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What Is the Role of Assessing Ischemia to Optimize Therapy and Outcomes for Patients with Stable Angina and Non-obstructed Coronary Arteries?

Cardiovasc Drugs Ther 2021 May 12. Epub 2021 May 12.

Division of Cardiovascular Medicine, University of Florida, Gainesville, FL, USA.

Ischemic heart disease (IHD) is a leading global cause of ill-health and premature death. Clinical research into IHD is providing new insights into the pathophysiology, epidemiology and treatment of this condition. The major endotypes of IHD include coronary heart disease (CHD) and vasomotor disorders, including microvascular angina and vasospastic angina. Read More

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The value of computed tomography in assessing the risk of death in COVID-19 patients presenting to the emergency room.

Eur Radiol 2021 May 12. Epub 2021 May 12.

Epidemiology Unit, AUSL-IRCCS di Reggio Emilia, Reggio Emilia, Italy.

Objective: The aims of this study were to develop a multiparametric prognostic model for death in COVID-19 patients and to assess the incremental value of CT disease extension over clinical parameters.

Methods: Consecutive patients who presented to all five of the emergency rooms of the Reggio Emilia province between February 27 and March 23, 2020, for suspected COVID-19, underwent chest CT, and had a positive swab within 10 days were included in this retrospective study. Age, sex, comorbidities, days from symptom onset, and laboratory data were retrieved from institutional information systems. Read More

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Distribution of Estimated Lifetime Breast Cancer Risk Among Women Undergoing Screening Mammography.

AJR Am J Roentgenol 2021 May 12:1-8. Epub 2021 May 12.

Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL.

Supplemental screening breast MRI is recommended for women with an estimated lifetime risk of breast cancer of greater than 20-25%. The performance of risk prediction models varies for each individual and across groups of women. The present study investigates the concordance of three breast cancer risk prediction models among women presenting for screening mammography. Read More

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CUN-BAE Index as a Screening Tool to Identify Increased Metabolic Risk in Apparently Healthy Normal-Weight Adults and Those with Obesity.

J Nutr 2021 May 12. Epub 2021 May 12.

Nutrigenomics and Obesity Group, University of the Balearic Islands, Palma, Spain.

Background: Imbalanced dietary intake is related to increased adiposity, which is linked to increased metabolic risk even in the absence of obesity. BMI is traditionally used to classify body fatness and weight range, but it only considers body weight and height. The Clínica Universidad de Navarra-Body Adiposity Estimator (CUN-BAE) equation has appeared as an additional tool to estimate adiposity considering also other relevant parameters, i. Read More

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Breast imaging hindered during covid-19 pandemic, in Brazil.

Rev Saude Publica 2021 10;55. Epub 2021 May 10.

Hospital São Luiz. Matter Group Assistência Médica. São Paulo, SP, Brasil.

Objective: To report the decrease in breast imaging after covid-19 pandemic, obtaining the number of mammograms performed in 2019 and 2020. Additionally, to investigate if there was an increase in the proportion of women undergoing mammography for diagnostic purposes, with palpable lesions.

Method: This is a cross-sectional study, based on the number of mammograms performed by the Brazilian public health services, provided by DATASUS, an open access database. Read More

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Understanding Women's Vaginal Douching Behaviors and Practices for Consideration in the Development of a Potential Future Vaginal Microbicide Douche for HIV Prevention: A Systematic Review of the Literature.

AIDS Behav 2021 May 12. Epub 2021 May 12.

Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, USA.

Despite clinicians consistently advising against vaginal douching, 29-92% of women worldwide report douching. This review documents women's douching practices, motivations for douching, and specific associations (or absence of associations) between vaginal douche use and vaginal outcomes thought to be associated with douching. Understanding women's existing douching behaviors and vaginal health outcomes is critical for developing a safe vaginal microbicide douche that can be used as HIV pre-exposure prophylaxis (PrEP). Read More

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Pelvic and acetabular trauma in amateur equestrian enthusiasts - A retrospective review.

Surgeon 2021 May 8. Epub 2021 May 8.

National Centre for Pelvic and Acetabular Trauma, Department of Trauma and Orthopaedics, Tallaght University Hospital, Dublin, Ireland.

Introduction: Horse riding related accidents can present with devastating pelvic and acetabular fractures. This study examines the nature, management and treatment outcomes of severe pelvic and acetabular trauma in amateur horse riders presenting to a national tertiary referral centre. We also aim to define certain at-risk groups. Read More

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Sex disparities in vitamin D status and the impact on systemic inflammation and survival in rectal cancer.

