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Trends, Predictors and Outcomes of Ischemic Stroke Among Patients Hospitalized with Takotsubo Cardiomyopathy.

J Stroke Cerebrovasc Dis 2021 Jul 28;30(10):106005. Epub 2021 Jul 28.

Department of Medicine, Morehouse School of Medicine, 720 Westview Drive S.W., Atlanta, GA 30310, United States. Electronic address:

Objectives: This study assessed the temporal trends in the incidence of ischemic stroke among patients hospitalized with takotsubo cardiomyopathy (TCM) stratified by the subtypes of ischemic stroke (cardioembolic versus thrombotic).Predictors of each stroke subtype, the association with atrial fibrillation (AF), the occurrence of ventricular fibrillation/ventricular tachycardia (VF/VT),cardiogenic shock (CS), in-hospital mortality, length of stay (LOS), and total healthcare cost were also assessed.

Background: Ischemic stroke in TCM is thought to be primarily cardioembolic from left ventricular mural thromboembolism. Read More

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Are oral lichen planus patients at high risk of hepatitis C? A case-control study.

J Stomatol Oral Maxillofac Surg 2021 Jul 28. Epub 2021 Jul 28.

Department of Oral and Maxillofacial Surgery, University Hospital of Giessen and Marburg, UKGM GmbH, Campus Marburg, Faculty of Medicine, Philipps-University of Marburg, Marburg, Germany.

Objective: To assess the correlation between oral lichen planus (OLP) and viral hepatitis C (HCV).

Methods: This retrospective case-control study included a sample of OLP patients in a 3-year interval. The predictor variable was the presence of OLP (yes/no). Read More

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Maternal immune activation leads to atypical turning asymmetry and reduced DRD2 mRNA expression in a rat model of schizophrenia.

Behav Brain Res 2021 Jul 28:113504. Epub 2021 Jul 28.

Division of Experimental and Molecular Psychiatry, Department of Psychiatry, Psychotherapy and Preventive Medicine, LWL University Hospital, Ruhr-University Bochum, Germany. Electronic address:

Atypical asymmetries have been reported in individuals diagnosed with schizophrenia, linking higher symptom severity to weaker lateralization. Furthermore, both lateralization and schizophrenia are influenced by the dopaminergic system. However, whether a direct link between the etiology of schizophrenia and atypical asymmetries exists is yet to be investigated. Read More

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Evaluation of a SARS-CoV-2 antigen-detecting rapid diagnostic test as a self-test: diagnostic performance and usability.

J Med Virol 2021 Jul 31. Epub 2021 Jul 31.

Centre hospitalier régional d'Orléans, service des maladies infectieuses et tropicales, Orléans.

In order to control the spread of the COVID-19 epidemics, it is necessary to have easy-to-use, reliable diagnostic tests available. The nasopharyngeal sampling method being often uncomfortable, nasal sampling could prove to be a viable alternative to the reference sampling method. We performed a multicentre, prospective validation study of the COVID-VIRO test, using a nasal swab sampling method, in a point-of-care setting. Read More

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Cyclothymic Temperament is Associated with Poor Medication Adherence and Disordered Eating in Type 2 Diabetes Patients: A Case-Control Study.

Diabetes Ther 2021 Jul 31. Epub 2021 Jul 31.

Division of Diabetes, Endocrinology and Metabolism, Department of Medicine, Kimitsu Chuo Hospital, Sakurai 1010, Kisarazu, Chiba, 292-0822, Japan.

Introduction: Poor medication adherence and disordered eating are major self-care problems in patients with type 2 diabetes that worsen glycemic control and increase the risk of developing severe diabetes complications. Affective temperament, which remains mostly unchanged throughout life, is speculated to predict poor treatment response and high comorbidity. The aim of this study was to explore the link between affective temperament and poor glycemic control due to insufficient self-care. Read More

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Serological prevalence and risk factors of Toxoplasma gondii in Zoo Mammals in Chile.

Prev Vet Med 2021 Jul 24;194:105445. Epub 2021 Jul 24.

