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"Allogeneic blood or marrow transplant with non-myeloablative conditioning and high dose cyclophosphamide-based graft-versus-host disease prophylaxis for secondary central nervous system lymphoma".

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

Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD 21287.

Secondary central nervous system (CNS) lymphoma is a rare and often fatal complication of non-Hodgkin lymphoma (NHL). Treatment options include radiation therapy, high-dose systemic chemotherapy, intrathecal chemotherapy, and high-dose chemotherapy with autologous stem cell rescue, but outcomes remain poor. Allogeneic blood or marrow transplant (alloBMT) is widely used in relapsed/refractory systemic NHL. Read More

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Clofazimine for treatment of multidrug-resistant non-tuberculous mycobacteria.

Pulm Pharmacol Ther 2021 Jul 19:102058. Epub 2021 Jul 19.

Department of Medicine and Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, Virginia. Electronic address:

Background: /Question: Nontuberculous mycobacteria (NTM) infections are increasingly detected but difficult to cure given complex drug-resistance patterns. Select U.S. Read More

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Effect of Early Feeding on Intestinal Permeability and Inflammation Markers in Infants with Genetic Susceptibility to Type 1 Diabetes: A Randomized Clinical Trial.

J Pediatr 2021 Jul 19. Epub 2021 Jul 19.

Pediatric Research Center, Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland; Center for Child Health Research, University of Tampere and Tampere University Hospital, Tampere, Finland; Department of Pediatrics, Tampere University Hospital, Tampere, Finland. Electronic address:

Objectives: To assess whether weaning to an extensively hydrolyzed formula (EHF) decreases gut permeability and/or markers of intestinal inflammation in infants with HLA-conferred diabetes susceptibility, when compared with conventional formula.

Study Design: By analyzing 1468 expecting biological parent pairs for HLA-conferred susceptibility for type 1 diabetes, 465 couples (32%) potentially eligible for the study were identified. After further parental consent, 332 babies to be born were randomized at 35 gestational week. Read More

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Low Rate of Spontaneous Closure in Premature Infants Discharged with a Patent Ductus Arteriosus: A Multicenter Prospective Study.

J Pediatr 2021 Jul 19. Epub 2021 Jul 19.

The MEDNAX Center for Research, Education, Quality and Safety, Sunrise, FL; Greenville Memorial Hospital, SC.

Objectives: To assess the rate of spontaneous closure and the incidence of adverse events in infants discharged home with a patent ductus arteriosus.

Study Design: In a prospective multicenter study, we enrolled 201 premature infants (gestational age 23-32 weeks at birth) discharged home with a persistently patent ductus arteriosus (PDA) and followed their PDA status at 6-month intervals through 18 months of age. The primary study outcome was the rate and timing of spontaneous ductal closure. Read More

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Efficacy and safety of once-weekly semaglutide 2·0 mg versus 1·0 mg in patients with type 2 diabetes (SUSTAIN FORTE): a double-blind, randomised, phase 3B trial.

Lancet Diabetes Endocrinol 2021 Jul 19. Epub 2021 Jul 19.

Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, NC, USA.

Background: Semaglutide is an effective treatment for type 2 diabetes; however, 20-30% of patients given semaglutide 1·0 mg do not reach glycaemic treatment goals. We aimed to investigate the efficacy and safety of once-weekly semaglutide 2·0 mg versus 1·0 mg in adults with inadequately controlled type 2 diabetes on a stable dose of metformin with or without a sulfonylurea.

Methods: We did a 40-week, randomised, active-controlled, parallel-group, double-blind, phase 3B trial (SUSTAIN FORTE) at 125 outpatient clinics in ten countries. Read More

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Prevalence of hyperventilation in patients with asthma.

J Asthma 2021 Jul 22:1-11. Epub 2021 Jul 22.

Radboud university medical center, Radboud Institute for Health Sciences, Department of Respiratory Diseases, 6525 GA Nijmegen, The Netherlands.

Objective: Asthma is frequently accompanied by dysfunctional breathing of which hyperventilation has been recognized as a subtype. The prevalence of hyperventilation in stable asthma has been scantily studied using blood gas analysis. Hence, a reliable estimate of its prevalence is lacking. Read More

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Efficacy of temporally intensified exposure for anxiety disorders: A multicenter randomized clinical trial.

