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Rotational Thromboelastometry in Neonates Admitted to a Neonatal Intensive Care Unit: A Large Cross-sectional Study.

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

Laboratory of Haematology and Blood Bank Unit, "Attikon" Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.

The aim of the present study was to assess the coagulation profile in neonatal critical illness using rotational thromboelastometry (ROTEM), and to investigate its association with disease severity and its potential prognostic role in this clinical setting. Over a period of 67 months (July 2014-February 2020) 423 critically ill neonates with confirmed or suspected sepsis, perinatal hypoxia, or respiratory distress syndrome, hospitalized in our neonatal intensive care unit were included in the study. Demographic, clinical, and laboratory data were recorded on admission day and arterial blood was analyzed on ROTEM analyzer using the standard extrinsically activated rotational thromboelastometry assay (EXTEM). Read More

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Association of Acute Kidney Injury with Outcomes in Patients Undergoing Transcatheter Mitral Valve Repair.

Cardiology 2021 Jun 15:1-7. Epub 2021 Jun 15.

Division of Cardiology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA.

Introduction: Although transcatheter mitral valve repair (TMVr) is a contrast-free procedure, prior single-center studies have demonstrated a high incidence of acute kidney injury (AKI) following TMVr. The main objective of this study was to examine risk factors for AKI, and its association with outcomes in patients undergoing TMVr.

Methods: We queried the National Readmission Database to identify TMVr procedures performed between January 2014 and December 2017. Read More

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Analysis of Unintentional Falls in Pediatric Population and Predictors of Morbidity.

J Surg Res 2021 Jun 12;267:48-55. Epub 2021 Jun 12.

Division of Pediatric Surgery, Children's Hospital of Orange County, Orange, California.

Introduction: Unintentional falls are a leading cause of pediatric traumatic injury. This study evaluates clinical outcomes of fall-related injuries in children under the age of 10.

Methods: The National Trauma Database was queried for children who experienced an unintentional fall. Read More

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Antibiotic-induced disruption of the microbiome exacerbates chemotherapy-induced diarrhoea and can be mitigated with autologous faecal microbiota transplantation.

Eur J Cancer 2021 Jun 12;153:27-39. Epub 2021 Jun 12.

Department of Medical Microbiology, University Medical Centre Groningen, The University of Groningen, Groningen, the Netherlands.

Background: Chemotherapy is well documented to disrupt the gut microbiome, leading to poor treatment outcomes and a heightened risk of adverse toxicity. Although strong associations exist between its composition and gastrointestinal toxicity, its causal contribution remains unclear. Our inability to move beyond association has limited the development and implementation of microbial-based therapeutics in chemotherapy adjuncts with no clear rationale of how and when to deliver them. Read More

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Clinical characteristics and outcomes of community-acquired pneumonia in western Saudi Arabia: A four-year retrospective analysis of medical records.

J Infect Public Health 2021 May 27;14(7):960-966. Epub 2021 May 27.

Infection Prevention and Control, King Abdulaziz Medical City, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia; King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.

Background: Community-acquired pneumonia (CAP) is a significant cause of morbidity and mortality, especially for the elderly and people who suffer from chronic conditions. This study was conducted to assess the clinical and microbiological characteristics and disease outcomes associated with the occurrence of CAP.

Methods: This retrospective chart review was conducted at King Abdulaziz Medical City, Jeddah, Saudi Arabia. Read More

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Early multidrug treatment of SARS-CoV-2 infection (COVID-19) and reduced mortality among nursing home (or outpatient/ambulatory) residents.

Med Hypotheses 2021 Jun 5;153:110622. Epub 2021 Jun 5.

Concerned Ontario Doctors, Toronto, ON, Canada. Electronic address:

The outbreak of COVID-19 from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread all over the world with tremendous morbidity and mortality in the elderly. In-hospital treatment addresses the multifaceted nature of the illness including initial viral replication, cytokine storm, and endothelial injury with thrombosis. We identified nine reports of early treatment outcomes in COVID-19 nursing home patients. Read More

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Stroke Mechanism in COVID-19 Infection: A Prospective Case-Control Study.

