to infection and receive treatment from staff less experienced with cancer-related problems. Our objective was to examine emergency department (ED) visits among people with cancer to understand how often and why they seek care. Read More

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Disaster Behavioral Health Research Involving Military Facilities and Populations after Mass Violence: Insights from the 2013 Washington Navy Yard Shooting.

Disaster Med Public Health Prep 2021 May 10:1-6. Epub 2021 May 10.

Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University, Bethesda, MD, USA.

Research on disaster behavioral health presents significant methodological challenges. Challenges are even more complex for research on mass violence events that involve military members, families, and communities, due to the cultural and logistical considerations of working with this population. The current article aims to inform and educate on this specialized area of research, by presenting a case study on the experience of designing and conducting disaster behavioral health research after a mass violence event in a military setting: the 2013 mass shooting at the Washington Navy Yard, in Washington, D. Read More

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Loss of function mutations in GEMIN5 cause a neurodevelopmental disorder.

Nat Commun 2021 May 7;12(1):2558. Epub 2021 May 7.

Department of Pediatric Neurophysiology AP-HP, Necker Enfants Malades Hospital, Paris University, Paris, France.

GEMIN5, an RNA-binding protein is essential for assembly of the survival motor neuron (SMN) protein complex and facilitates the formation of small nuclear ribonucleoproteins (snRNPs), the building blocks of spliceosomes. Here, we have identified 30 affected individuals from 22 unrelated families presenting with developmental delay, hypotonia, and cerebellar ataxia harboring biallelic variants in the GEMIN5 gene. Mutations in GEMIN5 perturb the subcellular distribution, stability, and expression of GEMIN5 protein and its interacting partners in patient iPSC-derived neurons, suggesting a potential loss-of-function mechanism. Read More

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MRSA Nasal Colonization Predicts MRSA Infection in Inpatient Paediatric Cellulitis.

Br J Dermatol 2021 May 6. Epub 2021 May 6.

Department of Dermatology, Massachusetts General Hospital, USA.

Cellulitis is an infection of the skin and skin-associated structures sometimes presenting with purulence, defined by generation of pus. Purulent infections can further be complicated by cutaneous abscess, a walled collection of pus in the subcutaneous space. Research on paediatric cellulitis is limited, and antimicrobial treatment widely varies even among paediatric infectious disease providers with some studies suggesting overuse of broad antibiotic coverage. Read More

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Benefits of conservative management of a retained appendicolith after laparoscopic appendectomy: A case series.

Int J Surg Case Rep 2021 Apr 27;82:105925. Epub 2021 Apr 27.

Trauma and Acute Care Surgery Unit, Department of Surgery, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia. Electronic address:

Introduction: Acute appendicitis is a disease with multifactorial etiology and frequently includes lumen obstruction. Appendicoliths can pose a challenge during the appendectomy procedure if not identified.

Methods: This is a prospective case series at our academic institution involving two medically free patients with intra-abdominal abscess formation secondary to an overlooked appendicolith who were treated conservatively with a follow up period of one year for each patient. Read More

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Endovascular Treatment of Popliteal Artery Aneurysms Has Comparable Long-Term Outcomes to Open Repair with Shorter Length of Stay.

J Vasc Surg 2021 May 3. Epub 2021 May 3.

Division of Vascular and Endovascular Surgery, Department of Surgery, NYU Langone Health, New York, NY. Electronic address:

Objective: Over the past two decades, the treatment of popliteal artery aneurysms (PAAs) has undergone a transformation. While open surgical repair (OR) remains the gold standard for treatment, endovascular repair (ER) has become an attractive alternative in select patient populations. The objective of this study was to compare the outcomes of open versus endovascular repair of PAAs at a single institution. Read More

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Pre-operative Risk Score Accuracy is Confirmed in a Modern Ruptured Abdominal Aortic Aneurysm Experience.

J Vasc Surg 2021 May 3. Epub 2021 May 3.

