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Iron Overload After Complement Inhibitor Treatment of Paroxysmal Nocturnal Hemoglobinuria.

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

Department of Hematology, assachusetts General Hospital, United States.

Paroxysmal nocturnal hemoglobinuria (PNH) is an uncommon bone marrow disorder associated with hemolytic anemia, thrombosis, and cytopenias. Prior to 2007, treatment for PNH was limited and patients with PNH were treated with corticosteroids, anticoagulation for thrombosis, and iron supplementation for their chronic iron deficiency secondary to intravascular hemolysis(1). In fact a hallmark feature of PNH was iron deficiency and iron supplementation continues to be recommended as a treatment for the manifestations of PNH. Read More

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Individual reversible plasticity as a genotype-level bet-hedging strategy.

J Evol Biol 2021 Apr 12. Epub 2021 Apr 12.

Centre for Biodiversity Dynamics, Department of Biology, Norwegian University of Science and Technology, Høgskoleringen 5, 7044, Trondheim, Norway.

Reversible plasticity in phenotypic traits allows organisms to cope with environmental variation within lifetimes, but costs of plasticity may limit just how well the phenotype matches the environmental optimum. An additional adaptive advantage of plasticity might be to reduce fitness variance, in other words: bet-hedging to maximize geometric (rather than simply arithmetic) mean fitness. Here we model the evolution of plasticity in the form of reaction norm slopes, with increasing costs as the slope or degree of plasticity increases. Read More

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Surgical Decision Making in Pancreatic Ductal Adenocarcinoma: Modeling Prognosis Following Pancreatectomy in the Era of Induction and Neoadjuvant Chemotherapy.

Ann Surg 2021 Apr 9. Epub 2021 Apr 9.

Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America Department of Surgery, New York University School of Medicine and NYU-Langone Medical Center, New York, New York, United States of America.

Objective: To develop a predictive model of oncologic outcomes for patients with pancreatic ductal adenocarcinoma (PDAC) undergoing resection after neoadjuvant or induction chemotherapy use.

Background: Early recurrence following surgical resection for PDAC is common. The use of neoadjuvant chemotherapy prior to resection may increase the likelihood of long-term systemic disease control. Read More

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Impact of maternal medication for opioid use disorder on neurodevelopmental outcomes of infants treated for neonatal opioid withdrawal syndrome.

J Neonatal Perinatal Med 2021 Apr 2. Epub 2021 Apr 2.

Department of Pediatrics, University of Massachusetts Medical School-Baystate, Springfield, MA, USA.

Background: Increasing rates of maternal opioid use disorder has led to greater number of opioid exposed newborns (OENs). Maternal enrollment in medication for opioid use disorder (MOUD) program improves short term neonatal outcomes. This study aimed at assessing neurobehavioral outcomes for OENs. Read More

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Understanding the evolution of coverage policies for prophylaxis treatments of hemophilia A without inhibitors: a payer Delphi panel.

J Manag Care Spec Pharm 2021 Apr 12:1-13. Epub 2021 Apr 12.

PRECISIONheor, Los Angeles, CA.

The landscape for hemophilia A prophylaxis is rapidly expanding from factor VIII replacement therapy to include novel treatments such as nonfactor replacement therapies that may enhance coagulation (e.g., emicizumab) or inhibit anticoagulant pathways (e. Read More

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Social Factors Key to Landscape-Scale Coastal Restoration: Lessons Learned from Three U.S. Case Studies.

Sustainability 2020 ;12(3)

Department of Marine and Environmental Sciences, Northeastern University, Marine Science Center, Nahant, MA 01908, USA.

In the United States, extensive investments have been made to restore the ecological function and services of coastal marine habitats. Despite a growing body of science supporting coastal restoration, few studies have addressed the suite of societally enabling conditions that helped facilitate successful restoration and recovery efforts that occurred at meaningful ecological (i.e. Read More

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January 2020

New obstacles and widening gaps: A qualitative study of the effects of the COVID-19 pandemic on U.S. adults with disabilities.

Disabil Health J 2021 Mar 30:101103. Epub 2021 Mar 30.

Johns Hopkins Disability Health Research Center, Johns Hopkins University, Baltimore, MD, USA; The Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, MD, USA; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. Electronic address:

Background: Prior research has demonstrated that the needs of the disability community have not been met during public health emergencies. The COVID-19 pandemic has exacerbated existing inequities for many populations including people with disabilities, and data is needed to develop inclusive public health response policies.

