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Spontaneous extracapsular parathyroid adenoma hemorrhage: when surgery is required?

Endocrine 2021 Sep 23. Epub 2021 Sep 23.

Department of Otolaryngology-Head and Neck Surgery, Scientific Institute of Hospitalization and Care San Raffaele Hospital, Vita-Salute University, Milan, Italy.

Purpose: Spontaneous bleeding is a rare but serious complication of parathyroid adenomas and few cases were reported in the literature. Clinical manifestations and treatment may vary but sometimes an immediate surgery is required. In other cases a conservative approach can be preferred based on clinical stability and patients' conditions. Read More

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September 2021

Does visuospatial motion perception correlate with coexisting movement disorders in Parkinson's disease?

J Neurol 2021 Sep 23. Epub 2021 Sep 23.

Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA.

Postural instability and balance impairment are common in Parkinson's disease (PD). Multiple factors, such as increased tone, bradykinesia, freezing of gait, posture, axial stiffness, and involuntary appendicular movements, can affect balance. The recent studies found that PD patients have abnormal perception of self-motion in vestibular domain. Read More

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September 2021

Quantifying Retinal Microvascular Morphology in Schizophrenia Using Swept-Source Optical Coherence Tomography Angiography.

Schizophr Bull 2021 Sep 23. Epub 2021 Sep 23.

Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA.

Background: Retinovascular changes are reported on fundus imaging in schizophrenia (SZ). This is the first study to use swept-source optical coherence tomography angiography (OCT-A) to comprehensively examine retinal microvascular changes in SZ.

Methods: This study included 30 patients with SZ/schizoaffective disorder (8 early and 15 chronic) and 22 healthy controls (HCs). Read More

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September 2021

Quantification of pulmonary perfusion abnormalities using DCE-MRI in COPD: comparison with quantitative CT and pulmonary function.

Eur Radiol 2021 Sep 22. Epub 2021 Sep 22.

Department of Diagnostic and Interventional Radiology, Subdivision of Pulmonary Imaging, University Hospital of Heidelberg, Im Neuenheimer Feld 420, 69120, Heidelberg, Germany.

Objectives: Pulmonary perfusion abnormalities are prevalent in patients with chronic obstructive pulmonary disease (COPD), are potentially reversible, and may be associated with emphysema development. Therefore, we aimed to evaluate the clinical meaningfulness of perfusion defects in percent (QDP) using DCE-MRI.

Methods: We investigated a subset of baseline DCE-MRIs, paired inspiratory/expiratory CTs, and pulmonary function testing (PFT) of 83 subjects (age = 65. Read More

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September 2021

Premature ejaculation: An investigative study into assumptions, facts and perceptions of patients from the Middle East (PEAP STUDY).

Arab J Urol 2021 9;19(3):303-309. Epub 2021 Jul 9.

Urology Department, Hamad Medical Corporation, Doha, Qatar.

To determine the prevalence of premature ejaculation (PE) in Qatar as a representative of the Middle East region and the population perception of normal ejaculation. This study was a cross-sectional, observational, non-interventional, epidemiological study, conducted from February 2012 to February 2013. Randomly selected married males were asked to answer two questionnaires in a direct interview. Read More

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Early cardiovascular structural and functional abnormalities as a guide to future morbid events.

Eur J Prev Cardiol 2021 Sep;28(11):1214-1221

Department of Medicine, Cardiovascular Division, University of Minnesota Medical School, Minneapolis, MN, USA.

Aims: Our aim was to evaluate the predictive value of a battery of 10 non-invasive tests of cardiovascular structural and functional health on the future risk of cardiovascular morbid events.

Methods And Results: A total of 1900 asymptomatic adults concerned about their risk for cardiovascular disease underwent non-invasive assessment with 10 tests of vascular and cardiac structure and function. A disease score (DS) was calculated for each individual based on these 10 tests. Read More

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September 2021

Epidemiology and Outcomes of ARDS After Pediatric Trauma.

Respir Care 2021 Sep 21. Epub 2021 Sep 21.

University Medical Center Utrecht, Utrecht, The Netherlands.

