3,044 results match your criteria risk terminated

Accuracy of the Standardized Early Fetal Heart Assessment in Excluding Major Congenital Heart Defects in High-Risk Population: A Single-Center Experience.

J Ultrasound Med 2021 Jul 20. Epub 2021 Jul 20.

Department of Obstetrics, Gynecology & Reproductive Sciences, University of Maryland School of Medicine, Baltimore, Maryland, USA.

Objective: To evaluate the ability of standardized early fetal heart assessment (EFHA) that includes the 4-chamber, outflow tract relationship (OTR), transverse arches views (TAV) of the great arteries in excluding major congenital heart defects (CHDs) in high-risk populations.

Methods: This retrospective study included high-risk pregnancies for CHDs undergoing EFHA at 11-14 weeks of gestation. Risk factors for CHDs were diabetes mellitus, a family history of CHDs, a history of a CHD use of teratogenic medications, seizure disorder, assisted reproductive treatment-conceived pregnancy, presence of at least one of the ultrasound markers: enlarged nuchal translucency (>95th percentile), tricuspid regurgitation, and reversed a-wave in the ductus venosus, presence of an extracardiac or a suspected cardiac anomaly, a high-risk first trimester combined screen result, and multiple pregnancies. Read More

View Article and Full-Text PDF

Therapeutic Use of Microbubbles and Ultrasound in Acute Peripheral Arterial Thrombosis: A Systematic Review.

Ultrasound Med Biol 2021 Jul 13. Epub 2021 Jul 13.

Department of Surgery, Amsterdam University Medical Centers (VUmc), Amsterdam, The Netherlands; Department of Physiology, Amsterdam University Medical Centers (VUmc), Amsterdam, The Netherlands.

Catheter-directed thrombolysis (CDT) for acute peripheral arterial occlusion is time consuming and carries a risk of major hemorrhage. Contrast-enhanced sonothrombolysis (CEST) might enhance outcomes compared with standard CDT. In the study described here, we systematically reviewed all in vivo studies on contrast-enhanced sonothrombolysis in a setting of arterial thrombosis. Read More

View Article and Full-Text PDF

Pilot study of extended-release lorcaserin for cocaine use disorder among men who have sex with men: A double-blind, placebo-controlled randomized trial.

PLoS One 2021 15;16(7):e0254724. Epub 2021 Jul 15.

Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA, United States of America.

Objective: To determine if men who have sex with men (MSM) with cocaine use disorder (CUD) and actively-using cocaine could be enrolled and retained in a pharmacologic intervention trial of lorcaserin-a novel 5-HT2cR agonist-and determine the degree to which participants would adhere to study procedures.

Methods: This was a phase II randomized, double-blind, placebo-controlled pilot study with 2:1 random parallel group assignment to daily extended-release oral lorcaserin 20 mg versus placebo (clinicaltrials.gov identifier-NCT03192995). Read More

View Article and Full-Text PDF

Anesthesia in Parturients Presenting with Marfan Syndrome.

Isr Med Assoc J 2021 Jul;23(7):437-440

Leviev Heart Center, Sheba Medical Center, Tel Hashomer, Israel.

Background: Pregnant women with Marfan syndrome (MS) have a high risk of aortic dissection around delivery and their optimal management requires a multi-disciplinary approach, including proper cardio-obstetric care and adequate pain management during labor, which may be difficult due to the high prevalence of dural ectasia (DE) in these patients.

Objectives: To evaluate the multidisciplinary management of MS patients during labor.

Methods: Nineteen pregnant women (31 pregnancies) with MS were followed by a multi-disciplinary team (cardiologist, obstetrician, anesthesiologist) prior to delivery. Read More

View Article and Full-Text PDF

Prenatal diagnosis of partial monosomy 8p (8p23.2→pter) and partial trisomy 15q (15q21.2→qter) and incidental detection of a familial chromosome translocation of paternal origin in a pregnancy associated with increased nuchal translucency and an abnormal maternal serum screening result.

