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Is peripartum maternal fever alone a reliable predictor of neonatal sepsis? A single-centre, retrospective cohort study.

J Paediatr Child Health 2021 Apr 22. Epub 2021 Apr 22.

College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia.

Aim: To determine the incidence rate of early-onset neonatal sepsis (EONS) among term neonates (gestation greater than 37 weeks) admitted to the neonatal intensive care unit for suspected sepsis and the association of EONS with maternal fever (temperature greater than 38°C).

Methods: A single-centre retrospective cohort study of all term neonates (gestation >37 weeks) admitted to and treated in the neonatal unit at the Townsville University Hospital between March 2015 and March 2020. Neonatal sepsis was confirmed with positive neonatal blood culture. Read More

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Physical Frailty and Cognitive Impairment in Older Adults in United States Nursing Homes.

Dement Geriatr Cogn Disord 2021 Apr 22:1-8. Epub 2021 Apr 22.

Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts, USA.

Introduction: In older US nursing home (NH) residents, there is limited research on the prevalence of physical frailty, its potential dynamic changes, and its association with cognitive impairment in older adults' first 6 months of NH stay.

Methods: Minimum Data Set (MDS) 3.0 is the national database on residents in US Medicare-/Medicaid-certified NHs. Read More

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Wrapping double-mattress anastomosis for pancreaticojejunostomy in minimally invasive pancreaticoduodenectomy can significantly reduce postoperative pancreatic fistula rate compared with conventional pancreaticojejunostomy in open surgery: An analysis of a propensity score-matched sample.

Surg Oncol 2021 Apr 9;38:101577. Epub 2021 Apr 9.

Department of Surgery, Fujita Health University, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi, 470-1192, Japan.

Background: Minimally invasive pancreaticoduodenectomy (MIPD), including laparoscopic pancreaticoduodenectomy (LPD) and robotic pancreaticoduodenectomy (RPD), is technically demanding because of pancreaticojejunostomy (PJ). Postoperative pancreatic fistula (POPF) is the most serious complication of MIPD and open pancreaticoduodenectomy (OPD). Contrary to expectations, conventional PJ in MIPD did not improve POPF rate and length of hospital stay. Read More

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Initial Outcomes of A Novel Irrigating Wound Protector for Reducing the Risk of Surgical Site Infection in Elective Colectomies.

J Surg Res 2021 Apr 19;265:64-70. Epub 2021 Apr 19.

Department of Surgery, Baylor Scott & White Health - Texas A&M, Temple, Texas. Electronic address:

Background: Surgical site infection (SSI) rates in elective colorectal surgery remain high due to intraoperative exposure of colonic bacteria at the surgical site. We aimed to evaluate 30-day SSI outcomes of a novel wound retractor that combines barrier protection with continuous wound irrigation in elective colorectal resection.

Materials And Methods: A retrospective single-center cohort-matched analysis included all patients undergoing elective colorectal resection utilizing the novel irrigating wound protector (IWP) from April 2015 to July 2019. Read More

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Identification of behaviour patterns in waste collection and disposal during the first wave of COVID-19 in Regina, Saskatchewan, Canada.

J Environ Manage 2021 Apr 18;290:112663. Epub 2021 Apr 18.

Industrial Systems Engineering, Faculty of Engineering and Applied Science, University of Regina, Canada.

The novel coronavirus (2019-nCov) has had significant impacts on almost every aspect of daily life. From 'stay-at-home' orders to the progressive lifting of restrictions, the COVID-19 pandemic has had unprecedented effects on consumer behaviours and waste disposal habits. The purpose of this short communication is to examine time series waste collection and disposal data in a mid-sized Canadian city to understand how behavioural changes have affected municipal waste management. Read More

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Outcomes of complex primary total knee arthroplasties performed with custom cutting guides.

Knee 2021 Apr 19;30:106-112. Epub 2021 Apr 19.

Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA. Electronic address:

Background: Total knee arthroplasty (TKA) is particularly challenging in patients with marked deformities or existing hardware due to the inability to use traditional instrumentation. One potential technique to mitigate this obstacle is the use of patient-specific cutting guides. The purpose of this study was to evaluate the use of custom cutting guides in complex primary TKAs. Read More

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Low skeletal muscle mass predicts poor clinical outcomes in patients with abdominal trauma.