Laboratory of Parasitology and Parasitic Diseases, Department of Preventive Veterinary Medicine, Faculty of Veterinary Medicine and Livestock Sciences, Universidad de Chile, Santa Rosa 11.735, La Pintana, Santiago, Chile. Electronic address:

Toxoplasma gondii is a zoonotic cosmopolitan protozoan that causes a high mortality rate among zoo mammals such as New World primates, meerkats, marsupials and Pallas' cat. It has been recently reported in Chile, mainly among wild populations, but also as the cause of death of a kangaroo and a mara. However, there has not been a T. Read More

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Social Determinants of Health Needs and Pediatric Health Care Use.

J Pediatr 2021 Jul 27. Epub 2021 Jul 27.

Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH USA; The Ohio State University College of Medicine, Department of Pediatrics, and College of Nursing, and College of Public Health, Columbus, OH USA.

Objective: To examine the associations between family-reported social needs in primary care settings and pediatric health care use.

Study Design: Data were used from a sample of 56,253 children (ages 0-21) who received primary care at a large hospital-based pediatric institution between June 2018 and October 2019 to estimate a propensity score for the probability of being seen in a primary care clinic. Inverse probability weighted regression specifications were used to understand the associations between reported social needs and health care use. Read More

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Effectiveness of drug safety measures for reducing the incidence of adverse drug reactions: Post-hoc analysis of data from all-case surveillance of iguratimod using generalized estimating equations.

PLoS One 2021 30;16(7):e0253513. Epub 2021 Jul 30.

Clinical Planning and Development Department, Medical HQ, Eisai Co., Ltd., Tokyo, Japan.

A post-marketing study was performed on all patients who had started treatment with iguratimod, a conventional synthetic disease-modifying antirheumatic drug approved in Japan. During the study period, various safety measures were implemented to reduce risks. We investigated the frequency of adverse drug reactions before and after implementation of each safety measure to examine the preventive effect of these measures. Read More

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Comparison of PROMIS Computerized Adaptive Testing versus Fixed Short Forms in Juvenile Myositis.

Arthritis Care Res (Hoboken) 2021 Jul 30. Epub 2021 Jul 30.

Division of Pediatric Rheumatology, Department of Pediatrics, Duke University School of Medicine, Durham, NC, USA.

Objective: Patient-Reported Outcomes Measurement Information System (PROMIS ) measures can be administered via computerized adaptive testing (CAT) or fixed short forms (FSF), but the empirical benefits of CAT versus FSF are unknown in juvenile myositis (JM). This study assesses if PROMIS CAT is feasible, precise, correlated with FSF, and less prone to respondent burden and floor/ceiling effects than FSF in JM.

Methods: Patients 8-17 yo (self-report and parent proxy) and parents of patients 5-7 yo (only parent proxy) completed PROMIS Fatigue, Pain Interference, Upper Extremity Function, Mobility, Anxiety and Depressive Symptoms measures. Read More

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Email Patient-Provider Communication and Cancer Screenings Among US Adults: Cross-sectional Study.

JMIR Cancer 2021 Jul 30;7(3):e23790. Epub 2021 Jul 30.

Center for Health Promotion and Prevention Research, Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, Dallas, TX, United States.

Background: The growth of electronic medical records and use of patient portals have allowed for patients and health care providers to communicate via email and direct messaging between health care visits. Email patient-provider communication (PPC) may enhance traditional face-to-face PPC by allowing patients to ask questions, receive clear explanations, engage in shared decision-making, and confirm their understanding between in-person visits. Despite increasing trends in the use of email PPC since the early 2000s, few studies have evaluated associations between email PPC and the uptake of preventive services. Read More

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Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med 2021 Jun;29(Special Issue):763-767

Moscow State University of Humanities and Economics, 107150, Moscow, Russia.

The article presents the results of a study aimed at identifying the problems of maintaining a healthy lifestyle in the context of the COVID-19 pandemic. The results of the study showed that not only people of older age groups are infected, but also young people with chronic diseases. Forced isolation, uncertainty of the future and stress have significantly worsened the physical, social and mental health of the population of all age groups. Read More

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Measuring the quality of dental care among privately insured children in the United States.

Health Serv Res 2021 Jul 29. Epub 2021 Jul 29.

Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA.

Objective: To examine whether quality of dental care varies by age and over time and whether community-level characteristics explain these patterns.

Data Source: Deidentified medical and dental claims from a commercial insurer from January 2015 to December 2019.

Study Design: A retrospective cohort study. Read More

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Risk assessment and disease burden of legionella presence in cooling towers of Iran's central hospitals.

