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Direct oral anticoagulants for the treatment of pulmonary embolism in patients with renal impairment.

Thromb Res 2021 Jun 19;204:101-107. Epub 2021 Jun 19.

Department of Vascular Medicine, Klinikum Darmstadt GmbH, Darmstadt, Germany; Center for Thrombosis and Hemostasis, University of Mainz, Mainz, Germany. Electronic address:

Pulmonary embolism (PE) is associated with adverse outcomes and substantial morbidity and mortality. Patients with PE often have renal impairment because of shared risk factors and close links between the renal and cardiovascular systems. Furthermore, patients with PE and renal impairment are at increased risk of recurrent thrombosis. Read More

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Elbow Overuse Injuries in Pediatric Female Gymnastic Athletes: Comparative Findings and Outcomes in Radial Head Stress Fractures and Capitellar Osteochondritis Dissecans.

J Bone Joint Surg Am 2021 Jun 24. Epub 2021 Jun 24.

Texas Scottish Rite Hospital for Children, Dallas, Texas.

Background: Radial head stress fractures (RHSFs) and capitellar osteochondritis dissecans (COCD) are rare but may be seen in gymnasts. The purpose of this study was to compare the clinical and radiographic characteristics and the outcomes of RHSF and COCD in pediatric and adolescent gymnastic athletes.

Methods: Classical gymnasts and competitive tumblers ≤18 years of age presenting with RHSF or COCD over a 5-year period were reviewed. Read More

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Association Between Orientation and Magnitude of Femoral Torsion and Propensity for Clinically Meaningful Improvement After Hip Arthroscopy for Femoroacetabular Impingement Syndrome: A Computed Tomography Analysis.

Am J Sports Med 2021 Jun 24:3635465211021610. Epub 2021 Jun 24.

Section of Young Adult Hip Surgery, Division of Sports Medicine, Department of Orthopaedic Surgery, Hip Preservation Center, Rush University Medical Center, Chicago, Illinois, USA.

Background: Femoral torsion imaging measurements and classifications are heterogeneous throughout the literature, and the influence of femoral torsion on clinically meaningful outcome improvement after hip arthroscopy for femoroacetabular impingement syndrome (FAIS) has not been well studied.

Purpose: To (1) perform a computed tomography (CT)-based analysis to quantify femoral torsion in patients with FAIS and (2) explore the relationship between the orientation and magnitude of femoral torsion and the propensity for clinically meaningful outcome improvement after hip arthroscopy.

Study Design: Cohort study; Level of evidence, 3. Read More

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Recovering Coronavirus Disease Patients in the Active Duty Military Population: A Review of Current Evidence and Special Considerations for Uniformed Providers.

Mil Med 2021 Jun 24. Epub 2021 Jun 24.

U.S. Naval Hospital Okinawa FPO AP 96382, Okinawa, Japan.

Patients acutely infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) coronavirus disease (COVID-19) may continue to have symptoms well beyond 2 weeks. The range of symptoms and physiological sequelae can impact medical readiness even in a relatively young and healthy cohort of service members. It is important to monitor, document, and investigate symptoms from all service members recovering from COVID-19. Read More

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Utilization of Multiple Sclerosis Therapies in the Middle East Over a Decade: 2009-2018.

CNS Drugs 2021 Jun 23. Epub 2021 Jun 23.

Department of Medicine, CORe, University of Melbourne, Melbourne, Victoria, Australia.

Background: The multiple sclerosis (MS) landscape has changed over the past two decades across the world and in the Middle East. The Middle East is an ethnically diverse region located between 12° and 42° of latitude and 35° and 54° of longitude and varying altitudes. The magnitude of the shifts observed in the epidemiology and management of MS differ in each region and from country to country. Read More

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Burnout in health care providers working in the intensive care units of a tertiary care hospital, South India-a questionnaire-based survey.

Can J Respir Ther 2021 4;57:68-72. Epub 2021 Jun 4.

Department of Respiratory Therapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Karnataka, India.

Background: The intensive care unit (ICU) is a special section of the hospital where intense monitoring and patient care are required. Health care providers (HCPs) who work in the ICU are exposed to a stressful environment and, in the long run, this may lead to exhaustion and burnout. It is observed that the burnout in HCPs in the ICU may have an impact on patient care and the psychological wellbeing of the caregiver. Read More

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Absorption, metabolism, excretion, and safety of [C]almonertinib in healthy Chinese subjects.