Depress Anxiety 2021 Jul 22. Epub 2021 Jul 22.

Institute of Clinical Psychology & Psychotherapy, Technische Universität Dresden, Dresden, Germany.

Background: The need to optimize exposure treatments for anxiety disorders may be addressed by temporally intensified exposure sessions. Effects on symptom reduction and public health benefits should be examined across different anxiety disorders with comorbid conditions.

Methods: This multicenter randomized controlled trial compared two variants of prediction error-based exposure therapy (PeEx) in various anxiety disorders (both 12 sessions + 2 booster sessions, 100 min/session): temporally intensified exposure (PeEx-I) with exposure sessions condensed to 2 weeks (n = 358) and standard nonintensified exposure (PeEx-S) with weekly exposure sessions (n = 368). Read More

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Mortality, Sepsis, and Organ Failure in Hospitalized Patients with Cirrhosis Vary by Type of Infection.

J Gastroenterol Hepatol 2021 Jul 22. Epub 2021 Jul 22.

Division of Gastroenterology and Hepatology, New York Presbyterian Hospital-Weill Cornell Medical Center, New York, NY, USA.

Background & Aims: Infection is associated with substantial morbidity and mortality in cirrhosis, but presumably not all infections carry the same risk of mortality. We compared outcomes of different sites of infection in a nationally representative sample of inpatients with cirrhosis.

Methods: We queried the Nationwide Readmissions Database (NRD) for patients with cirrhosis from 2011-2014. Read More

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Intensity-modulated radiation therapy and doxorubicin in thyroid cancer: A prospective phase 2 trial.

Cancer 2021 Jul 22. Epub 2021 Jul 22.

Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York.

Background: The use of external-beam radiotherapy for locally advanced nonanaplastic thyroid cancer remains controversial. This prospective study evaluated the efficacy and tolerability of intensity-modulated radiation therapy (IMRT) with or without concurrent chemotherapy in patients with locally advanced thyroid cancer.

Methods: The authors conducted a nonrandomized phase 2 trial of IMRT with or without concurrent doxorubicin in patients with gross residual or unresectable nonanaplastic thyroid carcinoma (ClinicalTrials. Read More

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Angularis oris axial pattern flap as a reliable and versatile option for rostral facial reconstruction in cats.

Vet Surg 2021 Jul 22. Epub 2021 Jul 22.

School of Veterinary Medicine and Animal Science, São Paulo State University, Botucatu, Brazil.

Objective: To evaluate outcomes associated with the use of an angularis oris axial pattern flap (AOAPF) for rostral facial reconstruction in cats.

Animals: Nine adult client-owned cats.

Study Design: Short case series. Read More

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Oils Rich in α-Linolenic Acid or Docosahexaenoic Acid Have Distinct Effects on Plasma Oxylipin and Adiponectin Concentrations and on Monocyte Bioenergetics in Women with Obesity.

J Nutr 2021 Jul 22. Epub 2021 Jul 22.

Department of Food and Human Nutritional Sciences, University of Manitoba, Manitoba, Canada.

Background: Omega-3 fatty acids, including DHA and α-linolenic acid (ALA), are proposed to improve metabolic health by reducing obesity-associated inflammation. Their effects are mediated in part by conversion to oxylipins. ALA is relatively understudied, and direct comparisons to other omega-3 fatty acids are limited. Read More

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Tracheal window resection and reconstruction via sternocleidomastoid flap for invasive thyroid carcinoma.

Interact Cardiovasc Thorac Surg 2021 Jul 19. Epub 2021 Jul 19.

Department of Otolaryngology-Head and Neck Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.

Objectives: The aim of this study was to present surgical techniques and evaluate outcomes of a sternocleidomastoid muscle (SCM) myoperiosteal flap used for the reconstruction of tracheal or laryngotracheal defects after the radical resection of invasive thyroid carcinoma.