Objective: To identify how COVID-19 has uniquely impacted the lives of adults with disabilities. Read More

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Clinical Performance of CAD/CAM Monolithic Lithium Disilicate Implant-Supported Single Crowns Using Solid or Pre-Drilled Blocks in a Fully Digital Workflow: A Retrospective Cohort Study With Up To 33 Months of Follow Up.

J Prosthodont 2021 Apr 11. Epub 2021 Apr 11.

Department of Restorative Dentistry, Oregon Health & Science University, Portland, OR, United States.

Purpose: To assess the clinical performance of CAD/CAM monolithic implant-supported restorations manufactured using a fully digital workflow and two different types of ceramic blocks.

Materials And Methods: One hundred and one patients received single-unit implant-supported restorations at a University predoctoral clinic. All restorations were designed and fabricated using either a pre-drilled LS block (group P, n = 59) or a conventional solid LS block with an occlusal opening drilled manually prior to crystallization (group M, n = 42). Read More

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Social support buffers the effects of maternal prenatal stress on infants' unpredictability.

Early Hum Dev 2021 Mar 17;157:105352. Epub 2021 Mar 17.

Department of Obstetrics & Gynecology, and Psychiatry, Columbia University, New York, NY, USA; New York State Psychiatric Institute, New York, NY, USA.

Objective: Exposure to stress in pregnancy has been shown to affect fetal development with short- and long-term physiological and behavioral consequences for the offspring. Although social support is known to lower perceived stress, no prior study has investigated the buffering role of social support in the context of prenatal stress effects on infant temperament. The aim of this study was to examine interactive effects of prenatal stress and social support on several dimensions of infant temperament at 9 months postpartum. Read More

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Long-term postoperative opioid prescription after cholecystectomy or gastric by-pass surgery: a retrospective observational study.

Scand J Pain 2021 Apr 12. Epub 2021 Apr 12.

Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.

Objectives: Opioids are commonly prescribed post-surgery. We investigated the proportion of patients who were prescribed any opioids 6-12 months after two common surgeries - laparoscopic cholecystectomy and gastric by-pass (GBP) surgery. A secondary aim was to examine risk factors prior to surgery associated with the prescription of any opioids after surgery. Read More

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First but not second postoperative day growth hormone assessments as early predictive tests for long-term acromegaly persistence.

J Endocrinol Invest 2021 Apr 10. Epub 2021 Apr 10.

Division of Endocrinology, Diabetes and Metabolism, Department of Medical Sciences, University of Turin, Corso Dogliotti 14, 10126, Turin, Italy.

Purpose: Postoperative assessment of acromegaly activity is typically performed at least 3 months after neurosurgery (NS). Few studies have evaluated the use of early postoperative growth hormone (GH) levels as a test to predict short- and long-term remission of acromegaly. Our objective was to evaluate the diagnostic performance of serum random GH on a postoperative day one (D1-rGH) and two (D2-rGH), particularly in predicting long-term disease persistence. Read More

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The Impact of Antipsychotic Formulations on Time to Medication Discontinuation in Patients with Schizophrenia: A Dutch Registry-Based Retrospective Cohort Study.

CNS Drugs 2021 Apr 10. Epub 2021 Apr 10.

Department of Psychiatry, Erasmus Medical Centre, Epidemiological and Social Psychiatric Research Institute, Rotterdam, the Netherlands.

Background: Many patients with schizophrenia discontinue antipsychotic medication, frequently with adverse outcomes. Although different antipsychotic formulations are associated with different times to discontinuation, not much is known about discontinuation rates with oral-weekly formulations. Such a formulation of penfluridol is available in both the Netherlands and several other countries. Read More

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Pre-surgical Prediction of Ischemic Mitral Regurgitation Recurrence Using In Vivo Mitral Valve Leaflet Strains.

Ann Biomed Eng 2021 Apr 9. Epub 2021 Apr 9.

James T. Willerson Center for Cardiovascular Modeling and Simulation, Oden Institute for Computational Engineering and Sciences, Department of Biomedical Engineering, The University of Texas at Austin, Austin, TX, USA.