Taiwan J Obstet Gynecol 2021 Jul;60(4):775-777

Department of Medical Research, MacKay Memorial Hospital, Taipei, Taiwan.

Objective: We present partial monosomy 8p (8p23.2→pter) and partial trisomy 15q (15q21.2→qter) and incidental detection of a familial chromosome translocation of paternal origin in a pregnancy associated with increased nuchal translucency (NT) and an abnormal maternal serum screening result. Read More

View Article and Full-Text PDF

Epigenetic therapy in combination with a multi-epitope cancer vaccine targeting shared tumor antigens for high-risk myelodysplastic syndrome - a phase I clinical trial.

Cancer Immunol Immunother 2021 Jul 4. Epub 2021 Jul 4.

Department of Hematology, Copenhagen University Hospital, Copenhagen, Denmark.

Background: Standard care for patients with high-risk myelodysplastic syndrome (MDS) is hypomethylating agents such as azacitidine (AZA), which can induce expression of methylated tumor-associated antigens and therefore potentiate immunotherapeutic targeting.

Method: In this phase 1 trial, we combined AZA with a therapeutic peptide vaccine targeting antigens encoded from NY-ESO-1, MAGE-A3, PRAME, and WT-1, which have previously been demonstrated to be upregulated by AZA treatment.

Result: Five patients who had responded to AZA monotherapy were included in the study and treated with the vaccine. Read More

View Article and Full-Text PDF

Associations Between Sleep Quality and Health Span: A Prospective Cohort Study Based on 328,850 UK Biobank Participants.

Front Genet 2021 15;12:663449. Epub 2021 Jun 15.

Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China.

Objective: To examine the associations between sleep quality and health span using a prospective cohort design based on the UK Biobank (UKB).

Materials And Methods: This longitudinal cohort study enrolled 328,850 participants aged between 37 and 73 years from UKB to examine the associations between sleep quality and risk of terminated health span. End of health span was defined by eight events strongly associated with longevity (cancer, death, congestive heart failure, myocardial infarction, chronic obstructive pulmonary disease, stroke, dementia, and diabetes), and a sleep score was generated according to five sleep behavioral factors (sleep duration, chronotype, sleeplessness, daytime sleepiness, and snoring) to characterize sleep quality. Read More

View Article and Full-Text PDF

A multi-center phase II randomized clinical trial of losartan on symptomatic outpatients with COVID-19.

EClinicalMedicine 2021 Jul 17;37:100957. Epub 2021 Jun 17.

Department of Emergency Medicine, Mayo Clinic, Rochester, MN, USA.

Background: The SARS-CoV-2 virus enters cells via Angiotensin-converting enzyme 2 (ACE2), disrupting the renin-angiotensin-aldosterone axis, potentially contributing to lung injury. Treatment with angiotensin receptor blockers (ARBs), such as losartan, may mitigate these effects, though induction of ACE2 could increase viral entry, replication, and worsen disease.

Methods: This study represents a placebo-controlled blinded randomized clinical trial (RCT) to test the efficacy of losartan on outpatients with COVID-19 across three hospital systems with numerous community sites in Minnesota, U. Read More

View Article and Full-Text PDF

Guillain-Barré syndrome in pregnancy

Ceska Gynekol 2021 ;86(3):189-193

Objective: A case report of a 23-year-old pregnant woman diagnosed with Guillain-Barré syndrome in the 31st week of pregnancy.

Case Report: We present a case study of a patient in the 31st week of pregnancy hospitalized at the University Hospital in Brno for expressed bulbar syndrome, neck muscle weakness, paresthesia of the arms and medical history of diarrhea in the previous week. During hospitalization, there was a rapid progression of symptoms and respiratory failure, requiring orotracheal intubation. Read More

View Article and Full-Text PDF

Lower WNT16 expression in patients with adolescent idiopathic scoliosis - potential link to lower bone mass in AIS?

