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6-month neurological and psychiatric outcomes in 236 379 survivors of COVID-19: a retrospective cohort study using electronic health records.

Lancet Psychiatry 2021 Apr 1. Epub 2021 Apr 1.

Department of Psychiatry, University of Oxford, Oxford, UK; Oxford Health NHS Foundation Trust, Oxford, UK. Electronic address:

Background: Neurological and psychiatric sequelae of COVID-19 have been reported, but more data are needed to adequately assess the effects of COVID-19 on brain health. We aimed to provide robust estimates of incidence rates and relative risks of neurological and psychiatric diagnoses in patients in the 6 months following a COVID-19 diagnosis.

Methods: For this retrospective cohort study and time-to-event analysis, we used data obtained from the TriNetX electronic health records network (with over 81 million patients). Read More

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Microbiome research in general and business newspapers: How many microbiome articles are published and which study designs make the news the most?

PLoS One 2021 9;16(4):e0249835. Epub 2021 Apr 9.

Department of Communication, Pompeu Fabra University, Barcelona, Spain.

The microbiome is a matter of interest for science, consumers and business. Our objective is to quantify that interest in academic journals and newspapers, both quantitatively and by study design. We calculated the number of articles on the microbiome from the total number of biomedicine articles featured in both PubMed and Spanish science news agency SINC, from 2008 to 2018. Read More

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Provider Personal and Demographic Characteristics and Patient Satisfaction in Orthopaedic Surgery.

J Am Acad Orthop Surg Glob Res Rev 2021 Apr 9;5(4). Epub 2021 Apr 9.

From the Department of Orthopaedic Surgery, Stanford University, Redwood City, CA (Dr. Lu, Dr. Sharabianlou Korth, Cheng, Dr. Finlay, Dr. Kamal, Dr. Goodman, Dr. Maloney, Dr. Huddleston, and Dr. Amanatullah); the Harvard Orthopaedic Residency Program, Department of Orthopaedics, Massachusetts General Hospital, Boston, MA (Dr. Lu); and the VA Palo Alto Health Care System, Palo Alto, CA (Dr. Finlay).

Introduction: Patient satisfaction has increasingly been used to assess physician performance and quality of care. Although there is evidence that patient satisfaction is associated with patient-reported health outcomes and communication-related measures, there is debate over the use of patient satisfaction in reimbursement policy. Patient characteristics that influence satisfaction have been studied, but the effects of personal and demographic characteristics of physicians on patient satisfaction have yet to be explored. Read More

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Effects of Myo-inositol Hexaphosphate (SNF472) on Bone Mineral Density in Patients Receiving Hemodialysis: An Analysis of the Randomized, Placebo-Controlled CaLIPSO Study.

Clin J Am Soc Nephrol 2021 Apr 7. Epub 2021 Apr 7.

Department of Medicine, Stanford University, Palo Alto, California.

Background And Objectives: In the CaLIPSO study, intravenous administration of SNF472 (300 or 600 mg) during hemodialysis significantly attenuated progression of coronary artery and aortic valve calcification. SNF472 selectively inhibits formation of hydroxyapatite, the final step in cardiovascular calcification. Because bone mineral is predominantly hydroxyapatite, we assessed changes in bone mineral density in CaLIPSO. Read More

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A two-arm, randomized, controlled, multi-centric, open-label phase-2 study to evaluate the efficacy and safety of Itolizumab in moderate to severe ARDS patients due to COVID-19.

Expert Opin Biol Ther 2021 Apr 9:1-12. Epub 2021 Apr 9.

Biocon Biologics India Ltd, Bengaluru, Karnataka, India.

: Efficacy and safety of Itolizumab, an immunomodulatory mAb, in treating moderate-to-severe acute respiratory distress syndrome (ARDS) due to cytokine release in COVID-19 patients was evaluated in a multi-centric, open-label, two-arm, controlled, randomized, phase-2 study.: Patients were randomized (2:1) to Arm-A (best supportive care [BSC]+Itolizumab) and Arm-B (BSC). Primary outcome of interest was reduction in mortality 30-days after enrollment. Read More

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Thrombosis and Thrombocytopenia after ChAdOx1 nCoV-19 Vaccination.

N Engl J Med 2021 Apr 9. Epub 2021 Apr 9.