Ischemic mitral regurgitation (IMR) is a prevalent cardiac disease associated with substantial morbidity and mortality. Contemporary surgical treatments continue to have limited long-term success, in part due to the complex and multi-factorial nature of IMR. There is thus a need to better understand IMR etiology to guide optimal patient specific treatments. Read More

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Use of 360° virtual reality video in medical obstetrical education: a quasi-experimental design.

BMC Med Educ 2021 Apr 10;21(1):202. Epub 2021 Apr 10.

Spaarne Gasthuis Academie, Spaarne Gasthuis Hospital, SpaarnePoort 1, 2134, TM, Hoofddorp, the Netherlands.

Background: Video-based teaching has been part of medical education for some time but 360° videos using a virtual reality (VR) device are a new medium that offer extended possibilities. We investigated whether adding a 360° VR video to the internship curriculum leads to an improvement of long-term recall of specific knowledge on a gentle Caesarean Sections (gCS) and on general obstetric knowledge.

Methods: Two weeks prior to their Obstetrics and Gynaecology (O&G) internship, medical students were divided in teaching groups, that did or did not have access to a VR-video of a gCS. Read More

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Epidemiological Features and Economic Burden of Guillain-Barré Syndrome in South Korea: A Nationwide Population-Based Study.

J Clin Neurol 2021 Apr;17(2):257-264

College of Pharmacy, Yonsei Institute of Pharmaceutical Sciences, Yonsei University, Incheon, Korea.

Background And Purpose: Guillain-Barré syndrome (GBS) is rare, but its symptoms are severe and they occasionally lead to long-term disability. Country-specific epidemiological evidence is useful for detecting potential problems at the population level. This study investigated the epidemiological and economic characteristics of GBS in South Korea. Read More

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Association between somatostatin analogues and diabetes mellitus in gastroenteropancreatic neuroendocrine tumor patients: A Surveillance, Epidemiology, and End Results-Medicare analysis of 5235 patients.

Cancer Rep (Hoboken) 2021 Apr 9:e1387. Epub 2021 Apr 9.

Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.

Background: Gastroenteropancreatic neuroendocrine tumors (GEP-NETs) are increasingly common malignancies and tend to have favorable long-term prognoses. Somatostatin analogues (SSA) are a first-line treatment for many NETs. Short-term experiments suggest an association between SSAs and hyperglycemia. Read More

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Global transcriptomic analysis of a murine osteocytic cell line subjected to spaceflight.

FASEB J 2021 May;35(5):e21578

Department of Translational Dental Medicine, Boston University Henry M. Goldman School of Dental Medicine, Boston, MA, USA.

Bone loss is a major health concern for astronauts during long-term spaceflight and for patients during prolonged bed rest or paralysis. Growing evidence suggests that osteocytes, the most abundant cells in the mineralized bone matrix, play a key role in sensing mechanical forces applied to the skeleton and integrating the orchestrated response into subcellular biochemical signals to modulate bone homeostasis. However, the precise molecular mechanisms underlying both mechanosensation and mechanotransduction in late-osteoblast-to-osteocyte cells under microgravity (µG) have yet to be elucidated. Read More

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Analysis of Anti-Doping Rule Violations That Have Impacted Medal Results at the Summer Olympic Games 1968-2012.

Sports Med 2021 Apr 9. Epub 2021 Apr 9.

Centre for Stress and Age-Related Disease, University of Brighton, Brighton, UK.

Introduction: Since 2004, the International Olympic Committee (IOC) store all samples collected at summer Olympic Games (OG) for retrospective re-analysis with more advanced analytical techniques to catch doping athletes.

Methods: All announced Anti-Doping Rule Violations (ADRVs) from IOC re-tests of the 2004, 2008 and 2012 OG (via IOC, International Federations and Athletics Integrity Unit public data) and other ADRVs confirmed to impact OG results from 1968 to 2012 (via the list of Doping Irregularities on olympedia.org) were collated to investigate how many medals have been impacted by ADRVs, when the ADRV was identified relative to the OG in question and its cause. Read More

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High turnover of types III and VI collagen in progressive idiopathic pulmonary fibrosis.

Respirology 2021 Apr 9. Epub 2021 Apr 9.

Department of Respiratory Medicine, Herlev and Gentofte University Hospital, Copenhagen, Denmark.

