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Ticagrelor effectively inhibits platelet aggregation in comatose survivors of cardiac arrest undergoing primary percutaneous coronary intervention treated with mild therapeutic hypothermia.

Cardiol J 2021 Jun 24. Epub 2021 Jun 24.

Jagiellonian University Medical College Institute of Cardiology, Department of Interventional Cardiology, Krakow, Poland.

Background: Mild therapeutic hypothermia (MTH) is believed to reduce the effectiveness of antiplatelet drugs. Effective dual-antiplatelet therapy after percutaneous coronary intervention (PCI) is mandatory to avoid acute stent thrombosis (ST). The effectiveness of ticagrelor in MTH-treated out-of-hospital cardiac arrest (OHCA) survivors is still a matter of debate. Read More

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Basal Cell Adenoma of the Parotid Gland.

Kathmandu Univ Med J (KUMJ) 2020 Oct.-Dec.;18(72):434-436

Department of ENT, Indira Gandhi Medical College and Research Institute, Pondicherry, India.

Basal Cell Adenoma (BCA) known as monomorphic adenoma is a rare type of benign epithelial salivary neoplasm that mostly occurs in the parotid gland. Clinically BCA appears as a firm, mobile, slow-growing mass and is usually diagnosed during the histopathological examination of the resected surgical specimen. Histological differential diagnosis ranges from benign to malignant neoplasms such as pleomorphic adenoma, basal cell adenocarcinoma, adenoid cystic carcinoma and basaloid squamous cell carcinoma. Read More

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Antibiotic Usage Pattern in Broiler Chicken Flocks in Germany.

Front Vet Sci 2021 7;8:673809. Epub 2021 Jun 7.

Department of Biometry, Epidemiology and Information Processing, WHO Collaborating Centre for Research and Training for Health at the Human-Animal-Environment Interface, University of Veterinary Medicine Hannover, Hannover, Germany.

In this work, antimicrobial usage data from 2,546 commercial broiler chicken flocks originating from 37 farms are presented. Antimicrobial usage data at the flock level were based on mandatory documentation of antibiotic treatments in livestock in Germany, collected retrospectively for the time period of 2013-2018. The data encompasses all antimicrobial treatments during the fattening period of each flock, starting with the placement of day-old chicks at the barn. Read More

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Endovascular Treatment of Acute Ischemic Stroke in Clinical Practice: Analysis of Workflow and Outcome in a Tertiary Care Center.

Front Neurol 2021 7;12:657345. Epub 2021 Jun 7.

Hannover Medical School, Institute for Diagnostic and Interventional Neuroradiology, Hannover, Germany.

Pre- and intra-hospital workflow in mechanical recanalization of large cervicocephalic arteries in patients with acute ischemic stroke still needs optimization. In this study, we analyze workflow and outcome in our routine care of stroke patients undergoing mechanical thrombectomy as a precondition for such optimization. Processes of pre- and intra-hospital management, causes of treatment delay, imaging results (Alberta Stroke Program Early Computed Tomography Score, localization of vessel occlusion), recanalization (modified thrombolysis in cerebral infarction score), and patient outcome (modified Rankin scale at discharge and at the end of inpatient rehabilitation) were analyzed for all patients who underwent mechanical thrombectomy between April 1, 2016, and September 30, 2018, at our site. Read More

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Letter to the Editor from Colle .

J Immunother Cancer 2021 Jun;9(6)

Sorbonne Université and Hospital Saint Antoine, Department of Medical rodiology, AP-HP, Paris, France.

In their article, Fucà highlight that early tumor shrinkage and depth of response predict the prognosis of patients with metastatic colorectal cancer (mCRC) microsatellite instability (MSI-H)/deficient mismatch repair (dMMR) treated by immune checkpoint inhibitors (ICI). We are surprised that no cases of pseudoprogression (PSPD) were reported in their study. PSPDs were described under ICI in patients treated for MSI/dMMR mCRC. Read More

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[Chronic urticaria].

Rev Prat 2021 Mar;71(3):293-297

"Groupe urticaire de la Société française de dermatologie, département de dermatologie, hôpital Saint-Éloi, CHU de Montpellier, Montpellier, France".

"Chronic urticaria.One French out of 5 will suffer from urticaria at least once in his life, but only in 10% of the cases will chronic urticaria occur. Physicians must know its main characteristics: hives and angioedema lasting less than 24h and 72h, respectively. Read More

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An unusual extranodal natural killer/T-cell lymphoma presenting as chronic laryngitis: A case report.