From the Departments of Hematology (N.H.S., G.E.T., P.A.H.), Immunology (L.A.M., F.L.-J.), Neurosurgery (M.W.), Neurology (A.-H.A.), and Radiology and Nuclear Medicine (T.H.S.), and the Research Institute of Internal Medicine (N.H.S., A.E.M., P.A.H.), Oslo University Hospital, and the Faculty of Medicine (A.E.M., G.E.T., P.A.H.), the KG Jebsen Center for B Cell Malignancy (L.A.M., G.E.T.), Institute of Clinical Medicine, and the ImmunoLingo Convergence Center (F.L.-J.), University of Oslo, the Department of Hematology, Akershus University Hospital, Lørenskog (N.H.S.), and the Norwegian National Unit for Platelet Immunology, Division of Diagnostics, University Hospital of North Norway, Tromsø (I.H.S., M.T.A.) - all in Norway.

We report findings in five patients who presented with venous thrombosis and thrombocytopenia 7 to 10 days after receiving the first dose of the ChAdOx1 nCoV-19 adenoviral vector vaccine against coronavirus disease 2019 (Covid-19). The patients were health care workers who were 32 to 54 years of age. All the patients had high levels of antibodies to platelet factor 4-polyanion complexes; however, they had had no previous exposure to heparin. Read More

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GnRH agonist-associated pituitary apoplexy: a case series and review of the literature.

Pituitary 2021 Apr 9. Epub 2021 Apr 9.

Neuroendocrine Unit, Massachusetts General Hospital and Department of Medicine, Harvard Medical School, 100 Blossom Street, Cox140, Boston, MA, 02114, USA.

Purpose: To examine the clinical presentation and longitudinal outcome of Pituitary Apoplexy (PA) after gonadotropin-releasing hormone agonist (GnRHa) in a series of patients and compare to prior reports.

Methods: A retrospective chart review was performed on seven patients receiving GnRHa who developed PA. Prior reported cases were analyzed. Read More

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Biomedical Researchers' Perceptions of the NIH's Sex as a Biological Variable Policy for Animal Research: Results from a U.S. National Survey.

J Womens Health (Larchmt) 2021 Apr 8. Epub 2021 Apr 8.

Department of Social Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.

In 2015, the National Institutes of Health (NIH) established a policy on sex as a biological variable (SABV) in an effort to address the overrepresentation of men and male animals in biomedical research and the lack of attention to sex-based responses to medical treatments. However, questions remain regarding how U.S. Read More

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Estrogen modulates epithelial progenitor cells in rat vagina.

Investig Clin Urol 2021 Apr 2. Epub 2021 Apr 2.

Department of Urology, Chonnam National University Medical School, Gwangju, Korea.

Purpose: The expression of epithelial progenitor cells (EPCs) in rat vagina was recently reported. The aims were to investigate the effects of estrogen on vaginal EPCs in the oophorectomized female rat model.

Materials And Methods: Female Sprague-Dawley rats (230-240 g, n=30) were divided into 3 groups: control (n=10), bilateral oophorectomy (OVX, n=10), and bilateral OVX followed by subcutaneous injections of 17β-estradiol (50 μg/kg/day, n=10). Read More

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Association of parental-reported vitamin D supplementation with dental caries of 3-year-old children in Poland: a cross-sectional study.

Clin Oral Investig 2021 Apr 8. Epub 2021 Apr 8.

Department of Paediatric Dentistry, Medical University of Warsaw, Binieckiego St. 6, 02-097, Warsaw, Poland.

Objective: The study aimed to assess the association between parental-reported vitamin D supplementation and caries in a national sample of 3-year-olds in Poland.

Materials And Methods: A total of 1900 children, representing all provinces of Poland, were invited. The questionnaires concerned vitamin D supplementation, socio-demographics, and oral health behaviours. Read More

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PD-L1 Expression and Outcome in Patients with Metastatic Non-Small Cell Lung Cancer and EGFR Mutations Receiving EGFR-TKI as Frontline Treatment.

Onco Targets Ther 2021 31;14:2301-2309. Epub 2021 Mar 31.

Division of Chest Medicine, Department of Internal Medicine, National Yang Ming Chiao Tung University Hospital, Yi-Lan, Taiwan.

Background: Epidermal growth factor receptor (EGFR) mutations are most common in Eastern Asia, and frequencies of 30-50% have been reported. EGFR-tyrosine kinase inhibitors (TKIs) are recommended as first-line therapeutic options for non-small cell lung cancer (NSCLC) with sensitizing EGFR mutations. Several immune checkpoint inhibitors have been successful in improving the outcomes of advanced lung cancer. Read More

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Improvement in Lung Function and Patient-Reported Outcomes in Patients with COPD with Comorbid Anxiety and Depression Receiving Nebulized Glycopyrrolate in the GOLDEN 3 and 4 Studies.