J Stroke Cerebrovasc Dis 2021 Jun 1;30(8):105919. Epub 2021 Jun 1.

Department of Neurology, Hacettepe University Hospitals Turkey.

Background: The characteristics and pathophysiological mechanisms involved in acute ischemic stroke in patients with COVID-19 infection have not been fully clarified. We prospectively studied the phenotypic and etiological features of acute stroke occurring in COVID-19 infection.

Patients & Methods: Within nine months starting from April-2020, the presence of COVID-19 infection was determined by thoracic CT and SARS-CoV-2 PCR in all acute stroke cases managed in a single tertiary center. Read More

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Predictors of Early Stroke or Death in Patients Undergoing Transcatheter Aortic Valve Implantation.

J Stroke Cerebrovasc Dis 2021 Jun 11;30(8):105912. Epub 2021 Jun 11.

Department of Neurology, CHU La Milétrie, Poitiers, France and University of Poitiers, France.

Background/objective: While postoperative stroke is a known complication of Transcatheter Aortic Valve Implantation (TAVI), predictors of early stroke occurrence have not been specifically reviewed. The objective of this study was to estimate the predictors and incidence of stroke during the first 30 days post-TAVI.

Methods: A cohort of 506 consecutive patients having undergone TAVI between January 2017 and June 2019 was extracted from a prospective database. Read More

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Nutritional Risk at intensive care unit admission and outcomes in survivors of critical illness.

Clin Nutr 2021 May 11;40(6):3868-3874. Epub 2021 May 11.

Critical Illness, Brain Dysfunction, and Survivorship (CIBS) Center, Nashville, TN, USA; Division of Pulmonary, Critical Care, and Sleep Medicine, The Ohio State University College of Medicine, Columbus OH, USA; Davis Heart and Lung Research Institute, The Ohio State University Wexner Medical Center, Columbus, OH, USA. Electronic address:

Background And Aims: Risk factors for poor outcomes after critical illness are incompletely understood. While nutritional risk is associated with mortality in critically ill patients, its association with disability, cognitive, and health-related quality of life is unclear in survivors of critical illness. This study's objective was to determine whether greater nutritional risk at ICU admission is associated with greater disability, worse cognition, and worse HRQOL at 3 and 12-month follow-up. Read More

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Comparison of treatment modalities in post-irradiation carotid blowout syndrome: a multi-center retrospective review.

World Neurosurg 2021 Jun 12. Epub 2021 Jun 12.

Department of Neurosurgery, Tuen Mun Hospital, Hong Kong.

Background: Carotid blowout syndrome is not uncommon in our locality, where head and neck cancers, especially nasopharyngeal carcinoma, are prevalent. Traditionally it carries high morbidity and mortality rate. Treatment paradigm has evolved from open surgeries to endovascular interventions, with each treatment modality carries its merits and drawbacks. Read More

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Sensitivity of the unruptured intracranial aneurysm treatment score (UIATS) in the elderly: retrospective analysis of ruptured aneurysms.

World Neurosurg 2021 Jun 12. Epub 2021 Jun 12.

Department of Neurological Surgery, University of California, San Francisco, CA, USA.

Introduction: The prevalence of intracranial aneurysms, as well as the incidence of subarachnoid hemorrhage (SAH) increase with age, and the elderly have poor outcomes after SAH. Age is a key factor in the unruptured intracranial aneurysm treatment score (UIATS), however, the sensitivity of the UIATS model in detecting risk of SAH among the elderly is unknown.

Materials And Methods: We retrospectively analyzed 153 consecutive ruptured aneurysms between 2012 and 2018. Read More

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Clinical Utility of Overlap Time for Incomplete Relaxation to Predict Cardiac Events in Heart Failure: Incomplete relaxation in heart failure.

J Card Fail 2021 Jun 12. Epub 2021 Jun 12.

Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, 2-50-1 Kuramoto, Tokushima, Japan.

Background: The overlap time of transmitral flow can be a novel marker of subclinical left ventricular (LV) dysfunction for predicting adverse events in heart failure (HF). We aimed to 1) investigate the role of overlap time of E-A wave in association with clinical parameters, and 2) evaluate whether the overlap time could add prognostic information with respect to other conventional clinical prognosticators in HF.

