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The Subarachnoid Hemorrhage Early Brain Edema Score (SEBES) as radiographic marker of clinically relevant intracranial hypertension and unfavorable outcome after subarachnoid hemorrhage.

Eur J Neurol 2021 Jul 22. Epub 2021 Jul 22.

Department of Neurosurgery and Spine Surgery, University Hospital of Essen, Germany.

Objective: The severity of early brain edema after aneurysm rupture was reported to be strongly associated with the risk of poor outcome after aneurysmal subarachnoid hemorrhage (SAH). Using the recently developed SEBES (Subarachnoid Hemorrhage Early Brain Edema Score), we analyzed the predictors of early brain edema and its impact on the complications related to intracranial pressure (ICP) increase after SAH and poor outcome.

Methods: All consecutive SAH cases treated between January 2003 and June 2016 with assessable SEBES were included (n=745). Read More

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Perioperative Pulmonary Optimization With Average Volume-Assured Pressure Support of a Pediatric Patient With Ullrich Congenital Muscular Dystrophy: A Case Report.

A A Pract 2021 Jul 22;15(7):e01504. Epub 2021 Jul 22.

From the Department of Anesthesiology, Vanderbilt University, Nashville, Tennessee.

Patients with preexisting respiratory compromise are at risk for perioperative respiratory failure. Adult literature has shown benefit with prophylactic postoperative use of noninvasive mechanical ventilation (NIMV). While pediatric literature has documented the increasing use of postoperative NIMV, there is no literature on prophylactic preoperative NIMV in patients with preexisting respiratory compromise. Read More

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Periocular Presentation of Solitary Plasmacytomas and Multiple Myeloma.

Ophthalmic Plast Reconstr Surg 2021 Jul 21. Epub 2021 Jul 21.

Orbital Service, Moorfields Eye Hospital, London, United Kingdon.

Aims: To describe patients with periocular solitary extramedullary plasmacytoma (SEMP) and multiple myeloma (MM), together with an estimate of the risk of progression from SEMP to MM.

Patients And Methods: A retrospective case-note review for patients seen between 1978 and 2020, examining demographics, presentation, imaging, pathology, management, and outcome.

Results: Twenty patients (10 male; 50%) presented at a mean age of 60. Read More

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Prediction and Prevention of Spontaneous Preterm Birth: ACOG Practice Bulletin, Number 234.

Authors:

Obstet Gynecol 2021 Aug;138(2):e65-e90

Preterm birth is among the most complex and important challenges in obstetrics. Despite decades of research and clinical advancement, approximately 1 in 10 newborns in the United States is born prematurely. These newborns account for approximately three-quarters of perinatal mortality and more than one half of long-term neonatal morbidity, at significant social and economic cost (1-3). Read More

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Prediction and Prevention of Spontaneous Preterm Birth: ACOG Practice Bulletin Summary, Number 234.

Authors:

Obstet Gynecol 2021 Aug;138(2):320-323

Preterm birth is among the most complex and important challenges in obstetrics. Despite decades of research and clinical advancement, approximately 1 in 10 newborns in the United States is born prematurely. These newborns account for approximately three-quarters of perinatal mortality and more than one half of long-term neonatal morbidity, at significant social and economic cost (1-3). Read More

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Metabolic Disorders/Obesity Is a Primary Risk Factor in Hidradenitis Suppurativa: An Immunohistochemical Real-World Approach.

Dermatology 2021 Jul 22:1-9. Epub 2021 Jul 22.

Departments of Dermatology, Venereology, Allergology and Immunology, Dessau Medical Center, Brandenburg Medical School Theodor Fontane and Faculty of Health Sciences Brandenburg, Dessau, Germany.

Background: Hidradenitis suppurativa (HS) is an inflammatory, potentially scarring disease of the hair follicle, affecting the apocrine gland-bearing skin areas. The major comorbid disorders associated with the occurrence or the aggravation of the disease are obesity and smoking. Numerous efforts to dissociate these factors led to controversial results. Read More

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A perspective on hospital-acquired (nosocomial) infection control of COVID-19: usefulness of spatial separation between wards and airborne isolation unit.

J Breath Res 2021 Jul 22. Epub 2021 Jul 22.

