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Diffuse large B-cell lymphoma in the liver accompanied by primary biliary cholangitis: A rare and difficult-to-diagnose tumor with portal venous thrombosis.

Int J Surg Case Rep 2021 Apr 30;82:105936. Epub 2021 Apr 30.

Department of Surgery, Shiga General Hospital, Moriyama, 5-4-30 Moriyama, Moriyama, Shiga 524-8524, Japan. Electronic address:

Introduction And Importance: The most common liver malignancies are hepatocellular carcinoma, intrahepatic cholangiocarcinoma, and metastatic tumors. Hepatocellular carcinoma and intrahepatic cholangiocarcinoma may invade the portal vein (PV). An association between diffuse large B-cell lymphoma (DLBCL) and primary biliary cholangitis (PBC) remains unclear. Read More

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One-and-one-half Ventricle Repair: Role for Restricting Antegrade Pulmonary Blood Flow.

Ann Thorac Surg 2021 May 5. Epub 2021 May 5.

Harvard Medical School, Boston, MA; Department of Cardiovascular Surgery, Boston Children's Hospital, Boston, MA. Electronic address:

Background: In patients with hypoplastic sub-pulmonary ventricles, the one-and-one-half ventricle (1.5V) repair is an alternative to the Fontan. However, 1. Read More

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Statin therapy and the incidence of thromboembolism and vascular events following liver transplantation.

Liver Transpl 2021 May 8. Epub 2021 May 8.

Mayo Clinic Arizona, Phoenix, AZ, USA.

Statin therapy may reduce the risk of venous thromboembolism (VTE), which may impact solid organ transplant outcomes. We evaluated the incidence of VTE and other complications after liver transplantation stratified by hyperlipidemia status and statin use using a retrospective cohort study approach from a high-volume liver transplant center. We reviewed all primary orthotopic liver transplant (OLT) records from January 2014-December 2019 from our center. Read More

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Prevalence of Venous Thromboembolism Following Acute Spinal Cord Injury in an Urban Inner City Hospital.

Int J Spine Surg 2021 May 7. Epub 2021 May 7.

Temple University Department of Orthopedic Surgery and Sports Medicine, Philadelphia, Pennsylvania.

Background: Venous thromboembolism (VTE) is known to occur at high rates in patients who suffer spinal cord injury (SCI). Large population studies in the United States have shown a prevalence of approximately 4-5%, with some studies suggesting higher prevalence. While the specific mechanism behind increased VTE incidence in the SCI population is unknown, it is likely tied to immobility and functional decline. Read More

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Epidemiology of pediatric sepsis in the pediatric intensive care unit of king Abdulaziz Medical City, Jeddah, Saudi Arabia.

BMC Pediatr 2021 May 7;21(1):222. Epub 2021 May 7.

Department of Pediatrics, King Abdulaziz Medical City, P.O. Box 65362, Jeddah, 21556, Saudi Arabia.

Background: Pediatric sepsis remains a significant cause of morbidity and mortality worldwide. This study aimed to identify the incidence of sepsis and septic shock among patients admitted to the pediatric intensive care unit (PICU) of a tertiary center in Saudi Arabia.  Patients' demographics and risk factors associated with sepsis-related mortality were also investigated. Read More

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Venous Thromboembolism among Noncritically Ill Hospitalized Children: Key Considerations for the Pediatric Hospital Medicine Specialist.

Semin Thromb Hemost 2021 May 7. Epub 2021 May 7.

Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland.

Venous thromboembolism (VTE) is a leading cause of morbidity and preventable harm among noncritically ill hospitalized children. Several clinical factors relevant to the noncritically ill hospitalized child significantly increase the risk of VTE including the presence of central venous catheters, systemic inflammation, and prolonged immobilization. Although risk mitigation strategies have been described, the diagnosis, treatment, and prevention of VTE require standardization of institutional practices combined with multidisciplinary collaboration among pediatric hospitalists, hematologists, and other care providers. Read More

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The safety profile and angioarchitectural changes after acute targeted embolization of ruptured arteriovenous malformations.

J Neurosurg 2021 May 7:1-10. Epub 2021 May 7.

