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Kidney Transplant List Status and Outcomes in the ISCHEMIA-CKD Trial.

J Am Coll Cardiol 2021 May 4. Epub 2021 May 4.

NYU Grossman School of Medicine, New York, NY, USA.

Background: Patients with chronic kidney disease (CKD) and coronary artery disease frequently undergo preemptive revascularization before kidney transplant listing.

Objectives: In this post-hoc analysis from ISCHEMIA-CKD, we compared outcomes of patients not listed versus those listed according to management strategy.

Methods: In ISCHEMIA-CKD (n=777), 194 patients (25%) with chronic coronary syndromes and at least moderate ischemia were listed for transplant. Read More

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Development of detection methods for diagnosis and analysis of highly toxic metal phosphides: A comprehensive and critical review.

Biotechnol Appl Biochem 2021 May 14. Epub 2021 May 14.

Medical Toxicology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.

Metal phosphides, specially aluminum phosphide, and phosphine are widely used as insecticides and rodenticides for protection of grains during process of storage and transportation. The main reason of poisoning with this compound is related to the conscious ingestion of salts or accidental inhalation of phosphine. So the early and accurate diagnosis of poisoning can significantly help to the effective clinical treatment or recognition of death cause. Read More

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A rare case of bilateral occipital condyle fractures associated with inferior clivus separation fracture resulting in craniocervical dislocation: a case report and modification of the Anderson and Montesano classification is proposed.

Acta Neurochir (Wien) 2021 May 14. Epub 2021 May 14.

London Bridge Hospital, London, UK.

The authors report a very rare case of bilateral occipital condyle fractures (OCF) that was associated with complete separation fracture of the inferior clivus resulting in craniocervical dislocation alongside dissociation of C1-C2 joint complex. Also, a new type of the Anderson and Montesano classification system is presented with two subtypes of injuries. Type IVA occurs when the OCF is associated a clivus avulsion fracture, while Type IVB occurs when the OCF is associated with complete "en piece" separation fracture of the inferior clivus. Read More

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Risk Factors and Reasons for Treatment Abandonment for Patients With Esophageal Atresia: A Study From a Tertiary Care Hospital in Beijing, China.

Front Pediatr 2021 27;9:634573. Epub 2021 Apr 27.

Department of Neonatal Surgery, National Center for Children's Health, Beijing Children's Hospital, Capital Medical University, Beijing, China.

This study aims to identify the risk factors and reasons for treatment abandonment for patients with esophageal atresia (EA) in a tertiary care hospital in China. A retrospective study was conducted on 360 patients with EA admitted to Beijing Children's Hospital between January 1, 2007 and June 1, 2020. Medical records for treatment abandonment and non-treatment abandonment patients were compared. Read More

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Noninvasive transcranial classification of stroke using a portable eddy current damping sensor.

Sci Rep 2021 May 13;11(1):10297. Epub 2021 May 13.

Department of Medical Engineering, California Institute of Technology, Pasadena, CA, USA.

Existing paradigms for stroke diagnosis typically involve computed tomography (CT) imaging to classify ischemic versus hemorrhagic stroke variants, as treatment for these subtypes varies widely. Delays in diagnosis and transport of unstable patients may worsen neurological status. To address these issues, we describe the development of a rapid, portable, and accurate eddy current damping (ECD) stroke sensor. Read More

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In vitro performance of free and encapsulated bromelain.

Sci Rep 2021 May 13;11(1):10195. Epub 2021 May 13.

Faculty of Pharmaceutical Sciences, University of Campinas (UNICAMP), Candido Portinari Street, 200, Cidade Universitária ″Zeferino Vaz″, Campinas, 13083-871, SP, Brazil.

For centuries, bromelain has been used to treat a range of ailments, even though its mechanism of action is not fully understood. Its therapeutic benefits include enzymatic debridement of the necrotic tissues of ulcers and burn wounds, besides anti-inflammatory, anti-tumor, and antioxidant properties. However, the protease is unstable and susceptible to self-hydrolysis over time. Read More

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Trends in risk stratification, in-hospital management and mortality of patients with acute pulmonary embolism: an analysis from China pUlmonary thromboembolism REgistry Study (CURES).

