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Treatment for bleeding oesophageal varices in people with decompensated liver cirrhosis: a network meta-analysis.

Cochrane Database Syst Rev 2021 Apr 10;4:CD013155. Epub 2021 Apr 10.

Division of Surgery and Interventional Science, University College London, London, UK.

Background: Approximately 40% to 95% of people with liver cirrhosis have oesophageal varices. About 15% to 20% of oesophageal varices bleed within about one to three years after diagnosis. Several different treatments are available, including, among others, endoscopic sclerotherapy, variceal band ligation, somatostatin analogues, vasopressin analogues, and balloon tamponade. Read More

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Global health-related quality of life in schizophrenia: systematic review and meta-analysis.

BMJ Support Palliat Care 2021 Apr 9. Epub 2021 Apr 9.

Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran

Background And Aim: Signs and symptoms of schizophrenia may have serious impacts on patients' quality of life leading to concern about different aspects of their lives. This study presents a systematic review and meta-analysis of the studies examining the quality of life among patients with schizophrenia and its relationship with patients' characteristics.

Materials And Methods: A total of 40 studies were extracted from searching of relevant databases published between 2000 and 2020. Read More

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Characterizing Immune-Mediated Cytopenias After Allogeneic Hematopoietic Cell Transplantation for Pediatric Nonmalignant Disorders.

Transplant Cell Ther 2021 Apr 20;27(4):316.e1-316.e8. Epub 2021 Jan 20.

University of Minnesota, Department of Pediatric Blood and Marrow Transplant; Minneapolis, MN, USA. Electronic address:

Immune-mediated cytopenias (IMC)-isolated or combined hemolytic anemia, thrombocytopenia, or neutropenia-are increasingly recognized as serious complications after allogeneic hematopoietic cell transplantation (HCT) for nonmalignant disorders (NMD). However, IMC incidence, duration, response to therapy, and risk factors are not well defined. This retrospective chart review identified cases of IMC with serologic confirmation among patients who underwent HCT for NMD at a single institution between 2010 and 2017. Read More

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Multi-omics analysis of the amygdala in a rat chronic unpredictable mild stress model of depression.

Neuroscience 2021 Apr 6. Epub 2021 Apr 6.

NHC Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China; Department of Physical Examination, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China. Electronic address:

Major depressive disorder is a serious and complex mental illness, and multiple brain regions are involved in its pathogenesis. There is increasing evidence that the amygdala is involved in depression; however, the underlying molecular mechanisms remain unclear. In this study, we applied a combination of liquid chromatography-tandem mass spectrometry (LC-MS/MS)-based metabolomic and isobaric tags for relative and absolute quantitation (iTRAQ) proteomic to study changes in the amygdala in a chronic unpredictable mild stress (CUMS) rat model of depression. Read More

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Donor-derived TB after kidney transplantation: a case report.

J Bras Nefrol 2021 Apr 9. Epub 2021 Apr 9.

Instituto de Cardiologia do Distrito Federal, Brasília, DF, Brasil.

Introduction: Tuberculosis (TB) is a possible serious complication of solid organ transplantation, associated with high mortality and morbidity. Post-transplant TB has varied pathogenesis with many approaches to its prevention, which is the most important way to reduce its incidence. Treatment of TB in organ recipients is challenging because of drug toxicity and interaction with immunosuppressants. Read More

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Hospitalization and mortality outcomes in the first 5 years after a childhood cancer diagnosis: a population-based study.

Cancer Causes Control 2021 Apr 9. Epub 2021 Apr 9.

Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.

Purpose: Children with cancer are frequently hospitalized. However, hospitalization and death by disease category are not well defined < 5 years from diagnosis.

Methods: We conducted a retrospective cohort study using linked cancer registry-hospital discharge-vital records to identify cancer cases < 20 years at diagnosis during 1987-2012 (n = 4,567) and comparison children without cancer, matched on birth year and sex (n = 45,582). Read More

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Application of portable real-time recombinase-aided amplification (rt-RAA) assay in the clinical diagnosis of ASFV and prospective DIVA diagnosis.