Nutrition 2021 Mar 4;89:111229. Epub 2021 Mar 4.

Department of Intensive Care Unit, Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing, Jiangsu Province, China. Electronic address:

Objective: The aim of this study was to investigate whether low skeletal muscle mass is associated with clinical outcomes in patients with abdominal trauma.

Methods: Patients presenting to our institution with abdominal trauma from January 2010 to April 2020 were retrospectively included. Low skeletal muscle mass was defined, using computed tomography, as skeletal muscle index (SMI) at the third lumbar vertebra below the lowest sex-specific quartile within 1 wk of admission. Read More

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Comparison of minimally invasive total versus subtotal resection of spinal tumors: a systematic review and meta-analysis.

World Neurosurg 2021 Apr 19. Epub 2021 Apr 19.

Department of Neurological Surgery, University of California, Irvine, CA, USA. Electronic address:

Objective: With the advent of minimally invasive techniques, minimally invasive spine surgery (MISS) has become a realistic option for many spine cases. This study aims to evaluate the operative and clinical outcomes of MISS for total versus subtotal tumor resection from current evidence.

Methods: A literature search was performed using the search term, (Minimally invasive surgery OR MIS) AND (spine tumor OR spinal tumor). Read More

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Role for Fibrin Glue (Sealant) in Seroma Reduction After Inguinal Lymphadenectomy; A Randomized Controlled Trial.

Int J Surg 2021 Apr 19:105950. Epub 2021 Apr 19.

Department of General Surgery, Faculty of Medicine, Menoufia University, Egypt.

Background: Seroma is one of the most commonly encountered morbidities after inguinal lymph node dissection (ILND). It causes much nuisance to both patients and doctors and its presence can lead to many complications. This study aimed to evaluate the role and impact of using fibrin glue to decrease seroma formation in patients undergoing ILND. Read More

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Perioperative Outcomes for Centers Routinely Admitting Postoperative Endovascular Aortic Aneurysm Repair to the ICU.

J Am Coll Surg 2021 Apr 16. Epub 2021 Apr 16.

Division of Vascular and Endovascular Surgery, Boston Medical Center, Boston University School of Medicine, Boston, MA. Electronic address:

Background: Intensive care unit (ICU) admission after endovascular aortic aneurysm repair (EVAR) varies across medical centers. We evaluated the association of postoperative ICU utilization with perioperative and long-term outcomes after EVAR.

Study Design: The Vascular Quality Initiative (2003-2019) was queried for index elective EVARs. Read More

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Understanding Value and Patient Complexity Among Common Inpatient Vascular Surgery Procedures.

J Vasc Surg 2021 Apr 19. Epub 2021 Apr 19.

Department of Surgery, University of California, San Francisco, San Francisco, CA, USA. Electronic address:

Objective: Vascular surgery patients are highly complex, second only to patients undergoing cardiac procedures. However, unlike cardiac surgery, work relative value units (wRVU) for vascular surgery were undervalued based on an overall patient complexity score. This study assesses the correlation of patient complexity with wRVUs for the most commonly performed inpatient vascular surgery procedures. Read More

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`Frailty as a Predictor of Outcomes in Patients Undergoing Carotid Artery Stenting.

J Vasc Surg 2021 Apr 19. Epub 2021 Apr 19.

University of California San Diego, San Diego, CA. Electronic address:

Background: The concept of frailty has been proposed to capture the vulnerability resulting from aging and has been implemented for the prediction of peri-operative outcomes. Carotid artery stenting (CAS) is considered as an appropriate minimally-invasive procedure in patients who are high risk for carotid endarterectomy. Recently, the predictive accuracy of peri-operative outcomes using the 5-item modified frailty index (5mFI) has been reported to have relatively poor predictive accuracy in cardiovascular surgery in comparison to other surgeries. Read More

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Short and Long-term Outcomes Following Concurrent Splenectomy for Thoracoabdominal Aortic Aneurysm Repair.

J Vasc Surg 2021 Apr 19. Epub 2021 Apr 19.