Environ Sci Pollut Res Int 2021 Jul 29. Epub 2021 Jul 29.

Department of Environmental Health Engineering, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran.

Regular monitoring and measurement of Legionella in tower water and preventive measures against contamination are particularly important in hospitals. This study aimed at risk assessment and disease burden because of legionella presence in cooling towers of Iran's central hospitals. Then its correlation with temperature, pH, turbidity, residual chlorine, and EC was investigated by the Pearson test. Read More

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Geographic variations in lipid-lowering therapy utilization, LDL-C levels, and proportion retrospectively meeting the ACC/AHA very high-risk criteria in a real-world population of patients with major atherosclerotic cardiovascular disease events in the United States.

Am J Prev Cardiol 2021 Jun 30;6:100177. Epub 2021 Mar 30.

IQVIA, Plymouth Meeting, PA USA.

Objective: We assessed national- and state-level geographic variations among patients with a history of ≥1 major atherosclerotic cardiovascular disease (ASCVD) event in: (1) the proportion of patients with retrospectively identified 2018 American College of Cardiology/American Heart Association guideline very high-risk (VHR) ASCVD criteria; (2) utilization of guideline-directed lipid-lowering therapy (LLT); and (3) the proportion of patients with persistent low-density lipoprotein cholesterol (LDL-C) elevations despite statin and/or ezetimibe use.

Methods: A retrospective cohort study using the Prognos LDL-C database linked to IQVIA longitudinal medical and prescription claims databases. The study period was from January 01, 2011, to November 30, 2019 and the index period was from January 01, 2016, to November 30, 2019; the index date was defined as the most recent LDL-C test during the index period. Read More

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County-level phenomapping to identify disparities in cardiovascular outcomes: An unsupervised clustering analysis: Short title: Unsupervised clustering of counties and risk of cardiovascular mortality.

Am J Prev Cardiol 2020 Dec 20;4:100118. Epub 2020 Nov 20.

Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA.

Introduction: Significant heterogeneity in cardiovascular disease (CVD) risk and healthcare resource allocation has been demonstrated in the United States, but optimal methods to capture heterogeneity in county-level characteristics that contribute to CVD mortality differences are unclear. We evaluated the feasibility of unsupervised machine learning (ML)-based phenomapping in identifying subgroups of county-level social and demographic risk factors with differential CVD outcomes.

Methods: We performed a cross-sectional study using county-level data from 2008 to 2018 from the Centers for Disease Control (CDC) WONDER platform and the 2020 Robert Wood Johnson County Health Rankings program. Read More

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December 2020

Same evidence, varying viewpoints: Three questions illustrating important differences between United States and European cholesterol guideline recommendations.

Am J Prev Cardiol 2020 Dec 13;4:100117. Epub 2020 Nov 13.

The Ciccarone Center for the Prevention of Cardiovascular Disease, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.

In 2018, the AHA/ACC Multisociety Guideline on the Management of Blood Cholesterol was released. Less than one year later, the 2019 ESC/EAS Dyslipidemia Guideline was published. While both provide important recommendations for managing atherosclerotic cardiovascular disease (ASCVD) risk through lipid management, differences exist. Read More

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December 2020

The risk of cardiometabolic disorders in lean non-alcoholic fatty liver disease: A longitudinal study.

Am J Prev Cardiol 2020 Dec 20;4:100097. Epub 2020 Oct 20.

Houston Methodist, Debakey Heart and Vascular Institute, Houston, TX, USA.

Background: Recent studies suggest that non-alcoholic fatty liver disease (NAFLD) in lean (BMI<25 ​kg/m) individuals presents a distinct phenotype. We sought to determine the cardiometabolic consequences of lean NAFLD in a population cohort of relatively young asymptomatic individuals who participated in a voluntary routine health promotion evaluation in Brazil.

Methods: We analyzed data in our population collected from 2004 to 2016. Read More

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December 2020

Medical Internet of Things to Realize Elderly Stroke Prevention and Nursing Management.

J Healthc Eng 2021 6;2021:9989602. Epub 2021 Jul 6.

School of Nursing Jinzhou Medical University, Jinzhou, Liaoning 121000, China.