Division of Vascular Surgery, Department of Surgery, University of Washington, Seattle, Washington. Electronic address:

Objectives: Various risk score calculators predicting 30-day mortality following the treatment for ruptured abdominal aortic aneurysms (rAAA) have produced mixed results with regard to usefulness and reproducibility. We sought to prospectively validate the accuracy of our preoperative scoring system in a modern cohort of rAAA patients.

Methods: A retrospective review of all rAAA patients presenting to a single academic center between January 2002 and December 2018 was performed. Read More

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Considering Frailty in SARS-CoV-2 Vaccine Development: How Geriatricians Can Assist.

Clin Interv Aging 2021 28;16:731-738. Epub 2021 Apr 28.

Health Sciences North Research Institute, Sudbury, Ontario, Canada.

The COVID-19 pandemic has disproportionately impacted frail older adults, especially residents of long-term care (LTC) facilities. This has appropriately led to prioritization of frail older adults and LTC residents, and those who care for them, in the vaccination effort against COVID-19. Older adults have distinct immunological, clinical, and practical complexity, which can be understood through a lens of frailty. Read More

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Aortic neck IFU violations during EVAR for ruptured infrarenal aortic aneurysms are associated with increased in-hospital mortality.

Ann Vasc Surg 2021 May 2. Epub 2021 May 2.

Division of Vascular Surgery and Endovascular Therapy, The Johns Hopkins Medical Institutions, Baltimore, MD, USA.

Objective: Vascular surgeons treating patients with ruptured abdominal aortic aneurysm (rAAA) must make rapid treatment decisions and sometimes lack immediate access to endovascular devices meeting the anatomic specifications of the patient at hand. We hypothesized that endovascular treatment of rAAA (rEVAR) outside manufacturer instructions-for-use (IFU) guidelines would have similar in-hospital mortality compared to patients treated on-IFU or with an infrarenal clamp during open repair (rOAR).

Methods: Vascular Quality Initiative (VQI) datasets for endovascular and open aortic repair were queried for patients presenting with ruptured infrarenal AAA between 2013-2018. Read More

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Anatomical Location of Initial and Repeat Mandible Fractures: A 5-Year, Multi-Institution Retrospective Study.

J Oral Maxillofac Surg 2021 Mar 27. Epub 2021 Mar 27.

Professor and Reichmann Chair, Department of Oral and Maxillofacial Surgery, University of Oklahoma, Oklahoma City, OK.

Purpose: The purpose of the present study was to investigate new fracture patterns resulting from low velocity mechanisms in subjects who had previously fractured their mandible and had been treated with open reduction and internal fixation (ORIF) or closed reduction.

Methods And Materials: A multi-institutional retrospective cohort study was designed to analyze subjects presenting at 2 tertiary care centers with mandibular fractures with specific interest in subjects who had repeat mandible fractures. Variables recorded included demographic (age, sex, etc) data, fracture location of all fractures treated, and the location of previous fracture. Read More

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Risk factors, demographic profiles, and management of uncomplicated recurrent urinary tract infections: a single institution study.

Menopause 2021 May 3. Epub 2021 May 3.

Department of Urology, The Ohio State University Wexner Medical Center, Columbus, OH.

Objective: Recurrent urinary tract infections (rUTI) are a common urologic chief complaint. Although rUTIs are a significant burden on the healthcare system, until recently there were no published guidelines to delineate optimal management of this condition. The objective of this study was to describe the demographic profile of rUTI patients and summarize practice patterns at a single tertiary health center, as well as to assess whether our real-life practice patterns parallel the recently published guidelines. Read More

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Emergency appendicectomy during COVID-19 pandemic - A single UK centre experience.

Pol Przegl Chir 2021 Mar;93(2):33-39

Department of Surgery, University Hospital North Midlands, Stoke-on-Trent, United Kingdom.

Background - In December 2019 following an outbreak of Novel coronavirus infection (COVID-19) in Wuhan, China, it spread rapidly overwhelming the healthcare systems globally. With little knowledge of COVID-19 virus, very few published reports on surgical outcomes; hospitals stopped elective surgery, whilst emergency surgery was offered only after exhausting all conservative treatment modalities. This study presents our experience of outcomes of emergency appendectomies performed during the pandemic. Read More

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The role of treatment delays in surgical site infection after appendicectomy in a South African rural regional hospital.