Int J Chron Obstruct Pulmon Dis 2021 31;16:865-875. Epub 2021 Mar 31.

Sunovion Pharmaceuticals Inc., Marlborough, MA, USA.

Background: Anxiety and depression (A/D) are common in patients with chronic obstructive pulmonary disease (COPD) and are often associated with lower adherence to treatment and worse patient-related outcomes. However, studies on the impact of comorbid A/D on responses to bronchodilators are limited.

Methods: This post hoc analysis of pooled data (N=861) from the GOLDEN 3 and 4 studies compared the efficacy and safety of nebulized glycopyrrolate (GLY) 25 µg in patients with moderate-to-very-severe COPD, grouped by self-reported A/D. Read More

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Characteristics of Veterans With Non-VA Encounters Enrolled in a Trial of Standards-Based, Interoperable Event Notification and Care Coordination.

J Am Board Fam Med 2021 Mar-Apr;34(2):301-308

From the Richard L. Roudebush VA Medical Center, U.S. Department of Veterans Affairs, Indianapolis, IN (RK, BED, ALS, JCY); IU Fairbanks School of Public Health, Indianapolis, IN (BED); Regenstrief Institute, Indianapolis, IN (BED): James J. Peters VA Medical Center, U.S. Department of Veterans Affairs, Bronx, NY (VG, KMJ, KB); Icahn School of Medicine at Mount Sinai, New York, NY (KB).

Introduction: Understanding how veterans use Veterans Affairs (VA) for primary care and non-VA for acute care can help policy makers predict future health care resource use. We aimed to describe characteristics of veterans enrolled in a multisite clinical trial of non-VA acute event notifications and care coordination and to identify patient factors associated with non-VA acute care.

Methods: Characteristics of 565 veterans enrolled in a prospective cluster randomized trial at the Bronx and Indianapolis VA Medical Centers were obtained by interview and chart review. Read More

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Delivering nutrition interventions to women and children in conflict settings: a systematic review.

BMJ Glob Health 2021 Apr;6(4)

Centre for Global Child Health, Hospital for Sick Children, Toronto, Ontario, Canada

Background: Low/middle-income countries (LMICs) face triple burden of malnutrition associated with infectious diseases, and non-communicable diseases. This review aims to synthesise the available data on the delivery, coverage, and effectiveness of the nutrition programmes for conflict affected women and children living in LMICs.

Methods: We searched MEDLINE, Embase, CINAHL, and PsycINFO databases and grey literature using terms related to conflict, population, and nutrition. Read More

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Incidence of COVID-19 in outpatients with cancer receiving active treatment in the context of a pandemic: An Andalusian cohort study.

Semin Oncol 2021 Jan 29. Epub 2021 Jan 29.

Oncology Department, Costa del Sol Hospital, Marbella, Spain. A-7, Km 187, 29603 Marbella, Málaga. Electronic address:

Background: Leading scientific societies have recommended delaying and/or suspending active cancer treatment during the COVID-19 pandemic. Nevertheless, data on this novel infection in patients with a diagnosis of cancer receiving active treatment are scarce and it is unknown if these recommendations could have repercussions on future progress of the disease. The main objective of this study is to learn the COVID-19 incidence rate in outpatients with cancer receiving active treatment. Read More

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January 2021

Myocardial Angiotensin Metabolism in End-Stage Heart Failure.

J Am Coll Cardiol 2021 Apr;77(14):1731-1743

Clinical Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria.

Background: The myocardium exhibits an adaptive tissue-specific renin-angiotensin system (RAS), and local dysbalance may circumvent the desired effects of pharmacologic RAS inhibition, a mainstay of heart failure with reduced ejection fraction (HFrEF) therapy.

Objectives: This study sought to investigate human myocardial tissue RAS regulation of the failing heart in the light of current therapy.

Methods: Fifty-two end-stage HFrEF patients undergoing heart transplantation (no RAS inhibitor: n = 9; angiotensin-converting enzyme [ACE] inhibitor: n = 28; angiotensin receptor blocker [ARB]: n = 8; angiotensin receptor neprilysin-inhibitor [ARNi]: n = 7) were enrolled. Read More

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The burden of mental disorder in Sierra Leone: a retrospective observational evaluation of programmatic data from the roll out of decentralised nurse-led mental health units.

Int J Ment Health Syst 2021 Apr 8;15(1):31. Epub 2021 Apr 8.

King's Sierra Leone Partnership, King's Global Health Partnerships, King's Centre for Global Health and Health Partnerships, School of Population and Environmental Sciences, King's College London, Freetown, Sierra Leone.