2Division of Neuroradiology, Department of Medical Imaging, and.

Objective: The aim of this study was to 1) compare the safety and efficacy of acute targeted embolization of angiographic weak points in ruptured brain arteriovenous malformations (bAVMs) versus delayed treatment, and 2) explore the angioarchitectural changes that follow this intervention.

Methods: The authors conducted a retrospective analysis of a prospectively acquired database of ruptured bAVMs. Three hundred sixteen patients with ruptured bAVMs who presented to the hospital within 48 hours of ictus were included in the analysis. Read More

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Longitudinal trends using a point-of-care gelatin-based model for ultrasound-guided central venous catheter insertion.

Med Educ Online 2021 Dec;26(1):1924350

Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Emory University, Atlanta, GA, USA.

Ultrasound (US)-guided central venous catheter (CVC) insertion is a procedure that carries the risk of significant complications. Simulation provides a safe learning atmosphere, but most CVC simulators are not available outside of simulation centers. To explore longitudinal trends in US-guided CVC insertion competency in internal medicine (IM) interns, we studied the use of a low-fidelity, gelatin-based, US-guided CVC insertion simulation model combined with a simulation curriculum. Read More

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December 2021

Capillary blood sampling increases the risk of preanalytical errors in pediatric hospital care: Observational clinical study.

J Spec Pediatr Nurs 2021 May 7:e12337. Epub 2021 May 7.

Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.

Purpose: The blood sampling procedure is complex and prone to failure, as reflected by preanalytical errors in pediatric hospital care. The primary aim was to evaluate if the risk of preanalytical errors was higher with capillary blood sampling than with venous blood sampling, and secondary, explore specific factors associated with preanalytical errors, both overall and stratified by capillary and venous blood sampling.

Design And Methods: This observational pediatric hospital study collected outcomes from medical records and blood sampling surveys from year 2014 to 2016. Read More

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Should we use a patient's port as the preferred intravenous route rather than inserting an additional venous access?

J Vasc Access 2021 May 7:11297298211015058. Epub 2021 May 7.

Catholic University Hospital, Rome, Italy.

Early in 2021, the Infusion Nursing Society has released the latest version of the Infusion Therapy Standards of Practice. In the last two decades, these Standards have been representing one of the most important evidence-based documents available in the world of venous access. Nevertheless, we were quite concerned reading a recommendation included in chapter 26 (Vascular Access Device Planning: practice recommendation I, C): "Use a patient's port, unless contraindicated (e. Read More

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The Prevalence of Hepatitis B Virus Markers among Students of Shiraz University of Medical Sciences.

Adv Biomed Res 2021 26;10. Epub 2021 Feb 26.

Department of Bacteriology and Virology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.

Background: Protection against hepatitis B virus (HBV) is based on the presence of antibodies against hepatitis B surface antigen (HBsAg). Vaccination of newborns is the most effective means of prevention. This study aimed to evaluate the frequency of anti-HBs antibody (anti-HBsAb), anti-HB core Ab (anti-HBcAb), HBsAg, and HBV DNA among university students in Fars province, Southern Iran. Read More

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February 2021

Body Adiposity, But Not Elements of Objectively Measured Sedentary Behavior or Physical Activity, Is Associated With Circulating Liver Enzymes in Adults With Overweight and Obesity.

Front Endocrinol (Lausanne) 2021 20;12:655756. Epub 2021 Apr 20.

Turku PET Centre, University of Turku and Turku University Hospital, Turku, Finland.

Objective: We studied the associations between accelerometer-measured sedentary behavior (SB) and habitual physical activity (PA) as well as markers of body adiposity and other cardiometabolic risk factors with liver enzymes alanine aminotransferase (ALT), aspartate aminotransferase (AST) and γ-glutamyltransferase (GGT).

Methods: A total of 144 middle-aged adults (mean age 57 (SD 6.5) years) with overweight or obesity (mean body mass index [BMI] 31. Read More

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Interplay between inflammation and thrombosis in cardiovascular pathology.

Nat Rev Cardiol 2021 May 6. Epub 2021 May 6.

Medizinische Klinik und Poliklinik I, University Hospital, LMU Munich, Munich, Germany.

