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Pre-sleep cognitive arousal exacerbates sleep disturbance in chronic pain: an exploratory daily diary and actigraphy study.

Scand J Pain 2021 Jun 14. Epub 2021 Jun 14.

Department of Psychological Medicine, The University of Auckland, Auckland, New Zealand.

Objectives: Insomnia is commonly comorbid with chronic pain, and typically leads to worse outcomes. Two factors that could contribute to a cycle of pain and sleeplessness are pre-sleep cognitive arousal (repetitive thought processes) and low mood. This study aimed to examine how pain, sleep disturbance, mood, and pre-sleep cognitive arousal inter-relate, to determine whether low mood or pre-sleep cognitive arousal contribute to a vicious cycle of pain and insomnia. Read More

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Evaluation of avascular necrosis risk factors after closed reduction for developmental dysplasia of the hip before walking age.

J Pediatr Orthop B 2021 Jun 9. Epub 2021 Jun 9.

Department of Orthopaedics and Traumatology Department of Radiology, Harran University Faculty of Medicine, Şanliurfa/Turkey Department of Orthopaedics and Traumatology, Dr. Sami Ulus Maternity and Child Health Training and Research Hospital, Ankara/Turkey.

Avascular necrosis (AVN) of the femoral head is one of the most important complications after closed reduction and spica cast application in developmental dysplasia of the hip (DDH) treatment. This study aims to put forth the impact of closed reduction age and other factors which can cause AVN. Inclusion criteria of the study were: closed reduction and spica cast application before walking age (12 months) and minimum 2 years duration of follow-up. Read More

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Pediatric Ocular Injury Due to Hand Sanitizer Exposure An Emerging Hazard.

Pediatr Emerg Care 2021 Jun 11. Epub 2021 Jun 11.

From the Department of Ophthalmology, Shaare Zedek Medical Center, Jerusalem Edmond and Lily Safra Children's Hospital, Chaim Sheba Medical Center, Tel Hashomer Pediatric Emergency Medicine, Shaare Zedek Medical Center, Jerusalem, Israel.

Objectives: The objective of this study was to describe the incidence and severity of ocular exposure to alcohol-based hand rub (ABHR) in children presenting to a tertiary medical center during the severe acute respiratory syndrome coronavirus 2 pandemic.

Methods: A retrospective single-center observational study conducted from February 21, 2020, to October 11, 2020. Subjects 10 years or younger who presented with ABHR-induced ocular injury were included. Read More

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Reappearance of Neurological Deficits in Pathologic Brain: Are Sedatives and Opioids Culprits? A Systematic Review.

J Neurosurg Anesthesiol 2021 Jun 10. Epub 2021 Jun 10.

Faculty of Medicine, University of Ottawa Department of Anesthesiology and Pain Medicine, Toronto Western Hospital, University Health Network, Toronto, ON Section Intervention Neuroradiology, Department of Radiology, University of Manitoba, Winnipeg, MB, Canada Department of Pathology, Institute of Cardiovascular Physiopathology, University of Buenos Aires, Buenos Aires, Argentina.

Following a brain insult, focal neurological deficits may develop. Despite resolution of these deficits with time, the subsequent administration of sedative medications and opioids may lead to recrudescence of previous neurological deficits. Therefore, the present systematic review aims to explore the role of different sedatives and opioid analgesics at reproducing focal neurological deficits in patients with previous brain insults undergoing surgery. Read More

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Inches, Centimeters, and Yards: Overlooked Definition Choices Inhibit Interpretation of Morphine Equivalence.

Clin J Pain 2021 Jun 11. Epub 2021 Jun 11.

Injury Prevention Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA Department of Health Outcomes & Biomedical Informatics, University of Florida College of Medicine, Gainesville, Florida, USA Institute for Pharmaceutical Outcomes & Policy, University of Kentucky College of Pharmacy, Lexington, Kentucky, USA Department of Pharmacy Practice and Science, University of Kentucky College of Pharmacy, Lexington, Kentucky, USA Division of Pharmaceutical Outcomes and Policy, University of North Carolina School of Pharmacy, Chapel Hill, North Carolina, USA Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA UNC Hospitals Pain Management Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA Department of Anesthesiology, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA.