Medicine (Baltimore) 2021 Jun;100(25):e26314

Service of Rheumatology, Hospital Clínico de la Universidad de Chile, Santiago de Chile.

Rationale: Nasal-type, extranodal natural killer (NK)/T-cell lymphoma is a rare lymphoma. The tumor usually shows ulcerative and necrotic lesions in the nasal cavities and sinuses. Tissue involvement outside the nasal cavity is uncommon. Read More

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Pleural metastasis of atypical meningioma: a novel therapeutic approach.

Interact Cardiovasc Thorac Surg 2021 Jun 23. Epub 2021 Jun 23.

Department of Thoracic Surgery, Louis Pradel Hospital, Hospices Civils de Lyon, Lyon, France.

Meningiomas are the most common intracranial tumours in adults and they are infrequently associated with a metastasis clinical course. Pleural metastases are extremely rare and no guidelines on a specific treatment have been established. When localized, surgical resection is the mainstay of treatment, but there is a high risk of pleural recurrence. Read More

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Pharmacokinetics and pharmacodynamics of antibiotics in cystic fibrosis: a narrative review.

Int J Antimicrob Agents 2021 Jun 19:106381. Epub 2021 Jun 19.

Department of Internal Medicine, Pharmacology & Toxicology Unit, University of Genoa, Viale Benedetto XV, 2 -16132, Genoa, Italy; Clinical Pharmacology Unit, EO Ospedali Galliera, Mura delle Cappuccine, 14 - 16128, Genoa, Italy. Electronic address:

Cystic fibrosis affects several organs, predisposing patients to severe bacterial respiratory infections, including those caused by methicillin-resistant Staphylococcus aureus. Cystic fibrosis is also associated with a wide spectrum of pathological changes that can significantly affect the absorption, distribution, metabolism and/or elimination of several drugs, including antibacterial agents. Awareness of the pharmacokinetic derangements in patients with cystic fibrosis is, therefore, mandatory for the optimization of antibiotic therapy. Read More

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Student perspectives on factors that influence the implementation of evidence-based practice in occupational therapy.

JBI Evid Implement 2021 Jun 21. Epub 2021 Jun 21.

Occupational Therapy, School of Health and Social Development, Deakin University, Geelong, Victoria, Australia.

Aim: Evidence-based practice (EBP) is perceived as an integral component of contemporary allied health practice. While allied health clinicians (such as occupational therapists) have generally positive attitudes towards EBP, research suggests that they find its implementation consistently challenging. The professional literature increasingly suggests that more effective EBP learning takes place when social constructivist approaches to learning are adopted. Read More

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Percutaneous Endoscopic Gastrostomy in Children: An Update to the ESPGHAN Position Paper.

J Pediatr Gastroenterol Nutr 2021 Jun 22. Epub 2021 Jun 22.

Faculty of Medicine, University Children's Hospital, University of Ljubljana, Ljubljana, Slovenia KidZ Health Castle UZ Brussel, Brussels, Belgium Department of Human Pathology in Adulthood and Childhood "G. Barresi"- University of Messina, Italy Al Jalila Children's Specialty Hospital, Dubai, UAE Digestive Endoscopy and Surgery Unit, Bambino Gesù Children's Hospital IRCCS, Rome. Italy University Lille, CHU Lille, Infinite U1286, Lille, F-59000, France Children's Hospital Zagreb, University of Zagreb School of Medicine, Zagreb Croatia, University J.J. Strossmayer, School of Medicine, Osijek, Croatia Sheffield Children's Hospital NHS Foundation Trust, Sheffield, South Yorkshire, UK Université Libre de Bruxelles, Hôpital Universitaire des Enfants Reine Fabiola, Belgium University Children's Hospital Basel, Division of Pediatric Gastroenterology & Nutrition, University of Basel, Switzerland Maternal and Child Health Department, Sapienza, University of Rome, Italy Centro Hospitalar S. João, Porto, Portugal.

Background: The ESPGHAN position paper from 2015 on percutaneous endoscopic gastrostomy (PEG) required updating in the light of recent clinical knowledge and data published in medical journals since 2014.

Methods: A systematic review of medical literature from 2014 to 2020 was carried out. Consensus on the content of the manuscript, including recommendations, was achieved by the authors through electronic and virtual means. Read More

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Epidemiological study of distal radius fractures in the sanitary area of Vigo.