Ann Transl Med 2021 May;9(10):867

Phase I Clinical Trial Unit, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China.

Background: Almonertinib Mesilate Tablets (HS-10296, Hansoh Pharma, Shanghai, China) is a novel and selective third-generation epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI). A phase I study of almonertinib in patients with non-small cell lung cancer (NSCLC) demonstrated a linear metabolic trend, a good tolerability/safety profile, and preliminary antitumor activity. However, the metabolism, excretion, and substance balance of almonertinib has not been clearly determined. Read More

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Pediatric metabolic liver diseases: Evolving role of liver transplantation.

World J Transplant 2021 Jun;11(6):161-179

Institute of Liver Disease and Transplantation, Dr Rela Institute and Medical Center, Chennai 600044, Tamil Nadu, India.

Metabolic liver diseases (MLD) are the second most common indication for liver transplantation (LT) in children. This is based on the fact that the majority of enzymes involved in various metabolic pathways are present within the liver and LT can cure or at least control the disease manifestation. LT is also performed in metabolic disorders for end-stage liver disease, its sequelae including hepatocellular cancer. Read More

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Liquid biopsy in non-small cell lung cancer-current status and future outlook-a narrative review.

Transl Lung Cancer Res 2021 May;10(5):2237-2251

Department of Thoracic Surgery, Medical University of Graz, Graz, Austria.

Lung cancer ranks first as the cause of cancer-associated deaths gobally. The American Cancer Society estimates for 228,820 new cases and 135,720 deaths from lung cancer in the United States for the year 2020. Targeted treatment options have rapidly emerged for non-small cell lung cancer (NSCLC) within the past decade. Read More

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Glycemic control and its determinants among patients with type 2 diabetes mellitus at Menelik II Referral Hospital, Ethiopia.

SAGE Open Med 2021 6;9:20503121211023000. Epub 2021 Jun 6.

School of Pharmacy, Wollo University, Dessie, Ethiopia.

Objective: The objective of the study was to explore the level of glycemic control and its determinants among patients with type 2 diabetes mellitus at Menelik II Referral Hospital, Addis Ababa, Ethiopia.

Methods: Cross-sectional study design was employed. The sample size was determined using a single proportion formula and 245 patients with type 2 diabetes mellitus were involved in this study. Read More

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Current Trends in Percutaneous Nephrolithotomy in China: A Spot Survey.

Risk Manag Healthc Policy 2021 16;14:2507-2515. Epub 2021 Jun 16.

Department of Urology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, 100020, The People's Republic of China.

Objective: To describe trends in the procedure of percutaneous nephrolithotomy (PCNL) in China to identify training needs.

Methods: A spot survey with 36 questions, which revealed demographic data, patterns of PCNL practice, and opinions regarding specific clinical cases, was administered to Chinese urologists during the 17 National Urological Urolithiasis Symposium held in Dandong in 2018.

Results: Out of 400 participants, 221 responses to the survey were received. Read More

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The COVID-19 Pandemic and Its Impact on Knowledge, Perception and Attitudes of Dentistry Students in Austria: A Cross-Sectional Survey.

J Multidiscip Healthc 2021 14;14:1413-1422. Epub 2021 Jun 14.

Department of Pediatric Dentistry, University Clinic of Dentistry, Medical University Vienna, Vienna, Austria.

Introduction: Universities with dental schools are faced with complex problems during the COVID-19 pandemic. Dentistry students are at a higher risk of contracting infections, specifically COVID-19, due to direct contact with patients. The aim of this study was to assess the knowledge, perception and attitude regarding COVID-19 among dentistry students in Austria. Read More

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Treatment of posterolateral tibial plateau fractures with a rotational support plate and special pressurizer: technical note and retrospective case series.

J Orthop Surg Res 2021 Jun 23;16(1):407. Epub 2021 Jun 23.

Orthopaedic Trauma Service Center, Major Laboratory of Orthopaedic Biomechanics in Hebei Province, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, China.

