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Contemporary Clinical Use of Aspirin: Mechanisms of Action, Current Concepts, Unresolved Questions, and Future Perspectives.

Semin Thromb Hemost 2021 Jun 15. Epub 2021 Jun 15.

Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark.

The ability of aspirin to inhibit platelet aggregation has positioned this agent within the most frequently used drugs worldwide. The aim of this article is to review the contemporary clinical use of aspirin and also to discuss unresolved issues not yet translated into clinical practice. Results from several clinical trials have led to strong guideline recommendations for aspirin use in the acute management and secondary prevention of cardiovascular disease. Read More

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Feasibility and safety of rVSV-ZEBOV vaccination of humanitarian health workers against Ebola virus disease: an observational study.

J Travel Med 2021 Jun 15. Epub 2021 Jun 15.

Division of Tropical and Humanitarian Medicine, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 6, Geneva 1205, Switzerland.

Background And Rationale: Geneva University Hospitals were granted a temporary authorization to administer the recombinant live vesicular stomatitis virus rVSV-ZEBOV (Ervebo®) vaccine to expatriate humanitarian frontline workers (FLWs) prior to mission deployment.

Objectives: Our aims were to assess the feasibility of FLW vaccination before deployment and to report adverse events (AEs).

Methods: FLWs received a single injection of rVSV-ZEBOV (>7. Read More

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Recurrent epistaxis in children.

Can Fam Physician 2021 Jun;67(6):427-429

Question: A child came to my clinic complaining of recurrent epistaxis with several episodes occurring every year since he was a toddler. The nosebleeds affect both nostrils, often lasting for an extended period of time and occurring in no apparent seasonal pattern. What interventions are safe and effective for recurrent epistaxis in children, and which patients warrant hematologic testing?

Answer: Epistaxis affects more than half of children by the time they are 10 years old, with 9% of children reported to have recurrent episodes. Read More

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Mood symptoms Associated with CADASIL Syndrome: A Case Report.

CNS Spectr 2021 Apr;26(2):144

Resident.

Objective: To discuss the psychiatric symptoms that are associated with CADASIL syndrome Abstract Cerebral:Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL) is a rare type of hereditary disease involving the small cerebral vessels. The clinical symptoms are various and include recurrent ischemic strokes, migraine with aura, seizures with epilepsy, psychiatric problems such as mood disturbances, and progressive cognitive decline leading to dementia. This disease needs awareness amongst the psychiatrists even though it is discussed much more in neurology literature. Read More

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Xylological Variant of Reverse Fregoli Syndrome, Delusions of Being a Tree.

CNS Spectr 2021 Apr;26(2):145

Smell and Taste Treatment and Research Foundation, Chicago, IL, USA.

Introduction: The delusion of being a living animate non-animal object has not heretofore been reported.

Methods: A 21-year-old right-handed cisgender female, two months prior to presentation, noted stiffness and difficulty with ambulation. One-month prior to admission, she experienced recurrent depression with myriad vegetative and nonvegetative symptoms of depression. Read More

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Embryo transfer can be performed in either uterine horn. Two successive pregnancies in a patient with uterus didelphys: a case report.

Authors:
Zakwan Khrait

J Med Case Rep 2021 Jun 14;15(1):317. Epub 2021 Jun 14.

Consultant, Reproductive Endocrinology and Infertility, FAKIH IVF Center, Dubai, UAE.

Background: Uterus didelphys results from a failure in Mullerian duct fusion and may be associated with complete or partial vaginal septa. Most cases of uterus didelphys are discovered incidentally during the workup of infertility or recurrent miscarriage. The incidence of uterus didelphys has been reported to be 0. Read More

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Post-mortem diagnosis of imported malaria in France: a case report.

Malar J 2021 Jun 14;20(1):271. Epub 2021 Jun 14.

Service de Parasitologie-Mycologie, Hôpital L'Archet, Centre Hospitalier Universitaire de Nice, UCA, 151 route de Saint Antoine de Giestière, 06000, Nice, France.