Methods: A retrospective study was performed for patients at Peking Union Medical College Hospital from January 2008 to December 2018 of papillary thyroid carcinoma with tracheal or laryngotracheal invasion. Patients were enrolled only when they received window resection and reconstruction via an SCM myoperiosteal flap. Read More

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Incidence, associated risk factors, and the ideal mode of delivery following preterm labour between 24 to 28 weeks of gestation in a low resource setting.

PLoS One 2021 22;16(7):e0254801. Epub 2021 Jul 22.

University of Manchester, Manchester, United Kingdom.

Background: Preterm labour, between 24 to 28 weeks of gestation, remains prevalent in low resource settings. There is evidence of improved survival after 24 weeks though the ideal mode of delivery remains unclear. There are no clear management protocols to guide patient management. Read More

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Mortality and associated risk factors of COVID-19 infection in dialysis patients in Qatar: A nationwide cohort study.

PLoS One 2021 22;16(7):e0254246. Epub 2021 Jul 22.

Hamad Medical Corporation, Doha, Qatar.

Context: Patients on maintenance dialysis are more susceptible to COVID-19 and its severe form. We studied the mortality and associated risks of COVID-19 infection in dialysis patients in the state of Qatar.

Methods: This was an observational, analytical, retrospective, nationwide study. Read More

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Acute postoperative endophthalmitis after resurgery following primary cataract surgery: 9 years experience from a tertiary eyecare center.

J Cataract Refract Surg 2021 Aug;47(8):1050-1055

From the Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Madurai, India.

Purpose: To report the incidence, risk factors, and visual outcomes of acute postoperative endophthalmitis in patients undergoing resurgery after cataract surgery.

Setting: Tertiary eye hospital in southern India.

Design: Retrospective, clinical registry. Read More

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Absence of a "July Effect" on Hospital Length of Stay After Primary Total Hip or Knee Arthroplasty.

Orthopedics 2021 Jul-Aug;44(4):e503-e508. Epub 2021 Jul 1.

There is a commonly held belief in a "July effect" resulting in suboptimal outcomes as residents begin or advance in their training each summer. Previous studies have shown an absence of a July effect on clinical outcomes after total hip arthroplasty (THA) or total knee arthroplasty (TKA). However, it remains unknown whether there is a July effect on hospital length of stay (LOS) after primary THA/TKA. Read More

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Liposomal Bupivacaine Versus Standard Bupivacaine in the Adductor Canal for Total Knee Arthroplasty: A Randomized, Controlled Trial.

Orthopedics 2021 Jul-Aug;44(4):249-255. Epub 2021 Jul 1.

Peripheral nerve blocks are commonly used in total knee arthroplasty (TKA). Liposomal bupivacaine is an extended-release anesthetic medication that maintains efficacy upwards of 72 hours. This study compared single-shot liposomal bupivacaine (LB) with the standard single-shot bupivacaine (SB) in a preoperative adductor canal block in TKA patients. Read More

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COVID-19 Shelter-In-Place Orders Associated With Delayed Presentation and Deep Venous Thrombosis in Geriatric Hip Fractures.

Orthopedics 2021 Jul-Aug;44(4):223-228. Epub 2021 Jul 1.

Geriatric hip fractures benefit from timely surgery. At the onset of the corona-virus disease 2019 (COVID-19) pandemic, shelter-in-place (SIP) orders were mandated in high-risk cities. The authors hypothesized that geriatric patients with hip fractures were more likely to present to the hospital greater than 24 hours after injury during SIP orders. Read More

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Spectrum of BCR-ABL Mutations and Treatment Outcomes in Ethiopian Imatinib-Resistant Patients With Chronic Myeloid Leukemia.

JCO Glob Oncol 2021 Jul;7:1187-1193

Fred Hutchinson Cancer Research Center, Seattle, WA.

Purpose: Despite the successes achieved in chronic myeloid leukemia (CML) with tyrosine kinase inhibitor (TKI) therapy, resistance remains an obstacle. The most common mechanism of resistance is the acquisition of a point mutation in the BCR-ABL kinase domain. Few studies have reported African patients with CML in regard to such mutations. Read More

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Prenatal stomach position and volume in relation to postnatal outcomes in left-sided congenital diaphragmatic hernia.

Prenat Diagn 2021 Jul 22. Epub 2021 Jul 22.