Background: In tibial plateau fractures, the posterolateral segment of the tibia plateau is frequently affected and challenging to treat. Although there are many surgical approaches and fixation methods for the treatment of these fractures, all of these methods have limitations. We designed a new rotational support plate (RSP) and a special pressurizer that can fix the fracture directly via the anterolateral approach. Read More

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Efficacy and safety of once-daily, single-inhaler fluticasone furoate/umeclidinium/vilanterol versus fluticasone furoate/vilanterol in Japanese patients with inadequately controlled asthma: the CAPTAIN study.

Curr Med Res Opin 2021 Jun 24. Epub 2021 Jun 24.

GSK, Brentford, Middlesex, UK.

Objective: In CAPTAIN a double-blind, parallel-group, Phase IIIA study, fluticasone furoate/umeclidinium/vilanterol (FF/UMEC/VI) improved lung function, symptoms and asthma control versus FF/VI in patients with inadequately controlled asthma. Here, we report efficacy and safety from a Japanese cohort in CAPTAIN.

Methods: Adults with inadequately controlled asthma despite inhaled corticosteroid/long-acting β-agonist (ICS/LABA) were randomized (1:1:1:1:1:1) to once-daily FF/VI (100/25mcg or 200/25mcg) or FF/UMEC/VI (100/31. Read More

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A risk signature with inflammatory and immune cells infiltration predicts survival and efficiency of chemotherapy in gastric cancer.

Int Immunopharmacol 2021 Jul 24;96:107589. Epub 2021 May 24.

Department of General Surgery, The Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, China. Electronic address:

Objective: Tumor immune microenvironment biomarkers might add predictive value for outcomes. This study aimed to construct a risk signature with tumor infiltration immune and inflammatory cells to improve the prediction of survival.

Methods: A risk signature model in combination with CD66b + neutrophils, CD3+ T, CD8+ T lymphocytes, and FOXP3 + regulatory T cells was developed in a training cohort of 327 GC patients undergoing surgical resection between 2011 and 2012, and validated in a validation cohort of 285 patients from 2012 to 2013. Read More

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Morphological Correlations in Nasolabial Formation After Primary Lip Repair for Unilateral Cleft Lip.

J Oral Maxillofac Surg 2021 May 19. Epub 2021 May 19.

Special Advisor, Department of Oral and Maxillofacial Surgery, Osaka Women's and Children's Hospital, Osaka, Japan.

Purpose: We aim to reveal postoperative morphological correlations between the nasolabial components in patients with unilateral cleft lip (UCL). The hypothetical correlations are first, a correlation between the vertical height of the cleft-side alar base and the length of the cleft-side red lip, and second, a correlation between the length of the cleft-side red lip and the vertical position of the cleft-side oral commissure. We explain how these morphological balances are controlled by surgery. Read More

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Image-Guided Intra-articular Hip Injections and Risk of Infection After Hip Arthroscopy.

Am J Sports Med 2021 Jun 23:3635465211022798. Epub 2021 Jun 23.

Department of Orthopaedic Surgery, Massachusetts General Hospital/Harvard Medical School, Boston, Massachusetts, USA.

Background: Although intra-articular injections are important in the management of patients who may later undergo hip arthroscopy, conflicting data are available regarding the safety of such injections when administered within 3 months of surgery. Furthermore, despite the increasing use of image-guided intra-articular hip injections, it is unknown whether the type of imaging modality used is associated with infection after hip arthroscopy.

Purpose: To assess the risk of infection associated with image-guided intra-articular injections before hip arthroscopy and, secondarily, compare that risk between ultrasound (US) and fluoroscopic (FL) guidance. Read More

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TUBB8 Mutations Cause Female Infertility with Large Polar Body Oocyte and Fertilization Failure.

Reprod Sci 2021 Jun 23. Epub 2021 Jun 23.

Key Laboratory of Molecular Biophysics of the Ministry of Education, College of Life Science and Technology and Center for Human Genome Research, Huazhong University of Science and Technology, Wuhan, 430074, Hubei, China.

Tubulin beta 8 class VIII (TUBB8) is a special β-tubulin isotype that mainly expressed in primate oocytes and early embryos and identified as the disease-causing gene of human oocyte maturation arrest. To identify the disease-causing genes in 2 patients with female infertility due to large polar body oocyte or fertilization failure, whole-exome sequencing was performed on the patients and available family members. We identified a novel heterozygous missense mutation c. Read More

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Risk Prediction Model of 90-Day Mortality After Esophagectomy for Cancer.