Rev Esp Cir Ortop Traumatol 2021 Jun 18. Epub 2021 Jun 18.

Departamento de Cirugía Ortopédica y Traumatología, Hospital Álvaro Cunqueiro, Vigo, Pontevedra, España.

Introduction: Distal radius fractures (DRF) are being a bigger burden for health resources as changes continue to happen in our population demography and in management strategies, so a precise epidemiologic comprehension is mandatory. We present a DRF epidemiology study and we compared it with other sanitary areas of the Iberian Peninsula and Europe.

Method: Every DRF in our sanitary area registered between 2017 and 2018 in patients older than 18 years old were observational and retrospectively recorded and classified using AO-OTA classification. Read More

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Paranasal mucoceles in children with cystic fibrosis: Management of a not so rare clinical condition.

Am J Otolaryngol 2021 Jun 16;42(6):103107. Epub 2021 Jun 16.

Unit of Pediatric Otorhinolaryngology, Spedali Civili, Brescia, Italy. Electronic address:

Purpose: Paranasal mucocele (PM) is reported as a complication in children with cystic fibrosis (CF) in up to 4% of patients. The objective of this study was to identify PMs in the personal large series of children with CF and to assess their diagnosis and treatment.

Material And Methods: Medical records of children with CF and PM who were admitted and treated by means of endoscopic nasal surgery between 2004 and 2020 were retrospectively reviewed. Read More

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Comparing the Effect of Different Antibiotics in Frozen-Thawed Ram Sperm: Is It Possible to Avoid Their Addition?

Front Vet Sci 2021 7;8:656937. Epub 2021 May 7.

Investigación en Técnicas de Reproducción Asistida - Universidad de León, Instituto de Desarrollo Ganadero y Sanidad Animal, University of León, León, Spain.

It is crucial to perform a deep study about the most extensively used antibiotics in sperm extenders. Most of the protocols and concentrations used in ram are direct extrapolations from other species. It is important to establish species-specific antibiotic treatments to optimize their use and if it is possible to reduce the quantity. Read More

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Oral Delivery of Biologics in Inflammatory Bowel Disease Treatment.

Front Bioeng Biotechnol 2021 3;9:675194. Epub 2021 Jun 3.

Advanced Drug Delivery and Biomaterials, Louvain Drug Research Institute, Université Catholique de Louvain, Brussels, Belgium.

Inflammatory bowel disease (IBD) has been posed as a great worldwide health threat. Having an onset during early adulthood, IBD is a chronic inflammatory disease characterized by remission and relapse. Due to its enigmatic etiology, no cure has been developed at the moment. Read More

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A review on role of nitrous oxide nanoparticles, potential vaccine targets, drug, health care and artificial intelligence to combat COVID-19.

Appl Nanosci 2021 Jun 16:1-8. Epub 2021 Jun 16.

Institute of Research and Development, Duy Tan University, Da Nang, 550000 Viet Nam.

The lives of human individuals and groups around the globe have changed drastically due to the emergence of novel corona virus in late 2019. The significant part of CoV-19 from the global point is transmission rate, and therefore, it is mandatory to identify and isolate the affected persons even with the mild infection. To stop the rapid transmission of virus to drastic manner, it is essential to follow the hygienic practices, identification of potential vaccines and proper health care management systems to combat the novel virus. Read More

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Tuberculosis Risk Stratification of Psoriatic Patients Before Anti-TNF-α Treatment.

Front Immunol 2021 3;12:672894. Epub 2021 Jun 3.

Laboratory of Vaccinology and Mucosal Immunity, Université Libre de Bruxelles (U.L.B.), Brussels, Belgium.

Psoriasis is a skin inflammatory condition for which significant progress has been made in its management by the use of targeted biological drugs. Detection of latent infection (LTBI) is mandatory before starting biotherapy that is associated with reactivation risk. Together with evaluation of TB risk factors and chest radiographs, tuberculin skin tests (TST) and/or blood interferon-γ-release assays (IGRA), like the QuantiFERON (QFT), are usually performed to diagnose infection. Read More

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Acute abdomen due to J-pouch outlet obstruction: A case report and review of literature.

Int J Surg Case Rep 2021 Jun 15;84:106075. Epub 2021 Jun 15.

State University of Ponta Grossa - Paraná, Ponta Grossa, PR, Brazil.

Introduction: Ileal pouch-anal anastomosis is the procedure of choice for re-establishing intestinal continuity for patients undergoing total proctocolectomy. Despite growing experience with this procedure, it is still associated with considerable morbidity rates.