Appl Microbiol Biotechnol 2021 Apr 9. Epub 2021 Apr 9.

Beijing Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Beijing, 100193, China.

African swine fever, a serious infectious disease, has been found in many countries around the world over the last nearly 100 years, and causes untold damage to the economy wherever it occurs. Diagnosis is currently performed by real-time PCR, which is highly sensitive but can only be carried out in a diagnostic laboratory environment with sophisticated equipment and expertise. A sensitive, rapid diagnostic method that can be implemented in agricultural settings is thus urgently needed for the detection and control of African swine fever virus (ASFV) infection. Read More

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Off-label use of PAH-targeted medications approved for adults and their financial coverage by health insurances are vital for children with pulmonary hypertension.

Eur J Clin Invest 2021 Apr 9:e13571. Epub 2021 Apr 9.

The European Pediatric Pulmonary Vascular Disease Network (EPPVDN), Berlin, Germany.

Pulmonary hypertension (PH), and especially pulmonary arterial hypertension (PAH), are chronic, progressive, and fatal conditions for which - apart from bilateral lung transplantation - there is currently no cure. However, recently developed, so-called "targeted" ("advanced") PAH medications, are now approved for adult PAH, and have improved quality of life and survival of affected children and adults. In 2020, two prospective pediatric observational studies on add-on macitentan and selexipag, respectively, have been published. Read More

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Medication-Related Osteonecrosis of the Jaw (MRONJ) due to Simvastatin: An Unusual Case Report.

World J Plast Surg 2021 Jan;10(1):132-135

Department of Orthodontics, Tehran University of Medical Science, Tehran, Iran.

Medication-related osteonecrosis of the jaw (MRONJ) is a serious pathological condition that usually results from anti-resorptive or anti-angiogenic drugs. We aimed to report an unusual MRONJ in a female patient due to long-term simvastatin administration. A 48-year female was referred to the Department of Oral and Maxillofacial, Mashhad Dental School, Mashhad, Iran in Dec 2019. Read More

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January 2021

TuberOus SClerosis registry to increAse disease awareness (TOSCA) Post-Authorisation Safety Study of Everolimus in Patients With Tuberous Sclerosis Complex.

Front Neurol 2021 23;12:630378. Epub 2021 Mar 23.

Pediatric Neurology Unit, Department of Paediatrics, UZ Brussel VUB, Brussels, Belgium.

This non-interventional post-authorisation safety study (PASS) assessed the long-term safety of everolimus in patients with tuberous sclerosis complex (TSC) who participated in the TuberOus SClerosis registry to increase disease Awareness (TOSCA) clinical study and received everolimus for the licensed indications in the European Union. The rate of adverse events (AEs), AEs that led to dose adjustments or treatment discontinuation, AEs of potential clinical interest, treatment-related AEs (TRAEs), serious AEs (SAEs), and deaths were documented. One hundred seventy-nine patients were included in the first 5 years of observation; 118 of 179 patients had an AE of any grade, with the most common AEs being stomatitis (7. Read More

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Identifying and Characterizing Children of Parents with a Serious Illness Using Survey and Register Data.

Clin Epidemiol 2021 1;13:253-263. Epub 2021 Apr 1.

National Institute of Public Health, University of Southern Denmark, Copenhagen, 1455, Denmark.

Purpose: To estimate the prevalence and characterize children and adolescents aged 0-21 years with a physically or mentally ill parent based on registers. Further, to explore the use of register and survey data to identify parental serious illness.

Methods: The study is based on: 1) a 20% register sample of children and adolescents aged 0-21 in 2014; and 2) survey data from the Danish Youth Profile 2014 including 63,437 youth education students linked to registers. Read More

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Pulmonary hypertension in fibrosing idiopathic interstitial pneumonia: Uncertainties, challenges and opportunities.

J Heart Lung Transplant 2021 Mar 5. Epub 2021 Mar 5.

Department of Respiratory Medicine, Hannover Medical School, Hannover, Germany and German Centre of Lung Research (DZL).