Background: In sub-Saharan Africa the treatment gap for mental disorders is high. In 2009, 98.0% of people with mental illness in Sierra Leone were not receiving treatment, partly due to the absence of public psychiatric facilities outside the capital. Read More

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Reducing prescribing of benzodiazepines in older adults: a comparison of four physician-focused interventions by a medical regulatory authority.

BMC Fam Pract 2021 Apr 8;22(1):68. Epub 2021 Apr 8.

Research and Evaluation Unit, College of Physicians and Surgeons of Alberta, 10020-100 Street NW, Edmonton, AB, 2700T5J 0N3, Canada.

Background: The inappropriate and/or high prescribing of benzodiazepine and 'Z' drugs (BDZ +) is a major health concern. The purpose of this study was to determine whether physician or pharmacist led interventions or a simple letter or a personalized prescribing report from a medical regulatory authority (MRA) was the most effective intervention for reducing BDZ + prescribing by physicians to patients 65 years of age or older.

Methods: This was a four-armed, one year, blinded, randomized, parallel-group, investigational trial in Alberta, Canada. Read More

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The synergistic effects of applying pulsed radiofrequency lesioning of the suprascapular nerve plus physical therapy on pain and function in patients with adhesive capsulitis: A protocol of a prospective, randomized, controlled trial.

Medicine (Baltimore) 2021 Apr;100(14):e25431

Department of Joint Surgery, Zhuzhou Central Hospital, Zhuzhou, Hunan, China.

Background: To our knowledge, there have been no published clinical trials to assess the synergistic effects of applying pulsed radiofrequency (PRF) stimulation of the suprascapular nerve (SSN) plus physical therapy on pain and function in patients with adhesive capsulitis. Therefore, we will conduct this present randomized, double-blind study to evaluate the synergistic effects of applying PRF stimulation of the SSN plus physical therapy on pain and function in patients with adhesive capsulitis.

Methods: The study protocol is a randomized, controlled, double-blind design. Read More

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Prognostic value of lactate dehydrogenase for melanoma patients receiving anti-PD-1/PD-L1 therapy: A meta-analysis.

Medicine (Baltimore) 2021 Apr;100(14):e25318

Department of Oncology Radiotherapy, Shaoxing People's Hospital, Shaoxing, Zhejiang Province, China.

Background: Several studies indicate the level of pretreatment lactate dehydrogenase (LDH) may be associated with the prognosis of patients receiving immune checkpoint inhibitors targeting programmed death receptor-1 (PD-1)/programmed death ligand 1 (PD-L1) which had been reported to dramatically improve the survival of patients with advanced or metastatic melanoma; however, no consensus has been reached because the presence of controversial conclusions. This study was to perform a meta-analysis to comprehensively explore the prognostic values of LDH for melanoma patients receiving anti-PD1/PD-L1 monotherapy.

Methods: A systematic electronic search in the databases of PubMed, EMBASE and the Cochrane library was performed to identify all related articles up to April, 2020. 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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Openness and COVID-19 induced xenophobia: The roles of trade and migration in sustainable development.

PLoS One 2021 8;16(4):e0249579. Epub 2021 Apr 8.

School of Ethnology and Sociology, Yunnan University, Kunming, China.

Along with the plight of the COVID-19 outbreak in 2020 come the xenophobic behaviors and hate crimes against people with Asian descent around the globe. The threat of a public health emergency catalyzed underlying xenophobic sentiments, manifesting them into racial discrimination of various degrees. With most discriminatory acts reported in liberal societies, this article investigates whether an economy more open to trade and migration can be more susceptible to xenophobia. Read More

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Lower extremity fracture prevention and management in persons with spinal cord injuries and disorders: The patient perspective.

J Spinal Cord Med 2021 Apr 8:1-11. Epub 2021 Apr 8.

Center of Innovation for Complex Chronic Healthcare (CINCCH), Health Services Research and Development Service, Department of Veterans Affairs, Hines VA Hospital, Hines, Illinois, USA.

Context/objective: To describe patient experiences with fracture prevention and management among persons with spinal cord injuries/disorders (SCI/D).

Design: Qualitative data collected via semi-structured telephone interviews.

Setting: Veterans Health Administration (VA) SCI/D System of Care. Read More

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Prevalence of Effective Audit-and-Feedback Practices in Primary Care Settings: A Qualitative Examination Within Veterans Health Administration.

Hum Factors 2021 Apr 8:187208211005620. Epub 2021 Apr 8.