Emergency Medicine and Critical Care, Saitama Medical Center, 1981 Kamoda, Kawagoe, Saitama, 350-8550, JAPAN.

The coronavirus disease 2019 (COVID-19) pandemic has imposed a considerable burden on hospitals and healthcare workers (HCWs) worldwide, increasing the risk of outbreaks and nosocomial transmission to "non-COVID-19" patients, who represent the highest-risk population in terms of mortality, and HCWs. Since HCWs are at the interface between hospitals on the one hand and the community on the other, they are potential reservoirs, carriers, or victims of severe acute respiratory syndrome coronavirus 2 cross-transmission. In addition, there has been a paradigm shift in the management of viral respiratory outbreaks, such as the widespread testing of patients and HCWs, including asymptomatic individuals. Read More

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Tumor Budding is a reliable predictor for death and metastasis in invasive ductal breast cancer and correlates with other prognostic clinicopathological parameters.

Ann Diagn Pathol 2021 Jul 15;54:151792. Epub 2021 Jul 15.

Recep Tayyip Erdoğan University, Faculty of Medicine, Department of Pathology, Turkey.

Background And Objective: Breast cancers are the most common type of cancer and the most common cause of mortality in women worldwide. Different prognostic factors are the subject of research to differentiate the prognosis even between cases at a similar stage and identify risky patients earlier and create individual treatment approaches. Tumor budding (TB) has been identified as a poor prognostic factor in many types of cancer, especially colorectal carcinomas. Read More

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Prognostic nomogram for progression-free survival in patients with BRCA mutations and platinum-sensitive recurrent ovarian cancer on maintenance olaparib therapy following response to chemotherapy.

Eur J Cancer 2021 Jul 19;154:190-200. Epub 2021 Jul 19.

National Health and Medical Research Council Clinical Trials Centre, The University of Sydney, Sydney, NSW 2050, Australia; Department of Medical Oncology, St George Hospital, Kogarah, NSW 2217, Australia; Australia New Zealand Gynecological Oncology Group, Camperdown, New South Wales, Australia.

Background: The impact of maintenance therapy with PARP inhibitors (PARPi) on progression-free survival (PFS) in patients with BRCA mutations and platinum-sensitive recurrent ovarian cancer (PSROC) varies widely. Individual prognostic factors do not reliably distinguish patients who progress early from those who have durable benefit. We developed and validated a prognostic nomogram to predict PFS in these patients. Read More

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Long term follow up in 183 high grade meningioma: A single institutional experience.

Clin Neurol Neurosurg 2021 Jul 10;207:106808. Epub 2021 Jul 10.

Neuro-oncology Unit, Department of Clinical Neurosciences, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria, 11, 20133 Milan, Italy.

Introduction: Meningiomas are usually considered benign lesions, however a proportion of them shows a more aggressive behavior, defined high-grade meningiomas (HGM). Effective medical treatments are lacking, especially at the time of recurrence.

Methods: Through a retrospective analysis, we examined epidemiological, diagnostic, therapeutic, recurrence information and survival data of HGM treated at our institution between 2010 and 2018. Read More

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Neurological presentations and cognitive outcome in Sturge-Weber syndrome.

Eur J Paediatr Neurol 2021 Jul 9;34:21-32. Epub 2021 Jul 9.

Great Ormond Street Hospital for Children Neurodisability Department, Great Ormond Street, UCL Great Ormond Street Institute of Child Health Clinical Neurosciences, London, United Kingdom.

Introduction: This study of children with Sturge-Weber syndrome (SWS) profiled neurological presentations; compared patients with (+) and without (-) port-wine stain (PWS); and determined risk factors for intellectual and language impairments.

Methods: A retrospective case note review was conducted at a national centre.

Results: This cohort (n = 140, male 72, median follow up 114 months) showed sex parity. Read More

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Paediatric velopharyngeal insufficiency following adenotonsillar surgery.

Int J Pediatr Otorhinolaryngol 2021 Jul 17;149:110847. Epub 2021 Jul 17.

Great Ormond Street Hospital for Children, London, UK.

Objective: Paediatric velopharyngeal insufficiency (VPI) is a known but rare complication following adenotonsillar surgery that can have significant adverse effects on the communication as well as psychological well-being of the patient and their family. We sought to assess risk factors, aetiology, assessment and management of these patients through a dedicated multidisciplinary clinic.

