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Sonographic and ophthalmic assessment of optic nerve in patients with idiopathic intracranial hypertension: A longitudinal study.

J Neurol Sci 2021 Sep 4;430:118069. Epub 2021 Sep 4.

Department of Neurology, Saarland University Medical Center, Homburg, Germany.

Background: To assess the validity of neurosonological parameters (transorbital sonography (TOS)) for detection and monitoring of patients with idiopathic intracranial hypertension (IIH).

Methods: Prospective, single-center, case-controlled study in 25 patients with IIH and 19 controls. Visual parameters of papilledema, visual acuity, computerized static threshold perimetry, fundus examination, and neurosonological parameters of papilledema/optic disc elevation (ODE), optic nerve sheath diameter (ONSD) and optic nerve diameter (OND) were recorded at baseline and only for patients with IIH again within 6 months. Read More

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September 2021

Safety and Immunogenicity of a 20-valent Pneumococcal Conjugate Vaccine in Healthy Infants in the United States.

Pediatr Infect Dis J 2021 Oct;40(10):944-951

Vaccine Research and Development, Pfizer Inc, Collegeville, Pennsylvania.

Background: The development and widespread use of pneumococcal conjugate vaccines (PCVs) substantially reduced the global burden of pneumococcal disease. Expanding the serotypes covered by PCVs may further reduce disease burden. A 20-valent PCV (PCV20) has been developed to add coverage for 7 additional serotypes (8, 10A, 11A, 12F, 15B, 22F and 33F) to those in the existing 13-valent PCV (PCV13). Read More

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October 2021

Locus-of-care disparities in end-of-life care intensity among adolescents and young adults with cancer: A population-based study using the IMPACT cohort.

Cancer 2021 Sep 15. Epub 2021 Sep 15.

Division of Haematology/Oncology, Hospital for Sick Children, Toronto, Ontario, Canada.

Background: Adolescents and young adults (AYAs) with cancer may experience elevated rates of high-intensity end-of-life (HI-EOL) care. Locus-of-care (LOC) disparities (pediatric vs adult) in AYA end-of-life (EOL) care are unstudied.

Methods: A decedent population-based cohort of Ontario AYAs diagnosed between 1992 and 2012 at the ages of 15 to 21 years was linked to administrative data. Read More

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September 2021

Analysis of State Cannabis Laws and Dispensary Staff Recommendations to Adults Purchasing Medical Cannabis.

JAMA Netw Open 2021 Sep 1;4(9):e2124511. Epub 2021 Sep 1.

Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, Oregon.

Importance: Over the last decade, cannabis has become more accessible through the proliferation of dispensaries in states that have legalized its use. Most patients using cannabis for medical purposes report getting advice from dispensaries, yet there has been little exploration of frontline dispensary staff practices.

Objective: To describe the practices of frontline dispensary workers who interact with customers purchasing cannabis for medical purposes and assess whether dispensary practices are associated with medicalization of state cannabis laws (degree to which they resemble regulation of prescription or over-the-counter drugs) and statewide adult use. Read More

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September 2021

Risk Factors Associated with Aggravation of Cervical Spine Lesions in Patients with Rheumatoid Arthritis.

Spine (Phila Pa 1976) 2021 Sep 14. Epub 2021 Sep 14.

Department of Orthopaedic Surgery, Yokohama City University Medical Center, 4-57 Urafune-cho, Minamai, Yokohama, Kanagawa, 232-0024, Japan.

Study Design: A retrospective cohort study.

Objective: To examine factors related to severe aggravation of pre-existing cervical lesions in patients with rheumatoid arthritis (RA) under current pharmacologic treatments with biologics.

Summary Of Background Data: Advanced RA cervical lesions carry a risk of irreversible damage to the spinal cord; however, risk factors for aggravation are unclear after the use of biologics became more popular. Read More

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September 2021

The Use of Community Health Workers in Community Health Centers.

Med Care 2021 Oct;59(Suppl 5):S457-S462

George Washington University School of Medicine, Washington, DC.

Background: Until 2016, community health centers (CHCs) reported community health workers (CHWs) as part of their overall enabling services workforce, making analyses of CHW use over time infeasible in the annual Uniform Data System (UDS).

Objective: The objective of this study was to examine changes in the CHW workforce among CHCs from 2016 to 2018 and factors associated with the use of CHWs.