Division of Vascular and Endovascular Surgery, Massachusetts General Hospital, Boston, MA, USA.

Objectives: Splenectomies are often performed during open Thoracoabdominal Aortic Aneurysm (TAAA) repair, as capsular tears are common and can be associated with significant bleeding. It is unknown whether splenectomies affect short or long-term outcomes after TAAA repair.

Methods: All open type I-IIV TAAA repairs performed from 1987- June 2015 were evaluated using a single institutional database. Read More

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Retinopathy of prematurity incidence and treatment modalities in moderate and late preterm infants: a study from two tertiary centers.

Can J Ophthalmol 2021 Apr 19. Epub 2021 Apr 19.

Gaziantep University Faculty of Medicine, Department of Ophthalmology, Gaziantep, Turkey.

Objective: The aim of this study was to evaluate the incidence, severity, and treatment modalities of retinopathy of prematurity (ROP) in moderate and late preterm infants with a gestational age (GA) >31 + 6 weeks.

Methods: ROP screening results of preterm infants with GA >31 + 6 weeks to 36 + 6 weeks between March 2013 and January 2019 were evaluated retrospectively. Infants were divided into 2 groups according to GA as 32-33 + 6 weeks (moderate preterm) and 34-36 + 6 weeks (late preterm). Read More

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The role of hemogram parameters and CRP in predicting mortality in COVID-19 infection.

Int J Clin Pract 2021 Apr 22:e14256. Epub 2021 Apr 22.

Mugla Sitki Kocman University, Faculty of Medicine, Department of Emergency Medicine, Mugla, Turkey.

Aim: This study aimed to investigate hemogram parameters and CRP that can be used in clinical practice to predict mortality in hospitalized patients with a diagnosis of COVID-19.

Methods: This cohort study was conducted at University Hospital, which is a designated hospital for COVID-19 patients. Adult patients who were admitted to our hospital emergency department with suspected COVID-19 and who were hospitalized in our institution with a COVID-19 diagnosis were analysed. Read More

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Association between Alcohol, Substance Use, and Inpatient Burn Outcomes.

J Burn Care Res 2021 Apr 22. Epub 2021 Apr 22.

Department of Surgery, University of North Carolina School of Medicine, Manning Drive Chapel Hill, North Carolina, United States of America.

The use of alcohol and illicit substances has been associated with impaired judgement and health, but the effect on inpatient outcomes after burn injury remains unsettled. Our objective was to evaluate the effect of alcohol and illicit substance use on our inpatient burn outcomes. Adult patients admitted with burn injury-including inhalation injury only-between January 1, 2014 and June 30, 2019 were eligible for inclusion. Read More

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Massive burns: retrospective analysis of changes in outcomes indicators across 18 years.

J Burn Care Res 2021 Apr 22. Epub 2021 Apr 22.

Department of Plastic, Reconstructive and Hand Surgery, Lausanne University Hospital, Switzerland.

Background: The treatment and management of massive burns, defined as burns affecting≥ 50% of total body surface area (TBSA) has considerably changed since the 90s. This study aimed at analyzing if the length of intensive care unit (ICU) stay, the success of skin grafting operations and the mortality changed in the last 18 years.

Methods: Between 2000 and 2018, 77 patients were admitted for massive burns to the ICU of a university hospital. Read More

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Psychiatric hospitalizations by the Unified Health System in Brazil between 2000 and 2014.

Rev Saude Publica 2021 16;55:14. Epub 2021 Apr 16.

Universidade Federal de Minas Gerais. Faculdade de Medicina. Departamento de Medicina Preventiva e Social. Belo Horizonte, MG, Brasil.

Objective: To characterize the profile of patients hospitalized for mental and behavioral disorders by the Unified Health System (SUS) in Brazil between 2000 and 2014, and to verify how aspects of the new mental health policy influenced the rate of hospitalized patients in that period.

Methods: Non-concurrent prospective cohort study using secondary data from inpatients with a primary diagnosis of mental and behavioral disorders between 01/01/2000 and 12/31/2014. Sociodemographic, clinical, and hospital characteristics variables were selected. Read More

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Convalescent plasma therapy in COVID-19 critically ill patients during advanced phases of clinical trials and their preliminary results.