Methods: Retrospective data collection was performed for patients seen in the Great Ormond Street Hospital for Children multidisciplinary VPI clinic from the 1 of January 2015 until 30 of April 2020. Read More

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Insourcing and scaling a telemedicine solution in under 2 weeks: Lessons for the digital transformation of health care.

Healthc (Amst) 2021 Jul 19;9(3):100568. Epub 2021 Jul 19.

University of Pennsylvania Health System, Penn Medicine Center for Health Care Innovation, 3400 Civic Center Blvd, 14(th) Floor South Pavilion, Philadelphia, PA, 19104, USA; University of Pennsylvania Health System, Office of the Chief Medical Information Officer, 3400 Civic Center Blvd, Philadelphia, PA, 19104, USA; University of Pennsylvania Health System, Cardiology, 3400 Civic Center Blvd, Philadelphia, PA, 19104, USA. Electronic address:

The Covid-19 pandemic required rapid scale of telemedicine as well as other digital workflows to maintain access to care while reducing infection risk. Both patients and clinicians who hadn't used telemedicine before were suddenly faced with a multi-step setup process to log into a virtual meeting. Unlike in-person examination rooms, locking a virtual meeting room was more error-prone and posed a risk of multiple patients joining the same online session. Read More

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Thrombotic risk in children with COVID-19 infection: A systematic review of the literature.

Thromb Res 2021 Jul 16;205:92-98. Epub 2021 Jul 16.

Department of Hematology and Transfusion Medicine, Carlo Poma Hospital, Mantova, Italy. Electronic address:

Objective: Coagulation and inflammatory parameters are mildly altered in children with SARS-CoV-2 (COVID-19) infection, and laboratory evidence of a proinflammatory and procoagulant state has been noted in multisystem inflammatory syndrome in children (MIS-C). It is not clear whether this pediatric condition is related to thrombotic events. With this study we reviewed the literature for thrombotic complications in children with COVID-19 infection and MIS-C. Read More

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The predictive value of segmentation metrics on dosimetry in organs at risk of the brain.

Med Image Anal 2021 Jul 13;73:102161. Epub 2021 Jul 13.

ARTORG Center for Biomedical Research, University of Bern, Bern, Switzerland. Electronic address:

Background: Fully automatic medical image segmentation has been a long pursuit in radiotherapy (RT). Recent developments involving deep learning show promising results yielding consistent and time efficient contours. In order to train and validate these systems, several geometric based metrics, such as Dice Similarity Coefficient (DSC), Hausdorff, and other related metrics are currently the standard in automated medical image segmentation challenges. Read More

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Serological responses following a single dose of SARS-CoV-2 vaccination in allogeneic stem cell transplant recipients.

Transplant Cell Ther 2021 Jul 19. Epub 2021 Jul 19.

The Royal Marsden NHS Hospital, Downs Road, Sutton, SM2 5PT, United Kingdom.

Immunocompromised individuals were not included in formal trials of SARS-CoV-2 mRNA vaccines. Subsequent studies in patients with haematological malignancies and solid organ transplant recipients suggest inferior responses to vaccination. We determined antibody responses to a single dose of vaccines in one of the most vulnerable patient groups, allogeneic haematopoietic cell transplant (allo-HCT) recipients. Read More

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Hematopoietic Stem Cell Transplantation For Patients With Autosomal Recessive Complete Interferon Gamma Receptor 2 Deficiency: Experience In Oman.

Transplant Cell Ther 2021 Jul 19. Epub 2021 Jul 19.

Department of, Hematology, Sultan Qaboos University Hospital, Muscat, Oman; Apollo Hospital, Muscat, Oman. Electronic address:

Autosomal recessive complete interferon- gamma receptor-2 (IFN-γR2) deficiency is a rare potentially fatal primary immune deficiency that predisposes to disseminated mycobacterial disease.Hematopoietic stem cell transplantation (HSCT) is currently the only curative treatment. Few patients had been reported so far. Read More

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Metformin use and risk of asthma exacerbation among asthma patients with glycemic dysfunction.

J Allergy Clin Immunol Pract 2021 Jul 19. Epub 2021 Jul 19.

Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore Maryland. Electronic address:

Background: Diabetes is associated with worse asthma morbidity. Metformin, which treats diabetes, may have a role among patients with asthma and glycemic dysfunction.

Objective: To determine the association between metformin use and asthma exacerbations among patients with diabetes. Read More

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Penicillin allergy label increases risk of worse clinical outcomes in COVID-19.

J Allergy Clin Immunol Pract 2021 Jul 19. Epub 2021 Jul 19.

Division of Gastroenterology and Hepatology, Pennsylvania State University College of Medicine, Hershey, PA, USA.

Background: Coronavirus disease-2019 (COVID-19) ranges from asymptomatic to severe. Several co-morbidities are associated with worse clinical outcomes. Antibiotic use is common in COVID-19 and penicillin (PCN) allergy can impact antibiotic choice and may influence COVID-19 outcomes. Read More

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Ciclesonide Impacts Clinicopathological Features of Eosinophilic Esophagitis.

J Allergy Clin Immunol Pract 2021 Jul 19. Epub 2021 Jul 19.

Department of Pediatrics, Gastrointestinal Eosinophilic Diseases Program, Section of Pediatric Gastroenterology, Hepatology and Nutrition, University of Colorado School of Medicine; Digestive Health Institute, Children's Hospital Colorado; Mucosal Inflammation Program, University of Colorado School of Medicine, Aurora, CO 80045, USA.

Background: - Eosinophilic Esophagitis (EoE) is a chronic allergen-mediated disease of the esophagus. Pharmacologic treatment has largely relied on repurposing corticosteroids. Ciclesonide (CIC) is a corticosteroid for the treatment of asthma with biochemical properties that improve topical potency. Read More

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Safety, efficacy, and serum concentration monitoring of bedaquiline in Chinese patients with multidrug-resistant tuberculosis.

Int J Infect Dis 2021 Jul 19. Epub 2021 Jul 19.

Affiliated Hangzhou Chest Hospital, Zhejiang University School of Medicine, Hangzhou 310000, China. Electronic address:

Objectives: To determine the safety and efficacy of bedaquiline for Chinese multidrug-resistant tuberculosis patients based on serum concentration monitoring and identify factors associated with QTc prolongation occurring during treatment.

Methods: We collected data from 35 patients who received treatment regimens containing bedaquiline for multidrug-resistant tuberculosis (MDR-TB) from May 2018 to December 2020. Blood samples were collected, and serum concentrations of bedaquiline were measured using high-performance liquid chromatography-mass spectrometry. Read More

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Durability of rilpivirine- versus integrase inhibitor-based regimens in a large cohort of naïve HIV-infected patients starting antiretroviral therapy.

Int J Antimicrob Agents 2021 Jul 19:106406. Epub 2021 Jul 19.

Clinic of Infectious Diseases, S. Paolo Hospital, University of Milan, Milano, Italy.

Objective: Comparisons between rilpivirine (RPV) and integrase strand transfer inhibitors (INSTIs) in antiretroviral therapy (ART)-naïve HIV-infected individuals are currently lacking. Aim of the study was to compare, in an observational cohort setting, the durability of treatment of RPV- and INSTI-based first-line regimens.

Methods: Patients who started first-line ARTs based on RPV or on INSTIs, with HIV-RNA <100,000 copies/mL, CD4 cells count >200 cells/μL, were included. Read More

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Molecular and epidemiological investigation of a colistin-resistant OXA-23/NDM-1-producing Acinetobacter baumannii outbreak in Southwest Indian Ocean.

Int J Antimicrob Agents 2021 Jul 19:106402. Epub 2021 Jul 19.

Centre National de Référence de la Résistance aux Antibiotiques, Centre Hospitalier Universitaire de Besançon, Besançon, France.; Laboratoire de Bactériologie, UMR CNRS 6249 Chrono-Environnement, Faculté de Médecine-Pharmacie, Université Bourgogne Franche-Comté, Besançon, France.. Electronic address:

Dual resistance to colistin and carbapenems is a milestone reached by certain extensively-drug resistant (XDR) Gram-negative bacteria. The present study describes the first outbreak of XDR colistin- and carbapenem-resistant OXA-23/NDM-1-producing Acinetobacter baumannii (CCRAB) in European overseas territory of Reunion Island (France, Indian Ocean). Between April 2019 and June 2020, 13 patients admitted to the University Hospital of Reunion Island were involved in the outbreak, of whom 8 were infected and 6 died. Read More

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Association of periodontal disease with breed size, breed, weight, and age in pure-bred client-owned dogs in the United States.

