339,484 results match your criteria primary outcome


Effectiveness of antibiotic prophylaxis in patients with centipede stings: a randomized controlled trial.

Clin Exp Emerg Med 2021 Mar 31;8(1):43-47. Epub 2021 Mar 31.

Department of Emergency Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.

Objective: Centipede stings are a common problem in tropical countries. Current treatment guidelines do not include recommendations for antibiotic prophylaxis to prevent the associated bacterial infection since no previous study has assessed the effectiveness of antibiotic treatment in patients bitten by centipedes. Thus, this study aimed to compare the effectiveness of antibiotic prophylaxis over placebo for the skin infections that occur after a centipede sting. Read More

View Article and Full-Text PDF

Association between the number of prehospital defibrillation attempts and neurologic outcomes in out-of-hospital cardiac arrest patients without on-scene return of spontaneous circulation.

Clin Exp Emerg Med 2021 Mar 31;8(1):21-29. Epub 2021 Mar 31.

Department of Emergency Medicine, Seoul National University Hospital, Seoul, Korea.

Objective: Delivery of prehospital defibrillation for shockable rhythms by emergency medical service providers is crucial for successful resuscitation in out-of-hospital cardiac arrest (OHCA) patients. The optimal range of prehospital defibrillation attempts for refractory shockable rhythms is unknown. This study evaluated the association between the number of prehospital defibrillation attempts and neurologic outcomes in OHCA patients. Read More

View Article and Full-Text PDF

Use of noninvasive volume assessment methods to predict acute blood loss in spontaneously breathing volunteers.

Clin Exp Emerg Med 2021 Mar 31;8(1):9-15. Epub 2021 Mar 31.

Department of Emergency Medicine, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey.

Objective: The use of noninvasive volume assessment methods to predict acute blood loss in spontaneously breathing patients remains unclear. We aimed to investigate changes in the pleth variability index (PVI), vena cava collapsibility index (VCCI), end-tidal carbon dioxide (EtCO2), pulse pressure (PP), and mean arterial pressure (MAP) in spontaneously breathing volunteers after acute loss of 450 mL blood and passive leg raise (PLR).

Methods: This prospective observational study enrolled healthy volunteers in the blood donation center of an academic hospital. Read More

View Article and Full-Text PDF

Public awareness and willingness to use automated external defibrillators in a metropolitan city.

Clin Exp Emerg Med 2021 Mar 31;8(1):1-8. Epub 2021 Mar 31.

Department of Emergency Medicine, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Seoul, Korea.

Objective: Early defibrillation is crucial for the survival of patients with out-of-hospital cardiac arrest. This study aimed to examine the trends and associated factors regarding public awareness and willingness to use automated external defibrillators (AEDs) through citywide surveys.

Methods: Three-round surveys were conducted in February 2012 (n=1,000), December 2016 (n=1,141), and December 2018 (n=1,001) among citizens in Daegu, South Korea, who were aged ≥19 years. Read More

View Article and Full-Text PDF

Early PARacetamol (EPAR) Trial: A Randomized Controlled Trial of Early Paracetamol to Promote Closure of the Ductus Arteriosus in Preterm Infants.

Neonatology 2021 Apr 12:1-8. Epub 2021 Apr 12.

Department of Newborn Care, Royal Hospital for Women, Sydney, New South Wales, Australia.

Introduction: This study aimed to investigate whether early treatment with paracetamol reduces the number of infants requiring intervention for patent ductus arteriosus (PDA) and assess the safety profile of paracetamol during the early postnatal period.

Methods: This was a double-blind, parallel, randomized, placebo-controlled trial. Preterm infants born at <29-week gestation with a ductus arteriosus >0. Read More

View Article and Full-Text PDF

The Skin-Sparing Debridement Technique in Necrotizing Soft-Tissue Infections: A Systematic Review.

J Surg Res 2021 Apr 9;264:296-308. Epub 2021 Apr 9.

