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Thrombus formation and ischemic necrosis of the uterus and adnexa due to purpura fulminans: A case report.

J Obstet Gynaecol Res 2021 Sep 15. Epub 2021 Sep 15.

Department of Obstetrics and Gynecology, Nihon University School of Medicine, Tokyo, Japan.

Purpura fulminans (PF) is a syndrome characterized by the sudden onset of progressive skin hemorrhage, necrosis of the extremities, and thrombotic occlusion. Although the cause is believed to be protein C deficiency, many aspects of this syndrome have yet to be clarified. A 45-year-old Japanese woman, G2P2 (vaginal delivery), developed fever and lower abdominal pain. Read More

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September 2021

Patients with Severe Lactic Acidosis in the Intensive Care Unit: A Retrospective Study of Contributing Factors and Impact of Renal Replacement Therapy.

Blood Purif 2021 Sep 15:1-7. Epub 2021 Sep 15.

Department of Nephrology, Ghent University Hospital, Ghent, Belgium.

Introduction: Hyperlactatemia is a regular condition in the intensive care unit, which is often associated with adverse outcomes. Control of the triggering condition is the most effective treatment of hyperlactatemia, but since this is mostly not readily possible, extracorporeal renal replacement therapy (RRT) is often tried as a last resort. The present study aims to evaluate the factors that may contribute to the decision whether to start RRT or not and the potential impact of the start of RRT on the outcome in patients with severe lactic acidosis (SLA) (lactate ≥5 mmol/L). Read More

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September 2021

Pseudohyponatremia Leading to a Fatal Outcome in a Patient With Familial Hypertriglyceridemia.

Cureus 2021 Aug 10;13(8):e17066. Epub 2021 Aug 10.

Internal Medicine, Hackensack Meridian Ocean Medical Center, Brick, USA.

Serum sodium assay is a commonly performed laboratory test in a clinical setting and the results are taken for granted without being aware of the actual methods involved. In conditions like hyperlipidemia and hyperproteinemia, excessive lipids in serum dilute the water component of the serum. Since sodium is dissolved only in the aqueous phase of serum, the sodium content per unit volume of plasma is reduced. Read More

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Long term monitoring of the reproductive behavior of wild Chinese pangolin (Manis pentadactyla).

Sci Rep 2021 Sep 13;11(1):18116. Epub 2021 Sep 13.

Institute of Wildlife Conservation, College of Veterinary Medicine, National Pingtung University of Science and Technology, Pingtung, Taiwan.

Observations of Chinese pangolin (Manis pentadactyla) in the wild are extremely rare and challenging because of their nocturnal and cryptic activity patterns and low population density. The present article reported the first field observation in eastern Taiwan, from October 4, 2012 to June 16, 2016, on the reproductive behavior of the Chinese pangolin based on the monitoring of a female (LF28) using radiotelemetry and camera traps. During this period, LF28 aged from 1-4. Read More

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September 2021

Protective Effect of Remdesivir Against Pulmonary Fibrosis in Mice.

Front Pharmacol 2021 26;12:692346. Epub 2021 Aug 26.

State Key Laboratory of Medicinal Chemical Biology, College of Pharmacy and Tianjin Key Laboratory of Molecular Drug Research, Nankai University, Tianjin, China.

Pulmonary fibrosis is a known sequela of severe or persistent lung damage. Existing clinical, imaging and autopsy studies have shown that the lungs exhibit a pathological pulmonary fibrosis phenotype after infection with coronaviruses, including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Pulmonary fibrosis may be one of the most serious sequelae associated with coronavirus disease 2019 (COVID-19). Read More

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Midodrine Improves the Tolerability of Diuretics in Patients with Acute-on-Chronic Liver Failure-A Pilot Study.

J Clin Exp Hepatol 2021 Sep-Oct;11(5):573-578. Epub 2020 Dec 17.

Department of Hepatology, Asian Institute of Gastroenterology, Hyderabad, India.

Background: Acute-on-chronic liver failure (ACLF) is a syndrome of acute portal hypertension with high short-term mortality. ACLF patients have low mean arterial pressure (MAP), systemic vascular resistance, and high cardiac output. This, in turn, leads to an increased incidence of ascites, acute kidney injury, and hyponatremia. Read More

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December 2020

Immunomodulatory and anti-infective effects of Cratylia mollis lectin (Cramoll) in a model of wound infection induced by Staphylococcus aureus.