Presentation Of Case: Herein, we report the case of a 14-year-old boy with familial adenomatous polyposis who underwent total proctocolectomy, ileal pouch-anal anastomosis, and diverting ileostomy. Read More

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Therapeutic approaches and targets for treatment of autoimmune bullous diseases.

Dermatol Ther 2021 Jun 18:e15032. Epub 2021 Jun 18.

Department of specialized, clinical and experimental medicine, Division of Dermatology, University of Bologna, Italy.

Autoimmune bullous diseases are a heterogeneous group of diseases characterized by the development of cutaneous and mucosal vesicles, blisters and, finally, erosions. The common pathogenetic mechanism is the presence of autoantibodies targeting structural proteins of the skin and mucous membranes (demosomes and hemidesmosomes): in the case of pemphigus, the antigens are intraepidermal, whereas in the case of pemphigoid, dermatitis herpetiformis and epidermolysis bullosa acquisita they are subepidermal. Mucosal involvement typically affects the oral and ocular mucosa, but in some cases the upper airways or the upper digestive tract are affected. Read More

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Focused parathyroidectomy without intraoperative parathyroid hormone measurement in primary hyperparathyroidism: Still a valid approach?

Surgery 2021 Jun 15. Epub 2021 Jun 15.

Endocrine Surgical Unit, University of Sydney, St Leonards, New South Wales, Australia; Sydney Medical School, Faculty of Medicine and Health, University of Sydney, New South Wales, Australia; Cancer Genetics Unit, Kolling Institute, Sydney, New South Wales, Australia.

Background: Concern regarding suboptimal cure rates has led to some endocrine surgery units abandoning focused parathyroidectomy for primary hyperparathyroidism in favor of open bilateral neck exploration or making intraoperative parathyroid hormone estimation mandatory in focused parathyroidectomy. This study explores whether focused parathyroidectomy for radiologically localized primary hyperparathyroidism without intraoperative parathyroid hormone is still a valid approach.

Methods: Retrospective review of a tertiary referral endocrine surgery unit database. Read More

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Continuum of care for patients with obstructive sleep apnea after one year from the COVID-19 pandemic onset: no time for further delays: practical issues for a safe and effective management.

Sleep Med 2021 May 31;84:98-106. Epub 2021 May 31.

Azienda USL Toscana Centro - Pneumology and Bronchial Endoscopy Unit, San Giuseppe Hospital, Empoli, FI, Italy.

Since the SARS-CoV-2 pandemic onset, many routine medical activities have been put on hold and this has deeply affected the management of patients with chronic diseases such as obstructive sleep apnea. Untreated OSA is associated with increased mortality and difficulties in social functioning. A delay in initiating treatment may therefore have harmful consequences. Read More

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Classification of acute appendicitis (CAA): treatment directed new classification based on imaging (ultrasound, computed tomography) and pathology.

Int J Colorectal Dis 2021 Jun 18. Epub 2021 Jun 18.

Abteilung für Radiologie und Nuklearmedizin Krankenhaus der Barmherzigen Brüder Salzburg, Salzburg, Austria.

Purpose: Acute appendicitis (AA) is amongst the most common causes of acute abdominal pain. In spite of progress based on risk stratifications, "negative" appendectomies are performed in up to 30% of patients whilst the appendix perforates in others. Preoperative classification of AA based on imaging is therefore recommended. Read More

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Pediatric Paroxysmal Exercise-Induced Neurological Symptoms: Clinical Spectrum and Diagnostic Algorithm.

Front Neurol 2021 1;12:658178. Epub 2021 Jun 1.

Unit of Child Neurology, Department of Pediatric Neuroscience, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Neurologico Carlo Besta, Milan, Italy.

Paroxysmal exercise-induced neurological symptoms (PENS) encompass a wide spectrum of clinical phenomena commonly presenting during childhood and characteristically elicited by physical exercise. Interestingly, few shared pathogenetic mechanisms have been identified beyond the well-known entity of paroxysmal exercise-induced dyskinesia, PENS could be part of more complex phenotypes including neuromuscular, neurodegenerative, and neurometabolic disease, epilepsies, and psychogenetic disorders. The wide and partially overlapping phenotypes and the genetic heterogeneity make the differential diagnosis frequently difficult and delayed; however, since some of these disorders may be treatable, a prompt diagnosis is mandatory. Read More

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Clinical practice patterns in multiple sclerosis management: Mexican consensus recommendations.