5228 University of Illinois at Chicago, Champaign, USA.

Objective: The purpose of this study is to uncover and catalog the various practices for delivering and disseminating clinical performance in various Veterans Affairs (VA) locations and to evaluate their quality against evidence-based models of effective feedback as reported in the literature.

Background: Feedback can enhance clinical performance in subsequent performance episodes. However, evidence is clear that the way in which feedback is delivered determines whether performance is harmed or improved. Read More

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How are uncertain prenatal genetic results perceived and managed 2 years after they were received? A qualitative interview study.

J Genet Couns 2021 Apr 8. Epub 2021 Apr 8.

Center for Fetal Diagnostics, Aarhus University Hospital, Aarhus, Denmark.

Chromosomal microarray has considerably improved our ability to identify or dismiss genetic conditions in the unborn child. However, this detailed analysis also reveals copy number variants (CNVs) of unknown or uncertain significance, in which the specific child's prognosis can be difficult to predict. Little is known about the longer-term impacts of receiving an uncertain prenatal CNV result. Read More

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Synchronous bilateral breast cancer treated with a 3-week hypofractionated radiotherapy schedule: clinical and dosimetric outcomes.

Clin Transl Oncol 2021 Apr 8. Epub 2021 Apr 8.

Hospital Universitari Son Espases, Radiation Oncology Department, Carretera de Valldemossa, 79, 07020, Palma de Mallorca (Islas Baleares), Spain.

Background And Purpose: Synchronous bilateral breast cancer (SBBC) accounts for 1-3.5% of breast cancer patients. The aim of this study was to evaluate dosimetric issues, clinical outcomes, and acute toxicities for SBBC patients receiving synchronous bilateral hypofractionated radiotherapy (SBHRT) and to compare them with patients treated with synchronous bilateral normofractionated RT schedule (SBNRT). Read More

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Cognitive function in methadone maintenance patients compared with abstinent opioid users.

J Addict Dis 2021 Apr 8:1-12. Epub 2021 Apr 8.

Department of Psychosomatic Medicine, Taleghani Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Background: Opioid is the second most prevalent illicit drug worldwide, whose consumption is very high in Iran, due to Iran's geographical proximity to producing countries. Methadone maintenance therapy is one of the most prevalent and accepted methods of substance abuse treatment. Nevertheless, cognitive disorders have been reported as one of its complications. Read More

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Understanding authorized generics-A review of the published clinical data.

J Clin Pharm Ther 2021 Apr 8. Epub 2021 Apr 8.

Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, Baltimore, MD, USA.

What Is Known And Objectives: Despite the large body of evidence demonstrating equivalent efficacy and safety for branded drugs and their generic counterparts, some patients and providers have the perception that generics may be less safe and effective than branded agents. Authorized generics (AGs) are a category of generic drugs defined by the United States Food and Drug Administration (FDA) as being the same as the brand-name drug without the brand's name on the label and which may have minor differences, such as tablet or capsule markings for identification. Studies in which AGs are considered along with other generics may increase our understanding of factors that may influence perceptions about generics and shed light on areas where education may be impactful. Read More

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The risk of malignancy in secukinumab-treated psoriasis, psoriatic arthritis and ankylosing spondylitis patients: analysis of up to five-year clinical trial and post-marketing surveillance data.

Br J Dermatol 2021 Apr 8. Epub 2021 Apr 8.

Department of Rheumatology, Swedish Medical Center/Providence St, Joseph Health and University of Washington, Seattle, Washington, USA.

Background: Data on the use of biologic therapy and malignancy risk are inconsistent due to limited long-term robust studies.

Objective: To assess the malignancy risk in secukinumab-treated psoriasis, psoriatic arthritis (PsA) and ankylosing spondylitis (AS) patients.

Methods: This integrated safety analysis from both the secukinumab clinical trial program and post-marketing safety surveillance data included any patient receiving at least one approved dose of secukinumab with a maximum of five years follow-up. Read More

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Effects of remote ischemic conditioning on microcirculatory alterations in patients with sepsis: a single-arm clinical trial.

Ann Intensive Care 2021 Apr 7;11(1):55. Epub 2021 Apr 7.

Department of Intensive Care Medicine, Lithuanian University of Health Sciences, Eiveniu str. 2, 50161, Kaunas, Lithuania.

Background: Remote ischemic conditioning (RIC) is a promising technique that may protect organs and tissues from the effects of additional ischemic episodes. However, the therapeutic efficacy of RIC in humans with sepsis remains unknown. We hypothesized that RIC might improve sublingual microcirculation in patients with sepsis. Read More

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