S Afr Med J 2021 Mar 2;111(3):271-275. Epub 2021 Mar 2.

Department of Surgery, Worcester Regional Hospital, Western Cape Department of Health, South Africa; Ukwanda, Centre for Rural Health, Stellenbosch University, Worcester Campus, South Africa; Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.

Background: Delays to surgery for acute appendicitis in low- and middle-income countries lead to significant morbidity.

Objectives: To investigate the role of time to surgery in the development of complicated appendicitis and surgical site infection (SSI) in a rural referral hospital in South Africa (SA).

Methods: A prospective cohort study was conducted of all patients presenting to a regional hospital in SA with acute appendicitis during 2017. Read More

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The clinical utility of intrapartum screening urinalysis for the prevention of postpartum pyelonephritis.

Eur J Obstet Gynecol Reprod Biol 2021 Apr 24;261:154-159. Epub 2021 Apr 24.

Department of Obstetrics and Gynecology, American University of Beirut Medical Center, Beirut, Lebanon. Electronic address:

Objectives: Urinary tract infection (UTI) is the most common bacterial infection to complicate pregnancy. Medical authorities recommend screening for asymptomatic bacteriuria (ASB) in pregnancy; albeit there is no consensus on ideal timing and frequency for testing. Due to the persistent physiologic changes of pregnancy postpartum, a recent trend to perform urinalysis upon presentation for delivery has been adopted at our institution and various satellite hospitals to putatively minimize cases of postpartum pyelonephritis. Read More

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How Free Is Free Health Care? An Assessment of Universal Health Coverage Among Jamaicans with Sickle Cell Disease.

Health Equity 2021 21;5(1):210-217. Epub 2021 Apr 21.

Caribbean Institute for Health Research-Sickle Cell Unit, The University of the West Indies Mona Campus, Kingston, Jamaica.

In an effort to transition toward universal health coverage (UHC), Jamaica abolished user fees at all public health facilities in 2008. We aimed to determine the extent of out-of-pocket payments (OPPs) and the other cost barriers to UHC among patients with sickle cell disease (SCD). Patients presenting to the Sickle Cell Unit in Kingston, Jamaica, for routine care between October 2019 and August 2020 were consecutively recruited and interviewed about their latest hospitalization within the previous 4 weeks. Read More

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Case Report: Stage VI Morel-Lavallée Lesion with a Large Challenging Defect.

Plast Reconstr Surg Glob Open 2021 Apr 28;9(4):e3502. Epub 2021 Apr 28.

Plastic Surgery Division, School of Medicine, Universidade de São Paulo, Brazil.

Morel-Lavallée lesion (MLL) is a closed degloving soft-tissue injury that results in the accumulation of a hemolymphatic fluid between the skin/superficial fascia and the deep fascia. This is a rare injury that may be challenging to diagnose, and necessitates early identification and treatment to achieve the best outcomes. We report the case of a 45-year-old male patient who was referred to our institution for large wound closure after undergoing debridement of a misdiagnosed MLL that became complicated by infection and sepsis. Read More

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Innovations in the national household random sampling in Brazilian National Health Survey: results from Starfield and Shi's adult primary care assessment tool (PCAT).

Int J Equity Health 2021 May 1;20(1):113. Epub 2021 May 1.

Post-Graduate Studies Program in Epidemiology, Federal University of Rio Grande do Sul (UFRGS), 2400 Ramiro Barcellos Street, Santa Cecília, Porto Alegre, RS, 90035-003, Brazil.

Background: Several middle and upper income countries carry out household surveys that seek to trace the profile of access and use of health services. Probably one of the most ambitious examples is Brazil, with its National Health Survey (PNS-2019). We evaluated PNS-2019, presenting in an unprecedented way, one of its innovations, which refer to Starfield and Shi's adult Primary Care Assessment Tool (PCAT). Read More

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