Background: Results of recent studies suggest that the incidence and mortality of ARDS may be higher than previously thought in pediatric trauma patients. We conducted a systematic review of the literature on incidence, risk factors, prognostic factors, and outcomes of ARDS after pediatric trauma in the ICU.

Methods: Medical literature databases were searched up to April 2020. Read More

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September 2021

Tracheostomy in Mechanically Ventilated Patients With SARS-CoV-2-ARDS: Focus on Tracheomalacia.

Respir Care 2021 Sep 21. Epub 2021 Sep 21.

Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy.

Background: The SARS-CoV-2 pandemic increased the number of patients needing invasive mechanical ventilation, either through an endotracheal tube or through a tracheostomy. Tracheomalacia is a rare but potentially severe complication of mechanical ventilation, which can significantly complicate the weaning process. The aim of this study was to describe the strategies of airway management in mechanically ventilated patients with respiratory failure due to SARS-CoV-2, the incidence of severe tracheomalacia, and investigate the factors associated with its occurrence. Read More

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September 2021

Different Sides of Depression in the Elderly: An In-depth View on the Role of Aβ Peptides.

Curr Med Chem 2021 Sep 21. Epub 2021 Sep 21.

Geriatric Psychiatry Department, Nathan S. Kline Institute, 140 Old Orangeburg Road, Orangeburg, NY 10962. United States.

Background: Late-onset depression (LOD) is the most common neuropsychiatric disorder associated with Alzheimer's disease (AD), often associated with structural and functional brain changes, neuropsychological impairments and negative family history for affective disorders. LOD could be a risk factor or a prodromal phase of AD; this has led to the investigation of the link between depression and amyloid-β (Aβ) peptides by measuring Aβ levels in plasma, cerebrospinal fluid (CSF) and brains of elderly depressed subjects.

Objective: Clarify the complex relationship between depression, Aβ peptides and AD. Read More

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September 2021

What does evidence tell us about the use of gait robotic devices in patients with multiple sclerosis? A comprehensive systematic review on functional outcomes and clinical recommendations.

Eur J Phys Rehabil Med 2021 Sep 22. Epub 2021 Sep 22.

Rehabilitation Unit, ULSS Euganea, Camposampiero Hospital, Padua, Italy.

Introduction: There is growing evidence on the efficacy of gait robotic rehabilitation in patients with multiple sclerosis (MS), but most of the studies have focused on gait parameters. Moreover, clear indications on the clinical use of robotics still lack. As part of the CICERONE Italian Consensus on Robotic Rehabilitation, the aim of this systematic review was to investigate the existing evidence concerning the role of lower limb robotic rehabilitation in improving functional recovery in patients with MS. Read More

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September 2021

A Cost Effectiveness Analysis of Intravitreal Aflibercept for the Prevention of Progressive Diabetic Retinopathy.

Ophthalmol Retina 2021 Sep 18. Epub 2021 Sep 18.

Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida. Electronic address:

Purpose: To calculate costs required to prevent center-involved diabetic macular edema (CI-DME) or proliferative diabetic retinopathy (PDR), and to improve the diabetic retinopathy severity score (DRSS) with intravitreal anti-VEGF injections as reported for aflibercept in two randomized control trials.

Design: Cost-effectiveness analysis modeling based on published data SUBJECTS: None METHODS: Results from PANORAMA and the Diabetic Retinopathy Clinical Research Network (DRCR.net) Protocol W were analyzed. Read More

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September 2021

The Effects of Donor-Specific Antibody Characteristics on Cardiac Allograft Vasculopathy.

Clin Transplant 2021 Sep 21:e14483. Epub 2021 Sep 21.

Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California.

Background: Cardiac allograft vasculopathy (CAV) causes late graft dysfunction and post-transplant mortality. Currently, the effects of different donor-specific antibodies (DSA) on the severity of CAV remain unclear.

Method: We evaluated 526 adult heart transplant recipients at a single center between January 2010 and August 2015. Read More

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September 2021

Testosterone, free, bioavailable and total, in patients with COVID-19.

Minerva Endocrinol (Torino) 2021 Sep 21. Epub 2021 Sep 21.

First Department of Critical Care Medicine & Pulmonary Services, Evangelismos Hospital, Medical School of National & Kapodistrian University of Athens, Athens, Greece.