Objective: Morphine-standardized doses are used in clinical practice and research to account for molecular potency. 90 milligrams of morphine equivalents (MME) per day are considered a "high dose" risk threshold in guidelines, laws, and by payers. Although ubiquitously cited, the "CDC definition" of daily MME lacks a clearly defined denominator. Read More

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Corneal Allograft Rejection Associated With Herpes Zoster Recombinant Adjuvanted Vaccine.

Authors:
Alice Matoba

Cornea 2021 Jun 9. Epub 2021 Jun 9.

Department of Ophthalmology, Baylor College of Medicine, Houston, TX.

Purpose: The purpose of this article is to report 3 cases of corneal allograft rejection that occurred in temporal proximity to administration of the zoster subunit vaccine (RZV).

Methods: Three cases of corneal transplant rejection that developed after RZV administration were identified. Clinical history, including existence of other risk factors, timing of rejection, corticosteroid therapy at the time of onset of rejection, and course were reviewed. Read More

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Predictors of progression in radiation-induced versus nonradiation-induced pediatric meningiomas: a large single-institution surgical experience.

J Neurosurg Pediatr 2021 Jun 11:1-7. Epub 2021 Jun 11.

1Department of Neurosurgery, Boston Children's Hospital.

Objective: The goal in this study was to outline unique differences between radiation-induced and nonradiation-induced pediatric meningiomas and to identify independent risk factors of tumor recurrence/progression.

Methods: This is a retrospective cohort study of all pediatric meningiomas diagnosed and surgically treated at the authors' institution between 1993 and 2017. Multivariable Cox regression was applied to identify independent risk factors for tumor recurrence/progression. Read More

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Retrosigmoid transhorizontal fissure approach to lateral pontine cavernous malformation: comparison to transpetrosal presigmoid retrolabyrinthine approach.

J Neurosurg 2021 Jun 11:1-10. Epub 2021 Jun 11.

Objective: The retrosigmoid (RS) approach is a classic route used to access deep-seated brainstem cavernous malformation (CM). The angle of access is limited, so alternatives such as the transpetrosal presigmoid retrolabyrinthine (TPPR) approach have been used to overcome this limitation. Here, the authors evaluated a modification to the RS approach, horizontal fissure dissection by using the RS transhorizontal (RSTH) approach. Read More

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Clinical management of patients with thymic epithelial tumors: the recommendations endorsed by the Italian Association of Medical Oncology (AIOM).

ESMO Open 2021 Jun 8;6(4):100188. Epub 2021 Jun 8.

Division of Medical Oncology for Melanoma, Sarcoma, and Rare Tumors, Istituto Europeo di Oncologia, IRCCS, Milan, Italy.

The Italian Association of Medical Oncology recommendations on thymic epithelial tumors, which have been drawn up for the first time in 2020 through an evidence-based approach, report indications on all the main aspects of clinical management of this group of rare diseases, from diagnosis and staging, to new available systemic treatments, such as targeted therapies and immunotherapies. A summary of key recommendations is presented here and complete recommendations are reported as Supplementary Materials, available at https://doi.org/10. Read More

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In-Hospital Acute Ischemic Stroke is Associated with Worse Outcome: Experience of a Single Center in Santiago Chile.

J Stroke Cerebrovasc Dis 2021 Jun 8;30(8):105894. Epub 2021 Jun 8.

Unidad de Neurología Vascular, Servicio de Neurología, Departamento de Neurología y Psiquiatría, Clínica Alemana de Santiago, Facultad de Medicina, Clínica Alemana Universidad del Desarrollo, Chile; Unidad de Neurología Vascular, Servicio de Neurología, Departamento de Neurología y Psiquiatría y Departamento de Paciente Critico, Clínica Alemana de Santiago, Facultad de Medicina Clínica Alemana Universidad del Desarrollo, Santiago, Chile.