Eur Respir J 2021 May 13. Epub 2021 May 13.

Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, P. R. China

Background: Similar trends of management and in-hospital mortality of acute pulmonary embolism (PE) have been reported in European and American populations. However, these tendencies were not clear in Asian countries.

Objectives: We retrospectively analyzed the trends of risk stratification, management and in-hospital mortality for patients with acute PE through a multicenter registry in China (CURES). Read More

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Sinus bradycardia with haemodynamic compromise following lithium intoxication.

BMJ Case Rep 2021 May 13;14(5). Epub 2021 May 13.

Department of Cardiovascular Medicine, University of Florida College of Medicine, Gainesville, Florida, USA.

Lithium is a well-established treatment for mood disorders and considered first-line pharmacological therapy for bipolar disorder as per the American Psychiatric Association guidelines. However, lithium is associated with significant toxicity. Cardiotoxicity including sinus node dysfunction is a rare but clinically significant presentation of lithium intoxication. Read More

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Variability in comorbidites and health services use across homeless typologies: multicenter data linkage between healthcare and homeless systems.

BMC Public Health 2021 May 13;21(1):917. Epub 2021 May 13.

Center for Housing and Health, Chicago, IL, USA.

Background: Homelessness is associated with substantial morbidity. Data linkages between homeless and health systems are important to understand unique needs across homeless populations, identify homeless individuals not registered in homeless databases, quantify the impact of housing services on health-system use, and motivate health systems and payers to contribute to housing solutions.

Methods: We performed a cross-sectional survey including six health systems and two Homeless Management Information Systems (HMIS) in Cook County, Illinois. Read More

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Natalizumab differentially affects plasmablasts and B cells in multiple sclerosis.

Mult Scler Relat Disord 2021 May 1;52:102987. Epub 2021 May 1.

Danish Multiple Sclerosis Center, Department of Neurology, Rigshospitalet, Copenhagen University Hospital, Glostrup, Denmark. Electronic address:

Background: Natalizumab treatment increases the frequencies of B cells in blood but reduces IgG in blood and CSF. Plasmablasts are important in the production of IgG, and the development of plasmablasts is CD49d dependent.

Objective: We hypothesized that natalizumab treatment affects the development of plasmablasts. Read More

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Metformin facilitates mesenchymal stem cell-derived extracellular nanovesicles release and optimizes therapeutic efficacy in intervertebral disc degeneration.

Biomaterials 2021 May 6;274:120850. Epub 2021 May 6.

Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China. Electronic address:

Extracellular vesicles (EVs) are extracellular nanovesicles that deliver diverse cargoes to the cell and participate in cell communication. Mesenchymal stem cell (MSCs)-derived EVs are considered a therapeutic approach in musculoskeletal degenerative diseases, including intervertebral disc degeneration. However, limited production yield and unstable quality have impeded the clinical application of EVs. Read More

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Allosteric MAPKAPK2 inhibitors improve plaque stability in advanced atherosclerosis.

PLoS One 2021 13;16(5):e0246600. Epub 2021 May 13.

Department of Medicine, Columbia University Irving Medical Center, New York, New York, United States of America.

Atherosclerotic vascular disease resulting from unstable plaques is the leading cause of morbidity and mortality in subjects with type 2 diabetes (T2D), and thus a major therapeutic goal is to discover T2D drugs that can also promote atherosclerotic plaque stability. Genetic or pharmacologic inhibition of mitogen-activated protein kinase-activated protein kinase-2 (MAPKAPK2 or MK2) in obese mice improves glucose homeostasis and enhances insulin sensitivity. We developed two novel orally active small-molecule inhibitors of MK2, TBX-1 and TBX-2, and tested their effects on metabolism and atherosclerosis in high-fat Western diet (WD)-fed Ldlr-/- mice. Read More

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Ultrasound-assisted catheter directed thrombolysis for pulmonary embolus during extracorporeal membrane oxygenation.