Thrombosis is the most feared complication of cardiovascular diseases and a main cause of death worldwide, making it a major health-care challenge. Platelets and the coagulation cascade are effectively targeted by antithrombotic approaches, which carry an inherent risk of bleeding. Moreover, antithrombotics cannot completely prevent thrombotic events, implicating a therapeutic gap due to a third, not yet adequately addressed mechanism, namely inflammation. Read More

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Dural Arteriovenous Fistulas of the Foramen Magnum Region: Clinical Features and Angioarchitectural Phenotypes.

AJNR Am J Neuroradiol 2021 May 6. Epub 2021 May 6.

From the Department of Radiology and Biomedical Imaging, Interventional Neuroradiology Section, University of California, San Francisco, San Francisco, California.

Background And Purpose: AVFs of the foramen magnum region, including fistulas of the marginal sinus and condylar veins, have complex arterial supply, venous drainage, symptoms, and risk features that are not well-defined. The purpose of this study was to present the angioarchitectural and clinical phenotypes of a foramen magnum region AVF from a large, single-center experience.

Materials And Methods: We retrospectively reviewed cases from a 10-year neurointerventional data base. Read More

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Association between ApoE status, circulating vitamin A and vitamin E levels with dyslipidemia in aging Chinese adults.

Arch Med Res 2021 May 3. Epub 2021 May 3.

School of Public Health, Capital Medical University, Beijing, PR China. Electronic address:

Background: The influence of ApoE or lipid-soluble vitamins on lipid profile has been well documented. However, the association between ApoE status, vitamin A (VA) and vitamin E (VE) with dyslipidemia has been seldom reported. The aim of the present study was to investigate the impact of ApoE status on circulating VA and VE in aging adults with dyslipidemia. Read More

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Abdominal ultrasound findings contribute to a multivariable predictive risk score for surgical necrotizing enterocolitis: A pilot study.

Am J Surg 2021 Apr 27. Epub 2021 Apr 27.

Department of Surgery, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA. Electronic address:

Background: Abdominal ultrasound (AUS) is a promising adjunct to abdominal x-ray (AXR) for evaluating necrotizing enterocolitis (NEC). We developed a multivariable risk score incorporating AUS to predict surgical NEC.

Methods: 83 patients were evaluated by AXR and AUS for suspected NEC. Read More

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Associations with thrombosis are stronger for antiphosphatidylserine/prothrombin antibodies than for the Sydney criteria antiphospholipid antibody tests in SLE.

Lupus 2021 May 6:9612033211014570. Epub 2021 May 6.

Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.

Objectives: Antiphosphatidylserine/prothrombin complex antibodies (aPS/PT) are risk factors for thrombosis, yet further validation of their clinical relevance in different ethnic groups is required. We investigated the performance of aPS/PT of IgA/G/M isotypes among Sudanese and Swedish systemic lupus erythematosus (SLE) patients.

Methods: Consecutive SLE patients/matched controls from Sudan (n = 91/102) and Sweden (n = 332/163) were included. Read More

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External Validation of the R2eD AVM Score to Predict the Likelihood of Rupture Presentation of Brain Arteriovenous Malformations.

Neurosurgery 2021 May 6. Epub 2021 May 6.

Department of Neurosurgery, Geisinger, Danville, Pennsylvania, USA.

Background: The R2eD AVM scoring system has been recently proposed to predict the risk of hemorrhagic presentation of brain arteriovenous malformations (AVMs).

Objective: To perform the first external validation of this R2eD AVM score.

Methods: Over a retrospective 10-yr period from 2009 to 2019, 122 patients with brain AVMs fit the inclusion criteria. Read More

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Cellulitis risk factors for patients with primary or secondary lymphedema.

J Vasc Surg Venous Lymphat Disord 2021 May 3. Epub 2021 May 3.

Department of Dermatology, Centre Hospitalier Universitaire de Rennes, Rennes; EA 7449 REPERES (Pharmacoepidemiology and Health Services Research), Rennes 1 University, Rennes, France.

Background: Limb lymphedema is a chronic disease with primary and secondary forms, the latter essentially after cancer treatment.