Research Design, Subjects, Measures: The two-part model estimated separate effects for the probability of using any CHW and extent of CHW full-time equivalents (FTEs) reported in those CHCs, using a total of 4102 CHC-year observations from 2016 to 2018. Read More

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October 2021

The Effect of National Health Service Corps Clinician Staffing on Medical and Behavioral Health Care Costs in Community Health Centers.

Med Care 2021 Oct;59(Suppl 5):S428-S433

Department of Health Policy and Management, Milken Institute School of Public Health, The George Washington University, Washington, DC.

Objective: Prior studies of community health centers (CHCs) have found that clinicians supported by the National Health Service Corps (NHSC) provide a comparable number of primary care visits per full-time clinician as non-NHSC clinicians and provide more behavioral health care visits per clinician than non-NHSC clinicians. This present study extends prior research by examining the contribution of NHSC and non-NHSC clinicians to medical and behavioral health costs per visit.

Methods: Using 2013-2017 data from 1022 federally qualified health centers merged with the NHSC participant data, we constructed multivariate linear regression models with health center and year fixed effects to examine the marginal effect of each additional NHSC and non-NHSC staff full-time equivalent (FTE) on medical and behavioral health care costs per visit in CHCs. Read More

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October 2021

An Enhanced SMS-based Support and Reminder Program for Young Adults with Type 2 Diabetes (TEXT2U): Randomized Controlled Trial.

J Med Internet Res 2021 Jul 21. Epub 2021 Jul 21.

Diabetes Centre, Royal Prince Alfred Hospital, Missenden Road, Camperdown, AU.

Background: Clinic attendance, metabolic control, engagement in self-management and psychological health are suboptimal in young-onset (<40 years) type 2 diabetes.

Objective: We examined the effectiveness of an enhanced SMS-based support and reminder program in improving clinic attendance, metabolic control, engagement in self-management and psychological health in young-onset type 2 diabetes.

Methods: A twelve-month, parallel-arm, randomized controlled trial comparing an enhanced, semi-personalized SMS-based intervention (incorporating one to eight, supportive and/or informative text messages/month) against standard care was conducted in a specialist, young adult type 2 diabetes clinic. Read More

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Initial visit symptoms in probable Behçet's syndrome is predictive of ISG criteria fulfillment in Behçet's syndrome: data from New York and Amsterdam cohorts.

Clin Exp Rheumatol 2021 Sep 13. Epub 2021 Sep 13.

New York University School of Medicine, New York, NY, USA.

Objectives: Behçet's syndrome (BS) is a systemic vasculitis with heterogeneous clinical presentation and a relapsing disease course. The International Study Group (ISG) criteria are most often used for classification. A significant proportion of patients is classified as probable BS because they do not fulfil the criteria at initial presentation. Read More

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September 2021

Diabetes Technology Use in Remote Pediatric Patients with Type 1 Diabetes Using Clinic-to-Clinic Telemedicine.

Diabetes Technol Ther 2021 Sep 15. Epub 2021 Sep 15.

University of Colorado - Anschutz Medical Campus, 129263, Barbara Davis Center for Diabetes, 1775 Aurora Court, Aurora, Colorado, United States, 80045-2559;

Background: Clinic-to-clinic telemedicine can increase visit frequency in pediatric patients with type 1 diabetes (T1D) living far from a diabetes specialty clinic, but the impact on adoption of diabetes technology is unclear.

Methods: Pediatric patients with T1D in Colorado and surrounding states who received diabetes care using clinic-to-clinic telemedicine were enrolled. Medical records and surveys were reviewed to ascertain technology use, and data were compared to patients from the main clinic population. Read More

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September 2021

Patient-Reported Outcomes with Selpercatinib Among Patients with RET Fusion-Positive Non-small Cell Lung Cancer in the Phase 1/2 LIBRETTO-001 Trial.

Oncologist 2021 Sep 15. Epub 2021 Sep 15.

University of California at San Francisco, USA.

Background: LIBRETTO-001 is an ongoing, global, open-label, phase 1/2 study of selpercatinib in patients with advanced or metastatic solid tumors. We report interim patient-reported outcomes in patients with RET fusion-positive non-small-cell lung cancer (NSCLC).

Patients And Methods: Patients completed the EORTC QLQ-C30 version 3. Read More

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September 2021

Depression mediates physical activity readiness and physical activity in patients with heart failure.