Background And Objective: Prediction of idiopathic pulmonary fibrosis (IPF) progression is vital for the choice and timing of treatment and patient follow-up. This could potentially be achieved by prognostic blood biomarkers of extracellular matrix (ECM) remodelling.

Methods: Neoepitope biomarkers of types III and VI collagen turnover (C3M, C6M, PRO-C3 and PRO-C6) were measured in 185 patients with newly diagnosed IPF. Read More

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North American boreal forests are a large carbon source due to wildfires from 1986 to 2016.

Sci Rep 2021 Apr 8;11(1):7723. Epub 2021 Apr 8.

Department of Environmental and Biological Sciences, University of Eastern Finland, PO Box 1627, 70211, Kuopio, Finland.

Wildfires are a major disturbance to forest carbon (C) balance through both immediate combustion emissions and post-fire ecosystem dynamics. Here we used a process-based biogeochemistry model, the Terrestrial Ecosystem Model (TEM), to simulate C budget in Alaska and Canada during 1986-2016, as impacted by fire disturbances. We extracted the data of difference Normalized Burn Ratio (dNBR) for fires from Landsat TM/ETM imagery and estimated the proportion of vegetation and soil C combustion. Read More

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Pneumonia.

Nat Rev Dis Primers 2021 Apr 8;7(1):25. Epub 2021 Apr 8.

Center of Experimental and Molecular Medicine, Division of Infectious Diseases, Amsterdam University Medical Centers, Location Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands.

Pneumonia is a common acute respiratory infection that affects the alveoli and distal airways; it is a major health problem and associated with high morbidity and short-term and long-term mortality in all age groups worldwide. Pneumonia is broadly divided into community-acquired pneumonia or hospital-acquired pneumonia. A large variety of microorganisms can cause pneumonia, including bacteria, respiratory viruses and fungi, and there are great geographical variations in their prevalence. Read More

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Intrapartum opioid analgesia and childhood neurodevelopmental outcomes among infants born preterm.

Am J Obstet Gynecol MFM 2021 Apr 5:100372. Epub 2021 Apr 5.

Center for Women's Reproductive Health, University of Alabama at Birmingham; Department of Obstetrics and Gynecology, University of Alabama at Birmingham.

Background: There are concerns regarding neurobehavioral changes in infants exposed to parenteral opioids during labor, yet long-term neurodevelopment remains unstudied.

Objective: We aimed to examine the association between parenteral opioids for labor analgesia and perinatal outcomes and childhood neurodevelopment until two years of age among infants born preterm. We hypothesized that intrapartum exposure to parenteral opioids is associated with impaired neurodevelopment and adverse perinatal outcomes. Read More

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Hybrid and Total Endovascular Approaches to Tandem Carotid Artery Lesions Have Similar Short- and Long-Term Outcomes.

Ann Vasc Surg 2021 Apr 5. Epub 2021 Apr 5.

Division of Vascular and Endovascular Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114.

Background: Addition of ipsilateral proximal endovascular intervention (PEI, common carotid/innominate) increases the risk of perioperative stroke/death for both carotid endarterectomy (CEA) and carotid stenting (CAS). However, these approaches have not been directly compared and is the subject of this study.

Methods: VQI (2005-2020) was queried for CEA and CAS with PEI, excluding emergent, bilateral, and repeat procedures, patients with prior ipsilateral CAS, ICA lesions with stenosis<50%, and transcarotid ICA stents. Read More

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Heart failure outcomes and Covid-19.

Diabetes Res Clin Pract 2021 Apr 5:108794. Epub 2021 Apr 5.

Forschergruppe Diabetes e.V. at Helmholtz Centre, Munich, Germany.

Pre-existing heart failure (HF) in diagnosed patients with coronavirus disease 2019 (COVID-19) is associated with a close to two-fold increased mortality rate compared to COVID-19 patients without prior HF history. Moreover, based both on biomarker as well as imaging findings, widespread endothelial and cardiac injury seems to be present in many patients presenting with COVID-19, associated with adverse outcomes including new onset HF. Systematic echocardiographic studies in patients with COVID-19 indicate that the most common cardiac pathology is right ventricular (RV) dilatation (39%) over and above both left ventricular (LV) diastolic dysfunction (16%) and LV systolic dysfunction (10%). Read More

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Ocular syphilis.