Methods: We prospectively evaluated 153 patients hospitalized with HF (mean age 68±15 years; 63% male). Read More

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Inhaled bronchodilators use and clinical course of adult inpatients with Covid-19 pneumonia in Spain: A retrospective cohort study.

Pulm Pharmacol Ther 2021 Jun 12:102007. Epub 2021 Jun 12.

Pneumology Department, La Paz University Hospital, IdiPAZ, Madrid.

Background: In the current coronavirus health crisis, inhaled bronchodilators(IB) have been suggested as a possible treatment for patients hospitalized. Patients with evidence of Covid-19 pneumonia worldwide have been prescribed these medications as part of therapy for the disease, an indication for which this medications could be ineffective taken on account the pathophysiology and mechanisms of disease progression.

Objective: The main objective was to evaluate whether there is an association between IB use and length of stay. Read More

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The role of sexual dimorphism in susceptibility to SARS-CoV-2 infection, disease severity, and mortality: facts, controversies and future perspectives.

Microbes Infect 2021 Jun 12:104850. Epub 2021 Jun 12.

Division of Endocrinology and Metabolism and Diabetes Center, First Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA University Hospital, Thessaloniki, Greece. Electronic address:

Former studies have revealed intersex variability in immune response to infectious diseases, including Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Epidemiological surveillance of the ongoing pandemic has demonstrated a male vulnerability to morbidity and mortality, despite similar infection rates between the two sexes. Divergence in the frequency of comorbidities between males and females, differences in hormonal profile, chromosomal composition and gender behavior have all been proposed as potential causative factors. Read More

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Long-term Kidney Function and Survival in Recipients of Allografts from Living Kidney Donors with Hypertension: A National Cohort Study.

Transpl Int 2021 Jun 15. Epub 2021 Jun 15.

Department of Surgery, Johns Hopkins University School of Medicine, Baltimore.

Allografts from living kidney donors with hypertension may carry subclinical kidney disease from the donor to recipient and thus lead to adverse recipient outcomes. We examined eGFR trajectories and all-cause allograft failure in recipients from donors with vs. without hypertension, using mixed-linear and Cox regression models stratified by donor age. Read More

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Population-based incidence and mortality of community-acquired pneumonia in Germany.

PLoS One 2021 15;16(6):e0253118. Epub 2021 Jun 15.

Pfizer Deutschland GmbH, Berlin, Germany.

Background: Little information on the current burden of community-acquired pneumonia (CAP) in adults in Germany is available.

Methods: We conducted a retrospective cohort study using a representative healthcare claims database of approx. 4 million adults to estimate the incidence rates (IR) and associated mortality of CAP in 2015. Read More

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Cement augmentation for trochanteric femur fractures: A meta-analysis of randomized clinical trials and observational studies.

PLoS One 2021 15;16(6):e0251894. Epub 2021 Jun 15.

Department of Orthopaedic and Trauma Surgery, Lucerne Cantonal Hospital, Lucerne, Switzerland.

Introduction: To date, it is unclear what the clinical benefit of cement augmentation in fixation for trochanteric fractures is. The aim of this meta-analysis is to compare cement augmentation to no augmentation in fixation of trochanteric femur fractures in the elderly patients (>65 years) following low energy trauma.

Methods: PubMed/Medline/Embase/CENTRAL/CINAHL were searched for both randomized clinical trials (RCT) and observational studies comparing both treatments. Read More

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Association of Sickle Cell Trait with Risk and Mortality of COVID-19: Results from the United Kingdom Biobank.

Am J Trop Med Hyg 2021 Jun 15. Epub 2021 Jun 15.

Program for Personalized Cancer Care, NorthShore University HealthSystem, Evanston, Illinois.