JAMA Surg 2021 Jun 23. Epub 2021 Jun 23.

Department of Gastrointestinal Surgery, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham Foundation Trust, Birmingham, United Kingdom.

Importance: Ninety-day mortality rates after esophagectomy are an indicator of the quality of surgical oncologic management. Accurate risk prediction based on large data sets may aid patients and surgeons in making informed decisions.

Objective: To develop and validate a risk prediction model of death within 90 days after esophagectomy for cancer using the International Esodata Study Group (IESG) database, the largest existing prospective, multicenter cohort reporting standardized postoperative outcomes. Read More

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Primary malignant melanoma of the esophagogastric junction: A case report.

Medicine (Baltimore) 2021 Jun;100(25):e26467

Division of General Surgery, Department of Surgery, Cathay General Hospital, Taipei City, Taiwan.

Rationale: Most gastrointestinal melanomas are metastatic from an oculocutaneous primary lesion; however, primary gastrointestinal melanomas have been found in all levels of the gastrointestinal tract. We present the case of Primary malignant melanoma of the esophagus and discuss the diagnostic methods, differentiation from metastatic lesions and treatment options.

Patient Concerns: A 78-year-old male patient presented with fresh blood vomiting and tarry stools for 1 day. Read More

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Identification of p.Arg205Cys in CASR in an autosomal dominant hypocalcaemia type 1 pedigree: A case report.

Medicine (Baltimore) 2021 Jun;100(25):e26443

Department of Neurology, China-Japan Union Hospital of Jilin University, Changchun, Jilin, China.

Rationale: Autosomal dominant hypocalcaemia type 1 (ADH1) is a genetic disease characterized by benign hypocalcemia, inappropriately low parathyroid hormone levels and mostly hypercalciuria. It is caused by the activating mutations of the calcium-sensing receptor gene (CASR), which produces a left-shift in the set point for extracellular calcium.

Patient Concerns: A 50-year-old man presenting with muscle spasms was admitted into the hospital. Read More

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Jejunal Dieulafoy lesion with intraintestinal calcification on computerized tomography: A case report.

Medicine (Baltimore) 2021 Jun;100(25):e26229

Department of Gastrointestinal Medicine, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China.

Rationale: A Dieulafoy lesion is a rare cause of gastrointestinal (GI) bleeding, especially in the jejunum, and the presence of calcifications on CT might be suspicious of the diagnosis.

Patient Concerns: We describe a 72-year-old woman with anemia and melena. Hemoglobin was 6. Read More

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ANTAGONISTIC ACTIVITY OF REPRESENTATIVES OF ORAL BIOCENOSIS.

Wiad Lek 2021 ;74(6):1493-1498

POLTAVA STATE MEDICAL UNIVERSITY, POLTAVA, UKRAINE.

Objective: The aim: Calculate the antagonistic activity of representatives of the oral biotope.

Patients And Methods: Materials and methods: The mathematical techniques used in biotechnology and dentistry. The calculations were carried out on the basis of the research data obtained by the investigators from Ukrainian Medical Stomatological Academy (UMSA) (Poltava). Read More

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Computer-Assisted Navigation Is Associated With Decreased Rates of Hardware-Related Revision After Instrumented Posterior Lumbar Fusion.

Global Spine J 2021 Jun 23:21925682211019696. Epub 2021 Jun 23.

Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY, USA.

Study Design: Retrospective cohort study.

Objective: To (1) define utilization trends for navigated instrumented posterior lumbar fusion (PLF), (2) compare reasons and rates of revision at 30-day, 60-day, 90-day, and 1-year follow-up, and (3) compare 90-day perioperative complications between navigated versus conventional instrumented PLF.

Methods: Patients who underwent navigated or conventional instrumented PLF were identified from the Humana insurance database using the PearlDiver Patient Records between 2007-2017. Read More

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Integrating Harm Reduction into Outpatient Opioid Use Disorder Treatment Settings : Harm Reduction in Outpatient Addiction Treatment.

J Gen Intern Med 2021 Jun 22. Epub 2021 Jun 22.

Section of General Internal Medicine, Boston University School of Medicine & Boston Medical Center, Boston, MA, USA.