Burn Centre, Red Cross Hospital, Beverwijk, The Netherlands; Department of Surgery, Rode Kruis Ziekenhuis Beverwijk, The Netherlands; Pediatric Surgical Centre, Emma Children's Hospital, Amsterdam UMC, location AMC, Amsterdam, The Netherlands; Department of Surgery, Red Cross Hospital, Beverwijk, The Netherlands. Electronic address:

Background: Skin-sparing debridement (SSd) was introduced as an alternative to en bloc debridement (EBd) to decrease morbidity caused by scars in patients surviving Necrotizing soft-tissue infections (NSTI). An overview of potential advantages and disadvantages is needed. The aim of this review was to assess (1) whether SSd is noninferior to EBd regarding general outcomes, that is, mortality, length of stay (LOS), complications, and (2) if SSd does indeed result in decreased skin defects. Read More

View Article and Full-Text PDF

Transcriptional signatures underlying dynamic phenotypic switching and novel disease biomarkers in a linear cellular model of melanoma progression.

Neoplasia 2021 Apr 9;23(4):439-455. Epub 2021 Apr 9.

Pharmacology Department, Universidade Federal de São Paulo, São Paulo, Brazil. Electronic address:

Despite advances in therapeutics, the progression of melanoma to metastasis still confers a poor outcome to patients. Nevertheless, there is a scarcity of biological models to understand cellular and molecular changes taking place along disease progression. Here, we characterized the transcriptome profiles of a multi-stage murine model of melanoma progression comprising a nontumorigenic melanocyte lineage (melan-a), premalignant melanocytes (4C), nonmetastatic (4C11-) and metastasis-prone (4C11+) melanoma cells. Read More

View Article and Full-Text PDF

Reproductive characteristics, semen quality, seminal oxidative status, steroid hormones, sperm production efficiency of rabbits fed herbal supplements.

Theriogenology 2021 Mar 31;168:41-49. Epub 2021 Mar 31.

Department of Science Technology, Federal Polytechnic Ado Ekiti, Ekiti State, Nigeria. Electronic address:

Today, orthodox medicine has almost exceeded its limits in resolving subfertility problems in animals, thus making phytomedicine a primary tool in the treatment of infertility. In this work, three herbal supplements obtained from freshly air-dried Moringa oleifera, Phyllanthus amarus and Viscum album leaves were evaluated to ascertain their comparative effect on the reproductive potentials of bucks. Sixty bucks were allotted four diets made up of standard grower rabbit ration without supplement and with 5% Moringa, Mistletoe and Phyllanthus supplementation for 84 days. Read More

View Article and Full-Text PDF

Pre-deployment personality traits predict prescription opioid receipt over 2-year post-deployment period in a longitudinal cohort of deployed National Guard soldiers.

Addict Behav 2021 Mar 22;119:106919. Epub 2021 Mar 22.

Minneapolis VA Health Care System, Minneapolis, MN, USA; Department of Psychiatry, University of Minnesota Medical School, Minneapolis, MN, USA; Department of Psychology, University of Minnesota, Minneapolis, MN, USA. Electronic address:

Background: While military service members are at risk forpain conditions, receipt of prescribed opioids is associated with a range of serious adverse outcomes. The goal of this study is to examine the association between pre-deployment personality traits and receipt of prescription opioids after return from deployment.

Method: Data were drawn from the Readiness and Resilience in National Guard Soldiers (RINGS) cohort study, an ongoing study of post-deployment health. Read More

View Article and Full-Text PDF

Genomic and clinical significance of multiple primary lung cancers (MPLCs) as determined by next generation sequencing (NGS).

J Thorac Oncol 2021 Apr 9. Epub 2021 Apr 9.

University of Melbourne Department of Surgery, St Vincent's Hospital, Fitzroy, Australia;; Victorian Comprehensive Cancer Centre, Parkville, Australia;; Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Parkville, Australia. Electronic address:

Introduction: Significant variations in survival rates have brought into question whether standard clinicopathological classification should be applied to patients presenting with multiple primary lung cancers (MPLC). This study investigated the genetic profiles of MPLCs in a cohort of patients using NGS and correlated Results to clinicopathological data and patient outcome.