Objectives: In-hospital acute ischemic stroke (HIS) accounts for 2-17% of all acute ischemic strokes (AIS) seen in hospital and they have worse prognosis. In this study we aimed to identify the frequency of HIS and their characteristics in our center.

Materials And Methods: Retrospective analysis of a prospective register of patients with AIS seen at Clínica Alemana de Santiago, between January 2017 and January 2019. Read More

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Exploration of the potential roles of m6A regulators in the uterus in pregnancy and infertility.

J Reprod Immunol 2021 Jun 2;146:103341. Epub 2021 Jun 2.

Laboratory of Neurobiology, College of Veterinary Medicine, China Agricultural University, Beijing, Haidian, 100193, People's Republic of China; Key Laboratory of Precision Nutrition and Food Quality, Ministry of Education, China Agricultural University, Beijing, Haidian, 100193, People's Republic of China. Electronic address:

Infertility is a prevalent female reproductive disease worldwide. Currently, there are many unknown etiologies of infertility. N6-methyladenosine (m6A) is the most prevalent modification of eukaryotic mRNA. Read More

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Relapses add to permanent disability in relapsing multiple sclerosis patients.

Mult Scler Relat Disord 2021 May 17;53:103029. Epub 2021 May 17.

The Danish Multiple Sclerosis Registry, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark; The Danish Multiple Sclerosis Center, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark. Electronic address:

Objective: Whether relapses have direct effects on permanent disability in multiple sclerosis is still an unsettled issue. We aimed at investigating the cumulative effect of breakthrough relapses on the Expanded Disability Status Scale (EDSS) in relapsing-onset MS patients under disease modifying therapy (DMT).

Methods: From the Danish Multiple Sclerosis Registry we identified all patients in Denmark with relapsing-onset MS who had started DMT and followed them from the first day of treatment. Read More

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Evaluation of IGF-1 as a novel theranostic biomarker for schizophrenia.

J Psychiatr Res 2021 Jun 2;140:172-179. Epub 2021 Jun 2.

Department of Psychiatry, Bakirkoy Prof Mazhar Osman Training and Research Hospital for Psychiatry, Neurology, and Neurosurgery, Istanbul, Turkey.

Objective: In the current study, we aimed to investigate fasting plasma levels of glucose, insulin, growth hormone, IGF-1, and lipid profile in remission schizophrenia patients, treatment resistant schizophrenia patients and healthy controls and to determine whether IGF-1 levels can be used as a theranostic biomarker in schizophrenia.

Methods: Sixty-two patients under remission from schizophrenia, sixty-five treatment-resistant patients with schizophrenia and sixty-two healthy controls were included in the study. All patients were recruited and evaluated over 11 months. Read More

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A Fast-track Pathway for Emergency General Surgery at an Academic Medical Center.

J Surg Res 2021 Jun 8;267:1-8. Epub 2021 Jun 8.

Department of Surgery, University of Massachusetts Medical School, Worcester, Massachusetts. Electronic address:

Background: Fast Track Pathways (FTP) directed at reducing length of stay (LOS) and overall costs are being increasingly implemented for emergency surgeries. The purpose of this study is to evaluate implementation of a FTP for Emergency General Surgery (EGS) at an academic medical center (AMC).

Methods: The study included 165 patients at an AMC between 2016 and 2018 who underwent laparoscopic appendectomy (LA), laparoscopic cholecystectomy (LC), or laparoscopic inguinal hernia repair (LI). Read More

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Evaluation of fully automated a priori MCO treatment planning in VMAT for head-and-neck cancer.

Phys Med 2021 Jun 8;87:31-38. Epub 2021 Jun 8.

Centre Léon Bérard, 28 rue Laennec 69373, LYON Cedex 08, France.

Purpose: Automated planning techniques aim to reduce manual planning time and inter-operator variability without compromising the plan quality which is particularly challenging for head-and-neck (HN) cancer radiotherapy. The objective of this study was to evaluate the performance of an a priori-multicriteria plan optimization algorithm on a cohort of HN patients.

Methods: A total of 14 nasopharyngeal carcinoma (upper-HN) and 14 "middle-lower indications" (lower-HN) previously treated in our institution were enrolled in this study. Read More

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Clinical evaluation of in-office tooth whitening with violet LED (405 nm): A double-blind randomized controlled clinical trial.