Int Immunopharmacol 2021 Sep 8;100:108094. Epub 2021 Sep 8.

Laboratório de Patogenicidade Microbiana, Universidade Ceuma, 65075-120 São Luís, MA, Brazil. Electronic address:

This work evaluated the immunomodulatory and anti-infective effects of Cratylia mollis lectin (Cramoll) in a model of wound infection induced by S. aureus. Swiss mice were divided into 3 groups (n = 12/group): non-inoculated (Control group); inoculated with S. Read More

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September 2021

Esophageal cancer in relation to alcohol drinking and tobacco use among men in Kerala, India - Karunagappally cohort.

Cancer Epidemiol 2021 Sep 7;74:102018. Epub 2021 Sep 7.

Department of Epidemiology and Preventive Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.

Background: In the Karunagappally cohort, esophageal cancer is the third most common cancer with an age-adjusted incidence rate of 6.2 per 100,000 person-years among men. The present study analyzed the risk of esophageal cancer in relation to alcohol drinking and tobacco use. Read More

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September 2021

Planned granulocyte-colony stimulating factor adversely impacts survival after allogeneic hematopoietic cell transplantation performed with Thymoglobulin for myeloid malignancy.

Transplant Cell Ther 2021 Sep 7. Epub 2021 Sep 7.

Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.

Background: The in vivo depletion of recipient and donor T-lymphocytes using anti-thymocyte globulin (ATG) is widely adopted in allogeneic hematopoietic stem cell transplantation (HCT) to reduce the incidence of both graft failure and graft versus host disease (GVHD). However excess toxicity to donor lymphocytes may hamper immune reconstitution, compromising anti-tumour effects and increasing infection. Granulocyte-colony stimulating factor (G-CSF) administered early after HCT may increase ATG-mediated lympho-toxicity. Read More

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September 2021

Do live birth rate and obstetric outcomes vary between immediate and delayed embryo transfers following freeze-all cycles?

J Gynecol Obstet Hum Reprod 2021 Sep 8;50(10):102224. Epub 2021 Sep 8.

Assisted Reproduction Unit, Department of Obstetrics and Gynecology, Koç University Hospital, Istanbul, Turkey. Electronic address:

Research Question: Do live birth rates (LBR), obstetric and perinatal outcomes vary between women who underwent frozen embryo transfer (ET) in the immediately subsequent menstrual cycle, and with those who underwent delayed frozen ET.

Design: Retrospective cohort study (n = 198) consisting of 119 women who underwent immediate transfer within 30 days of oocyte retrieval (OR) and 79 women who underwent delayed transfer which was performed after >30 days following OR. Either flexible antagonist or flexible progestin-primed ovarian stimulation protocols were started after a baseline ultrasonography on the second or third day of menstrual cycle. Read More

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September 2021

Congenital Tracheoesophageal Fistula in Very Low Birth Weight Preterm Neonate with an Oligohydramnios as a Rare Presentation: A Case Report.

JNMA J Nepal Med Assoc 2020 Dec 31;58(232):1075-1079. Epub 2020 Dec 31.

Laligurans Hospital, Talchhikhel-14, Lalitpur, Nepal.

Tracheoesophageal fistula is a challenging anomaly with a rare prevalence with symptoms mainly respiratory, sometimes digestive. We present a rare case of oesophageal atresia with distal Tracheoesophageal fistula in a female child whose mother presented with severe oligohydramnios on ultrasonography with intrauterine growth retardation before cesarean section. After the birth of preterm and very low birth weight neonate, we initially diagnosed as respiratory distress syndrome with a club foot. Read More

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December 2020

Severe anaphylaxis caused by intravenous anti-cancer drugs.

Cancer Med 2021 Sep 10. Epub 2021 Sep 10.

Department of Pulmonology, Yokohama City University Hospital, Yokohama, Japan.

Background: The incidence and risk factors of severe anaphylaxis by intravenous anti-cancer drugs are unclear, whereas those of milder reactions have been reported.

Study Design: Electronic medical charts of cancer patients who have undergone intravenous chemotherapy between January 2013 and October 2020 in a university hospital were retrospectively reviewed. Non-epithelial malignancies were also included in the analysis. Read More

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September 2021

Antibody response to the first dose of AZD1222 vaccine in COVID-19 convalescent and uninfected individuals in Bangladesh.