Sickle cell trait (SCT) carriers inherit one copy of the Glu6Val mutation in the hemoglobin gene and is particularly common in Black individuals (5-10%). Considering the roles of hemoglobin in immune responses and the higher risk for coronavirus disease (COVID-19) among Black individuals, we tested whether Black SCT carriers were at increased risk for COVID-19 infection and mortality according to the United Kingdom Biobank. Among Black individuals who were tested for COVID-19, we found similar infection rates among SCT carriers (14/72; 19. Read More

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Comparative Analysis of Pediatric COVID-19 Infection in Southeast Asia, South Asia, Japan, and China.

Am J Trop Med Hyg 2021 Jun 15. Epub 2021 Jun 15.

Duke-NUS Medical School, Singapore.

There is a scarcity of data regarding coronavirus disease 2019 (COVID-19) infection in children from southeast and south Asia. This study aims to identify risk factors for severe COVID-19 disease among children in the region. This is an observational study of children with COVID-19 infection in hospitals contributing data to the Pediatric Acute and Critical Care COVID-19 Registry of Asia. Read More

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A Knowledge Distillation Ensemble Framework for Predicting Short and Long-term Hospitalisation Outcomes from Electronic Health Records Data.

IEEE J Biomed Health Inform 2021 Jun 15;PP. Epub 2021 Jun 15.

The ability to perform accurate prognosis of patients is crucial for proactive clinical decision making, informed resource management and personalised care. Existing outcome prediction models suffer from a low recall of infrequent positive outcomes. We present a highly-scalable and robust machine learning framework to automatically predict adversity represented by mortality and ICU admission from time-series vital signs and laboratory results obtained within the first 24 hours of hospital admission. Read More

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Gender Differences in the Presentation and Outcomes of Hospitalized Patients With COVID-19.

J Hosp Med 2021 Jun;16(6):349-352

Hospital Clínico San Carlos, Madrid, Spain.

Gender-related differences in COVID-19 clinical presentation, disease progression, and mortality have not been adequately explored. We analyzed the clinical profile, presentation, treatments, and outcomes of patients according to gender in the HOPE-COVID-19 International Registry. Among 2,798 enrolled patients, 1,111 were women (39. Read More

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Commentary: The COVID-19 Pandemic Is Not a Good Time to Weaken Restrictions on Alcohol Availability.

Healthc Policy 2021 May;16(4):25-30

Senior Scientist, Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON.

Alcohol use is well established globally as one of the major risk factors for burden of disease and mortality. Although it is not yet clear how the COVID-19 pandemic has impacted the overall level of alcohol use in Canada, we do know that various levels of government have promoted its use - either by designating it essential or by increasing its availability. Such actions may have both an immediate and sustained impact on alcohol-related harm in Canada. Read More

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Demographic disparities of penile cancer in Appalachian Kentucky.

Can J Urol 2021 Jun;28(3):10713-10718

Department of Urology, University of Kentucky College of Medicine, Lexington, Kentucky, USA.

Introduction: Appalachian Kentucky is a region characterized by poor healthcare literacy and access. We investigate the disparities in demographic distribution and outcomes of penile squamous cell carcinoma (pSCC) in rural Kentucky.

Materials And Methods: Data were retrieved for patients with pSCC from 1995-2015 from the Kentucky Cancer Registry and the Surveillance, Epidemiology and End Results Program (SEER) and were used to investigate differences between Appalachian Kentucky and the remainder of the state and country. Read More

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Perioperative stroke and myocardial infarction in urologic surgery.

Can J Urol 2021 Jun;28(3):10678-10684

Department of Urology, Oregon Health and Science University, Portland, Oregon, USA.

INTRODUCTION Perioperative stroke and myocardial infarction are uncommon but devastating thromboembolic complications. There is no comprehensive study detailing these complications for urologic procedures. The primary aim of this study is to determine which urologic procedures and patients carry the highest risk of perioperative stroke and myocardial infarction. Read More

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Impact of Insulin Treatment on the Effect of Eplerenone: Insights From the EMPHASIS-HF Trial.

Circ Heart Fail 2021 Jun 15;14(6):e008075. Epub 2021 Jun 15.

Université de Lorraine, Inserm, Centre d'Investigations Cliniques, - Plurithématique 14-33, and Inserm U1116, CHRU, F-CRIN INI-CRCT (Cardiovascular and Renal Clinical Trialists), Nancy, France (J.P.F., Z.L., P.R., F.Z.).

