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Effect of Test Sequence on Maximal Anaerobic and Aerobic Power Achievements in Adults.

Int J Exerc Sci 2021 1;14(4):657-665. Epub 2021 Aug 1.

Department of Exercise Science, Bloomsburg University of Pennsylvania, Bloomsburg, PA, USA.

The purpose of this study was to examine the effect of test sequence on adults' ability to achieve maximal aerobic and anaerobic power during a single assessment visit. Forty-one adults (24 men, 17 women; 22.0 ± 1. Read More

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Platelet-rich Fibrin in Nonhealing Leg Ulcers: A Simple and Effective Therapeutic Option.

J Cutan Aesthet Surg 2021 Apr-Jun;14(2):160-165

Department of Dermatology, Dr Ram Manohar Lohia Hospital and Atal Bihari Vajpayee Institute of Medical Sciences, New Delhi, India.

Background: Nonhealing ulcers can occur due to a variety of causes and are associated with high morbidity, expensive, and prolonged treatment. We conducted this study to determine the efficacy of autologous platelet-rich fibrin (PRF) in nonhealing ulcers in various disorders, which is a very cost-effective and safe treatment option.

Materials And Methods: Eighteen patients with nonhealing leg ulcers were included. Read More

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September 2021

Can the adverse childhood experiences (ACEs) checklist be utilized to predict emergency department visits among children and adolescents?

BMC Med Res Methodol 2021 09 25;21(1):195. Epub 2021 Sep 25.

Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, T2N4Z6, Canada.

Background: Extensive literature has shown an association of Adverse Childhood Experiences (ACEs) with adverse health outcomes; however, its ability to predict events or stratify risks is less known. Individuals with mental illness and ACE exposure have been shown to visit emergency departments (ED) more often than those in the general population. This study thus examined the ability of the ACEs checklist to predict ED visits within the subsequent year among children and adolescents presenting to mental health clinics with pre-existing mental health issues. Read More

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September 2021

Allopurinol adherence, persistence and patterns of use in individuals with diabetes and gout: A retrospective, population-based cohort analysis.

Semin Arthritis Rheum 2021 Sep 16;51(6):1162-1169. Epub 2021 Sep 16.

Department of Medicine, University of Toronto, Toronto, ON, Canada; ICES, ON, Canada; Women's College Hospital, Women's College Research Institute, Toronto, ON, Canada.

Objective: There has been growing interest in the potential role for allopurinol to reduce cardiovascular events in people with diabetes. While adherence to allopurinol is poor in those with gout, our aim was to characterize persistence, patterns of use, and predictors of allopurinol use in a population-based cohort of individuals with diabetes and gout.

Methods: Individuals with diabetes older than 66 (thus eligible for prescription medication coverage) and newly prescribed allopurinol were followed for up to three years in a retrospective cohort study. Read More

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September 2021

Surgical versus non-surgical treatment of lateral clavicle fractures: A short-term follow-up of treatment and complications in 122 patients.

J Orthop Trauma 2021 Mar 22. Epub 2021 Mar 22.

Department of Orthopedics, Institute of Surgical Sciences, Uppsala University Hospital.

Objectives: To assess the total number of procedures in initially surgically and non-surgically treated patients with lateral clavicle fractures, and to compare patient-reported outcomes.

Design: Retrospective cohort study.

Setting: Level 1 trauma center. Read More

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Variability in estimated glomerular filtration rate and patients' outcomes in a real-world heart failure population.

ESC Heart Fail 2021 Sep 23. Epub 2021 Sep 23.

Department of Nephrology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.

Aims: The prognostic significance of renal function variability has not been fully elucidated in heart failure (HF). This multicentre, prospective cohort study aimed to evaluate the usefulness of visit-to-visit variability in estimated glomerular filtration rate (eGFR) for predicting patients' outcomes in a real-world HF population.

Methods: A total of 564 patients who had survived HF hospitalization were randomly assigned with a 2:1 ratio to derivation and validation cohorts, and they were then followed after discharge. Read More

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September 2021

Impact of Teleconsultation on Subsequent Disease Activity and Flares in Patients with Systemic Lupus Erythematosus.