Einstein (Sao Paulo) 2021 19;19:eRW6186. Epub 2021 Apr 19.

Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.

The objective of this study was to highlight the global scientific effort to fight the SARS-CoV-2, addressing the preliminary results of passive immunization through convalescent plasma. We performed a search at the major databases of interventional clinical trial protocols about the transfusion of convalescent plasma in patients with COVID-19, as well as, published articles (n≥25), using the following search strategy: [(COVID-19 OR SARS-CoV-2 OR nCoV-2019) AND (Convalescent plasma OR Plasma exchange) AND (Treatment OR Therapy)]. A total of 24 interventional clinical trial protocols (advanced in phases II-III, III, and IV) were included in this review, as well as three studies that had enough outcomes to evaluate the efficacy of convalescent plasma therapy for patients with COVID-19. Read More

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Delayed intensive care unit admission from the emergency department: impact on patient outcomes. A retrospective study.

Rev Bras Ter Intensiva 2021 Jan-Mar;33(1):125-137

Department of Critical Care, King Saud Medical City - Riyadh, Arábia Saudita.

Objective: To study the impact of delayed admission by more than 4 hours on the outcomes of critically ill patients.

Methods: This was a retrospective observational study in which adult patients admitted directly from the emergency department to the intensive care unit were divided into two groups: Timely Admission if they were admitted within 4 hours and Delayed Admission if admission was delayed for more than 4 hours. Intensive care unit length of stay and hospital/intensive care unit mortality were compared between the groups. Read More

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Changes in the management and clinical outcomes of critically ill patients without COVID-19 during the pandemic.

Rev Bras Ter Intensiva 2021 Jan-Mar;33(1):68-74

Unidade de Terapia Intensiva, Hospital Italiano de Buenos Aires - Buenos Aires, Argentina.

Objective: To analyze whether changes in medical care due to the application of COVID-19 protocols affected clinical outcomes in patients without COVID-19 during the pandemic.

Methods: This was a retrospective, observational cohort study carried out in a thirty-eight-bed surgical and medical intensive care unit of a high complexity private hospital. Patients with respiratory failure admitted to the intensive care unit during March and April 2020 and the same months in 2019 were selected. Read More

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Predisposing factors and impact of healthcare-associated infections in patients with status epilepticus.

Arq Neuropsiquiatr 2021 Mar;79(3):209-215

San Francisco University of Quito, Neuroscience Institute, Quito, Ecuador.

Background: Few studies have evaluated the incidence, predisposing factors and impact of healthcare-associated infections (HCAIs) in relation to outcomes among patients with status epilepticus (SE).

Objective: To investigate the variables associated with development of HCAIs among patients with SE and the impact of factors relating to HCAIs on mortality at three months.

Methods: This study was a retrospective analysis on our prospectively collected dataset, from November 2015 to January 2019. Read More

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Association of prescription opioid use on mortality and hospital length of stay in the intensive care unit.

PLoS One 2021 22;16(4):e0250320. Epub 2021 Apr 22.

Department of Medicine, Kent Hospital/Brown University, Warwick, RI, United States of America.

Objective: Several studies show that chronic opioid dependence leads to higher in-hospital mortality, increased risk of hospital readmissions, and worse outcomes in trauma cases. However, the association of outpatient prescription opioid use on morbidity and mortality has not been adequately evaluated in a critical care setting. The purpose of this study was to determine if there is an association between chronic opioid use and mortality after an ICU admission. Read More

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Dementia and patient outcomes after hip surgery in older patients: A retrospective observational study using nationwide administrative data in Japan.

PLoS One 2021 22;16(4):e0249364. Epub 2021 Apr 22.

Graduate School of Health Care Sciences, Tokyo Medical and Dental University, Tokyo, Japan.

Objective: To investigate whether dementia is associated with incidence of adverse events and longer hospital stays in older adults who underwent hip surgery, after adjusting for individual social and nursing care environment.

Design And Setting: Retrospective observational study using the linked data between the Japanese Diagnosis Procedure Combination database and the reports of the medical functions of hospital beds database in Japan (April 2016-March 2017).