Pulmonary hypertension is a serious complication of chronic fibrosing idiopathic interstitial pneumonia (PH-fIIP) leading to greater morbidity and mortality. The pathophysiologic basis for PH in fIIP is not completely understood, but microvascular rarefaction may play a key role. Severe hypoxemia and reduced diffusion capacity are characteristic. Read More

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Atypical antipsychotics in the treatment of patients with a dual diagnosis of schizophrenia spectrum disorders and substance use disorders: the results of a randomized comparative study.

J Addict Dis 2021 Apr 9:1-20. Epub 2021 Apr 9.

Moscow Research and Practical Centre on Addictions of the Moscow Department of Healthcare, Moscow, Russia.

The article presents the results of a randomized comparative study of Aripiprazole and Quetiapine in the treatment of patients with a dual diagnosis: schizophrenia and substance use disorders. During the study, 90 of the 266 male patients were screened. Among them, 54 individuals (60%) had a previously established diagnosis of mental disorder and 36 patients (40%) had no established psychiatric diagnosis. Read More

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Bandage lens for treatment of corneosclera melting two weeks after pterygium surgery: A case report.

Medicine (Baltimore) 2021 Apr;100(14):e25348

Eye Center, The Second Affiliated Hospital of Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, China.

Introduction: Pterygium is a common chronic ocular surface condition in ophthalmology.At present, the main treatment modality is surgical resection. Although the recurrence rate can be controlled to varying degrees, some patients can still develop serious complications, such as scleral melting, corneal melting, and even corneal perforation. Read More

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Opsoclonus-myoclonus syndrome with severe clinical course and beneficial outcome: A case report.

Medicine (Baltimore) 2021 Apr;100(14):e25261

Department of Neurology.

Rationale: Opsoclonus-myoclonus syndrome (OMS) is a rare immune-mediated movement disorder, mostly of paraneoplastic or idiopathic origin. The disease usually has an acute onset, serious course and leads rapidly to disability in adult patients. To the best of our knowledge, this is the fourth presented case of OMS with a severe course and complete reversibility of neurological symptoms in a pregnant woman. Read More

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A Smart Mobile Application to Monitor Visual Function in Diabetic Retinopathy and Age-related Macular Degeneration: The CLEAR Study: Mobile Device for Measuring Visual Acuity and Function.

Am J Ophthalmol 2021 Apr 5. Epub 2021 Apr 5.

Retina Associates of Cleveland, Cleveland, OH; Case Western Reserve University, Cleveland, OH; Bascom Palmer Eye Institute, Miami, FL.

Purpose: To determine if a mobile application, Checkup Vision Assessment System (Checkup; Verana Health, San Francisco, CA), can reliably monitor visual acuity (VA) and metamorphopsia remotely vs standard VA reference tests in the clinic. With the current COVID-19 pandemic, an even greater need for remote monitoring exists. Mobile tools enhance ability to monitor patients virtually by enabling remote monitoring of VA and Amsler grid findings. Read More

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Recognition and management of neonatal sepsis.

Br J Nurs 2021 Apr;30(7):410-415

Consultant Paediatrician, Yeovil District Hospital, Yeovil.

Neonatal sepsis results from acute bacterial or viral infection occurring in the first 28 days of life. It causes significant morbidity and mortality, although the outcome can be improved by early recognition and prompt treatment by health professionals. This article describes the most common causes of sepsis, and explains why neonates are particularly vulnerable to infection. Read More

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How are uncertain prenatal genetic results perceived and managed 2 years after they were received? A qualitative interview study.

J Genet Couns 2021 Apr 8. Epub 2021 Apr 8.

Center for Fetal Diagnostics, Aarhus University Hospital, Aarhus, Denmark.

Chromosomal microarray has considerably improved our ability to identify or dismiss genetic conditions in the unborn child. However, this detailed analysis also reveals copy number variants (CNVs) of unknown or uncertain significance, in which the specific child's prognosis can be difficult to predict. Little is known about the longer-term impacts of receiving an uncertain prenatal CNV result. Read More

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Mucosal Kaposi's sarcoma in HIV-negative patients: a large case series from a single, tertiary referral center in Italy.