Rheumatology (Oxford) 2021 Sep 23. Epub 2021 Sep 23.

Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, SINGAPORE.

Objectives: Despite the widespread adoption of teleconsultations amid the COVID-19 pandemic, its safety in systemic lupus erythematosus (SLE) patients has not been evaluated. Here, we examined subsequent disease activity and flares among SLE patients who received teleconsultation vs in-person consultation. To discern differences in physicians' prescription behavior during both forms of consultations, we compared corticosteroid dose adjustments. Read More

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September 2021

Evaluation of patient compliance with the use of scrotal cooling devices.

F S Rep 2021 Sep 30;2(3):289-295. Epub 2021 Jun 30.

Division of Urology, Department of Surgery, University of Toronto, Toronto, Ontario, Canada.

Objective: To evaluate the compliance of infertile men with the use of scrotal cooling devices. As a secondary objective, sperm parameters, deoxyribonucleic acid fragmentation, and hormone profiles were examined.

Design: This exploratory study on scrotal cooling provided scrotal cooling devices to men with primary infertility and abnormal semen parameters. Read More

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September 2021

Sperm deoxyribonucleic acid fragmentation: predictors, fertility outcomes, and assays among infertile males.

F S Rep 2021 Sep 19;2(3):282-288. Epub 2021 Jun 19.

Duke University School of Medicine, Durham, North Carolina.

Objective: To examine the factors associated with increased deoxyribonucleic acid fragmentation index (DFI), evaluate the pregnancy outcomes of men with increased DFI, and compare three independent DFI assays.

Design: Secondary analysis.

Setting: Nine US-based fertility centers. Read More

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September 2021

The Effect of Intraoperative Radiographs on Component Position and Leg Length during Routine Posterior Approach Total Hip Arthroplasty.

Hip Pelvis 2021 Sep 6;33(3):128-139. Epub 2021 Sep 6.

Department of Orthopaedic Surgery, Anderson Orthopaedic Research Institute, Alexandria, VA, USA.

Purpose: Accurate component placement and restoration of patient anatomy are critical in total hip arthroplasty (THA) surgery. Although intraoperative radiographs are sometimes utilized, it is unclear whether this practice can improve accuracy.

Materials And Methods: This study evaluated acetabular cup abduction, anteversion, leg length, and offset among 100 posterior approach THAs performed without imaging (No X-ray group) and compared them to a subsequent series of 100 THAs where an intraoperative radiograph was taken with the trial components in place (X-ray group). Read More

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September 2021

Incident Major Depressive Disorder Predicted by Three Measures of Insulin Resistance: A Dutch Cohort Study.

Am J Psychiatry 2021 Sep 23:appiajp202120101479. Epub 2021 Sep 23.

Department of Epidemiology and Population Health (Watson, Simard, Henderson), Department of Psychiatry and Behavioral Sciences (Watson, Nutkiewicz, Rasgon), and Department of Neurology and Neurological Sciences (Henderson), Stanford School of Medicine, Stanford, Calif.; Department of Psychiatry and Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit, Amsterdam (Lamers, Penninx); and Harold and Margaret Milliken Hatch Laboratory of Neuroendocrinology, Rockefeller University, New York (Nasca).

Objective: Major depressive disorder is the leading cause of disability worldwide. Yet, there remain significant challenges in predicting new cases of major depression and devising strategies to prevent the disorder. An important first step in this process is identifying risk factors for the incidence of major depression. Read More

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September 2021

A Statewide EMS Viral Syndrome Pandemic Triage Protocol: 24 Hour Outcomes.

Prehosp Emerg Care 2021 Sep 22:1-10. Epub 2021 Sep 22.

Maryland Institute for Emergency Medical Services, Baltimore, 21201 United States.