Methods: Patients treated surgically with curative intent for two putative primaries of similar histology from January 2000 to December 2019 at St Vincent's Hospital Melbourne. Read More

View Article and Full-Text PDF

Bacterial infections in patients with acute variceal bleeding in the era of antibiotic prophylaxis.

J Hepatol 2021 Apr 9. Epub 2021 Apr 9.

Servicio de Gastroenterología y Hepatología, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Universidad de Alcalá, Madrid, Spain; Centro de Investigación Biomédica Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain. Electronic address:

Background And Aims: Antibiotic prophylaxis reduces the risk of infection and mortality in cirrhotic patients with acute variceal bleeding (AVB). This study examines the incidence and risk factors of bacterial infections during hospitalization in patients with AVB on antibiotic prophylaxis.

Methods: Post-hoc analysis of the database of an international, multicenter, observational study designed to examine the role of preemptive TIPS in patients with cirrhosis and AVB. Read More

View Article and Full-Text PDF

A Real-World Comparison of Cardiovascular, Medical and Costs Outcomes in New Users of SGLT2 Inhibitors versus GLP-1 Agonists.

Diabetes Res Clin Pract 2021 Apr 9:108800. Epub 2021 Apr 9.

Humana Healthcare Research, Inc., Humana Inc., Louisville, KY.

Aims: To compare SGLT2 inhibitors and GLP-1 agonists on cardiovascular (CV) outcomes, treatment persistence/discontinuation, healthcare utilization and costs.

Methods: This retrospective cohort study utilized medical and pharmacy claims to identify new SGLT2 inhibitor or GLP-1 agonist users from January 2015 to June 2017. A total of 5,507 patients were included in each treatment group after 1:1 propensity score matching. Read More

View Article and Full-Text PDF

Inhaled budesonide in the treatment of early COVID-19 (STOIC): a phase 2, open-label, randomised controlled trial.

Lancet Respir Med 2021 Apr 9. Epub 2021 Apr 9.

Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK; National Institute for Health Research (NIHR), Oxford Biomedical Research Centre, Oxford, UK. Electronic address:

Background: Multiple early reports of patients admitted to hospital with COVID-19 showed that patients with chronic respiratory disease were significantly under-represented in these cohorts. We hypothesised that the widespread use of inhaled glucocorticoids among these patients was responsible for this finding, and tested if inhaled glucocorticoids would be an effective treatment for early COVID-19.

Methods: We performed an open-label, parallel-group, phase 2, randomised controlled trial (Steroids in COVID-19; STOIC) of inhaled budesonide, compared with usual care, in adults within 7 days of the onset of mild COVID-19 symptoms. Read More

View Article and Full-Text PDF

Tremelimumab plus durvalumab retreatment and 4-year outcomes in patients with mesothelioma: a follow-up of the open label, non-randomised, phase 2 NIBIT-MESO-1 study.

Lancet Respir Med 2021 Apr 9. Epub 2021 Apr 9.

Center for Immuno-Oncology, Medical Oncology and Immunotherapy, Department of Oncology, University Hospital of Siena, Siena, Italy; EPigenetic Immune-Oncology Consortium Airc (EPICA), Rome, Italy; Department of Medicine, Surgery, and Neuroscience, University of Siena, Siena, Italy; Fondazione Italian Network for Tumour Biotherapy (NIBIT) Onlus, Siena, Italy. Electronic address:

Background: The NIBIT-MESO-1 study demonstrated the efficacy and safety of tremelimumab combined with durvalumab in patient with unresectable mesothelioma followed up for a median of 52 months [IQR 49-53]. Here, we report 4-year survival and outcomes after retreatment, and the role of tumour mutational burden (TMB) in identifying patients who might have a better outcome in response to combined therapy.