Vet J 2021 Jul 19:105717. Epub 2021 Jul 19.

Waltham Petcare Science Institute, Freeby Lane, Waltham-on-the-Wolds, Melton Mowbray, Leicestershire, LE14 4RT, UK.

Despite periodontal disease (PD) being amongst the most common diagnoses in primary-care practice, the disease is generally underdiagnosed. However, the millions of clinical records generated by pet hospitals each year provide unique opportunities to generate insights about disease risk across large numbers of dogs. The objective of this study was to undertake a retrospective analysis of medical records to ascertain which sizes and breeds of dog are most frequently diagnosed with PD. Read More

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Association between bariatric surgery with long-term analgesic prescription and all-cause mortality among patients with osteoarthritis: a general population-based cohort study.

Osteoarthritis Cartilage 2021 Jul 19. Epub 2021 Jul 19.

Division of Rheumatology, Allergy, and Immunology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, USA;; The Mongan Institute, Massachusetts General Hospital, Harvard Medical School, Boston, USA. Electronic address:

Objectives: There is still a large unmet need for novel osteoarthritis (OA) treatments that could provide clinically important effects on long-term pain relief (≥12 months). We examined the relation of bariatric surgery along with weight loss to analgesic prescription and all-cause mortality among individuals with OA.

Methods: We conducted a cohort study among individuals with OA using The Health Improvement Network. Read More

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Perinatal SSRI exposure disrupts G protein-coupled receptor BAI3 in developing dentate gyrus and adult emotional behavior: relevance to psychiatric disorders.

Neuroscience 2021 Jul 19. Epub 2021 Jul 19.

School of Neuroscience, Virginia Polytechnic Institute and State University, Blacksburg, VA, 24061, USA. Electronic address:

Selective serotonin reuptake inhibitor (SSRI) antidepressants are widely prescribed to pregnant women suffering with depression, although the long-term impact of these medications on exposed offspring are poorly understood. Perinatal SSRI exposure alters human offspring's neurodevelopment and increases risk for psychiatric illness in later life. Rodent studies suggest that perinatal SSRI-induced behavioral abnormalities are driven by changes in the serotonin system as well as epigenetic and transcriptomic changes in the developing hippocampus. Read More

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Seminal vesicle intrafraction motion during the delivery of radiotherapy sessions on a 1.5 T MR-Linac.

Radiother Oncol 2021 Jul 19. Epub 2021 Jul 19.

University Medical Center Utrecht, Department of Radiotherapy, Utrecht 3508 GA, The Netherlands.

PurposeTo evaluate seminal vesicle (SV) intrafraction motion using cinematic magnetic resonance imaging (cine-MR) during the delivery of online adaptive MR-Linac radiotherapy fractions, in preparation of MR-guided extremely hypofractionated radiotherapy for intermediate to high-risk prostate cancer patients.Material and MethodsFifty prostate cancer patients were treated with 5 x 7.25 Gy on a 1. Read More

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Polysubstance use trends and variability among individuals with opioid use disorder in rural versus urban settings.

Prev Med 2021 Jul 19:106729. Epub 2021 Jul 19.

Washington University in St. Louis School of Medicine, Department of Psychiatry, Campus Box 8134, 660 S. Euclid Avenue, St. Louis, MO 63110, United States.

Rural areas of the United States have been disproportionately impacted by the opioid epidemic, exacerbated by COVID-19-related economic upheavals. While polysubstance use is an important determinant of overdose risk, variability in polysubstance use as a result of numerous factors (e.g. Read More

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Efficient Roles of miR-146a in Cellular and Molecular Mechanisms of Neuroinflammatory Disorders: An Effectual Review in Neuroimmunology.

Immunol Lett 2021 Jul 19. Epub 2021 Jul 19.

Department of Immunology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Electronic address:

Known as one of the most sophisticated systems of the human body, the nervous system consists of neural cells and controls all parts of the body. It is closely related to the immune system. The effects of inflammation and immune reactions have been observed in the pathogenesis of some neurological disorders. Read More

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