J Card Surg 2021 May 12. Epub 2021 May 12.

Division of Cardiac Surgery, University of Maryland Medical Center, Baltimore, Maryland, USA.

Background: Acute pulmonary embolism (PE) is the third most common cause of cardiovascular death. For patients who are hemodynamically unstable, veno-arterial extracorporeal membrane oxygenation (VA-ECMO) support has been shown to provide hemodynamic stability, and allow time for definitive treatment and recovery. Ultrasound-assisted catheter directed thrombolysis (USAT) has the potential to be a safe adjunct and expedite right ventricular (RV) recovery for patients requiring VA-ECMO for PE. Read More

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Relationship among clinical characteristics, morphological culprit plaque features, and long-term prognosis in patients with acute coronary syndrome.

Int J Cardiovasc Imaging 2021 May 12. Epub 2021 May 12.

Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017, Japan.

Culprit lesions of acute coronary syndrome (ACS) could be classified as plaque rupture (PR), erosion, or calcified nodule (CN). We aimed to determine the relationship among clinical characteristics, morphological plaque features, and long-term prognosis in ACS. Patients with ACS, who underwent pre-intervention optical coherence tomography between April 2013 and July 2018 were retrospectively enrolled, and classified into the three groups based on the culprit lesion morphology. Read More

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Non-operative Treatment of Osteoporotic Thoracolumbar Extension-distraction Fracture Using Teriparatide in Elderly Female Patient with Severe Osteoporosis under Inoperable Condition: A Case Report.

Korean J Neurotrauma 2021 Apr 19;17(1):70-74. Epub 2021 Apr 19.

Department of Neurosurgery, Yeungnam University Hospital, Yeungnam University College of Medicine, Daegu, Korea.

Vertebral extension-distraction fractures are a type of unstable fracture and require surgical stabilization with instrumentation. Unfortunately, in elderly patients with severe osteoporosis, poor bone quality can be related to postoperative pseudo-arthrosis and instability. Teriparatide is known as an effective anabolic agent for bone healing, union, and managing osteoporosis. Read More

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Efficacy and Safety of Long-Term Evolocumab Use Among Asian Subjects - A Subgroup Analysis of the Further Cardiovascular Outcomes Research With PCSK9 Inhibition in Subjects With Elevated Risk (FOURIER) Trial.

Circ J 2021 May 12. Epub 2021 May 12.

TIMI Study Group, Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School.

Background: There are concerns that Asian patients respond differently to some medications. This study evaluated the efficacy and safety of evolocumab among Asian vs. other subjects in the FOURIER trial, which randomized stable atherosclerosis patients to receive either evolocumab or placebo. Read More

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Volar locking plate versus external fixation for unstable distal radius fractures: a systematic review and meta-analysis based on randomized controlled trials.

BMC Musculoskelet Disord 2021 May 12;22(1):433. Epub 2021 May 12.

Department of Orthopedics, The First People's Hospital of Longquanyi District, 610100, Chengdu, China.

Background: The outcomes for volar locking plate (VLP) and external fixation (EF) in distal radius fracture cases remain controversial. The current study of randomized controlled trials (RCTs) aimed to assess VLP and EF, which might benefit distal radius fracture cases.

Methods: RCTs comparing VLP and EF in distal radius fracture cases, until 18 March 2020, were systematically reviewed and summarized. Read More

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Procedural and 1-year outcomes following large vessel coronary artery perforation treated by covered stents implantation: Multicentre CRACK registry.

PLoS One 2021 12;16(5):e0249698. Epub 2021 May 12.

Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland.

Background: Data regarding the clinical outcomes of covered stents (CSs) used to seal coronary artery perforations (CAPs) in the all-comer population are scarce. The aim of the CRACK Registry was to evaluate the procedural, 30-days and 1-year outcomes after CAP treated by CS implantation.