ESC Heart Fail 2021 Sep 15. Epub 2021 Sep 15.

Heart Failure and Transplants Unit, Department of Cardiology, Universitary and Politecnic La Fe Hospital, Valencia, Spain.

Aims: Although physical activity (PA) and exercise are essential for patients with heart failure (HF), adherence to the recommended guidelines is low. Not much is known about the mediating effect of HF patients' mental state with their readiness for PA and reported activity levels. The purpose of this study is to investigate the mediatory effect of depression on PA readiness (physical limitation and psychological readiness) and self-reported PA in patients with HF. Read More

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September 2021

Exposure-lag-response associations between extreme environmental conditions and primary Sjögren's syndrome.

Clin Rheumatol 2021 Sep 14. Epub 2021 Sep 14.

Technical University of Munich, Heilbronn, Germany.

Introduction: Patients with primary Sjögren's syndrome (pSS) reportedly believe that their symptoms worsen on extreme weather days due to variations in environmental conditions. However, few studies have assessed the acute effects of environmental exposure on the onset of pSS. This study aimed to evaluate the exposure-response relationship between extreme environmental conditions and pSS outpatient visits. Read More

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September 2021

The impact of constant antibiotic prophylaxis in children affected by spinal dysraphism performing clean intermittent catheterization: a 2-year monocentric retrospective analysis.

Childs Nerv Syst 2021 Sep 14. Epub 2021 Sep 14.

Unità Operativa Spina Bifida e Uropatie Malformative, Dipartimento Di Scienze Della Salute Della Donna, Del bambino e Di sanità pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.

Introduction: Spinal dysraphism (SD) is a general term used to refer to developmental abnormalities of the spine that involves many clinical conditions including myelomeningocele (MMC). In these patients, neurogenic bladder (NB) is a common and predisposing factor for renal damage; the most frequently used approach to manage this situation is based on clean intermittent catheterization (CIC) and anticholinergic drugs. Urinary tract infections (UTIs) are a significant concern for these patients, and antibiotic prophylaxis is frequently used even if it is still a debated topic of literature. Read More

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September 2021

Stratifying the risk of NAFLD in patients with HIV under combination antiretroviral therapy (cART).

EClinicalMedicine 2021 Oct 5;40:101116. Epub 2021 Sep 5.

Department of Internal Medicine I, University Hospital Frankfurt, Germany.

Background: De novo steatosis is the main criteria for non-alcoholic fatty liver disease (NAFLD), which is becoming a clinically relevant comorbidity in HIV-infected patients. This may be due to the HIV virus itself, as well as long-term toxicities deriving from antiretroviral therapy. Therefore, HIV infected patients require prevention and monitoring regarding NAFLD. Read More

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October 2021

The Pattern of Superficial Lymphadenopathy on Fine Needle Aspiration Cytology in Clinical Practice in Islamabad.

Cureus 2021 Aug 10;13(8):e17075. Epub 2021 Aug 10.

Medical Affairs and Clinical Research, Hilton Pharma Pvt. Ltd., Karachi, PAK.

Background:  In adults, lymph nodes are not normally palpable. A number of patients with asymptomatic lymphadenopathy never visit physicians for the condition, and thus, this important sign is often missed by the medical practitioner if it is not the presenting complaint. The incidence of lymphadenopathy is suggested to be increasing. Read More

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Anterior Hip Dislocation After Hip Arthroscopy Complicated by Iliopsoas Bursitis.

Cureus 2021 Aug 10;13(8):e17044. Epub 2021 Aug 10.

Orthopedic Surgery, Monmouth Medical Center, Long Branch, USA.

Hip dislocation after hip arthroscopy is an uncommon postoperative complication. We report a case of a 51-year-old woman who underwent right hip arthroscopy and presented with an anterior hip dislocation on postoperative day five. The index surgery involved capsulotomy, cam lesion debridement, and femoroplasty for an anterosuperior labral tear and cam-type femoroacetabular impingement. Read More

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Intractable Vomiting in an 11-Month-Old Boy With Trisomy 21: A Case Report on Abnormal Calcium/Calcinosis/Creatinine in Down Syndrome.

Cureus 2021 Aug 2;13(8):e16827. Epub 2021 Aug 2.

Pediatrics and Adolescent Medicine, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, USA.