Clin Exp Optom 2021 Apr 8:1-4. Epub 2021 Apr 8.

Department of Optometry, Northwest Permanente-Kaiser Permanente, Portland, OR, USA.

Syphilis is a sexually transmitted, systemic, inflammatory disease caused by the spirochaete, . The natural history of untreated syphilis progresses through four distinct stages: primary, secondary, latent, and tertiary syphilis. Ocular involvement can occur at any stage of syphilis and any part of the eye can be affected. Read More

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Shared Decision Making for Children With Chronic Respiratory Failure-It Takes a Village And a Process.

Pediatr Pulmonol 2021 Apr 8. Epub 2021 Apr 8.

Stony Brook Children's Hospital and Renaissance School of Medicine at Stony Brook University Department of Pediatrics, Stony Brook, NY.

Background And Objectives: Shared decision making (SDM) prior to non-urgent tracheostomy in a child with chronic respiratory failure (CRF) is often recommended, but has proven challenging to implement in practice. We hypothesize that utilization of the microsystem model for analysis of the complex ecosystem in which SDM occurs will yield insights that enable formation of a reproducible, measurable SDM process.

Methods: Retrospective chart review of a case series of children with CRF in whom a SDM process was pursued. Read More

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The SANTÉ study at 10 years of follow-up: Effectiveness, safety, and sudden unexpected death in epilepsy.

Epilepsia 2021 Apr 8. Epub 2021 Apr 8.

Department of Neurology, Stanford University, Stanford, California, USA.

Objective: We evaluated the efficacy and safety of deep brain anterior thalamus stimulation after 7 and 10 years, and report the incidence of sudden unexpected death in epilepsy (SUDEP) and overall mortality in adults in the Stimulation of the Anterior Nucleus of the Thalamus for Epilepsy (SANTÉ) study.

Methods: After the 3-month blinded and 9-month unblinded phases, subjects continued to be assessed during long-term follow-up (LTFU) and later a continued therapy access phase (CAP), to further characterize adverse events and the incidence of SUDEP. Stimulus parameter and medication changes were allowed. Read More

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Ophthalmic complications of Lemierre syndrome.

Acta Ophthalmol 2021 Apr 8. Epub 2021 Apr 8.

Clinic of Angiology, University Hospital Zurich, Zurich, Switzerland.

Purpose: Lemierre syndrome is a life-threatening condition characterized by head/neck bacterial infection, local suppurative thrombophlebitis and septic embolic complications in a range of sites of distant organs. No prior study focused on the course and characteristics of ophthalmic complications of Lemierre syndrome.

Methods: We analysed data of 27 patients with ophthalmic complications from a large cohort of 712 cases with Lemierre syndrome reported globally between 2000 and 2017. Read More

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The Cost Effectiveness of Immunoglobulin vs. Hematopoietic Stem Cell Transplantation for CIDP.

Front Neurol 2021 22;12:645263. Epub 2021 Mar 22.

Academic Department of Neuroscience and Sheffield, NIHR Translational Neuroscience BRC, Sheffield Teaching Hospitals NHS Foundation Trust, University of Sheffield, Sheffield, United Kingdom.

Intravenous immunoglobulin (IVIG) is effective as standard first line therapy for chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), but some patients remain dependent on its long-term use. Recently, we have reported that autologous non-myeloablative hematopoietic stem cell transplantation (HSCT) is an effective second line therapy for CIDP. To compare the cost of chronic IVIG vs. Read More

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Protocol for a randomized controlled trial of pre-pregnancy lifestyle intervention to reduce recurrence of gestational diabetes: Gestational Diabetes Prevention/Prevención de la Diabetes Gestacional.

Trials 2021 Apr 7;22(1):256. Epub 2021 Apr 7.

Weight Control and Diabetes Research Center, The Miriam Hospital, Providence, USA.

Background: Gestational diabetes mellitus (GDM) is associated with several maternal complications in pregnancy, including preeclampsia, preterm labor, need for induction of labor, and cesarean delivery as well as increased long-term risks of type 2 diabetes, metabolic syndrome, and cardiovascular disease. Intrauterine exposure to GDM raises the risk for complications in offspring as well, including stillbirth, macrosomia, and birth trauma, and long-term risk of metabolic disease. One of the strongest risk factors for GDM is the occurrence of GDM in a prior pregnancy. Read More

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