Early during the COVID-19 pandemic, Emergency Medical Services (EMS) systems encountered many challenges that prompted crisis-level strategies. Maryland's statewide EMS system implemented the which contained a decision tool to help identify patients potentially safe for self-care at home. This study assessed the effects of the and the safety of referring patients for self-care at home. Read More

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September 2021

Inpatient Outcomes Following a Return Visit to the Emergency Department: A Nationwide Cohort Study.

West J Emerg Med 2021 Aug 30;22(5):1124-1130. Epub 2021 Aug 30.

National Taiwan University Hospital, Department of Emergency Medicine, Taipei, Taiwan.

Introduction: Emergency department (ED) revisits are traditionally used to measure potential lapses in emergency care. However, recent studies on in-hospital outcomes following ED revisits have begun to challenge this notion. We aimed to examine inpatient outcomes and resource use among patients who were hospitalized following a return visit to the ED using a national database. Read More

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Use of Telemedicine to Expedite and Expand Care During COVID-19.

West J Emerg Med 2021 Aug 19;22(5):1028-1031. Epub 2021 Aug 19.

Rush University Medical Center, Department of Emergency Medicine, Chicago, Illinois.

Introduction: The novel coronavirus disease 2019 (COVID-19) created challenges with access to care including increased burden on healthcare systems and potential exposure risks for vulnerable patients. To address these needs, Rush University Medical Center created a virtual, urgent care program specifically designed to address these challenges during the COVID-19 pandemic.

Methods: This was a retrospective study analyzing adult patients with COVID-19-related telemedicine visits performed between March 1-June 30, 2020. Read More

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Variation in Diagnosis, Treatment, and Outcome of Esophageal Cancer in a Regionalized Care System in Ontario, Canada.

JAMA Netw Open 2021 Sep 1;4(9):e2126090. Epub 2021 Sep 1.

Ontario Health (Cancer Care Ontario), Toronto, Canada.

Importance: Esophageal cancer remains one of the most deadly cancers, ranking sixth highest among cancers leading to the greatest years of life lost.

Objective: To determine how patients with esophageal cancer are diagnosed and treated in Ontario's regionalized thoracic surgery centers.

Design, Setting, And Participants: This cohort study included patients diagnosed with esophageal cancer between January 1, 2010, and December 31, 2018, identified from the Ontario Cancer Registry, in a single-payer health care system with regionalization of thoracic surgery in the province of Ontario, Canada. Read More

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September 2021

Chronic Thromboembolic Pulmonary Hypertension Mimicking Acute Pulmonary Embolism: A Case Report.

Am J Case Rep 2021 Sep 21;22:e933031. Epub 2021 Sep 21.

Department of Internal Diseases, Riga Stradiņš University, Riga, Latvia.

BACKGROUND Chronic thromboembolic pulmonary hypertension (CTEPH) is a rare form of pulmonary hypertension which is often caused by recurrent emboli. The reported prevalence in Latvia is 15.7 cases per million inhabitants. Read More

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September 2021

Comparison of active versus passive audiovisual distraction tools on children's behaviour, anxiety and pain in paediatric dentistry: a randomised crossover clinical trial.

Eur J Paediatr Dent 2021 Sep;22(3):230-236

Department of Paediatric Dentistry, Universitat de Barcelona, Barcelona, Spain.

Aim: To determine the effect of active distraction when playing PlayStation® video games, compared to passive distraction when watching a cartoon with audiovisual eyeglasses, on parental perception of patients' anxiety, and children's anxiety, pain, behaviour and heart rate during restorative procedures in paediatric dentistry.

Materials And Methods: Study design: Randomised crossover clinical trial. There were 34 patients in the cartoon film group (passive distraction) and 34 in the Playstation® video game group (active distraction), aged 6-8 years, who required a minimum of 2 visits for restorative treatment. Read More

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September 2021

Home-Based Telemental Health: A Proposed Privacy and Safety Protocol and Tool.

J Child Adolesc Psychopharmacol 2021 09;31(7):464-474

Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington, USA.