Objectives: To analyze retrospectively cellulitis frequency and its associated risk factors in patients with primary or secondary limb lymphedema.

Methods: Information from all 1,991 patients referred to a specialized lymphedema center, from January to June 2018, was collected: previous cellulitis episode(s), clinical and lymphedema characteristics. Read More

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Safety Monitoring of the Janssen (Johnson & Johnson) COVID-19 Vaccine - United States, March-April 2021.

MMWR Morb Mortal Wkly Rep 2021 May 7;70(18):680-684. Epub 2021 May 7.

CDC COVID-19 Response Team.

On February 27, 2021, the Food and Drug Administration (FDA) issued an Emergency Use Authorization (EUA) for Janssen (Ad.26.COV2. Read More

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Combined computed tomography and magnetic resonance imaging improves diagnosis of hepatocellular carcinoma ≤ 3.0 cm.

Hepatol Int 2021 May 6. Epub 2021 May 6.

Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-Ro 43-Gil, Songpa-Gu, Seoul, 05505, Republic of Korea.

Background/purpose: Imaging diagnosis of hepatocellular carcinoma (HCC) is important, but the diagnostic performance of combined computed tomography (CT) and magnetic resonance imaging (MRI) using the Liver Imaging Reporting and Data System (LI-RADS) v2018 is not fully understood. We evaluated the clinical usefulness of combined CT and MRI for diagnosing HCC ≤ 3.0 cm using LI-RADS. Read More

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Prevalence and clinical significance of antiphospholipid antibodies in patients with coronavirus disease 2019 admitted to intensive care units: a prospective observational study.

Rheumatol Int 2021 May 5. Epub 2021 May 5.

Rheumatology Department, Hamad Medical Corporation, Doha, Qatar.

Coronavirus disease 2019 (COVID-19) increases the risk of coagulopathy. Although the presence of antiphospholipid antibodies (aPLs) has been proposed as a possible mechanism of COVID-19-induced coagulopathy, its clinical significance remains uncertain. Therefore, this study aimed to evaluate the prevalence and clinical significance of aPLs among critically ill patients with COVID-19. Read More

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Seroconfirmed Typhoid Fever and Knowledge, Attitude, and Practices among Febrile Patients Attending at Injibara General Hospital, Northwest Ethiopia.

Biomed Res Int 2021 13;2021:8887266. Epub 2021 Apr 13.

Department of Medical Laboratory Science, College of Medicine and Health Science, Bahir Dar University, Ethiopia.

Introduction: Typhoid fever (TF) is a febrile global health problem caused by serovar Typhi ( Typhi) with relatively high prevalence in low- and middle-income countries including Ethiopia. Identifying local prevalence and gaps in knowledge, attitude, and practice (KAP) towards TF is recommended by the World Health Organization to implement preventive measures. Therefore, this study determined the prevalence of . Read More

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Homoarginine and methylarginines independently predict long-term outcome in patients presenting with suspicion of venous thromboembolism.

Sci Rep 2021 May 5;11(1):9569. Epub 2021 May 5.

Department of Preventive Cardiology and Preventive Medicine, Center for Cardiology, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstr. 1, 55131, Mainz, Germany.

Endogenous arginine derivatives homoarginine, asymmetric dimethylarginine (ADMA) and symmetric dimethyarginine (SDMA) are independent mortality predictors in atherosclerotic cardiovascular disease (CVD). Our study reports the first analysis, whether homoarginine, ADMA and SDMA predict venous thromboembolism (VTE) recurrence and overall mortality in patients with suspected acute VTE. We assessed serum levels of homoarginine, ADMA and SDMA by LC-MS/MS in 865 individuals from a prospective consecutive cohort of patients with clinical suspicion of VTE. Read More

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Cardiovascular complications of systemic lupus erythematosus: impact of risk factors and therapeutic efficacy-a tertiary centre experience in an Appalachian state.