Methods: NIBIT-MESO-1 was an open-label, non-randomised, phase 2 trial of patients with unresectable pleural or peritoneal mesothelioma who received intravenous tremelimumab (1 mg/kg bodyweight) and durvalumab (20 mg/kg bodyweight) every 4 weeks for four doses, followed by maintenance intravenous durvalumab at the same dose and schedule for nine doses. Read More

View Article and Full-Text PDF

SARS-CoV-2 infection rates of antibody-positive compared with antibody-negative health-care workers in England: a large, multicentre, prospective cohort study (SIREN).

Lancet 2021 Apr 9. Epub 2021 Apr 9.

Public Health England Colindale, Colindale, London, UK; The National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance at the University of Oxford, University of Oxford, Oxford, UK.

Background: Increased understanding of whether individuals who have recovered from COVID-19 are protected from future SARS-CoV-2 infection is an urgent requirement. We aimed to investigate whether antibodies against SARS-CoV-2 were associated with a decreased risk of symptomatic and asymptomatic reinfection.

Methods: A large, multicentre, prospective cohort study was done, with participants recruited from publicly funded hospitals in all regions of England. Read More

View Article and Full-Text PDF

Prophylactic Use of Negative Pressure Therapy in General Abdominal Surgery: A Systematic Review and Meta-Analysis.

Surg Infect (Larchmt) 2021 Apr 12. Epub 2021 Apr 12.

Department of General, Visceral, and Transplantation Surgery, Clinic and University Hospital Virgen de la Arrixaca, IMIB-ARRIXACA, Murcia, Spain.

Surgical site infections (SSIs) represent an economic burden to healthcare systems. The use of negative pressure wound therapy (NPWT) for SSI prophylaxis remains uncertain. A systematic literature search was conducted in Medline/PubMed, CINAHL, and Web of Science for relevant studies. Read More

View Article and Full-Text PDF

Venetoclax with azacitidine or decitabine in blast-phase myeloproliferative neoplasm: a multicenter series of 32 consecutive cases.

Am J Hematol 2021 Apr 12. Epub 2021 Apr 12.

Division of Hematology, Mayo Clinic, Rochester, MN, USA.

Venetoclax (Ven) combined with a hypomethylating agent (HMA) has now emerged as an effective treatment regimen for acute myeloid leukemia, in both de novo and relapsed/refractory setting. The current multicenter study retrospectively examined Ven+HMA treatment outcome among 32 patients (median age 69 years; 59% males) with blast-phase myeloproliferative neoplasm (MPN-BP). Pre-leukemic phenotype included essential thrombocythemia (ET)/post-ET myelofibrosis (34%), polycythemia vera (PV)/post-PV myelofibrosis (38%) and primary myelofibrosis (28%). Read More

View Article and Full-Text PDF

Children with Primary Septic Arthritis Have a Markedly Lower Risk of Adverse Outcomes Than Those with Contiguous Osteomyelitis.

J Bone Joint Surg Am 2021 Apr 12. Epub 2021 Apr 12.

Children's Health System of Texas, Dallas, Texas.

Background: It is widely believed that septic arthritis poses a risk of joint destruction and long-term adverse outcomes for children if not treated emergently. In the present study, children who had primary confirmed septic arthritis were compared with those who had septic arthritis and adjacent osteomyelitis to evaluate differences that affect the relative risk of adverse outcomes.

Methods: Children who underwent multidisciplinary treatment for septic arthritis with or without contiguous osteomyelitis between 2009 and 2019 were retrospectively studied. Read More

View Article and Full-Text PDF

Erythritol air-polishing in the non-surgical treatment of peri-implantitis; a randomized controlled trial.

Clin Oral Implants Res 2021 Apr 12. Epub 2021 Apr 12.

Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.

Objectives: To compare erythritol air-polishing with piezoelectric ultrasonic scaling in the non-surgical treatment of peri-implantitis.

Material And Methods: Eighty patients (n=139 implants) with peri-implantitis (probing pocket depth (PPD) ≥5mm, marginal bone loss (MBL) ≥2mm as compared to bone level at implant placement, bleeding and/or suppuration on probing (BoP/SoP)) were randomly allocated to air-polishing or ultrasonic treatment. The primary outcome was mean BoP (%) at 3 months after therapy (T3). Read More

View Article and Full-Text PDF

Posterior drooling in children with cerebral palsy and other neurodevelopmental disorders.