Expert Rev Vaccines 2021 Sep 15:1-10. Epub 2021 Sep 15.

Gonoshasthaya-RNA Molecular Diagnostic & Research Center, Dhanmondi, Dhaka, Bangladesh.

Background: Vaccination with the Oxford-AstraZeneca COVID-19 vaccine (AZD1222) initially started in the UK and quickly implemented around the Globe, including Bangladesh. Up to date, more than nine million doses administrated to the Bangladeshi public.

Method: Herein, we studied the antibody response to the first dose of AZD1222 in 86 Bangladeshi individuals using in-house ELISA kits. Read More

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September 2021

Computer-aided X-ray screening for tuberculosis and HIV testing among adults with cough in Malawi (the PROSPECT study): A randomised trial and cost-effectiveness analysis.

PLoS Med 2021 Sep 9;18(9):e1003752. Epub 2021 Sep 9.

Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Blantyre, Malawi.

Background: Suboptimal tuberculosis (TB) diagnostics and HIV contribute to the high global burden of TB. We investigated costs and yield from systematic HIV-TB screening, including computer-aided digital chest X-ray (DCXR-CAD).

Methods And Findings: In this open, three-arm randomised trial, adults (≥18 years) with cough attending acute primary services in Malawi were randomised (1:1:1) to standard of care (SOC); oral HIV testing (HIV screening) and linkage to care; or HIV testing and linkage to care plus DCXR-CAD with sputum Xpert for high CAD4TBv5 scores (HIV-TB screening). Read More

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September 2021

A severe case of Israeli spotted fever with pleural effusion in Italy.

Infection 2021 Sep 9. Epub 2021 Sep 9.

Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, 90127, Palermo, Italy.

Background: The most common Italian rickettsiosis is Mediterranean Spotted Fever (MSF). MSF is commonly associated with a symptom triad consisting of fever, cutaneous rash, and inoculation eschar. The rash is usually maculopapular but, especially in severe presentations, may be petechial. Read More

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September 2021

Early anticoagulation in atrial fibrillation-related acute ischaemic stroke: efficacy and safety profile.

J Neurol 2021 Sep 9. Epub 2021 Sep 9.

Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal.

Objectives: To evaluate the effects of early anticoagulation on functional outcome, recurrent ischaemic events and haemorrhagic complications in Atrial Fibrillation (AF)-related acute ischaemic strokes (AIS).

Materials And Methods: We retrospectively evaluated patients hospitalised in a Stroke Unit due to AF-related AIS. Patients were divided according to anticoagulation initiation timing (0-4 days, 5-14 days, no anticoagulation by the 14th day). Read More

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September 2021

Evaluation of Intraventricular/Intrathecal Antimicrobial Therapy in the Treatment of Nosocomial Meningitis Caused by Multidrug-Resistant Gram-Negative Bacteria after Central Nervous System Surgery.

Can J Infect Dis Med Microbiol 2021 27;2021:9923015. Epub 2021 Aug 27.

University of Health Science, Istanbul Training and Research Hospital, Department of Neurological Surgery, Istanbul, Turkey.

Introduction: Postoperative meningitis (POM) is an infection with high mortality and morbidity following central nervous system surgery due to trauma or tumor. Intrathecal/intraventricular (IT/IVT) antibiotic administrations have been considered as the last treatment options for multidrug-resistance (MDR) Gram-negative bacteria that do not respond to intravenous (IV) regimens. IT/IVT can bypass the blood-brain barrier, obtain a more effective antibiotic concentration in CSF, and reduce systemic side effects. Read More

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Small bowel hemorrhage from check point inhibitor enteritis: a case report.

BMC Gastroenterol 2021 Sep 7;21(1):345. Epub 2021 Sep 7.

Division of Gastroenterology and Hepatology, Oregon Health and Science University, Portland, OR, USA.

Background: There is rising utilization of immune checkpoint inhibitors (ICI) for a growing number of metastatic malignancies. While gastrointestinal side effects of ICI are common, isolated ICI-induced enteritis leading to small bowel hemorrhage is rare.

Case Presentation: A 71-year-old man with a previously resected right colon adenocarcinoma on atezolizumab and recently treated Clostridioides difficile presented with acute on chronic abdominal pain and non-bloody diarrhea. Read More

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September 2021

Clinician Stress and Adolescent Patient Anxiety: Understanding an Unfamiliar Case of a Dark Green-Effusion Peritoneal Dialysis Fluid.