Background: Patients with heart failure with reduced ejection fraction (HFrEF) and insulin-treated diabetes have a high risk of cardiovascular complications. Mineralocorticoid receptor antagonists may mitigate this risk. We aim to explore the effect of eplerenone on cardiovascular outcomes and all-cause mortality in HFrEF patients with diabetes, including those treated with insulin in the EMPHASIS-HF trial (Eplerenone in Patients with Systolic Heart Failure and Mild Symptoms). Read More

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Cladophialophora bantiana and Nocardia farcinica infection simultaneously occurring in a kidney transplant recipient: Case report and literature review.

Immun Inflamm Dis 2021 Jun 15. Epub 2021 Jun 15.

Division of Community Internal Medicine, Mayo Clinic Jacksonville, Florida, USA.

Solid organ transplant recipients are at increased risk of acquiring devastating infections with unusual pathogens. Nocardia are aerobic actinomycetes that affect the lungs, brain, skin and soft tissue. Cladophialophora species are dematiaceous fungi that overwhelmingly cause infections in the brain. Read More

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Impact of polypharmacy on all-cause mortality and hospitalization in incident hemodialysis patients: a cohort study.

Clin Exp Nephrol 2021 Jun 15. Epub 2021 Jun 15.

Department of Hemovascular Medicine and Artificial Organs, Faculty of Medicine, University of Miyazaki, 5200 Kihara Kiyotake, Miyazaki city, Miyazaki, 889-1692, Japan.

Background: Polypharmacy (PP) is common in end-stage chronic renal disease patients largely due to the presence of multiple comorbid conditions. Although PP is potentially harmful, its relationship with mortality and morbidity in hemodialysis patients currently remains unclear.

Methods: Study design: cohort study. Read More

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Same-day discharge arthroplasty has a higher overall complications rate than fast-track arthroplasty: a systematic review and meta-analysis.

Arch Orthop Trauma Surg 2021 Jun 15. Epub 2021 Jun 15.

Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, 37# Guoxue Road, 610041, Chengdu, Sichuan, People's Republic of China.

Background: Published studies have reported many inconsistent results regarding the comparison of same-day discharge total joint arthroplasty (TJA) and inpatient TJA. More notably, many recent studies comparing same-day discharge TJA with fast-track TJA presented higher rates of complications for same-day discharge TJA, which raises concerns about the safety of same-day discharge TJA.

Methods: We systematically searched the MEDLINE, Embase, and Cochrane Central Register of Controlled Trials databases up to June 2020 for studies comparing mortality, readmission, and complications in same-day discharge and inpatient total hip or knee arthroplasty. Read More

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Diaphragmatic herniation after esophagogastric surgery: systematic review and meta-analysis.

Langenbecks Arch Surg 2021 Jun 15. Epub 2021 Jun 15.

Division of General Surgery, Department of Biomedical Science for Health, Istituto Clinico Sant'Ambrogio, University of Milan, Via Luigi Giuseppe Faravelli, 16, 20149, Milan, Italy.

Introduction: The anatomy of the esophageal hiatus is altered during esophagogastric surgery with an increased risk of postoperative hiatus hernia (HH). The purpose of this article was to examine the current evidence on the surgical management and outcomes associated with HH after esophagogastric surgery for cancer.

Materials And Methods: Systematic review and meta-analysis. Read More

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β-Adrenergic blockade in patients with dementia and hip fracture is associated with decreased postoperative mortality.

Eur J Trauma Emerg Surg 2021 Jun 15. Epub 2021 Jun 15.

School of Medical Sciences, Orebro University, 702 81, Orebro, Sweden.

Purpose: Dementia, present in 20% of hip fracture patients, is associated with an almost threefold increase in postoperative mortality risk. These patients have a substantially higher incidence of cardiovascular, respiratory, and cerebrovascular mortality after hip fracture surgery compared to patients without dementia. This study aimed to investigate the association between beta-blocker therapy and postoperative mortality in patients with dementia undergoing hip fracture surgery. Read More

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