Methods: This multicenter all-comer registry included data of consecutive patients with CAP treated by CS implantation. Read More

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Modern management of paediatric tibial shaft fractures: an evidence-based update.

Eur J Orthop Surg Traumatol 2021 May 12. Epub 2021 May 12.

St George's University Hospitals NHS Foundation Trust, London, UK.

Aims: This review provides a summary of recent evidence surrounding the treatment of paediatric tibial shaft fractures and presents an algorithm to aid management of these injuries. This article reviews the relevant anatomy, epidemiology and aetiology of tibial shaft fractures and summarises contemporary treatment principles. Management recommendations and supporting evidence are given for fractures according to age (< 18 months, 18 months-5 years, 6-12 years, and 13-18 years). Read More

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Magnetic resonance imaging glossary of findings of pediatric pancreatitis and the revised Atlanta classification.

Pediatr Radiol 2021 May 12. Epub 2021 May 12.

Department of Radiology, M Health Fairview University of Minnesota Masonic Children's Hospital, Mayo Memorial Building, 420 Delaware St. SE, Minneapolis, MN, 55455, USA.

While still uncommon, the incidence of acute pancreatitis in children has been increasing over the last two decades. The Atlanta classification for acute pancreatitis, developed for adults, stratifies cases of acute pancreatitis based on imaging and clinical criteria. This classification scheme allows for standardized use of terminology to facilitate treatment and prognostication. Read More

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Necrotizing fasciitis of the jaw, neck and mediastinum caused by Klebsiella oxytoca and Streptococcus constellatus: a case report.

Ann Palliat Med 2021 May 11. Epub 2021 May 11.

Department of Otolaryngology, Head and Neck Surgery, Tongji Hospital of Tongji University, Tongji University School of Medicine, Shanghai, China.

Necrotizing fasciitis (NF) is a rare, fulminant, lethal soft-tissue infection result in fascial necrosis, it is rarer in the head and neck area. Infection caused by Klebsiella oxytoca is much less common. Therefore, we reported a case of NF in the maxillofacial region, neck and upper mediastinum caused by Klebsiella oxytoca as the main cause recently treated in our department. Read More

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Preclinical studies conducted on nanozyme antioxidants: shortcomings and challenges based on US FDA regulations.

Nanomedicine (Lond) 2021 May 11. Epub 2021 May 11.

Pharmaceutical Sciences Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.

The wide prevalence of oxidative stress-induced diseases has led to a growing demand for antioxidant therapeutics worldwide. Nanozyme antioxidants are drawing enormous attention as practical alternatives for conventional antioxidants. The considerable body of research over the last decade and the promising results achieved signify the potential of nanozyme antioxidants to secure a place in the expanding market of antioxidant therapeutics. Read More

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Analysis of risk factors for different subtypes of acute coronary syndrome.

J Int Med Res 2021 May;49(5):3000605211008326

Department of Comprehensive Cardiology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang Province, China.

Aims: To investigate the different risk factors among different subtypes of patients with acute coronary syndrome (ACS).

Methods: A total of 296 patients who had ACS were retrospectively enrolled. Blood and echocardiographic indices were assessed within 24 hours after admission. Read More

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Reduction of TMAO level enhances the stability of carotid atherosclerotic plaque through promoting macrophage M2 polarization and efferocytosis.

Biosci Rep 2021 May 10. Epub 2021 May 10.

Shanghai Huashan Hospital, Shanghai, China.

It has been demonstrated that trimethylamine N-oxide (TMAO) serves as a driver of atherosclerosis, suggesting that reduction of TMAO level might be a potent method to prevent the progression of atherosclerosis. Herein, we explored the role of TMAO in the stability of carotid atherosclerotic plaques, and disclosed the underlying mechanisms. The unstable carotid artery plaque models were established in C57/BL6 mice. Read More

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Spontaneous coronary dissection should not be ignored in patients with chest pain in autosomal dominant polycystic kidney disease: A case report.