Participants: A total of 48,797 individuals aged 65 and older who underwent hip surgery and were discharged during the study period. Read More

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Anesthetic Complications Associated with SARS-CoV-2 in Pediatric Patients.

Anesth Analg 2021 Apr 21. Epub 2021 Apr 21.

Department of Anesthesiology and Pain Management, Division of Pediatric Anesthesia, University of Texas Southwestern, Dallas, TX and Children's Health, Dallas, TX.

Background: Coronavirus disease 19 (COVID-19) is associated with high perioperative morbidity and mortality among adults. The incidence and severity of anesthetic complications in children with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is unknown. We hypothesized that there would be an increased incidence of intra- and postoperative complications in children with SARS-CoV-2 infection as compared to those with negative testing. Read More

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COVID-19 and On-site Dining in Tokyo: A Time-series Analysis Using Mobile Phone Location Data.

JMIR Mhealth Uhealth 2021 Apr 11. Epub 2021 Apr 11.

Research Center for Social Science & Medicine, Tokyo Metopolitan Institute of Medical Science, 2-1-6 Kamikitazawa, Setagaya-ku, Tokyo, JP.

Background: During the second COVID-19 wave in August 2020, the Tokyo Metropolitan Government implemented public health and social measures (PHSMs) to reduce on-site dining. Assessing the associations between human behavior, infection, and social measures is essential to understand achievable reductions in cases and identify the factors driving changes in social dynamics.

Objective: We investigated the association between night-time populations, the COVID-19 epidemic, and the implementation of PHSMs in Tokyo. Read More

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Household chaos, maternal stress, and maternal health behaviors in the United States during the COVID-19 outbreak.

Womens Health (Lond) 2021 Jan-Dec;17:17455065211010655

Pennington Biomedical Research Center, Baton Rouge, LA, USA.

Objectives: Household chaos, including disorder, noise, and crowding within the home, is a risk factor for poor mental and physical health. Household chaos may act upon maternal behaviors of physical activity and sleep, potentially via higher stress. The purpose of this study is to evaluate the relationships among household chaos, maternal stress, and maternal physical activity and sleep, and identify barriers to home organization during the COVID-19 outbreak. Read More

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Functional impairments and rehabilitation outcomes of patients with immunotherapy-induced Acute Inflammatory Demyelinating Polyradiculoneuropathy, Myasthenia Gravis and Myositis.

Am J Phys Med Rehabil 2021 Apr 8. Epub 2021 Apr 8.

The University of Texas MD Anderson Cancer Center, Department of Palliative, Rehabilitation and Integrative Medicine, Houston, Texas.

Abstract: Immunotherapy has led to a higher survival rate among different oncological disease groups but also associated with adverse related events in multiple organ systems. Immunotherapy related musculoskeletal weakness often results in a loss of cancer survivors' physical function, ultimately impacting their independence and quality of life. This is a retrospective study of 24 cancer patients who were treated with immunotherapy either alone or in conjunction with other oncological treatments. Read More

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Laparoscopic surgery and robotic surgery for single-incision cholecystectomy: an updated systematic review.

Updates Surg 2021 Apr 22. Epub 2021 Apr 22.

Department of Hepatobiliary and Pancreatic Surgery, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, 310014, Zhejiang, China.

The role of single-incision laparoscopic cholecystectomy (SILC) and single-incision robotic cholecystectomy (SIRC) is still unclear. We update the summarization of the feasibility and safety of SILC and SIRC. A comprehensive search of SILC and SIRC of English literature published on PubMed database between January 2015 and November 2020 was performed. Read More

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[Influence of the corona pandemic on pain patients : Which impacts of the pandemic on their care do patients with chronic pain experience?]

Schmerz 2021 Apr 22. Epub 2021 Apr 22.

Schmerzklinik Wuppertal, Helios Universitätsklinikum Wuppertal, Universität Witten/Herdecke, Klinik Bergisch-Land GmbH, Im Saalscheid 5, 42369, Wuppertal, Deutschland.

Background: Diseases caused by the novel coronavirus (SARS-CoV-2) have led to a pandemic in a very dynamic manner. The epidemiological situation of national importance required infection control measures with the aim of reducing morbidity and mortality. An overburdening of the healthcare system should be avoided. Read More

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