Transplant Proc 2021 Sep 3. Epub 2021 Sep 3.

Faculty of Nursing Sciences, Tel Aviv-Jaffa Academic College, Jaffa, Israel.

A 17-year-old Palestinian patient has been undergoing peritoneal dialysis for the past 4 years owing to reflux nephropathy. The patient was recently diagnosed positive for coronavirus disease 2019. Seven days after the diagnosis she complained of loss of vision in the right eye. Read More

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September 2021

Anti-COVID property of subcutaneous ivermectin in synergy with zinc among midlife moderately symptomatic patients: a structured summary of a study protocol for a randomised controlled trial.

Trials 2021 Sep 6;22(1):591. Epub 2021 Sep 6.

Department of Pharmacology and Toxicology, University of veterinary and animal sciences, Lahore, Pakistan.

Objectives: The study objective is to quantify the effectiveness of ivermectin (subcutaneous/oral IVM) in the presence or absence of zinc (Zn) for clinical and radiological improvement in coronavirus disease 2019 (COVID-19) patients with moderate severity.

Trial Design: This quadruple-blinded, placebo-controlled randomized clinical trial will be a multiarmed multi-centered study with superiority framework.

Participants: Quinquagenarian and sexagenarian patients with moderate COVID-19 symptoms and positive severe respiratory syndrome coronavirus -2 (SARS-CoV-2) PCR will be included. Read More

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September 2021

Persistent Hypoglycemia Induced by Long-acting Insulin Degludec.

Intern Med 2021 Sep 4. Epub 2021 Sep 4.

Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School.

A 58-year-old Japanese man was brought to the emergency room due to disturbance of consciousness. He regained consciousness on the day of admission and started taking hospital meals, but he needed intravenous glucose administration for eight days. The total amount of glucose administration was 4,464 g. Read More

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September 2021

Limited impact of a top-down approach to improve enhanced recovery programme in French university hospitals: a before-after retrospective survey.

Perioper Med (Lond) 2021 Sep 6;10(1):29. Epub 2021 Sep 6.

Anaesthesia and Intensive Care Department, Ambroise Paré Hospital, APHP, 9 avenue Charles de Gaulle, 92100, Boulogne-Billancourt, France.

Background: Enhanced recovery programme (ERP) after surgery needs development in Assistance Publique Hôpitaux de Paris (APHP).

Methods: A retrospective before-and-after study was performed in 2015 and 2017 on three surgical models (total knee arthroplasty (TKA), colectomy and hysterectomy) in 17 hospitals including 29 surgical departments. Data were collected in one control intervention (total hip arthroplasty (THA), gastrectomy and ovariectomy). Read More

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September 2021

Combined Phialemonium curvatum and Acanthamoeba Keratitis: The Importance of Early Diagnosis and Specific Therapy.

Cornea 2021 Oct;40(10):1340-1343

Department of Biomedical Sciences, Ophthalmology Clinic, University of Messina, Messina, Italy; and.

Purpose: To report the clinical and confocal findings of a unique case of combined Phialemonium curvatum and Acanthamoeba keratitis and to highlight the role of the prompt diagnosis and specific medical treatment in preserving visual function.

Methods: A case report and literature review.

Results: A 54-year-old woman presented with a 3-day history of visual impairment, photophobia, and ocular pain in her right eye. Read More

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October 2021

Cutaneous manifestations associated with SARS-CoV-2: an emerging topic in a pandemic era.

BMJ Case Rep 2021 Sep 3;14(9). Epub 2021 Sep 3.

Internal Medicine, SESARAM, Funchal, Portugal.

A 70-year-old man was admitted to our COVID-19 ward with thoracalgia, productive mucus cough, fatigue and erythematous-violaceous macules on the inner side of feet and interdigital regions. The patient was started on oxygen and dexamethasone. On the day of discharge, he maintained the skin changes despite the resolution of COVID-19 symptoms. Read More

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September 2021

Spontaneous massive hemothorax as a complication of necrotizing pneumonia in a patient with severe acute respiratory syndrome coronavirus 2 induced acute respiratory distress syndrome: a case report.

J Med Case Rep 2021 Sep 3;15(1):444. Epub 2021 Sep 3.