Int J Dermatol 2021 Apr 8. Epub 2021 Apr 8.

Dermatology Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy.

Background: Mucosal involvement in HIV-negative Kaposi's sarcoma (KS) is uncommon but has potentially serious repercussions on patient care. Evidence regarding its epidemiology and optimal management is limited. Invasive endoscopic staging at diagnosis and periodically during follow-up is currently recommended by major guidelines. Read More

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Persistent bone resorption lacunae on necrotic bone distinguish bisphosphonate-related osteonecrosis of jaw from denosumab-related osteonecrosis.

J Bone Miner Metab 2021 Apr 8. Epub 2021 Apr 8.

Tokyo Dental College Research Branding Project, 2-9-18 Kanda-Misaki-cho, Chiyoda-ku, Tokyo, 101-0061, Japan.

Background: Bisphosphonate and denosumab are widely used for the treatment of osteoporosis and bone metastasis of cancer to prevent excessive bone resorption. Osteonecrosis of the jaw is a serious adverse effect of bisphosphonate or denosumab referred to as bisphosphonate-related osteonecrosis of the jaw (BRONJ) or denosumab-related osteonecrosis of the jaw (DRONJ), respectively. Since bisphosphonate and denosumab inhibit bone resorption by different mechanism, we evaluated whether these drug types result in different histopathological characteristics related to bone resorption. Read More

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Triglycerides to high-density lipoprotein cholesterol ratio for diagnosing nonalcoholic fatty liver disease.

Minerva Gastroenterol (Torino) 2021 Apr 8. Epub 2021 Apr 8.

ReGenera R&D International for Aging Intervention, Milano, Italy.

Background: Nonalcoholic Fatty Liver Disease (NAFLD) is a widespread disease in the western world. It can develop into more serious pathological conditions (i.e. Read More

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[The Association Between Abdominal Obesity and Diabetes among Middle-aged and Older Adults with Normal BMI].

Sichuan Da Xue Xue Bao Yi Xue Ban 2021 Mar;52(2):340-344

Department of Health Behavior and Social Medicine, West China School of Public Health and West China Forth Hospital, Sichuan University, Chengdu 610041, China.

Objective: To explore the relationship between abdominal obesity and diabetes among middle-aged and older adults with normal body mass index (BMI) and to provide reference information for formulating targeted diabetes prevention and control measures for this population.

Methods: Data were extracted from the China Health and Retirement Longitudinal Study (CHARLS) done in 2015. Middle-aged and older adults who were aged 45 and older and had normal BMI were included in the study. Read More

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[Application and Progress of Convolutional Neural Network-based Pathological Diagnosis of Gastric Cancer].

Sichuan Da Xue Xue Bao Yi Xue Ban 2021 Mar;52(2):166-169

Department of Pathology, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100000, China.

The incidence of gastric cancer is the highest among all kinds of malignant tumors in China. Because gastric cancer is very hard to identify in its early stage, the early diagnosis rate of gastric cancer in China is relatively low. At present, the pathological diagnosis of gastric cancer mainly depends on the diagnosis of pathologists. Read More

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Safety Evaluation of Recombinant Fusion Protein RP22 as a Skin Test Reagent for Tuberculosis Diagnosis: A Phase I Clinical Trial.

Infect Dis Ther 2021 Apr 7. Epub 2021 Apr 7.

Shanghai Public Health Clinical Center, Fudan University, Shanghai, China.

Introduction: This phase I clinical trial was conducted to evaluate the safety of RP22 as a skin test reagent for tuberculosis (TB) diagnosis and to explore the appropriate dosage.

Methods: We used a randomized, double-blind, placebo-controlled identification allergen (IA) skin test. A total of 72 healthy adult volunteers with negative chest X-ray results were randomized into six groups and given a QuantiFERON-TB Gold (QFT) test. Read More

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Evolution of Pathology Patterns in Persons Who Died From COVID-19 in Italy: A National Study Based on Death Certificates.