Background: Malaria is a potentially lethal parasitic disease due to infection by Plasmodium parasites, transmitted by Anopheles mosquito vectors. Various preventative measures may be recommended for travellers who visit endemic areas. The diagnosis is generally evoked in the context of a febrile patient returning from an endemic zone. Read More

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Risk factors and modes of failure in the modern dual mobility implant. A systematic review and meta-analysis.

BMC Musculoskelet Disord 2021 Jun 14;22(1):541. Epub 2021 Jun 14.

Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, No. 201, Sec 2, Shi-Pai Road, Taipei 112, Taiwan.

Background: The aims of this meta-analysis were to: (1) validate the outcome of modern dual mobility (DM) designs in patients who had undergone primary and revision total hip arthroplasty (THA) procedures and (2) to identify factors that affect the outcome.

Methods: We searched for studies that assessed the outcome of modern DM-THA in primary and revision procedures that were conducted between January, 2000 to August, 2020 on PubMed, MEDLINE, Cochrane Reviews and Embase. The pooled incidence of the most common failure modes and patient reported outcomes were evaluated in patients who have received: (1) primary THA, (2) revision THA for all causes or (3) for recurrent dislocation. Read More

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Intravesical gemcitabine for non-muscle invasive bladder cancer.

Cochrane Database Syst Rev 2021 Jun 14;6:CD009294. Epub 2021 Jun 14.

Urology Section, Minneapolis VA Health Care System, Minneapolis, Minnesota, USA.

Background: It remains unclear whether people with non-muscle invasive bladder cancer (NMIBC) benefit from intravesical gemcitabine compared to other agents in the primary or recurrent setting following transurethral resection of a bladder tumor. This is an update of a Cochrane Review first published in 2012. Since that time, several randomized controlled trials (RCTs) have been reported, making this update relevant. Read More

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Vulvar Melanoma: Molecular Characteristics, Diagnosis, Surgical Management, and Medical Treatment.

Am J Clin Dermatol 2021 Jun 14. Epub 2021 Jun 14.

Department of Dermatology and Allergology, Paracelsus Medical University, Salzburg, Austria.

Ten percent of all women have pigmented vulvar lesions. Fortunately, most of these are benign but 1% of all melanomas in women affect the vulva. While the mortality rate of cutaneous melanoma has dropped by 7% annually during the last 5 years, the prognosis of vulvar melanoma remains dismal: the 5-year overall survival rate is 47% compared with 92% for cutaneous melanoma. Read More

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SMARCA2-NR4A3 is a novel fusion gene of extraskeletal myxoid chondrosarcoma identified by RNA next-generation sequencing.

Genes Chromosomes Cancer 2021 Jun 14. Epub 2021 Jun 14.

Department of Pathology, Fox Chase Cancer Center, Philadelphia, PA.

Extraskeletal myxoid chondrosarcoma (EMC) is a rare sarcoma of uncertain differentiation, characterized by recurrent chromosomal translocation involving NR4A3 (9q22.33) in more than 90% of cases. Five fusion partners for NR4A3 have been described including: EWSR1 (22q12. Read More

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Case Report: Stress Fracture in an International Triple Jumper: Importance of an Integrated Care Approach Which Also Incorporates Biomechanics.

Front Sports Act Living 2021 28;3:683691. Epub 2021 May 28.

CHRU-Nancy, University Center of Sports Medicine and Adapted Physical Activity, Nancy, France.

Athletes fear stress fracture (SF) injuries as they can put a premature end to their athletic careers. Understanding any mechanical constraints can suggest preventive management approach. Specifically, for the triple jump, the mechanical stresses that occur during the event appear to be the main factors for risk of injury. Read More

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Impact of Bisoprolol on Ventricular Arrhythmias in Experimental Myocardial Infarction.

Chonnam Med J 2021 May 24;57(2):132-138. Epub 2021 May 24.

Department of Pathology, Busan National University Yangsan Hospital, Yangsan, Korea.