Abnormal calcium/calcinosis/creatinine in Down syndrome (ABCD syndrome) is a very rare condition with no clear etiology. In this paper, we describe our clinical encounter with this disease. We report the case of an 11-month-old male infant with Down syndrome (DS) who presented to the hospital with intractable vomiting and decreased oral intake and urine output. Read More

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Comparative Results Between "Epi-Off" Accelerated and "Epi-Off" Standard Corneal Collagen Crosslinking-UVA in Progressive Keratoconus - 7 Years of Follow-Up.

Ther Clin Risk Manag 2021 7;17:975-988. Epub 2021 Sep 7.

Department of Ophthalmology, Medicine and Pharmacy Science and Technology University "George Emil Palade", Târgu Mureș, Romania.

Purpose: The purpose of the present study was to assess the long-term efficiency and safety of the "epi-off" accelerated CXL (9 mW/cm for 10 minutes) in comparison to the standard "epi-off" CXL (3 mW/cm for 30 minutes) in terms of topographical and keratometric parameters, refractive data and visual outcomes at 7 years of follow-up, in progressive keratoconus.

Material And Method: A retrospective and comparative study was performed. A total of 183 eyes from 183 patients with documented progressive keratoconus were included in the study. Read More

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September 2021

Increased Serum Soluble Interleukin-2 Receptor Associated with Severity of Acute Exacerbation of Chronic Obstructive Pulmonary Disease.

Int J Chron Obstruct Pulmon Dis 2021 7;16:2561-2573. Epub 2021 Sep 7.

Department of Respiratory Medicine, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, People's Republic of China.

Background: This study aimed to reveal the correlation between serum soluble interleukin-2 receptor (sIL-2R) and prognosis in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).

Methods: A total of 315 patients diagnosed with AECOPD between December 2017 and June 2020 were enrolled. The patients were divided into the good and adverse groups based on the outcomes. Read More

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September 2021

Brolucizumab in Neovascular Age-Related Macular Degeneration - Indian Real-World Experience: The BRAILLE Study.

Clin Ophthalmol 2021 7;15:3787-3795. Epub 2021 Sep 7.

Department of Vitreoretinal Services, Disha Eye Hospitals, Kolkata, West Bengal, India.

Purpose: To assess the short-term efficacy and safety profile of intravitreal brolucizumab injection in Indian eyes with neovascular age-related macular degeneration (nAMD) under real-world conditions.

Patients And Methods: This was a multicenter, retrospective chart review of 94 eyes of 94 patients with nAMD (treatment-naïve and switch-therapy) undergoing brolucizumab therapy. Re-treatment as per pro-re-nata protocol was performed based on fixed visual and tomographic criteria. Read More

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September 2021

Outcomes and longitudinal trend of traumatic cataract wound dehiscence in patients with blunt ocular injury.

Sci Rep 2021 Sep 14;11(1):18191. Epub 2021 Sep 14.

Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan.

Longitudinal trends on traumatic cataract wound dehiscence are scant. In this study, we present the characteristics of traumatic cataract wound dehiscence using 15 years of longitudinal trend in one of the largest medical centers in Taiwan for a period when cataract surgeries were gradually shifting from extracapsular cataract extraction (ECCE) to phacoemulsification. All patients with a prior cataract surgery who suffered from blunt open globe trauma between 2001 and 2015 at a tertiary referral center in Taiwan were included. Read More

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September 2021

Demographic, occupational and societal risk exposures to physical injuries in a rural community in Western Kenya: a 12-week longitudinal study.

BMJ Open 2021 Sep 14;11(9):e053161. Epub 2021 Sep 14.

School of Public Health, Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya.

Objective: We studied factors associated with the weekly occurrence of physical injuries in a rural setting to determine injury-related burden and risk exposures.

Design: Prospective cohort study.

Setting: Suna-West subcounty, Migori County, Western Kenya. Read More

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September 2021

Minimal Model-Derived Insulin Sensitivity Index Underestimates Insulin Sensitivity in Black Americans.

Diabetes Care 2021 Sep 14. Epub 2021 Sep 14.

Clinical Endocrine Section, Diabetes, Endocrinology, and Obesity Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD

Objective: To examine the ethnic differences in insulin sensitivity (S) as measured by the minimal model approach (S-MM) and the reference method, the euglycemic-hyperinsulinemic clamp (EHC).