Background: Low Testosterone (mainly total testosterone; TTe) has been noted in patients with COVID-19. Calculated free testosterone (FTe) and bioavailable testosterone (BavTe) may reflect more accurately this hormone's levels. In this study, we sought to assess TTe, FTe as well as BavTe in male patients with COVID-19. Read More

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September 2021

Application of serum mid-infrared spectroscopy combined with an ensemble learning method in rapid diagnosis of gliomas.

Anal Methods 2021 Sep 21. Epub 2021 Sep 21.

College of Software, Xinjiang University, Urumqi 830046, China.

The diffuse growth of glioma cells leads to gliomatosis, which has less cure rate and high mortality. As the severity deepens, the treatment difficulty and mortality of glioma patients gradually increase. Therefore, a rapid and non-invasive diagnostic technique is very important for glioma patients. Read More

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September 2021

Loss of Pulmonary Vascular Volume as a Predictor of Right Ventricular Dysfunction and Mortality in Acute Pulmonary Embolism.

Circ Cardiovasc Imaging 2021 Sep 21;14(9):e012347. Epub 2021 Sep 21.

University of Pennsylvania, Philadelphia. Division of Pulmonary and Critical Care Medicine (S.M.H., E.H., S.A., S.M., A.B.W., G.R.W., F.N.R.), Brigham and Women's Hospital, Harvard Medical School, Boston.

Background: In acute pulmonary embolism, chest computed tomography angiography derived metrics, such as the right ventricle (RV): left ventricle ratio are routinely used for risk stratification. Paucity of intraparenchymal blood vessels has previously been described, but their association with clinical biomarkers and outcomes has not been studied. We sought to determine if small vascular volumes measured on computed tomography scans were associated with an abnormal RV on echocardiography and mortality. Read More

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September 2021

The Modified Pancreatitis Activity Scoring System Shows Distinct Trajectories in Acute Pancreatitis: An International Study.

Clin Gastroenterol Hepatol 2021 Sep 17. Epub 2021 Sep 17.

Division of Gastroenterology, Hepatology, and Nutrition, The Ohio State University, Wexner Medical Center, Columbus, Ohio, USA. Electronic address:

Background And Aims: The aims of this study were to: 1) assess the performance of the pancreatitis activity scoring system (PASS) in a large intercontinental AP cohort, 2) investigate whether a modified PASS, yields a similar predictive accuracy and produces distinct early trajectories between severity subgroups.

Methods: Data was prospectively collected through the APPRENTICE consortium (2015-2018) involving 22 centers from four continents. AP severity was categorized per Revised Atlanta Classification. Read More

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September 2021

BMI Category and Adverse Events in Hospitalized Children.

Acad Pediatr 2021 Sep 17. Epub 2021 Sep 17.

Department of Anesthesiology and Critical Care Medicine, Johns Hopkins School of Medicine, 733 N Broadway, Baltimore, MD 21205 USA. Electronic address:

Objective: To identify associations between patient body mass index (BMI) category and adverse event (AE) rate, severity, and preventability in a cohort of children discharged from an academic children's hospital.

Methods: We identified patients 2-17 years old consecutively discharged between June and October 2018. Patient age, sex, height, and weight were used to categorize patients as having underweight, normal weight, overweight, or obesity. Read More

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September 2021

Reboxetine plus Oxybutynin for Obstructed Sleep Apnea Treatment A 1-week Randomized, Placebo-controlled, Double-Blind Crossover Trial.

Chest 2021 Sep 17. Epub 2021 Sep 17.

Istituto Auxologico Italiano, IRCCS, Sleep Disorders Center & Department of Cardiovascular, Neural and Metabolic Sciences, San Luca Hospital, Milan, Italy; Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy.

Background: The recent discovery that a combination of noradrenergic and antimuscarinic drugs improved upper airway muscle function during sleep and reduced obstructive sleep apnea (OSA) severity has revitalized interest in pharmacological therapies for OSA.

Research Question: Would 1-week of reboxetine plus oxybutynin be effective on OSA severity?