Following acute myocardial infarction (AMI), early use of beta-blockers (BBs) reduced the incidences of ventricular arrhythmia (VA) and death in the pre reperfusion era. However, some studies have reported a worsening of clinical outcomes and therefore, this study used a porcine model of AMI to evaluate the efficacy of bisoprolol on VAs and mortality. Twenty pigs were divided into two groups with one group using oral bisoprolol which was given for 3 hours before the experiment and then maintained for 7 days. Read More

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Arteriovenous Malformation of the Upper Eyelid: A Case Report.

Plast Reconstr Surg Glob Open 2021 Jun 10;9(6):e3609. Epub 2021 Jun 10.

Division of Plastic Surgery, Department of Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia.

Arteriovenous malformations (AVMs) are rare lesions formed by direct connection of arteries and veins bypassing capillary beds. AVM locations can vary; however, extracranial AVMs remain the least common. The vast majority of these malformations are congenital and can be triggered by hormonal changes. Read More

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Complex Revision Glenoid Reconstruction with Use of a Distal Tibial Allograft.

JBJS Essent Surg Tech 2021 Jan-Mar;11(1). Epub 2021 Jan 20.

The Steadman Clinic, Vail, Colorado.

Background: Coracoid transfer procedures have been increasingly utilized for anterior shoulder instability with associated glenoid bone loss. Unfortunately, in a young, high-risk patient population, these procedures can fail secondary to traumatic causes but also because of bone graft resorption or malposition or hardware prominence, among other reasons. In active patients, revision glenoid reconstruction may be indicated. Read More

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January 2021

Systemic Characterization of Novel Immune Cell Phenotypes in Recurrent Pregnancy Loss.

Front Immunol 2021 28;12:657552. Epub 2021 May 28.

Institute of Reproductive Health, Center for Reproductive Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

Recurrent pregnancy loss (RPL) is a disturbing disease in women, and 50% of RPL is reported to be associated with immune dysfunction. Most previous studies of RPL focused mainly on the relationship between RPL and either T cells or natural killer (NK) cells in peripheral blood and the decidua; few studies presented the systemic profiles of the peripheral immune cell subsets in RPL women. Herein, we simultaneously detected 63 immune cell phenotypes in the peripheral blood from nonpregnant women (NPW), women with a history of normal pregnancy (NP) and women with a history of RPL (RPL) by multi-parameter flow cytometry. Read More

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Attenuated Induction of the Unfolded Protein Response in Adult Human Primary Astrocytes in Response to Recurrent Low Glucose.

Front Endocrinol (Lausanne) 2021 26;12:671724. Epub 2021 May 26.

Institute of Biomedical and Clinical Sciences, University of Exeter Medical School, Exeter, United Kingdom.

Aims/hypothesis: Recurrent hypoglycaemia (RH) is a major side-effect of intensive insulin therapy for people with diabetes. Changes in hypoglycaemia sensing by the brain contribute to the development of impaired counterregulatory responses to and awareness of hypoglycaemia. Little is known about the intrinsic changes in human astrocytes in response to acute and recurrent low glucose (RLG) exposure. Read More

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Novel combined variants of WT1 and TET2 in a refractory and recurrent AML patient.

BMC Med Genomics 2021 Jun 13;14(1):158. Epub 2021 Jun 13.

Department of Hematology, Xuanwu Hospital, Capital Medical University, No. 45 Changchun Street, Beijing, 100053, People's Republic of China.

Background: Somatic mutations in Wilms' tumor 1 (WT1) and tet methylcytosine dioxygenase 2 (TET2) genes were separately perceived as contributors to hematopoietic disorders and usually thought to have a mutually exclusive effect in acute myeloid leukemia (AML). However, we found novel WT1 and TET2 variants persistently co-existed in a refractory and recurrent AML patient with t(9;11)(p21.3;q23. Read More

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Second Report of Fusion in Pediatric Spindle Cell Sarcoma With Infantile Fibrosarcoma-Like Morphology Suggesting Fusion Is a Recurrent Event.

Pediatr Dev Pathol 2021 Jun 13:10935266211012186. Epub 2021 Jun 13.