To describe the development of a protocol and practical tool for the safe delivery of telemental health (TMH) services to the home. The COVID-19 pandemic forced providers to rapidly transition their outpatient practices to home-based TMH (HB-TMH) without existing protocols or tools to guide them. This experience underscored the need for a standardized privacy and safety tool as HB-TMH is expected to continue as a resource during future crises as well as to become a component of the routine mental health care landscape. Read More

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September 2021

A comprehensive framework for navigating patient care in systemic sclerosis: A global response to the need for improving the practice of diagnostic and preventive strategies in SSc.

Best Pract Res Clin Rheumatol 2021 Sep 15;35(3):101707. Epub 2021 Sep 15.

Federation of European Scleroderma Associations, Copenhagen, Denmark; Federation of European Scleroderma Associations, Budapest, Hungary; Federation of European Scleroderma Associations, London, UK.

Systemic sclerosis (SSc), the most lethal of rheumatologic conditions, is the cause of death in >50% of SSc cases, led by pulmonary fibrosis followed by pulmonary hypertension and then scleroderma renal crisis (SRC). Multiple other preventable and treatable SSc-related vascular, cardiac, gastrointestinal, nutritional and musculoskeletal complications can lead to disability and death. Vascular injury with subsequent inflammation transforming to irreversible fibrosis and permanent damage characterizes SSc. Read More

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September 2021

Predicting 30 - Day outcomes in emergency department patients discharged with COVID-19.

Am J Emerg Med 2021 Sep 2;50:513-517. Epub 2021 Sep 2.

St. Luke's University Health Network, 801 Ostrum Street, Bethlehem, PA 18015, United States. Electronic address:

Introduction: Determining disposition for COVID-19 patients can be difficult for emergency medicine clinicians. Previous studies have demonstrated risk factors which predict severe infection and mortality however little is known about which risk factors are associated with failure of outpatient management and subsequent admission for COVID-19 patients.

Methods: We conducted a retrospective observational chart review of patients who had a confirmed positive COVID-19 test collected during an ED visit between March 1, 2020 and October 11, 2020. Read More

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September 2021

Association of perioperative hypotension with subsequent greater healthcare resource utilization.

J Clin Anesth 2021 Sep 15;75:110516. Epub 2021 Sep 15.

Mayo Clinic, Department of Anesthesiology & Critical Care Medicine, 200 1st Street SW, Rochester, MN 55905, USA.

Study Objective: Determine if perioperative hypotension, a modifiable risk factor, is associated with increased postoperative healthcare resource utilization (HRU).

Design: Retrospective cohort study.

Setting: Multicenter using the Optum® electronic health record database. Read More

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September 2021

[Comparative efficacy of various methods of treatment of chronic venous oedema in real clinical practice].

Angiol Sosud Khir 2021 ;27(3):77-83

Chair of Faculty Surgery #2 of Therapeutic Department, Pirogov Russian National Research Medical University of the RF Ministry of Public Health, Moscow, Russia.

Aim: The study was aimed at assessing efficacy and safety of micronized purified flavonoid fraction (MPFF, Detralex) in comprehensive treatment of chronic venous oedema induced by lower limb varicose veins.

Patients And Methods: We performed a post hoc analysis of the results of treatment of 708 patients included into the observational programme VAP-PRO-C3 (ClinicalTrials.gov. Read More

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September 2021

Opportunity costs of attending surgical clinic appointments and experiences with telemedicine for follow-up care.

SAGE Open Med 2021 11;9:20503121211045247. Epub 2021 Sep 11.

Department of Orthopedic Surgery, University of Saskatchewan, Saskatoon, SK, Canada.

Objectives: Telemedicine has been rapidly implemented in orthopedics during the coronavirus (COVID-19) pandemic. The purpose of this study was to quantify opportunity costs for patients attending typical in-person appointments and understand their perceptions of telemedicine for follow-up care.

Methods: A cross-sectional study was performed by surveying patients who had elective orthopedic surgery and attended at least one in-person and one phone call appointment. Read More

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September 2021

Generalized Anxiety Disorder 7-Item (GAD-7) Scores in Medically Authorized Cannabis Patients-Ontario and Alberta, Canada.

Can J Psychiatry 2021 Sep 14:7067437211043393. Epub 2021 Sep 14.