Department of Obstetrics and Gynecology, Division of Obstetrics and Fetal Medicine, Erasmus MC-Sophia Children's Hospital University Medical Center Rotterdam, Rotterdam, The Netherlands.

Objective: To examine the association between prenatal stomach position (SP) grade and stomach volume (SV) and the need for pulmonary hypertension (PH) treatment after birth in prenatally diagnosed left-sided congenital diaphragmatic hernia (CDH), live born >34 weeks.

Methods: In retrospect, SP grade and SV were determined in fetuses with isolated left-sided CDH from 19 weeks gestational age (GA) onwards at three different time periods (≤24 weeks' GA: US1, 24-30 weeks' GA: US2; ≥30 weeks' GA: US3). Primary outcome was need for treatment of PH after birth. Read More

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Compliance with sentinel lymph node biopsy guidelines for invasive melanomas treated with Mohs micrographic surgery.

Cancer 2021 Jul 22. Epub 2021 Jul 22.

Department of Dermatology, University of Pennsylvania Health System, Philadelphia, Pennsylvania.

Background: Sentinel lymph node biopsy (SLNB) has not been studied for invasive melanomas treated with Mohs micrographic surgery using frozen-section MART-1 immunohistochemical stains (MMS-IHC). The primary objective of this study was to assess the accuracy and compliance with National Comprehensive Cancer Network (NCCN) guidelines for SLNB in a cohort of patients who had invasive melanoma treated with MMS-IHC.

Methods: This retrospective cohort study included all patients who had primary, invasive, cutaneous melanomas treated with MMS-IHC at a single academic center between March 2006 and April 2018. Read More

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Therapeutic Effects of Ba-Duan-Jin versus Pregabalin for Fibromyalgia Treatment: Protocol for a Randomized Controlled Trial.

Rheumatol Ther 2021 Jul 22. Epub 2021 Jul 22.

Department of Rheumatology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.

Introduction: Fibromyalgia is characterized by multi-focal pain and is associated with fatigue, unrefreshing sleep and psychological impairment. Pregabalin is one of the most frequently used agents in fibromyalgia treatment. However, it has failed to demonstrate benefit over placebo for reducing fatigue and psychological impairment, and may cause adverse effects (e. Read More

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Intensive Blood Pressure Lowering and DWI Lesions in Intracerebral Hemorrhage: Exploratory Analysis of the ATACH-2 Randomized Trial.

Neurocrit Care 2021 Jul 22. Epub 2021 Jul 22.

Department of Neurology J. P. Kistler Stroke Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.

Background: With the increasing use of magnetic resonance imaging in the assessment of acute intracerebral hemorrhage, diffusion-weighted imaging hyperintense lesions have been recognized to occur at sites remote to the hematoma in up to 40% of patients. We investigated whether blood pressure reduction was associated with diffusion-weighted imaging hyperintense lesions in acute intracerebral hemorrhage and whether such lesions are associated with worse clinical outcomes by analyzing imaging data from a randomized trial.

Methods: We performed exploratory subgroup analyses in an open-label randomized trial that investigated acute blood pressure lowering in 1000 patients with intracerebral hemorrhage between May 2011 and September 2015. Read More

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Pazopanib for severe bleeding and transfusion-dependent anemia in hereditary hemorrhagic telangiectasia.

Angiogenesis 2021 Jul 22. Epub 2021 Jul 22.

Division of Hematology, Massachusetts General Hospital, Zero Emerson Pl Suite 118, Office 112, Boston, MA, 02114, USA.

Hereditary hemorrhagic telangiectasia (HHT) is a rare angiogenic disorder causing chronic gastrointestinal bleeding, epistaxis, and severe anemia. Pazopanib is an oral multi-kinase angiogenesis inhibitor with promise to treat bleeding in HHT. We analyzed outcomes of HHT patients with the most severe bleeding causing RBC transfusion dependence treated on a predefined institutional pazopanib treatment pathway (with data collected retrospectively). Read More

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Association of Concomitant Bone Resorption Inhibitors With Overall Survival Among Patients With Metastatic Castration-Resistant Prostate Cancer and Bone Metastases Receiving Abiraterone Acetate With Prednisone as First-Line Therapy.