Division of Molecular Pathology, Translational Genomics Research Institute, Phoenix, Arizona.

Infantile/congenital fibrosarcoma (IFS) is the most common soft tissue tumor in children less than one year of age. The most common anatomic site of IFS is in the extremities or trunk, and rarely in the abdomen or retroperitoneum. Approximately 70-90% of cases are characterized by a distinct t(12;15)(p13;q25) translocation resulting in an gene fusion. Read More

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Medial patellofemoral ligament reconstruction with and without trochleoplasty for patients with patella instability-correlation of trochlear dysplasia and patient outcome, classification and outcome measure in the past decade-a systematic review.

Eur J Orthop Surg Traumatol 2021 Jun 12. Epub 2021 Jun 12.

Consortium for Clinical Research and Innovation, Singapore Clinical Research Institute, Singapore, Singapore.

Purpose: The primary aim of the study is to compare the patient outcome in medial patellofemoral ligament reconstruction (MPFLR) or MPFLR concurrent with trochleoplasty (MPFLR + TP) and correlate it with the degree of trochlear dysplasia (TD). The secondary aim is to review TD classification, outcome measure, chronological and geographical trend of such studies in the past decade.

Methods: A systemic review of the literature in the past decade on studies of patients with patella instability and underwent either a MPFLR or MPFLR + TP. Read More

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Heart Failure Hospitalization in Adults Receiving Hemodialysis and the Effect of Intravenous Iron Therapy.

JACC Heart Fail 2021 Jun 3. Epub 2021 Jun 3.

Department of Renal Medicine, King's College Hospital, London, United Kingdom.

Objectives: The study sought to examine the effect of intravenous iron on heart failure events in hemodialysis patients.

Background: Heart failure is a common and deadly complication in patients receiving hemodialysis and is difficult to diagnose and treat.

Methods: The study analyzed heart failure events in the PIVOTAL (Proactive IV Iron Therapy in Hemodialysis Patients) trial, which compared intravenous iron administered proactively in a high-dose regimen with a low-dose regimen administered reactively. Read More

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Implementation of fecal microbiota transplantation in a medical center for recurrent or refractory Clostridioides difficile infection and report of preliminary outcome.

Biomed J 2021 Jun 9. Epub 2021 Jun 9.

Chang Gung Microbiota Therapy Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Division of Pediatric Infectious Diseases, Department of Pediatrics, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan; Genomic Medicine Core Laboratory, Chang Gung Memorial Hospital, Linkou, Taiwan; Molecular Infectious Disease Research Center, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan. Electronic address:

Background: Fecal microbiota transplantation (FMT) has been shown to highly effective in the treatment of recurrent or refractory Clostridioides difficile infection (rCDI) in many countries of the world. Not until 2018, Ministry of Health and Welfare, Taiwan approved the application of FMT for rCDI under a special law. The study reported the first implementation of the technology in the medical center in Taiwan and the preliminary outcome. Read More

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Long-read nanopore sequencing enables accurate confirmation of a recurrent PMS2 insertion-deletion variant located in a region of complex genomic architecture.

Cancer Genet 2021 May 28;256-257:122-126. Epub 2021 May 28.

Leeds Institute of Medical Research, University of Leeds, St. James's University Hospital, Leeds LS9 7TF, United Kingdom; The Clinical Genetics Department, Chapel Allerton Hospital, Leeds LS7 4SA, United Kingdom.

Targeted next generation sequencing (NGS) is the predominant methodology for the molecular genetic diagnosis of inherited conditions. In many laboratories, NGS-identified variants are routinely validated using a different method, to minimize the risk of a false-positive diagnosis. This can be particularly important when pathogenic variants are located in complex genomic regions. Read More

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Evaluation of efficacy and safety of oral voriconazole in the management of recalcitrant and recurrent dermatophytosis.

Clin Exp Dermatol 2021 Jun 11. Epub 2021 Jun 11.

Dermatology, CUTIS Academy of cutaneous sciences, Bangalore, Karnataka, India.