Department of Anaesthesiology and Intensive Care Medicine, Medical School Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.

Background: We present an unusual bleeding complication in a patient with severe acute respiratory distress syndrome in coronavirus disease 2019.

Case Presentation: The patient, a 63-year-old Caucasian man, received venovenous extracorporeal membrane oxygenation support after rapid deterioration of lung function on day 6 after admission to hospital. After initial stabilization on lung protective ventilation and prone positioning, he started to develop mild bleeding complications until he went into occult profound hemorrhagic shock. Read More

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September 2021

Virologic outcomes of people living with human immunodeficiency virus who started antiretroviral treatment on the same-day of diagnosis in Ethiopia: A multicenter observational study.

PLoS One 2021 3;16(9):e0257059. Epub 2021 Sep 3.

Addis Continental Institute of Public Health, Addis Ababa, Ethiopia.

Introduction: There have been tremendous achievements in scaling-up antiretroviral therapy (ART) for treatment of human immunodeficiency virus (HIV), following universal "test and treat" policy implementation in low- and middle-income countries. However, its effects on virologic outcomes is not yet well investigated. We compared low viral load status in people living with HIV between those who were initiated on ART on the same-day and after 7 days of being diagnosed with HIV infection. Read More

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September 2021

Symmetrical Skin Lesions on the Gluteal Region in a Patient with Anti-Laminin-332 Mucous Membrane Pemphigoid.

Acta Dermatovenerol Croat 2021 Jul;29(2):105-107

Nobuki Maki; MD, Department of Dermatology Akita National Hospital, 84-40 Idonosawa, Iwakiuchimichikawa, Yurihonjo, Akita 018-1393 Japan;

Mucous membrane pemphigoid (MMP), previously called cicatricial pemphigoid, is a rare subepidermal immunobullous disorder that primarily affects the mucous membranes (1,2). MMP is divided into two major subtypes, anti-BP180-type MMP and anti-laminin-332 (previously called laminin 5 or epiligrin) MMP. Anti-laminin-332 MMP is known to be associated with malignant tumors (3), which may cause overexpression of autoantibodies and induce autoimmunity to laminin-332 (4). Read More

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The possible impact of passive smoke exposure on radiation-related risk estimates for lung cancer among women: The Life Span Study of atomic bomb survivors.

Int J Radiat Biol 2021 Sep 2:1-24. Epub 2021 Sep 2.

Department of Epidemiology, University of Washington, Seattle, Washington.

Purpose: Analyses of the Life Span Study cohort of atomic bomb survivors have shown a statistically significant sex difference in the excess risk of incident lung cancer due to radiation exposure, with the radiation-related excess relative risk per gray (ERR/Gy) for women approximately 4 times that for men, after accounting for active smoking. We sought to determine the extent to which this risk difference could be explained by adjustment for passive smoke exposure, which is a known risk factor for lung cancer that was not measured among Life Span Study participants, and which could be particularly influential among female never-smokers.

Materials And Methods: The Life Span Study includes survivors of the atomic bombings of Hiroshima and Nagasaki and city residents who were not in either city at the time of the bombings, matched to survivors on city, sex, and age. Read More

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September 2021

[A Case of Emphysematous Pyelonephritis after Starting Treatment for Acute Pyelonephritis].

Hinyokika Kiyo 2021 Aug;67(8):373-379

The Department of Urology, Matsusaka City Hospital.

A 68-year-old man sought evaluation at our emergency department in the early morning of day X with a feverfor3 days. The physical examination revealed pain in the left back, and an abdominal computed tomography (CT) showed a high density of fatty tissue around the left kidney. With a diagnosis of left acute bacterial pyelonephritis, he was hospitalized, antibacterial drug treatment was started, and he was transferred to our department on the same day. Read More

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Starting late does not increase the risk of post-operative complications in patients undergoing common general surgical procedures.

Surg Endosc 2021 Sep 1. Epub 2021 Sep 1.

Department of Surgery, University of Toronto, Toronto, Canada.

Background: There is a paucity of evidence surrounding the issue of delays on the day of surgery with respect to both causes and consequences. We sought to determine whether patients whose operations started late were at increased risk of post-operative complications.

Methods: We conducted a retrospective cohort study of 1420 first-of-the-day common general surgical procedures, dividing these into "on-time start" (OTS) and "late-start" (LS) cases. Read More

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September 2021