Photodiagnosis Photodyn Ther 2021 Jun 8:102385. Epub 2021 Jun 8.

Postgraduate Program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho, UNINOVE, São Paulo, Brazil. Electronic address:

Background: Although there is little evidence showing the effectiveness of violet LED on in-office tooth whitening, there are some studies which have reported satisfactory results. This double-blind randomized controlled clinical trial aimed to evaluate the effect of a violet light emission diode (LED) (405nm) system, used in-office, on tooth whitening, sensitivity, use of medication after whitening and quality of life.

Methods: Eight patients were randomized into 4 groups (n = 20): G1 - violet LED, G2 - 35% carbamide peroxide (CP) and violet LED, G3 only CP 35% and G4 35% hydrogen peroxide (HP). Read More

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Partial Arthroscopic Trapeziectomy and Stabilisation by Ligamentoplasty: Outcomes in Patients Younger than 60 Years.

Orthop Traumatol Surg Res 2021 Jun 8:102983. Epub 2021 Jun 8.

Service de chirurgie orthopédique et traumatologique, centre hospitalier de Versailles, 78150 Le Chesnay, France.

Background: Thumb carpo-metacarpal joint (TCMJ) osteoarthritis is the fourth leading cause of referral to elective hand surgery. None of the available techniques has proved superior over the others. Some techniques carry unacceptable risks for younger patients, such as loss of strength and shortening of the thumb column after total trapeziectomy, or wear and loosening after total arthroplasty. Read More

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Revision of failed trapeziometacarpal prothesis by CMI pyrocarbon implant: Retrospective study of 28 patients with a mean follow-up of 7.5 years.

Orthop Traumatol Surg Res 2021 Jun 8:102984. Epub 2021 Jun 8.

Orthopôle, 53 bis Avenue Maryse Bastié, 33520, Bruges, France.

Introduction: There is no consensus on the best salvage option after a failed trapeziometacarpal prothesis. Conserving the trapezium and inserting a pyrocarbon hemiarthroplasty implant will prevent thumb shortening and preserve the thumb's motion. The aim of this study was to evaluate the clinical and radiological outcomes in the medium term of trapeziometacarpal prothesis revisions done using the CMI pyrocarbon implant. Read More

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Changes in kinematics, kinetics, and muscle activity in patients with lumbar spinal stenosis during gait: systematic review.

Spine J 2021 Jun 8. Epub 2021 Jun 8.

Department of Orthopaedic Surgery, University of Arkansas for Medical Science, Little Rock, AR; Mechanical and Biomedical Engineering Department, College of Engineering, Boise State University, Boise, ID.

Background Context: Lumbar spinal stenosis (LSS) is one of the most common orthopaedic conditions and affects more than half a million people over the age of 65 in the US. Patients with LSS have gait dysfunction and movement deficits due to pain and symptoms caused by compression of the nerve roots within a narrowed spinal canal.

Purpose: The purpose of the current systematic review was to summarize existing literature reporting biomechanical changes in gait function that occur with LSS, and identify knowledge gaps that merit future investigation in this important patient population. Read More

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Tuberculosis of the spine in children - Does drug resistance affect surgical outcomes?

Spine J 2021 Jun 8. Epub 2021 Jun 8.

Paediatric TB Clinic, Bai Jerbai Wadia Hospital for Children, Mumbai, India. Electronic address:

Background Context: The emergence of drug resistance has complicated the management of spinal tuberculosis (TB). While it is well known that the medical management of drug-resistant spinal TB is more difficult, the surgical outcomes of the same have not been studied sufficiently, particularly in children.

Purpose: To analyze the surgical outcomes in a cohort of children treated for spinal TB, and to thus assess whether drug resistant (DR) disease is associated with poorer surgical outcomes. Read More

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Prospective, Randomized, Double-Blinded Clinical Trial Comparing PEEK and Allograft Spacers in Patients Undergoing Transforaminal Lumbar Interbody Fusion Surgeries.