Study Design And Methods: We performed a randomized, placebo-controlled, double-blind, crossover trial comparing 4 mg reboxetine plus 5 mg oxybutynin (reb-oxy) to placebo in OSA subjects. After a baseline in-lab polysomnogram (PSG), patients performed PSGs after 7 nights of reb-oxy and 7 nights of placebo to compare apnea-hypopnea index (AHI, primary outcome). Read More

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September 2021

Potent T cell mediated anti-inflammatory role of the selective CB2 agonist lenabasum in multiple sclerosis.

Neuropathol Appl Neurobiol 2021 Sep 20. Epub 2021 Sep 20.

Laboratory of Resolution of Neuroinflammation, IRCCS Santa Lucia Foundation, Rome, Italy.

Background: Lenabasum is a synthetic cannabinoid receptor type-2 (CB2) agonist able to exert potent anti-inflammatory effects, but its role on T cells remains unknown.

Objectives: The present study was undertaken to investigate anti-inflammatory mechanisms of lenabasum in T lymphocyte subsets and its in vivo therapeutic efficacy in experimental autoimmune encephalomyelitis (EAE).

Methods: Mononuclear cells from 17 healthy subjects (HS) and 25 relapsing-remitting multiple sclerosis (RRMS) patients were activated in presence or absence of lenabasum and analysed by flow cytometry and qRT-PCR. Read More

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September 2021

The Effects of Prebiotics, Synbiotics and Short-Chain Fatty Acids On Respiratory Tract Infections and Immune Function: A Systematic Review And Meta-Analysis.

Adv Nutr 2021 Sep 20. Epub 2021 Sep 20.

School of Biomedical Sciences & Pharmacy, University of Newcastle, Callaghan, Australia NSW 2308.

Prebiotics, synbiotics and short-chain fatty acids (SCFA) have been shown to decrease systemic inflammation and play a protective role in chronic respiratory conditions. However, the effect on infection and immune function are unclear. The objective of this systematic review was to summarise the current evidence for prebiotic, synbiotic and SCFA supplementation on respiratory tract infections (RTIs) and immune function. Read More

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September 2021

Does reactogenicity after a second injection of the BNT162b2 vaccine predict spike IgG antibody levels in healthy Japanese subjects?

PLoS One 2021 20;16(9):e0257668. Epub 2021 Sep 20.

Department of Laboratory and Transfusion Medicine, Hospital of University of Occupational and Environmental Health, School of Medicine, Kitakyushu, Japan.

Background: Adverse reactions are more common after the second injection of messenger RNA vaccines such as Pfizer/BioNTech's BNT162b2. We hypothesized that the degree and severity of reactogenicity after the second injection reflects the magnitude of antibody production against the SARS CoV-2 virus spike protein (spike IgG).

Methods And Results: Blood samples were obtained from 67 Japanese healthcare workers three weeks after the first injection and two weeks after the second injection of the BNT162b2 vaccine to measure spike IgG levels. Read More

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September 2021

The Effectiveness of Ischemia Modified Albumin in Determining Acute Cholecystitis and its Severity.

Clin Lab 2021 Sep;67(9)

Background: Acute cholecystitis (AC) is caused by chemical and bacterial inflammation of the gallbladder. The use of Tokyo guidelines is recommended in determining the diagnosis of AC and its clinical severity. In the early stages of AC, many cytokines are secreted due to the local inflammatory cell activation, leading to exacerbation of inflammation and organ failure. Read More

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September 2021

The co-occurrence of calcaneal spur and hallux valgus: A radiological evaluation.

J Back Musculoskelet Rehabil 2021 Sep 9. Epub 2021 Sep 9.

Department of Orthopaedics and Traumatology, Bagcilar Training and Research Hospital, University of Health Sciences, Istanbul, Turkey.

Background: Calcaneal spur and hallux valgus are common foot deformities and both conditions have been shown to disrupt foot biomechanics.

Objectives: This study aimed to investigate the association between calcaneal spur and hallux valgus using radiographic and demographic data.

Methods: A total of 1375 patients (1083 women; mean age: 45. Read More

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September 2021

Validity and reliability of the fatigue impact scale in stroke.

Top Stroke Rehabil 2021 Sep 20:1-12. Epub 2021 Sep 20.

Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Gazi University, Ankara, Turkey.

Background: Fatigue is one of the significant problems of post-stroke patients as it causes a decreased quality of life. Although the fatigue impact scale (FIS) is used in stroke, it lacks validation studies.

Objective: This study evaluates the psychometric properties of the FIS in patients with stroke. Read More

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September 2021

Validity of the Severity of Dependence Scale for detecting dependence behaviours in chronic migraine with medication overuse.

Cephalalgia 2021 Sep 20:3331024211039817. Epub 2021 Sep 20.

Headache Science and Neurorehabilitation Centre, IRCCS C. Mondino Foundation, Pavia, Italy.

Aims: In this study, we tested the validity of the Severity of Dependence Scale in detecting dependence behaviours in patients with chronic migraine and medication overuse (CM + MO) using the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) and the Leeds Dependence Questionnaire as gold standard measures.

Methods: Four hundred and fifty-four patients with CM + MO filled in the Severity of Dependence Scale and the Leeds Dependence Questionnaire and underwent a psychological evaluation for the diagnosis of substance dependence according to the DSM-IV criteria.

Results: Sixty-nine percent of subjects (n = 313) presented substance dependence according to the DSM-IV criteria. Read More

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September 2021

Fractional CO laser treatment as adjunctive therapy to topical steroids for managing vulvar lichen sclerosus.

Lasers Surg Med 2021 Sep 20. Epub 2021 Sep 20.

Lumina Med Spa, South Burlington, Vermont, USA.

Objectives: Uncontrolled vulvar lichen sclerosus (VLS) is often associated with distressful symptoms of genital itch, irritation, and pain and can lead to a pathological process including anatomical changes, scarring, and an elevated risk of cancer in the genital area. First-line topical corticosteroid as monotherapy is frequently not adequate to fully suppress disease activity and control symptoms. This study evaluated the efficacy of fractional CO laser treatments as adjunctive therapy where recalcitrant VLS had been improved, but not adequately controlled, with topical corticosteroid treatment. Read More

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September 2021

A Comparative Study of Valsalva Maneuver, Lidocaine, and Valsalva Maneuvers with Administration of Lidocaine to Reduce the Pain Associated with Administration of Etomidate During General Anesthesia.

Anesth Pain Med 2021 Jun 23;11(3):e113408. Epub 2021 Jun 23.

School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

Objectives: The purpose of this study is a comparison of Valsalva, lidocaine, and Valsalva with administration of lidocaine to reduce the pain associated with administration of etomidate.

Methods: The present study is a clinical trial study. The number of samples in each group was 30 and a total of 90 people were selected. Read More

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Effect of vitamin B12 deficiency anemia on peripapillary retinal nerve fiber layer.

Int J Ophthalmol 2021 18;14(9):1424-1429. Epub 2021 Sep 18.

Department of Ophthalmology, Shri Guru Ram Rai Institute of Medical and Health Science, Patel Nagar, Dehradun 248001, India.

Aim: To evaluate the effect of vitamin B12 deficiency anemia (BDA) on peripapillary retinal nerve fiber layer thickness (RNFLT) using spectral domain optical coherence tomography (SD-OCT), and to determine any correlation arising thereof.

Methods: In this cross-sectional observational study, 99 eyes of 50 BDA patients of age 18-65y were compared with 100 eyes of 50 healthy control subjects. All subjects underwent comprehensive clinical, ophthalmic, and hematological evaluation, followed by peripapillary RNFLT assessment using SD-OCT. Read More

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September 2021

Mental health indicators in the later phase of lockdown due to COVID-19 pandemic in healthy youth combined elderly people: a web-based cross-sectional survey.

Int J Physiol Pathophysiol Pharmacol 2021 15;13(4):117-125. Epub 2021 Aug 15.

Department of Physiology, Dr Ram Manohar Lohia Institute of Medical Sciences Lucknow, India.

Lockdown was implemented throughout the world in March 2020 to control the spread of covid-19 infection. It affected the mental health of people in various ways. This web-based cross-sectional survey was conducted in the general population of India with an aim to evaluate the mental health of the healthy individuals in the later stage of the lockdown period. Read More

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