70411School of Public Health, 12357University of Alberta, Edmonton, Alberta, Canada.

Objectives: Despite increasing rates of legalization of medical cannabis worldwide, the current evidence available on its effect on mental health outcomes including anxiety is of mixed results. This study assesses the effect of medical cannabis on generalized anxiety disorder 7-item (GAD-7) scores in adult patients between 2014 and 2019 in Ontario and Alberta, Canada.

Methods: An observational cohort study of adults authorized to use medical cannabis. Read More

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September 2021

Do we have good activity indices in systemic sclerosis?

Curr Rheumatol Rev 2021 Sep 12. Epub 2021 Sep 12.

Carol Davila University of Medicine and Pharmacy, Bucharest. Romania.

Background: No fully validated index is available for assessing overall disease activity in systemic sclerosis (SSc).

Objectives: To estimate the effect of disease activity as measured by different disease activity indices on the risk of subsequent organ damage.

Methods: The European Systemic sclerosis study group activity index (EScSG AI), the European Scleroderma Trials and Research Group Activity Index (r-EUSTAR AI), 12 point activity index proposed by Minier (12point AI) were calculated for 91 patients; the CRISS (The Composite Response Index for Systemic Sclerosis) for patients included after 2016. Read More

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September 2021

Effects of on-treatment ALT flares on serum HBsAg and HBV RNA in patients with chronic HBV infection.

J Viral Hepat 2021 Sep 12. Epub 2021 Sep 12.

Toronto Centre for Liver Disease, University Health Network, Toronto, ON, Canada.

As pegylated interferon-alpha (PEG-IFN-α) is increasingly used in combination regimens of novel drugs, we aimed to characterize ALT flares and their relationship with serum HBsAg and HBV RNA kinetics in a large, combined cohort of chronic hepatitis B (CHB) patients on PEG-IFN-α-based therapy. In this post hoc analysis of four international randomized trials, 269/130/124/128 patients on PEG-IFN-α monotherapy, PEG-IFN-α plus nucleos(t)ide analogue (NA) de novo combination, PEG-IFN-α add-on to NA, or NA monotherapy were included, respectively. A flare was defined as an episode of ALT ≥5×ULN. Read More

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September 2021

Brief Report: Are Serious Falls Associated With Subsequent Fragility Fractures Among Veterans Living With HIV?

J Acquir Immune Defic Syndr 2021 Oct;88(2):192-196

VA Connecticut Healthcare System, West Haven, CT.

Background: The extensive research on falls and fragility fractures among persons living with HIV (PWH) has not explored the association between serious falls and subsequent fragility fracture. We explored this association.

Setting: Veterans Aging Cohort Study. Read More

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October 2021

Heavy clinical and economic burden of osteoporotic fracture among elderly female Medicare beneficiaries.

Osteoporos Int 2021 Sep 10. Epub 2021 Sep 10.

Amgen Inc., Thousand Oaks, CA, USA.

We comprehensively described elderly Medicare women with an outpatient visit in 2011 and fracture within 2 years before. These women were at very high risk for subsequent fracture and high healthcare utilization and cost, especially those with vertebral or multiple fractures. However, rates of fracture prevention treatments were low. Read More

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September 2021

Psychophysiological Markers of Performance and Learning during Simulated Marksmanship in Immersive Virtual Reality.

J Cogn Neurosci 2021 Jun;33(7):1253-1270

Duke University School of Medicine.

The fusion of immersive virtual reality, kinematic movement tracking, and EEG offers a powerful test bed for naturalistic neuroscience research. Here, we combined these elements to investigate the neuro-behavioral mechanisms underlying precision visual-motor control as 20 participants completed a three-visit, visual-motor, coincidence-anticipation task, modeled after Olympic Trap Shooting and performed in immersive and interactive virtual reality. Analyses of the kinematic metrics demonstrated learning of more efficient movements with significantly faster hand RTs, earlier trigger response times, and higher spatial precision, leading to an average of 13% improvement in shot scores across the visits. Read More

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