Spine J 2021 Jun 8. Epub 2021 Jun 8.

Boulder Neurosurgical Associates, Boulder, Colorado, USA; Justin Parker Neurological Institute, Boulder, Colorado, USA. Electronic address:

Background Context: Allograft and polyether-ether-ketone (PEEK) radiographic, biomechanical, histological properties have been extensively studied and both spacers have their advantages and shortcomings. There are no comparative randomized or double-blinded spinal fusion clinical trials reported to date.

Purpose: The study's primary objective was to prospectively investigate clinical and radiological outcomes in patients undergoing lumbar interbody fusions and randomized to receive either PEEK or structural bone allografts. Read More

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Improvement of pneumococcal pneumonia diagnosis using quantitative real-time PCR targeting lytA in adult patients: A prospective cohort study.

Clin Microbiol Infect 2021 Jun 8. Epub 2021 Jun 8.

Infectious Diseases Unit, Hospital Universitari Mútua de Terrassa, Barcelona; Universitat Internacional de Catalunya. Electronic address:

Objectives: The aim of the study was to assess the performance of real-time polymerase chain reaction (PCR) targeting the lytA gene (rtPCR-lytA) in plasma, urine and nasopharyngeal (NP) samples for the diagnosis of pneumococcal community-acquired pneumonia (P-CAP).

Methods: Prospective observational study including all consecutive adult CAP patients from November 2015 to May 2017. P-CAP was defined if pneumococcus was identified using conventional methods (CM) and/or a positive rtPCR-lytA was detected in blood, urine or NP samples (NP cut-off ≥8000 copies/mL). Read More

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Functional Somatic Syndromes are Associated with Suboptimal Outcomes and High Cost after Shoulder Arthroplasty.

J Shoulder Elbow Surg 2021 Jun 8. Epub 2021 Jun 8.

Department of Orthopaedic Surgery, New England Baptist Hospital, Tufts University School of Medicine, Boston, MA, USA. Electronic address:

Introduction: The presence of functional somatic syndromes (chronic physical symptoms with no identifiable organic cause) in patients undergoing elective joint arthroplasty may affect the recovery experience. We explored the prevalence of functional somatic syndromes among shoulder arthroplasty patients, and their association with postoperative outcomes and costs.

Methods: We identified 480 patients undergoing elective total shoulder arthroplasty (anatomic or reverse) between 2015-2018 in our institutional registry with minimum 2-year follow-up. Read More

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Efficacy and safety of ciprofol for the sedation/anesthesia in patients undergoing colonoscopy: Phase IIa and IIb multi-center clinical trials.

Eur J Pharm Sci 2021 Jun 8:105904. Epub 2021 Jun 8.

Department of Anesthesiology, West China Hospital, Sichuan University & The Research Units of West China (2018RU012), Chinese Academy of Medical Sciences Chengdu, China. Electronic address:

Objective: Ciprofol is a new intravenous anesthetic agent similar to propofol that has the pharmacodynamic characteristics of a rapid rate of onset and recovery in pre-clinical experiments. The aims of the present clinical trials were to compare the efficacy and safety of ciprofol emulsion for sedation or general anesthesia during colonoscopy and to define optimal doses for a subsequent phase III clinical trial.

Methods: A phase IIa multi-center, open-label, non-randomized, positive control, dose-escalating study was performed to determine a recommended phase IIb dose (RP2D) of ciprofol to induce sedation or anesthesia in patients undergoing colonoscopy. Read More

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Superficial fibromatosis: MRI radiomics and T2 mapping correlate with treatment response.

Magn Reson Imaging 2021 Jun 8. Epub 2021 Jun 8.

Department of Radiology, Sylvester Comprehensive Cancer Center, the University of Miami Miller School of Medicine/Jackson Memorial Hospital, Miami, FL 33136, USA. Electronic address:

Background: Superficial fibromatosis exhibits variable MR signal intensity due to collagenous and fibroproliferative components. Quantifying this signal heterogeneity using image texture analysis and T2-mapping could have prognostic and therapeutic implications.