Dev Med Child Neurol 2021 Apr 12. Epub 2021 Apr 12.

Department of Otorhinolaryngology-Head and Neck Surgery, Institute for Health Sciences, Radboud University Medical Centre, Nijmegen, the Netherlands.

Aim: To evaluate the effect of botulinum neurotoxin A (BoNT-A) injections, submandibular gland excision (SMGE), and bilateral submandibular duct ligation (2DL) for the control of posterior drooling in children with neurological impairment.

Method: In a retrospective cohort, children with neurological impairment (e.g. Read More

View Article and Full-Text PDF

Monitoring of stimulated cycles in assisted reproduction (IVF and ICSI).

Cochrane Database Syst Rev 2021 Apr 12;4:CD005289. Epub 2021 Apr 12.

Division of Applied Health Sciences, University of Aberdeen, Aberdeen Maternity Hospital, Aberdeen, UK.

Background: Monitoring of in vitro fertilisation (IVF) and intra-cytoplasmic sperm injection (ICSI) is necessary to detect as well as reduce the incidence and severity of ovarian hyperstimulation syndrome (OHSS) whilst achieving the optimal ovarian response needed for assisted reproduction treatment. Traditional monitoring of ovarian hyperstimulation during in vitro fertilisation IVF and ICSI treatment has included transvaginal ultrasonography (TVUS) plus serum estradiol levels. The need for combined monitoring (using TVUS and serum estradiol) during ovarian stimulation in assisted reproduction is controversial. Read More

View Article and Full-Text PDF

Association of visceral adiposity index with new-onset type 2 diabetes and impaired fasting glucose in hypertensive Chinese adults.

Eat Weight Disord 2021 Apr 12. Epub 2021 Apr 12.

Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou, 510515, China.

Purpose: Visceral adiposity index (VAI) is a reliable indicator for the distribution and function of adipose tissue in the body. The relation of VAI with new-onset type 2 diabetes and new-onset impaired fasting glucose (IFG) remains uncertain. We aimed to investigate the prospective relation of VAI with new-onset type 2 diabetes and new-onset IFG in Chinese hypertensive adults. Read More

View Article and Full-Text PDF

Restarting Elective Bariatric and Metabolic Surgery Under a Security Protocol During the COVID-19 Pandemic-a Prospective Observational Cohort Study.

Obes Surg 2021 Apr 12. Epub 2021 Apr 12.

Faculdade de Medicina, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil.

Background: During the SARS-CoV-2 pandemic, in order to protect the patient and to save hospital beds, cancelation of elective surgeries has become a great challenge. Considering that obesity is a chronic disease and the possible effect imposed by quarantine on weight gain with worsening rates of obesity and metabolic comorbidities, the creation of a protocol for a safe return to bariatric surgery became essential.

Objective: The aim of this study was to identify the incidence of new-onset severe acute respiratory syndrome coronavirus (SARS-CoV-2) symptoms in patients who underwent bariatric procedures during the declining curve period. Read More

View Article and Full-Text PDF

Beneficial effect of low-dose radioiodine ablation for Graves' orbitopathy: results of a retrospective study.

J Endocrinol Invest 2021 Apr 12. Epub 2021 Apr 12.

Department of Clinical and Experimental Medicine, Endocrinology Unit II, University of Pisa and University Hospital of Pisa, Via Paradisa 2, 56124, Pisa, Italy.

Objective: Graves' orbitopathy (GO) reflects an autoimmune response against antigens expressed by the thyroid and orbital tissues. Elimination of thyroid antigens may be beneficial for GO. Total thyroid ablation (TTA) [thyroidectomy (Tx), followed by 30 mCi of radioiodine] was shown to exert a beneficial effect on GO following intravenous glucocorticoids (ivGC) compared with Tx alone. Read More

View Article and Full-Text PDF

Exit Strategies in Natalizumab-Treated RRMS at High Risk of Progressive Multifocal Leukoencephalopathy: a Multicentre Comparison Study.