Lupus Sci Med 2021 May;8(1)

Internal Medicine Department, Division of Rheumatology, University of Kentucky, Lexington, Kentucky, USA

Objectives: Cardiovascular complications became a notable cause of morbidity and mortality in patients with lupus as therapeutic advancements became more efficient at managing other complications. The Appalachian community in Kentucky has a higher prevalence of traditional cardiovascular risk factors, predisposing them to cardiovascular events. Namely, the mean body mass index of the members of the Kentucky Appalachian community was reported at 33 kg/m and 94. Read More

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Thromboembolic Complications of Vascular Catheters Used for Pediatric Continuous Renal Replacement Therapy: Prevalence in a Single-Center, Retrospective Cohort.

Pediatr Crit Care Med 2021 May 4. Epub 2021 May 4.

Department of Perioperative Medicine and Intensive Care, Karolinska University Hospital, Huddinge, Stockholm, Sweden. Department of Physiology and Pharmacology, Section of Anaesthesia and Intensive Care, Karolinska Institutet, Stockholm, Sweden. Department of Pediatric Perioperative Medicine and Intensive Care, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden. Department of Clinical Science Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden.

Objectives: Pediatric venous thromboembolic events are commonly associated with in situ central venous catheters. The risk for severe venous thromboembolism increases if a larger portion of the vessel lumen is occupied by the central venous catheter. A functioning vascular catheter is required when the continuous renal replacement therapy is used in critically ill children. Read More

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Comparison of peripherally inserted central catheters and totally implanted venous access devices as chemotherapy delivery routes in oncology patients: A retrospective cohort study.

Sci Prog 2021 Apr-Jun;104(2):368504211011871

Division of Vascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.

This study aimed to evaluate peripherally inserted central catheters (PICCs) and totally implanted venous access devices (TIVADs) as chemotherapy delivery routes. From May 2016 to April 2019, patients with malignancies who had PICCs or TIVADs inserted for chemotherapy were enrolled. We reviewed the patients' medical records for information concerning demographics, comorbidities, catheter-related complications, and catheter -service days. Read More

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Soluble P-selectin levels in patients with obstructive sleep apnea: a systematic review and meta-analysis.

Eur Arch Otorhinolaryngol 2021 May 5. Epub 2021 May 5.

Department of Internal Medicine, Cancer Hospital of the University of Chinese Academy of Sciences, Zhejiang Cancer Hospital, Hangzhou, 310022, China.

Purpose: Obstructive sleep apnea (OSA) patients are at increased risk for cardiovascular disease, stroke, atherosclerosis, hypertension, and venous thromboembolism. Elevated soluble P-selectin (sP-selectin) levels are also associated with increased risk of above diseases. But whether sP-selectin levels in OSA patients are higher than their counterparts remain unclear, since previous studies yielded inconsistent results. Read More

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MRI Staging in an Evolving Management Paradigm for Rectal Cancer, From the Special Series on Cancer Staging.

AJR Am J Roentgenol 2021 May 5. Epub 2021 May 5.

Department of Surgical Oncology, MD Anderson Cancer Center Houston Texas 77030.

The treatment of rectal cancer centers around the distinct but related goals of management of distant metastases and management of local disease. Optimal local management requires attention to the primary tumor and its anatomic relationship to surrounding pelvic structures, with the goal of minimizing local recurrence (LR). High-resolution MRI is ideally suited for this purpose; application of MRI-based criteria in conjunction with optimized surgical and pathologic techniques have successfully reduced LR rates. Read More

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Patients with chronic venous insufficiency in the times of COVID-19 and the risk of thrombus formation - suggestions on conservative treatment of such patients based on the principles of pathophysiology.

Pol Przegl Chir 2021 Apr;93(2):43-52

Klinika Chirurgii Naczyniowej, Wewnątrznaczyniowej, Angiologii i Flebologii, Instytut Chirurgii, Uniwersytet Medyczny w Poznaniu.

The current limitations of surgical treatment, as well as restrictions on professional and sport activities related to COVID-19 pandemic require seeking therapeutic solutions for the vast population of patients with chronic venous insufficiency (CVI, chronic venous insufficiency). To understand the principles of pharmacotherapy of this disease, the authors used data related to epidemiology and pathophysiology of CVI. They provided the latest data on venoactive drugs and recommendations that should be followed and summarized the literature based on the EBM. Read More

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