Methods: This IRB-approved retrospective study included 13 patients with superficial fibromatosis, managed by observation, electron beam radiotherapy (EBT), or pentoxifylline/vitamin E. Read More

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The Incessant increase Curve during the Oral Glucose Tolerance Test and its association with gut hormone level in Chinese T2DM Adults: A preliminary study.

Peptides 2021 Jun 8:170595. Epub 2021 Jun 8.

Department of Endocrinology, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China.

Purpose: To investigate glucose curve shape during an oral glucose tolerance test (OGTT) and its association with β-cell function or gut hormone.

Materials And Methods: Glucose curves during 180 min OGTTs (n = 89) were classified as incessant increase and monophasic. Data on demographics, β-cell function, and insulin sensitivity were collected. Read More

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Treatments and outcomes of generalized pustular psoriasis: a cohort of 1516 patients in a nationwide inpatient database in Japan.

J Am Acad Dermatol 2021 Jun 8. Epub 2021 Jun 8.

Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan.

Background: Because generalized pustular psoriasis (GPP) is uncommon, there are few studies reporting treatments and outcomes for large numbers of patients.

Objective: To report treatments and outcomes in a large cohort of hospitalized patients with GPP.

Methods: Using a Japanese national inpatient database, we identified 1516 patients with GPP who required hospitalization from July 2010 to March 2019. Read More

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Sestrin2 suppression aggravates oxidative stress and apoptosis in endothelial cells subjected to pharmacologically induced endoplasmic reticulum stress.

Eur J Pharmacol 2021 Jun 8:174247. Epub 2021 Jun 8.

Department of Pharmaceutical Sciences, College of Pharmacy, QU Health, Qatar University, P.O. Box 2713, Doha, Qatar; Biomedical and Pharmaceutical Research Unit (BPRU), QU Health, Qatar University, P.O. Box 2713, Doha, Qatar; Office of Vice President for Research and Graduate Studies, Qatar University, P.O. Box 2713, Doha, Qatar. Electronic address:

Endoplasmic reticulum (ER) stress is an inflammatory response that contributes to endothelial dysfunction, a hallmark of cardiovascular diseases, in close interplay with oxidative stress. Recently, Sestrin2 (SESN2) emerged as a novel stress-inducible protein protecting cells from oxidative stress. We investigated here, for the first time, the impact of SESN2 suppression on oxidative stress and cell survival in human endothelial cells subjected to pharmacologically (thapsigargin)-induced ER stress and studied the underlying cellular pathways. Read More

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EUS-GUIDED FINE-NEEDLE BIOPSY WITH OR WITHOUT RAPID ON-SITE EVALUATION FOR DIAGNOSIS OF SOLID PANCREATIC LESIONS: A RANDOMIZED CONTROLLED NON-INFERIORITY TRIAL.

Gastroenterology 2021 Jun 8. Epub 2021 Jun 8.

Second Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan.

Background And Aims: Benefit of rapid on-site evaluation (ROSE) on diagnostic accuracy of endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) has never been evaluated in a randomized study. This trial aimed to test the hypothesis that in solid pancreatic lesions (SPLs), diagnostic accuracy of EUS-FNB without ROSE was not inferior to that of EUS-FNB with ROSE.

Methods: Non-inferiority study (non-inferiority margin 5%) conducted at 14 centers in eight countries. Read More

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New ratio as a useful marker for early diagnosis of proximal urea cycle disorders.

Clin Chim Acta 2021 Jun 8. Epub 2021 Jun 8.

Expanded Newborn Screening Laboratory, Referral Center for Inherited Metabolic Disorders, Pediatric Clinical, University-Hospital "Gaspare Rodolico - San Marco", Catania, Italy; Clinical and Experimental Medicine Department, University of Catania, Catania, Italy.

Background And Aims: Proximal urea cycle disorders (PUCDs) are not included in most newborn screening programs due to the lack of adequate markers to monitor. Failure to alter citrulline and glutamine levels, the prognostic markers commonly used, can results in high false negative. Therefore, new biomarkers, prognostic of PUCDs, are strongly desirable. Read More

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