Mult Scler Relat Disord 2021 May 30;53:103053. Epub 2021 May 30.

Servicio de Neurología, Hospital Español de México, Mexico City, Mexico. Electronic address:

Background: Multiple sclerosis affects more than 2 million people. Clinical decisions are performed under evidence-based medicine. The appearance of new disease-modifying therapies and changes in diagnostic criteria complicates the decision-making process in clinical practice. Read More

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Laboratory Parameters related to Severe Disease and Death in SARS-CoV-2 Pneumonia: Retrospective Analysis.

J Med Virol 2021 Jun 17. Epub 2021 Jun 17.

Infectious Disease Unit, San Salvatore Hospital, 67100, L'Aquila, Italy.

Clinical evolution of COVID-19 is highly variable and hospitalized patients can rapidly develop conditions requiring oxygen support, intensive care unit (ICU) or high dependency unit (HDU) cares. Early identification of high-risk patients is mandatory. We retrospectively collected medical history, symptoms, radiological and laboratory findings of COVID-19 patients hospitalized between February and April 2020. Read More

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[Telemedicine in secondary prevention and rehabilitation of stroke during the COVID-19 pandemic].

Medicina (B Aires) 2021 ;81(3):415-420

Unidad de ACV, Sanatorio Güemes, Buenos Aires, Argentina.

The COVID-19 pandemic resulted in limited access of post-stroke patients to their usual medical follow-up and rehabilitation. To continue these activities, we adopted a technology that is free and has universal access. We remotely followed 32 patients after discharge from the stroke unit during the mandatory lock-down. Read More

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Direct antiviral agents in hepatitis C virus related liver disease: Don't count the chickens before they're hatched.

World J Gastroenterol 2021 Jun;27(21):2771-2783

Department of Internal Medicine, V. Cervello Hospital, Palermo 90146, Italy.

Since molecules with direct-acting antiviral (DAA) became available, the landscape of the treatment of hepatitis C virus (HCV) infection has completely changed. The new drugs are extremely effective in eradicating infection, and treatment is very well tolerated with a duration of 8-12 wk. This review aims to report the outstanding clinical benefits of DAA and to highlight their critical disadvantages, identifying some clinically relevant hot topics. Read More

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[Necrotizing Fasciitis].

Handchir Mikrochir Plast Chir 2021 Jun 16;53(3):312-319. Epub 2021 Jun 16.

Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil; Universitätsklinik für Plastische Chirurgie und Handchirurgie, Schwerbrandverletztenzentrum, Sarkomzentrum.

Necrotizing fasciitis (NF) is a soft tissue infection spreading along the fasciae to the surrounding subcutaneous fat, overlying skin and finally musculature, that may rapidly lead to septic shock and death. In order to avoid a massive systemic spread of the infective process, an immediate and extensive radical debridement of necrotic tissues is mandatory complemented by a broad spectrum intravenous antibiotic therapy. Nevertheless, mortality is persistently high at 20-40 %. Read More

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Contemporary Clinical Use of Aspirin: Mechanisms of Action, Current Concepts, Unresolved Questions, and Future Perspectives.

Semin Thromb Hemost 2021 Jun 15. Epub 2021 Jun 15.

Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark.

The ability of aspirin to inhibit platelet aggregation has positioned this agent within the most frequently used drugs worldwide. The aim of this article is to review the contemporary clinical use of aspirin and also to discuss unresolved issues not yet translated into clinical practice. Results from several clinical trials have led to strong guideline recommendations for aspirin use in the acute management and secondary prevention of cardiovascular disease. Read More

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The process of EUSOMA certification improves the quality of breast cancer care: the experience of an Italian EUSOMA certificated Breast Unit (BU) according to the results of a cross-sectional study.

Recenti Prog Med 2021 Jun;112(6):458-464

Unit of Medical Oncology, Brest Unit located at the Mater Salutis Hospital in Legnago, Italy.

Introduction: The adherence to recognized guidelines and the constant monitoring of performance throughout quality indicators (QIs) are strategic tools to improve the quality of care. The study is aimed to assess the effect of the EUSOMA (European Society of Breast Cancer Specialists) certification process on the quality of breast cancer care of an EUSOMA certified Breast Unit (BU) of Northern Italy.

Materials And Methods: Seventeen mandatory and recommended EUSOMA QIs, based on 594, were analysed for the years 2015-2018. Read More

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