Stud Health Technol Inform 2021 Jun;280:23-28

Department of Orthopaedics and Traumatology, SH Ho Scoliosis Research Laboratory, The Chinese University of Hong Kong, Shatin, NT, Hong Kong SAR, China.

Adolescent Idiopathic Scoliosis (AIS) occurs during pubertal rapid growth period and is closely associated with low bone mass. The underlying mechanisms for systemic low bone mass in AIS remains unclear. Wnt signalling pathway is one of the important pathways regulating bone metabolism and influencing bone strength, its family member Wnt16 associates with lower bone mineral density (BMD) in late adulthood, and plays key regulatory role in determining cortical bone quality in adult mice. Read More

View Article and Full-Text PDF

Factors Impacting the Decision of an Individual With Lynch Syndrome to Terminate a Health Care Provider Relationship.

J Patient Exp 2021 13;8:23743735211008755. Epub 2021 Apr 13.

Department of Population Health Sciences, Albany College of Pharmacy and Health Sciences, Albany, NY, USA.

Lynch syndrome (LS) is a genetic cancer syndrome that puts affected individuals at a significantly higher risk of developing multiple cancers. Participants (n = 57) were recruited through social media. Data were collected through online surveys and phone interviews; the interview data (n = 55) were analyzed to identify provider terminations and the factors that motivated these decisions. Read More

View Article and Full-Text PDF

Opioid Management in Older Adults: Lessons Learned From a Geriatric Patient-Centered Medical Home.

Fed Pract 2021 Apr;38(4):168-173

is an Advanced Practice Nurse, is a Clinical Pharmacist, and is the Clinical Associate Director at the Geriatric Research Education and Clinical Center, all at the Tennessee Valley Healthcare System. James Powers is a Geriatrician at the Vanderbilt Center for Quality Aging in Nashville.

Background: The United States continues to confront an opioid crisis that also affects older adults. Best practices for prescription opioid management in older adults are challenging to implement in this population. We present our experience with a 1-year management of 48 high-risk older patients who received guideline-based best practices for chronic prescription opioid therapy at a US Department of Veterans Affairs (VA) patient aligned care team (PACT) patient-centered medical home. Read More

View Article and Full-Text PDF

Does immune checkpoint inhibitor increase the risks of poor outcomes in COVID-19-infected cancer patients? A systematic review and meta-analysis.

Cancer Immunol Immunother 2021 Jun 26. Epub 2021 Jun 26.

Division of Hematology and Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia - Cipto Mangunkusumo Hospital, Jakarta, Indonesia.

Background: The association between immune checkpoint inhibitor (ICI) and outcomes of cancer patients with coronavirus disease 2019 (COVID-19) infection has yet to be systematically evaluated. This meta-analysis aims to investigate the effects of ICI treatment on COVID-19 prognosis, including mortality, severity, and any other prognosis-related outcomes.

Methods: Eligible studies published up to 27 February 2021 were included and assessed for risk of bias using the Quality in Prognosis Studies tool. Read More

View Article and Full-Text PDF

Sjögren's syndrome with nervous system injury combined with pulmonary and osseous cryptococcosis: a case report.

J Med Case Rep 2021 Jun 25;15(1):325. Epub 2021 Jun 25.

Department of Rheumatology and Immunology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, 310006, China.

Background: Sjögren's syndrome is a common autoimmune disease that can involve the nervous system, but rarely both the central and peripheral. Long-term use of high-dose corticosteroids and immunosuppressants are the main risk factors for Cryptococcus infection in patients with Sjögren's syndrome, of which pulmonary infection is the most common, while multiple bone infections are rare.

Case Presentation: A 46-year-old Chinese woman with a 2-year history of Sjögren's syndrome presented to our hospital with numbness of limbs, shortness of breath, and weakness. Read More

View Article and Full-Text PDF

The association between ABO blood groups and gestational diabetes mellitus: a retrospective population-based cohort study.