Research Design And Methods: In a prospective study design, thirty black Americans (BA) were age, sex, and BMI matched with non-Hispanic whites (NHW). Participants underwent frequently sampled intravenous tolerance test (FSIVGTT) and EHC on 2 separate days during a single visit. Read More

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September 2021

Improving the follow up rate for pediatric patients (0-16 years) attending Bharatpur Eye Hospital, Bharatpur, Chitwan, Nepal: A Public Health Intervention Study.

JMIR Res Protoc 2021 Sep 13. Epub 2021 Sep 13.

Bharatpur Eye Hospital, Bharatpur Metropolitan City-10 Bypass Road, Bharatpur, NP.

Background: The follow up of pediatric patients ensures regular ocular morbidity monitoring and better treatment outcome. Hiralal Santudevi Pradhan Institute of Ophthalmic Science (Bharatpur Eye Hospital (BEH)) noticed that the follow up rates was only 22% among its pediatric patients. Several factors like lack of awareness and forgetfulness among patients may contribute in less number of follow up visits. Read More

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September 2021

Bikes for Life: Measuring the effects of a bicycle distribution program on 6 to 12-year-old children's BMI and health behaviors.

Obes Res Clin Pract 2021 Sep 11. Epub 2021 Sep 11.

Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus and Children's Hospital Colorado, 13001 E 17th Pl, Aurora, CO 80045, United States; Department of Family Medicine, University of Colorado Anschutz Medical Campus, 13001 E 17th Pl, Aurora, CO 80045, United States. Electronic address:

Treating pediatric obesity is challenging. The objective was to evaluate effect of receiving a bicycle on (a) physical activity, (b) sedentary activity, (c) Body Mass Index (BMI), and (d) eating habits. A stepped-wedge randomized controlled trial of 6- to 12-year-old patients with overweight/obesity was conducted April 2012-2018. Read More

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September 2021

Association between first oral examination characteristics and dental treatment needs in privately insured children: A claims data analysis.

J Am Dent Assoc 2021 Sep 11. Epub 2021 Sep 11.

Background: Early childhood caries (ECC) remains the most common, preventable infectious disease among children in the United States. Screening is recommended after the eruption of the first tooth, but it is unclear how the age at first dental examination is associated with eventual restorative treatment needs. The authors of this study sought to determine how provider type and age at first dental examination are associated longitudinally with caries experience among children in the United States. Read More

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September 2021

Adherence to ruxolitinib, an oral JAK1/2 inhibitor, in patients with myelofibrosis: interim analysis from an Italian, prospective cohort study (ROMEI).

Leuk Lymphoma 2021 Sep 15:1-10. Epub 2021 Sep 15.

Hematology, Department of Translational and Precision Medicine, Azienda Policlinico Umberto I, Sapienza University, Rome, Italy.

ROMEI, a prospective, observational study in patients with myelofibrosis receiving the oral JAK1/2 inhibitor ruxolitinib in real-world practice, assesses treatment adherence based on the 8-item Morisky Medication Adherence Scale (MMAS-8). Here, we present MMAS-8 results at week 24. Overall, 101 of 188 evaluable patients completed the questionnaire at every visit (full completers). Read More

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September 2021

Pregnant Black Women and Emergency Department Utilization: Assessing Self-Reported Receipt of Prenatal Counseling.

West J Nurs Res 2021 Sep 15:1939459211043941. Epub 2021 Sep 15.

Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, USA.

There is limited literature on emergency department (ED) use among pregnant women. In this article, we examined the associations between prenatal counseling with the use of the ED during pregnancy. In our cohort of Black women in the Metro Detroit area, we found that approximately 70. Read More

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September 2021

Pediatric patients accessing Accident and Emergency Department (A&E) for non-urgent treatment: Why do parents take their children to the A&E?

Int Emerg Nurs 2021 Sep 11;58:101053. Epub 2021 Sep 11.

Academic Department of Pediatrics, Bambino Gesù Children's Hospital, IRCCS, Piazza Sant'Onofrio 4, 00165 Rome, Italy. Electronic address:

Introduction: About 20-30% of children access the Pediatric Accident and Emergency Department (A&E) for non-urgent health care that should normally follow other health care paths. This study aimed to investigate why parents take their children to the A&E for non-urgent visits rather than using primary care services.

Methods: A one-year cross-sectional study was conducted in a large pediatric A&E in Italy. Read More

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September 2021