Opioid use disorder (OUD) is increasingly recognized as a chronic, relapsing brain disease whose treatment should be integrated into primary care settings alongside other chronic conditions. However, abstinence from all non-prescribed substance use continues to be prioritized as the only desired goal in many outpatient, primary care-based treatment programs. This presents a barrier to engagement for patients who continue to use substances and who may be at high risk for complications of ongoing substance use such as human immunodeficiency virus (HIV), hepatitis C virus (HCV), superficial and deep tissue infections, and overdose. Read More

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The Current Status and Challenges in the Development of Vaccines and Drugs against Severe Acute Respiratory Syndrome-Corona Virus-2 (SARS-CoV-2).

Biomed Res Int 2021 1;2021:8160860. Epub 2021 Jun 1.

Center of Excellence in Molecular Biology and Regenerative Medicine (CEMR), Department of Biochemistry, JSS Academy of Higher Education & Research (JSS AHER), Mysore, 570015 Karnataka, India.

Severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection causes coronavirus disease-19 (COVID-19), which is characterized by clinical manifestations such as pneumonia, lymphopenia, severe acute respiratory distress, and cytokine storm. S glycoprotein of SARS-CoV-2 binds to angiotensin-converting enzyme II (ACE-II) to enter into the lungs through membrane proteases consequently inflicting the extensive viral load through rapid replication mechanisms. Despite several research efforts, challenges in COVID-19 management still persist at various levels that include (a) availability of a low cost and rapid self-screening test, (b) lack of an effective vaccine which works against multiple variants of SARS-CoV-2, and (c) lack of a potent drug that can reduce the complications of COVID-19. Read More

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Botulinum toxin A improves neurogenic bladder fibrosis by suppressing transforming growth factor β1 expression in rats.

Transl Androl Urol 2021 May;10(5):2000-2007

Department of Urology, Xuanwu Hospital Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, China.

Background: Intradetrusor botulinum toxin A injection is recommended for the treatment of refractory detrusor overactivity (DO) in patients with neurogenic bladder, however, whether it could inhibit neurogenic bladder fibrosis is uncertain. This study aimed to investigate the effect of botulinum toxin A on neurogenic bladder fibrosis and the underlying mechanism.

Methods: Forty eight Female Wistar rats were evenly randomized into 4 groups: Sham, T10 transection, Early and Late groups. Read More

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An Unusual Case of Type 1 Narcolepsy in an Ethiopian Patient.

Ethiop J Health Sci 2021 Jan;31(1):205-208

Georgetown University School of Medicine, 3800 Reservoir Rd NW, 20007.

Background: Narcolepsy is a chronic disabling central neurological disorder of daytime hypersomnia. It is categorized into two subtypes-type 1 (N1) and type 2 (N2). Symptoms of N1 commonly include excessive daytime sleepiness (EDS), cataplexy, sleep paralysis, hypnogogic/hypnopompic hallucinations, and disturbed nighttime sleep. Read More

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January 2021

Factors Associated with Multi-Drug Resistant Tuberculosis among TB Patients in Selected Treatment Centers of Amhara Region: A Case-Control Study.

Ethiop J Health Sci 2021 Jan;31(1):25-34

Department of Epidemiology and Biostatistics, Bahir Dar University, Bahir Dar, Ethiopia.

Background: Multi-drug Resistant Tuberculosis (MDR-TB) is found to be a major public health problem both in developed and developing countries. Ethiopia is one of the 30 high MDR-TB burden countries in the world. Although several studies were done to identify the determinants of MDR-TB, the reported findings are heterogeneous across the world. Read More

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January 2021

Intensive Care Unit Admission, Mechanical Ventilation, and Mortality Among Patients With Type 1 Diabetes Hospitalized for COVID-19 in the U.S.

Diabetes Care 2021 Jun 22. Epub 2021 Jun 22.

Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA.

Objective: To assess whether risk of severe outcomes among patients with type 1 diabetes mellitus (T1DM) hospitalized for coronavirus disease 2019 (COVID-19) differs from that of patients without diabetes or with type 2 diabetes mellitus (T2DM).

Research Design And Methods: Using the Premier Healthcare Database Special COVID-19 Release records of patients discharged after COVID-19 hospitalization from U.S. Read More

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