J Matern Fetal Neonatal Med 2021 Jun 24:1-5. Epub 2021 Jun 24.

Department of Obstetrics and Gynecology, Emek Medical Center, Afula, Israel.

Objective: There is a lot of evidence that connects blood type to several diseases, including the development of diabetes mellitus type 2. The evidence for an association between ABO blood groups and the possibility of developing gestational diabetes mellitus (GDM) is scant and inconclusive. We aimed to examine the link between ABO blood group types and GDM by the use of a large population-based cohort of pregnant women. Read More

View Article and Full-Text PDF

Expectant management of cesarean scar pregnancy in 13 patients.

J Matern Fetal Neonatal Med 2021 Jun 23:1-6. Epub 2021 Jun 23.

Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, China.

Objective: To monitor Cesarean scar pregnancy (CSP) patients preferring to continue their pregnancy and analyze their clinical characteristics as well as maternal and fetal outcomes.

Methods: A retrospective cohort study including 13 pregnant women diagnosed with CSP (including types I, II, III) and continued their pregnancy with cautious monitoring at Peking University First Hospital between January, 2014 and December, 2018.

Results: 8/13 (61. Read More

View Article and Full-Text PDF

Oral neomycin and bacitracin are effective in preventing surgical site infections in elective colorectal surgery: a multicentre, randomized, parallel, single-blinded trial (COLORAL-1).

Updates Surg 2021 Jun 20. Epub 2021 Jun 20.

Department of Surgical Sciences, University of Torino, Corso Dogliotti 14, 10126, Torino, Italy.

Several regimens of oral and intravenous antibiotics (OIVA) have been proposed with contradicting results, and the role of mechanical bowel preparation (MBP) is still controversial. This study aims to assess the effectiveness of oral antibiotic prophylaxis in preventing Surgical Site Infections (SSI) in elective colorectal surgery. In a multicentre trial, we randomized patients undergoing elective colorectal resection surgery, comparing the effectiveness of OIVA versus intravenous antibiotics (IVA) regimens to prevent SSI as the primary outcome (NCT04438655). Read More

View Article and Full-Text PDF

Dynamic Esophageal Patency Assessment: An effective method for prenatally diagnosing esophageal atresia.

Am J Obstet Gynecol 2021 Jun 16. Epub 2021 Jun 16.

Diagnostic Ultrasound Unit of the Institute of Obstetrical and Gynecological Imaging, Department of Obstetrics and Gynecology, Sheba Medical Center, Tel-Hashomer, Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel. Electronic address:

Objective: Esophageal atresia is a major anomaly with a low prenatal detection rate. We propose a sonographic method termed Dynamic Esophageal Patency Assessment (DEPA). The aim of the study was to assess the feasibility and performance of this method in a high-risk population. Read More

View Article and Full-Text PDF

Safety and efficacy of pioglitazone for the delay of cognitive impairment in people at risk of Alzheimer's disease (TOMMORROW): a prognostic biomarker study and a phase 3, randomised, double-blind, placebo-controlled trial.

Lancet Neurol 2021 07;20(7):537-547

Takeda Development Center Americas, Cambridge, MA, USA.

Background: The identification of people at risk of cognitive impairment is essential for improving recruitment in secondary prevention trials of Alzheimer's disease. We aimed to test and qualify a biomarker risk assignment algorithm (BRAA) to identify participants at risk of developing mild cognitive impairment due to Alzheimer's disease within 5 years, and to evaluate the safety and efficacy of low-dose pioglitazone to delay onset of mild cognitive impairment in these at-risk participants.