Neurotherapeutics 2021 Apr 12. Epub 2021 Apr 12.

Department "G.F. Ingrassia", MS Center, Organization University of Catania, Catania, Italy.

The main aim of the study is to evaluate the efficacy and safety profile of ocrelizumab (OCR), rituximab (RTX), and cladribine (CLA), employed as natalizumab (NTZ) exit strategies in relapsing-remitting multiple sclerosis (RRMS) patients at high-risk for progressive multifocal leukoencephalopathy (PML). This is a multicentre, retrospective, real-world study on consecutive RRMS patients from eleven tertiary Italian MS centres, who switched from NTZ to OCR, RTX, and CLA from January 1st, 2019, to December 31st, 2019. The primary study outcomes were the annualized relapse rate (ARR) and magnetic resonance imaging (MRI) outcome. Read More

View Article and Full-Text PDF

Percutaneous ablation of post-surgical solitary early recurrence of colorectal liver metastases is an effective "test-of-time" approach.

Updates Surg 2021 Apr 12. Epub 2021 Apr 12.

Division of Hepatobiliary and General Surgery, Department of Surgery, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089, Rozzano, Milan, Italy.

Standard treatment of early recurrence of colorectal liver metastases (CLM) after liver resection (LR) is chemotherapy followed by loco-regional therapy. We reviewed the outcome of a different strategy ("test-of-time" approach): upfront percutaneous ablation without chemotherapy. Twenty-six consecutive patients with early solitary liver-only recurrence amenable to both resection and ablation (< 30 mm, distant from vessels) undergone "test-of-time" approach were analyzed. Read More

View Article and Full-Text PDF

Sinonasal mucosal melanoma: treatment strategies and survival rates for a rare disease entity : A single center experience and review of literature.

Wien Klin Wochenschr 2021 Apr 12. Epub 2021 Apr 12.

Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Graz, Auenbruggerplatz 26, 8036, Graz, Austria.

Background: Sinonasal mucosal melanoma (SNMM) is a rare disease entity comprising 0.4-1.3% of all melanomas. Read More

View Article and Full-Text PDF

Nutritional status and risk of contrast-associated acute kidney injury in elderly patients undergoing percutaneous coronary intervention.

Clin Exp Nephrol 2021 Apr 12. Epub 2021 Apr 12.

Department of Geriatric Medicine, Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fujian Provincial Institute of Clinical Geriatrics, Fujian Key Laboratory of Geriatrics, Fujian Provincial Center for Geriatrics, Fuzhou, 350001, Fujian, China.

Background: This study aimed to investigate the connection between malnutrition evaluated by the Controlling Nutritional Status (CONUT) score and the risk of contrast-associated acute kidney injury (CA-AKI) in elderly patients who underwent percutaneous coronary intervention (PCI).

Methods: A total of 1308 patients aged over 75 years undergoing PCI was included. Based on the CONUT score, patients were assigned to normal (0-1), mild malnutrition (2-4), moderate-severe malnutrition group (≥ 5). Read More

View Article and Full-Text PDF

Clinical and Demographic Factors, Treatment Patterns, and Overall Survival Associated With Rare Triple-Negative Breast Carcinomas in the US.

JAMA Netw Open 2021 Apr 1;4(4):e214123. Epub 2021 Apr 1.

Department of Hematology-Oncology, Maroone Cancer Center, Cleveland Clinic Florida, Weston, Florida.

Importance: Triple-negative breast cancers are known collectively to demonstrate a more aggressive clinical course and earlier recurrence than cancers of other histological subtypes. However, the literature on rare triple-negative breast cancers and the association of histological type with survival and risk of metastasis is sparse.

Objective: To present the clinical and demographic characteristics, treatment patterns, and overall survival (OS) for histologically rare (<10% of breast cancers) triple-negative breast cancer types: medullary carcinoma, adenoid cystic carcinoma, and metaplastic breast carcinoma. Read More

View Article and Full-Text PDF