World J Clin Cases 2021 May;9(13):3095-3101

Department of Cardiology, Tongji Hospital, Tongji University School of Medicine, Shanghai 200065, China.

Background: When autosomal dominant polycystic kidney disease (ADPKD) presents with acute coronary syndrome (ACS), the possibility of spontaneous coronary artery dissection (SCAD) should be highly considered. In some cases, SCAD is considered an extrarenal manifestation of ADPKD depending on the pathological characteristics of the unstable arterial wall in ADPKD.

Case Summary: Here, we report a 46-year-old female patient with ADPKD who presented with ACS. Read More

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Personalised positive-pressure ventilation in cystic fibrosis

Orv Hetil 2021 05 9;162(19):760-765. Epub 2021 May 9.

1 Heim Pál Országos Gyermekgyógyászati Intézet, Fül-Orr-Gégészeti Osztály, Budapest, Üllői út 86., 1089.

Összefoglaló. A cystás fibrosis az egyik leggyakoribb veleszületett genetikai rendellenesség, előfordulása Magyarországon 1:4000. Az érintett szervekben a mirigyek által termelt nyák emelkedett viszkozitása krónikus gyulladáshoz vezet. Read More

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Emulsion acid colloidal stability and droplet crystallinity modulate postprandial gastric emptying and short-term satiety: a randomized, double-blinded, crossover, controlled trial in healthy adult males.

Am J Clin Nutr 2021 May 8. Epub 2021 May 8.

Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, Ontario, Canada.

Background: Emulsion droplet triacylglycerol (TAG) crystallinity and colloidal stability can alter the postprandial metabolism, although evidence of their interactive effects is limited.

Objectives: This acute meal crossover study investigated the influences of droplet TAG crystallinity at 37°C and colloidal gastric stability on gastric emptying (GE), acute lipemia, and satiety.

Methods: We gave 15 healthy adult males (mean ± SD age, 24. Read More

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Laminoplasty with selective fusion at unstable segment versus laminectomy with fusion for multilevel cervical myelopathy: a case-control study.

BMC Musculoskelet Disord 2021 May 7;22(1):426. Epub 2021 May 7.

Shanghai Key Laboratory of Orthopedic Implants, Department of Orthopedics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, 200011, Shanghai, People's Republic of China.

Background: Segmental cervical instability is a risk factor for the progression of osteophytic bone spurs and development of myelopathy, and is treated as a relative contraindication of cervical laminoplasty. The aim of this study was to compare laminoplasty with selective fixation (LPSF) versus laminectomy with fusion (LCF) in patients with multilevel cervical myelopathy accompanied by segmental instability.

Methods: A case-control study was conducted by reviewing data from 63 patients who underwent LPSF (n = 30) or LCF (n = 33). Read More

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Invasive Therapies for Acute Coronary Syndromes in the COVID-19 Era.

Curr Cardiol Rep 2021 05 7;23(6):69. Epub 2021 May 7.

Division of Cardiology, Baylor College of Medicine, Houston, TX, USA.

Purpose Of Review: To identify and address the challenges associated with the care of ACS patients during the coronavirus 2019 pandemic.

Recent Findings: The COVID-19 pandemic has had a considerable global impact with over 2.0 million deaths worldwide so far. Read More

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Transarterial Embolization for Bleeding in Patients with Head and Neck Cancer: Who Benefits?

Laryngoscope 2021 May 7. Epub 2021 May 7.

Department of Diagnostic and Interventional Radiology, Aichi Cancer Center Hospital, Nagoya, Aichi, Japan.

Objectives/hypothesis: The present study aimed to investigate the efficacy of transarterial embolization (TAE) for bleeding in patients with head and neck cancer (HNC) and to evaluate the prognostic factors after TAE.

Study Design: Outcome study.

Methods: This retrospective study included 31 consecutive patients (27 men and 4 women; median age, 61 years) who presented uncontrollable hemorrhage associated with HNC and underwent emergency TAE at our institution during a 10-year period (January 2011-December 2020). Read More

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