Methods: In this phase 3, multicentre, randomised, double-blind, placebo-controlled, parallel-group study, we enrolled cognitively healthy, community living participants aged 65-83 years from 57 academic affiliated and private research clinics in Australia, Germany, Switzerland, the UK, and the USA. Read More

View Article and Full-Text PDF

Paclitaxel-Coated Balloons Compared to Plain Balloon Angioplasty in the Management of Dysfunctional Arteriovenous Fistulae: A Single-Center Randomized Clinical Trial.

Saudi J Kidney Dis Transpl 2021 Jan-Feb;32(1):118-127

Department of Medical Imaging, Division of Vascular and Interventional Radiology, Ministry of National Guard Health Affairs; King Abdullah International Medical Research Center; King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.

The study aimed to compare paclitaxel-coated balloons (PCB) to percutaneous transluminal plain balloon angioplasty (PTA) in the management of dysfunctional arteriovenous fistulae. This single institution randomized controlled trial was approved by the institutional and local review boards and is registered in the ClinicalTrials.gov website. Read More

View Article and Full-Text PDF

Effectiveness of isoniazid preventive therapy on incidence of tuberculosis among HIV-infected adults in programme setting.

Indian J Med Res 2020 Dec;152(6):648-655

Department of Clincial Research, ICMR-National Institute for Research in Tuberculosis, Chennai, India.

Background & Objectives: As India and other developing countries are scaling up isoniazid preventive therapy (IPT) for people living with HIV (PLHIV) in their national programmes, we studied the feasibility and performance of IPT in terms of treatment adherence, outcome and post-treatment effect when given under programmatic settings.

Methods: A multicentre, prospective pilot study was initiated among adults living with HIV on isoniazid 300 mg with pyridoxine 50 mg after ruling out active tuberculosis (TB). Symptom review and counselling were done monthly during IPT and for six-month post-IPT. Read More

View Article and Full-Text PDF
December 2020

Efficacy of a carrageenan gel in preventing anal human papillomavirus (HPV) infection: interim analysis of the Lubricant Investigation in Men to Inhibit Transmission of HPV Infection (LIMIT-HPV) randomised controlled trial.

Sex Transm Infect 2021 Jun 17. Epub 2021 Jun 17.

Division of Cancer Epidemiology, McGill University, Montreal, Quebec, Canada

Background: Carrageenan, a non-toxic gelling agent derived from red algae, has potent anti-human papillomavirus (HPV) activity in in vitro and animal studies. We assessed, in an interim analysis, the efficacy of a carrageenan-based gel in reducing the risk of new detections of anal HPV among gay, bisexual and other men who have sex with men (gbMSM).

Methods: The LIMIT-HPV study (Lubricant Investigation in Men to Inhibit Transmission of HPV Infection) is a phase IIb, double-blind, placebo-controlled randomised controlled trial conducted in Montreal, Canada. Read More

View Article and Full-Text PDF

Epidemiology of nursing home dialysis patients-A hidden population.

Hemodial Int 2021 Jun 16. Epub 2021 Jun 16.

Dialyze Direct, Neptune City, New Jersey, USA.

Introduction: Dialysis patients are often discharged from hospitals to skilled nursing facilities (SNFs), but little has been published about their natural history.

Methods: Using electronic medical record data, we conducted a retrospective cohort study of nursing home patients treated with in-SNF hemodialysis from January 1, 2018 through June 20, 2020 within a dialysis organization across eight states. A dialytic episode began with the first in-SNF dialysis and was ended by hospitalization, death, transfer, or cessation of treatment. Read More

View Article and Full-Text PDF

Oral isotretinoin: 29 years of medical malpractice cases in the United States.

J Am Acad Dermatol 2021 Aug 12;85(2):404-408. Epub 2021 Jun 12.

Department of Otolaryngology, University of Virginia, Charlottesville, Virginia.

Background: Reviews of malpractice claims in the United States show trends of increasing payments with statistically higher payouts for more debilitating and permanent injuries.

Objectives: To examine lawsuits involving notable associated adverse reactions of isotretinoin.