Stroke is a major disease that seriously endangers the lives and health of middle-aged and elderly people in our country, but its implementation of secondary prevention needs to be improved urgently. The application of IoT technology in home health monitoring and telemedicine, as well as the popularization of cloud computing, contributes to the early identification of ischemic stroke and provides intelligent, humanized, and preventive medical and health services for patients at high risk of stroke. This article clarifies the networking structure and networking objects of the rehabilitation system Internet of Things, clarifies the functions of each part, and establishes an overall system architecture based on smart medical care; the design and optimization of the mechanical part of the stroke rehabilitation robot are carried out, as well as kinematics and dynamic analysis. Read More

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Comparative Evaluation of Quality of Obturation and Its Effect on Postoperative Pain between Pediatric Hand and Rotary Files: A Double-blinded Randomized Controlled Trial.

Int J Clin Pediatr Dent 2021 Jan-Feb;14(1):88-96

Department of Paediatric and Preventive Dentistry, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Chennai, Tamil Nadu, India.

Background: One of the cardinal points to be considered during endodontic procedures in children is the measure of postoperative pain.

Aim And Objective: To evaluate the quality of obturation and its effect on postoperative pain with three file systems in primary mandibular molars during 1 week follow-up.

Materials And Methods: The study was conducted as a double-blinded randomized controlled trial. Read More

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Effectiveness of Sealants Treatment in Permanent Molars: A Longitudinal Study.

Int J Clin Pediatr Dent 2021 Jan-Feb;14(1):41-45

Department of Innovative Technologies in Medicine and Dentistry, University "Gabriele D'Annunzio" Chieti, Italy.

Background: Our study gives a clear result about sealants treatment in preventing dental caries manifestation and reducing its prevalence in children aged 6-11 years old.

Aim And Objective: This study aims to compare and evaluate the progress of dental caries in the first and second permanent molars and also to evaluate, within a period of 24 months, the clinical effects of dental sealants, used in the treatment of occlusive cavities, among children 6-11 years old.

Materials And Methods: Participants: The overall sample was composed of 120 children, to whom we randomly chose 480 posterior teeth, which were divided into two groups. Read More

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Comparison of Clinical and Radiographic Success of Rotary with Manual Instrumentation Techniques in Primary Teeth: A Systematic Review.

Int J Clin Pediatr Dent 2021 Jan-Feb;14(1):8-13

Department of Pediatric and Preventive Dentistry, KSR Institute of Dental Science and Research, Tiruchengode, Namakkal, Tamil Nadu, India.

Aim And Objective: A systematic review was planned to compare the clinical and radiographic success rate of pulpectomy in primary molars using a rotary system and hand files system.

Study Design: The literature search was undertaken in electronic databases from January 2000 to December 2019 using keywords. Four hundred and forty-two studies were identified after applying limits. Read More

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Indirect Effects of the Family Check-Up on Youth Extracurricular Involvement at School-Age through Improvements in Maternal Positive Behavior Support in Early Childhood.

Soc Dev 2021 Feb 15;30(1):311-328. Epub 2020 Jul 15.

University of Pittsburgh.

Extracurricular involvement in the school-age years has widespread potential benefits for children's subsequent socioemotional development, especially for low-income youth. However, there is a dearth of research on interventions aimed at increasing school-age extracurricular involvement in low-income youth. Thus, the present study aimed to test the collateral effect of a brief, family-focused intervention for low-income families, the Family Check-Up, on children's school-age extracurricular involvement via improvements in maternal Positive Behavior Support in early childhood. Read More

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February 2021

Impact of SARS-CoV-2 on training and mental well-being of surgical gynecological oncology trainees.

Int J Gynecol Cancer 2021 Jul 29. Epub 2021 Jul 29.

Department of Gynaecological Oncology, Barts and The London NHS Trust, London, UK

Introduction: The SARS-CoV-2 global pandemic has caused a crisis disrupting health systems worldwide. While efforts are being made to determine the extent of the disruption, the impact on gynecological oncology trainees/training has not been explored. We conducted an international survey of the impact of SARS-CoV-2 on clinical practice, medical education, and mental well-being of surgical gynecological oncology trainees. Read More

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HARMONY: a pragmatic cluster randomised controlled trial of a culturally competent systems intervention to prevent and reduce domestic violence among migrant and refugee families in general practice: study protocol.

BMJ Open 2021 Jul 29;11(7):e046431. Epub 2021 Jul 29.

Centre for Academic Primary Care, Bristol Medical School, University of Bristol, Bristol, UK.