Introduction: Dermatophytosis is a worldwide public health problem affecting more than 20-25% of the world's population. There is a rampant increase in the resistant, recurrent dermatophytosis in the past few years, especially in India. Azole resistance in dermatophytes has been reported as high as 19% worldwide. Read More

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Lipid transfer protein syndrome due to wild grape juice and various vegetables: A life-threatening food allergen.

J Dermatol 2021 Jun 11. Epub 2021 Jun 11.

Department of Dermatology, Iwate Medical University School of Medicine, Shiwa-gun, Japan.

We report a 16-year-old Japanese male with mugwort pollinosis in whom ingestion of wild grape juice and various vegetables caused recurrent general urticaria, abdominal pain, dyspnea, and loss of consciousness. A skin prick test demonstrated positive reactions to a wide variety of both non-heated and heated vegetables and fruits such as wild grape, bell pepper, onion, Chinese cabbage, tomato, eggplant, and broccoli. The serum immunoglobulin E levels (ImmunoCAP ISAC ) for Art v 3, Pla a 3, Pru p 3, and Jug r 3, which are lipid transfer protein (LTP) homologs, were positive but those for Bet v 1 and Bet v 2 were negative. Read More

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Philadelphia chromosome-positive B-lymphoblastic lymphoma successfully treated with chemotherapy regimen containing imatinib: A rare case report and literature review.

Medicine (Baltimore) 2021 Jun;100(23):e26323

The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.

Rationale: B-lymphoblastic lymphoma (B-LBL) with BCR/ABL mutation (Ph+ B-LBL) is a rare type of cancer in both childhood and adults. Its clinical manifestations are similar to those of other types lymphoma. However, the targeted therapy can substantially improve the outcome of Ph+ B-LBL. Read More

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Giant axonal neuropathy: cross sectional analysis of a large natural history cohort.

Brain 2021 Jun 11. Epub 2021 Jun 11.

National Institutes of Health, Neuromuscular and Neurogenetic Disorders of Childhood Section, Bethesda, MD 20892, USA.

Giant axonal neuropathy (GAN) is an ultra-rare autosomal recessive, progressive neurodegenerative disease with early childhood onset that presents as a prominent sensorimotor neuropathy and commonly progresses to affect both the peripheral nervous system and central nervous system. The disease is caused by biallelic mutations in the GAN gene located on 16q23.2, leading to loss of functional gigaxonin, a substrate specific ubiquitin ligase adapter protein necessary for the regulation of intermediate filament turnover. Read More

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KCNT1-related epilepsies and epileptic encephalopathies: phenotypic and mutational spectrum.

Brain 2021 Jun 11. Epub 2021 Jun 11.

Pediatric Neurology Department, Lyon University Hospital, 69500 Bron, France.

Variants in KCNT1, encoding a sodium-gated potassium channel (subfamily T member 1), have been associated with a spectrum of epilepsies and neurodevelopmental disorders. These range from familial autosomal dominant or sporadic sleep-related hypermotor epilepsy ((AD)SHE) to epilepsy of infancy with migrating focal seizures (EIMFS) and include developmental and epileptic encephalopathies (DEE). This study aims to provide a comprehensive overview of the phenotypic and genotypic spectrum of KCNT1 mutation-related epileptic disorders in 248 individuals, including 66 unpreviously published and 182 published cases, the largest cohort reported so far. Read More

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Decreased anxiety after catheter ablation for paroxysmal atrial fibrillation is associated with augmented parasympathetic reactivity to stress.

Heart Rhythm O2 2020 Aug 10;1(3):189-199. Epub 2020 Jun 10.

Department of Psychiatry, Shizuoka Saiseikai General Hospital, Shizuoka, Japan.

Background: Psychological improvement after catheter ablation for atrial fibrillation (AF) has been reported, but its mechanism is unclear.

Objective: This study aimed to clarify the relationship between cardiac autonomic modification and psychological changes after catheter ablation for paroxysmal AF (PAF).

Methods: Thirty-five consecutive patients (60. Read More

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