Methods: Court records of US legal trials from 1985 to 2014 were obtained from a major computerized database: LexisNexis. Read More

View Article and Full-Text PDF

Radiation Therapy for Brain Metastases: A Systematic Review.

Pract Radiat Oncol 2021 Jun 9. Epub 2021 Jun 9.

Southern California Evidence-Based Practice Center, RAND Corporation, Santa Monica, California; Southern California Evidence Review Center, Keck School of Medicine, University of Southern California, Los Angeles, California.

Purpose: This evidence report synthesizes the available evidence on radiation therapy for brain metastases.

Methods And Materials: The literature search included PubMed, EMBASE, Web of Science, Scopus, CINAHL, clinicaltrials.gov, and published guidelines in July 2020; independently submitted data, expert consultation, and contacting authors. Read More

View Article and Full-Text PDF

Pregnancy-related acute kidney injury at high altitude: a retrospective observational study in a single center.

BMC Nephrol 2021 Jun 9;22(1):215. Epub 2021 Jun 9.

Department of Nephrology, Shanghai Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.

Background: Pregnancy-related acute kidney injury (Pr-AKI) is associated with maternal and fetal morbidity and mortality. There are few studies focusing on Pr-AKI at high altitude in the literature.

Objectives: to investigate the incidence, etiology, clinical features and maternal-fetal outcomes of Pr-AKI in women living at high altitude. Read More

View Article and Full-Text PDF

Employing the Risk-Need-Responsivity (RNR) model and predicting successful completion in an alternative drug court program: Preliminary findings from the Orleans Parish Drug Court.

J Subst Abuse Treat 2021 Apr 30;131:108453. Epub 2021 Apr 30.

Department of Psychiatry and Behavioral Sciences, Tulane University School of Medicine, 1440 Canal St., #8448, New Orleans, LA 70112, USA. Electronic address:

Drug courts have been in operation for decades to provide treatment alternatives to individuals whose substance use and related behaviors have brought them into contact with the criminal justice system. As research on drug courts have evolved, it has been demonstrated that different types of offenders have different mental health and substance use treatment needs. One way of approaching treatment in court-mandated substance use treatment is by the application of the risk-need-responsivity (RNR) model (Andrews, Zinger et al. Read More

View Article and Full-Text PDF

Sources of Missing Sexual Orientation and Gender Identity Data in the Behavioral Risk Factor Surveillance System.

Bill M Jesdale

Am J Prev Med 2021 Aug 1;61(2):281-290. Epub 2021 Jun 1.

Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts. Electronic address:

Introduction: This paper describes the sources, magnitude, and correlates of missing data in the Behavioral Risk Factor Surveillance System Sexual Orientation and Gender Identity module.

Methods: Missing data from the Behavioral Risk Factor Surveillance System Sexual Orientation and Gender Identity module fielded from 2014 to 2019 were ascribed to 4 sources: the optional nature of the Sexual Orientation and Gender Identity module, out-of-state cell phone respondents, interview termination, and item nonresponse. The prevalence of missingness from these 4 sources was examined in relation to sociodemographic factors and survey process factors. Read More

View Article and Full-Text PDF

Cycle length of nonsustanied ventricular tachycardias among ICD patients: implications on subsequent appropriate therapies.

BMC Cardiovasc Disord 2021 May 31;21(1):268. Epub 2021 May 31.

Arrhythmias Unit, Cardiology Department, IBSAL-University Hospital, CIVER-CV, Universidad de Salamanca, Paseo de San Vicente, 58-182, 37007, Salamanca, Spain.

Background: ICD patients with episodes of nonsustained ventricular tachycardias (NSVT) are at risk of appropriate therapies. However, the relationship between the cycle length (CL) of such NSVTs and the subsequent incidence of appropriate interventions is unknown.

Methods: 416 ICD patients with LVEF < 45% were studied. Read More

View Article and Full-Text PDF