Introduction: Domestic violence and abuse (DVA) is prevalent, harmful and more dangerous among diaspora communities because of the difficulty accessing DVA services, language and migration issues. Consequently, migrant/refugee women are common among primary care populations, but evidence for culturally competent DVA primary care practice is negligible. This pragmatic cluster randomised controlled trial aims to increase DVA identification and referral (primary outcomes) threefold and safety planning (secondary outcome) among diverse women attending intervention vs comparison primary care clinics. Read More

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Early effects of the COVID-19 pandemic on fertility preferences in the United States: an exploratory study.

Fertil Steril 2021 Jul 26. Epub 2021 Jul 26.

Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California; Department of Psychology, University of Southern California, Los Angeles, California.

Objective: To explore early disparate impacts of the COVID-19 pandemic on fertility preferences DESIGN: Cross-sectional study SETTING: Online survey questionnaire PATIENT(S): A total of 440 female participants who were trying to conceive (TTC) in the past year or currently are TTC.

Intervention(s): No interventions administered.

Main Outcome Measure(s): Change in fertility preference RESULT(S): Approximately 1 in 3 participants reported changing their fertility preferences because of the COVID-19 pandemic. Read More

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Efficient methods for acute stress detection using heart rate variability data from Ambient Assisted Living sensors.

Biomed Eng Online 2021 Jul 29;20(1):73. Epub 2021 Jul 29.

Cardiac Rehabilitation Institute of the Military Hospital, Balatonfüred, Hungary.

Background: Using Ambient Assisted Living sensors to detect acute stress could help people mitigate the harmful effects of everyday stressful situations. This would help both the healthy and those affected more by sudden stressors, e.g. Read More

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Evaluating preferences for colorectal cancer screening in individuals under age 50 using the Analytic Hierarchy Process.

BMC Health Serv Res 2021 Jul 29;21(1):754. Epub 2021 Jul 29.

Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park, USA.

Background: In 2021, the United States Preventive Services Task Force updated their recommendation, stating that individuals ages 45-49 should initiate screening for colorectal cancer. Since several screening strategies are recommended, making a shared decision involves including an individual's preferences. Few studies have included individuals under age 50. Read More

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Overtreatment in nonmalignant lesions detected in a colorectal cancer screening program: a retrospective cohort study.

BMC Cancer 2021 Jul 29;21(1):869. Epub 2021 Jul 29.

Dirección Xeral de Saúde Pública, Conselleria de Sanidade, Santiago de Compostela, Spain.

Background: Although colorectal cancer (CRC) screening programs reduce CRC incidence and mortality, they are associated with risks in healthy subjects. However, the risk of overtreatment and overdiagnosis has not been determined yet. The aim of this study was to report the surgery rates in patients with nonmalignant lesions detected within the first round of a fecal immunochemical test (FIT) based CRC screening program and the factors associated with it. Read More

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Efficacy and safety of fremanezumab for chronic migraine prevention: Multicenter, randomized, double-blind, placebo-controlled, parallel-group trial in Japanese and Korean patients.

Headache 2021 Jul 29. Epub 2021 Jul 29.

Medical Affairs, Otsuka Pharmaceutical Co., Ltd., Tokushima, Japan.

Objective: To determine the efficacy and safety of fremanezumab administration in Japanese and Korean patients with chronic migraine (CM).

Background: Available preventive treatments for CM are limited by various efficacy and safety issues. Fremanezumab, a monoclonal antibody that targets the calcitonin gene-related peptide pathway involved in migraine pathogenesis, has been shown to be effective and well tolerated in large-scale, international Phase 3 trials. Read More

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Target product profile for a dengue pre-vaccination screening test.

PLoS Negl Trop Dis 2021 Jul 29;15(7):e0009557. Epub 2021 Jul 29.

International Diagnostics Centre, Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, United Kingdom.

With increasing geographic spread, frequency, and magnitude of outbreaks, dengue continues to pose a major public health threat worldwide. Dengvaxia, a dengue live-attenuated tetravalent vaccine, was licensed in 2015, but post hoc analyses of long-term data showed serostatus-dependent vaccine performance with an excess risk of hospitalized and severe dengue in seronegative vaccine recipients. The World Health Organization (WHO) recommended that only persons with evidence of past dengue infection should receive the vaccine. Read More

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