Front Med (Lausanne) 2021 22;8:645543. Epub 2021 Mar 22.

Statistical Service, Istituto Superiore di Sanità, Rome, Italy.

In Italy, during the first epidemic wave of 2020, the peak of coronavirus disease 2019 (COVID-19) mortality was reached at the end of March. Afterward, a progressive reduction was observed until much lower figures were reached during the summer, resulting from the contained circulation of SARS-CoV-2. This study aimed to determine if and how the pathological patterns of the individuals deceased from COVID-19 changed during the phases of epidemic waves in terms of: (i) main cause of death, (ii) comorbidities, and (iii) complications related to death. Read More

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Abdominal Variant of Lemierre's Syndrome in a Patient with Pancreatic Adenocarcinoma.

Medeni Med J 2021 26;36(1):58-62. Epub 2021 Mar 26.

Bahçeşehir University School of Medicine, Department of Radiology, Istanbul, Turkey.

Lemierre's syndrome is an illness characterized by internal jugular vein thrombophlebitis related to infectious agents, primarily Fusobacterium necrophorum. These bacteria, residing in both the oropharynx and the gastrointestinal tract, may lead to pylephlebitis, a serious condition that could result in the development of hepatic abscesses. This manifestation of the disease is regarded as the abdominal variant of Lemierre's syndrome. Read More

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Paediatrics: how to manage scabies.

Drugs Context 2021 26;10. Epub 2021 Mar 26.

Department of Dermatology, Liverpool and Campbelltown Hospitals, South Western Sydney Local Health District, Sydney, NSW, Australia.

This narrative review addresses scabies, a highly contagious, pruritic infestation of the skin caused by the mite S. Scabies is a common disorder that has a prevalence worldwide estimated to be between 200 and 300 million cases per year. Infestation is of greatest concern in children, the elderly, immunocompromised people and resource-poor endemic populations at risk of chronic complications. Read More

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Bronchoalveolar Lavage Complements Transbronchial Cryobiopsy Diagnosis in Diffuse Interstitial Lung Diseases.

J Bronchology Interv Pulmonol 2021 Apr 6. Epub 2021 Apr 6.

Departments of Respiratory Medicine Pathology Radiology, Hospital de la Santa Creu i Sant Pau Sant Pau Institute of Biomedical Research (IIB Sant Pau), Barcelona, Spain.

Background: Bronchoalveolar lavage (BAL) is a technique classically used for the study of diffuse interstitial lung diseases (DILDs). Given the recent advances in the diagnosis of DILD by transbronchial cryobiopsy (TBCB), it is relevant to assess what BAL can contribute to TBCB.

Patients And Methods: This is a retrospective descriptive study that included patients with DILD who, between 2013 and 2017, underwent BAL and TBCB in the same bronchoscopy intervention. Read More

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Identification of hub genes related to the progression of type 1 diabetes by computational analysis.

BMC Endocr Disord 2021 Apr 7;21(1):61. Epub 2021 Apr 7.

Department of Ayurveda, Rajiv Gandhi Education Society's Ayurvedic Medical College, Ron, Karanataka, 582209, India.

Background: Type 1 diabetes (T1D) is a serious threat to childhood life and has fairly complicated pathogenesis. Profound attempts have been made to enlighten the pathogenesis, but the molecular mechanisms of T1D are still not well known.

Methods: To identify the candidate genes in the progression of T1D, expression profiling by high throughput sequencing dataset GSE123658 was downloaded from Gene Expression Omnibus (GEO) database. Read More

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Fecal Microbiota Transplantation: Is It Safe?

Clin Endosc 2021 Mar 30;54(2):157-160. Epub 2021 Mar 30.

Department of Internal Medicine, Digestive Disease Research Institute, Wonkwang University College of Medicine, Iksan, Korea.

Fecal microbiota transplantation (FMT) is an accepted procedure for the management of recurrent Clostridioides difficile infections. FMT is generally considered safe and well-tolerated - even in high-risk patients. Most short-term risks are mild and known to be associated with delivery methods. Read More

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