JAMA Netw Open 2021 Jul 1;4(7):e2116536. Epub 2021 Jul 1.

Division of Medical Oncology, Tom Baker Cancer Centre, Calgary, Alberta, Canada.

Importance: Bone resorption inhibitors (BRIs) are recommended by international guidelines to prevent skeletal-related events (SREs) among patients with metastatic castration-resistant prostate cancer (mCRPC) and bone metastases. Abiraterone acetate with prednisone is currently the most common first-line therapy for the treatment of patients with mCRPC; however, the clinical impact of the addition of BRIs to abiraterone acetate with prednisone in this disease setting is unknown.

Objective: To evaluate the association of the use of concomitant BRIs with overall survival (OS) and time to first SRE among patients with mCRPC and bone metastases receiving abiraterone acetate with prednisone as first-line therapy. Read More

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Outcomes and prognostic factors in angioimmunoblastic T-cell lymphoma: final report from the international T-cell Project.

Blood 2021 Jul;138(3):213-220

Department of Surgery, Medicine, Dentistry and Morphological Sciences with Transplant Surgery, Oncology and Regenerative Medicine Relevance (CHIMOMO), University of Modena and Reggio Emilia, Modena, Italy.

Angioimmunoblastic T-cell lymphoma (AITL) is a unique subtype of peripheral T-cell lymphoma (PTCL) with distinct clinicopathologic features and poor prognosis. We performed a subset analysis of 282 patients with AITL enrolled between 2006 and 2018 in the international prospective T-cell Project (NCT01142674). The primary and secondary end points were 5-year overall survival (OS) and progression-free survival (PFS), respectively. Read More

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Outcomes of Primary Ileocolic Resection for Pediatric Crohn's Disease in the Biologic Era.

J Pediatr Gastroenterol Nutr 2021 Jul 20. Epub 2021 Jul 20.

Department of Pediatrics. Mount Sinai Hospital and Susan and Leonard Feinstein Inflammatory Bowel Disease Clinical Center, New York, NY Department of Surgery, Mount Sinai Hospital and Susan and Leonard Feinstein Inflammatory Bowel Disease Clinical Center, New York, NY.

Objectives: Current clinical algorithms position surgery as the last option in pediatric Crohn's disease (CD). Studies suggest improved outcomes with earlier surgery, but pediatric postoperative outcomes data in the biologic era are limited. We aimed to describe the preoperative management and postoperative outcomes in a pediatric CD cohort who underwent ileocolic resection (ICR) at a tertiary care IBD center over the last decade. Read More

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A Comparative Study of A Novel Postural Garment Versus Exercise for Women with Nonspecific Cervical Pain: A Randomized Cross-Over Trial.

Spine (Phila Pa 1976) 2021 Jul 20. Epub 2021 Jul 20.

Rehabilitation Department - Hospital Nostra Sra. de Meritxell - Andorra, Research Group on Health Sciences and Health Services - University of Andorra University of Andorra Institute of Clinical Osteology, Bad Pyrmont, Germany Head of Pharmacy Department - Hospital Nostra Sra de Meritxell - Andorra; Research Group on Health Sciences and Health Services - University of Andorra.

Study Design: Randomized crossover study.

Objective: To compare exercise, the gold standard, to the postural garment PosturePlusForce® in the management of nonspecific cervical pain in women. We also analyzed both interventions with regards to baseline posture, use of pharmacological pain relievers, compliance, and comfort. Read More

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Sepsis in patients hospitalized with coronavirus disease 2019: how often and how severe?

Curr Opin Crit Care 2021 Jul 20. Epub 2021 Jul 20.

Anesthesiology, Pain and Intensive Care Medicine Department, Federal University of São Paulo, São Paulo, Brazil.

Purpose Of Review: To discuss why severe COVID-19 should be considered sepsis and how co-infection and secondary infection can aggravate this condition and perpetuate organ dysfunction leading to high mortality rates.

Recent Findings: In severe COVID-19, there is both direct viral toxicity and dysregulated host response to infection. Although both coinfection and/or secondary infection are present, the latest is of greater concern mainly in resource-poor settings. Read More

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