BMC Cancer 2021 May 11;21(1):535. Epub 2021 May 11.

Department of Oncology, Akershus University Hospital, Lørenskog, Norway.

Background: We reported previously that rectal cancer patients given curative-intent chemotherapy, radiation, and surgery for non-metastatic disease had enhanced risk of metastatic progression and death if circulating levels of 25-hydroxyvitamin D [25(OH) D] were low. Here we investigated whether the association between the vitamin D status and prognosis pertains to the general, unselected population of rectal cancer patients.

Methods: Serum 25(OH) D at the time of diagnosis was assessed in 129 patients, enrolled 2013-2017 and representing the entire range of rectal cancer stages, and analyzed with respect to season, sex, systemic inflammation, and survival. Read More

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How do pregnant women's perceptions of obstetric forceps change according to their demographic background: a cross sectional study.

BMC Pregnancy Childbirth 2021 May 11;21(1):371. Epub 2021 May 11.

Department of OBGYN, The University of Kansas Health System, 3901 Rainbow Blvd, Kansas City, Kansas, 66160, USA.

Background: Women's attitudes towards obstetric forceps likely contribute to declining use and opportunities for residency training, but formal documentation of women's attitudes towards obstetric forceps is currently limited. A clearer understanding should help guide our attempts to preserve its use in modern obstetrics and to improve residency training. Our objective is to document women's attitudes towards obstetric forceps and the influence basic demographic variables have on those attitudes. Read More

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Primary Follicular Dendritic Cell Sarcoma of Breast: 2 Further Cases with Review of the Literature.

Int J Surg Pathol 2021 May 11:10668969211017317. Epub 2021 May 11.

Aga Khan University Hospital, Karachi, Pakistan.

Follicular dendritic cell sarcoma (FDCS) is a tumor derived from antigen-presenting cells and can occur within lymphoid tissue or at extranodal sites. FDCS of the breast is remarkably rare, with only 4 cases previously reported in literature. FDCS appears grossly as a well-circumscribed, firm mass with a grey-yellow surface, areas of necrosis, and histologically comprises of spindled, oval, or epithelioid cells with intensely eosinophilic cytoplasm. Read More

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Retinal Migraine: Evaluation and Management.

Curr Neurol Neurosci Rep 2021 May 11;21(7):35. Epub 2021 May 11.

Division of Neurology, University of Toronto, Toronto, Canada.

Purpose Of Review: This review aims to summarize the last 15 years of literature and case reports detailing retinal migraine-an uncommon and somewhat poorly understood migraine variant.

Recent Findings: In the last 15 years, only 12 cases of retinal migraine have been outlined. Similar to other migraine statistics, retinal migraine appears to affect women more so than men and presents with unilateral headache which tends to be ipsilateral to the side of vision loss. Read More

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Evidence-based priorities of under-served pregnant and parenting adolescents: addressing inequities through a participatory approach to contextualizing evidence syntheses.

Int J Equity Health 2021 May 10;20(1):118. Epub 2021 May 10.

Participatory Research at McGill (PRAM), Department of Family Medicine, McGill University, Montreal, Quebec, Canada.

Purpose: This study describes an interdiscursive evidence-based priority setting process with pregnant and parenting adolescents and their services providers.

Methods: A mixed methods literature review identified studies reporting on perinatal outcomes and experiences of adolescents during pregnancy to 12 months post-partum published in Canada after 2000. We also calculated relative risks for common perinatal risk factors and outcomes for adolescents compared to adult populations from 2012 to 2017 based on data from a provincial database of maternal and newborn outcomes. Read More

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Invasive breast Cancer treatment in Tanzania: landscape assessment to prepare for implementation of standardized treatment guidelines.

BMC Cancer 2021 May 10;21(1):527. Epub 2021 May 10.

Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., Office E6150, Baltimore, MD, 21205, USA.

Background: Incidence of breast cancer continues to rise in low- and middle-income countries, with data from the East African country of Tanzania predicting an 82% increase in breast cancer from 2017 to 2030. We aimed to characterize treatment pathways, receipt of therapies, and identify high-value interventions to increase concordance with international guidelines and avert unnecessary breast cancer deaths.

Methods: Primary data were extracted from medical charts of patients presenting to Bugando Medical Center, Tanzania, with breast concerns and suspected to have breast cancer. Read More

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Function and disability status among women with fistula using WHODAS2.0: A descriptive study from Rwanda and Democratic Republic of Congo.

Int J Gynaecol Obstet 2021 May 10. Epub 2021 May 10.

Johns Hopkins University School of Medicine, Baltimore, MD, USA.

Objective: To assess function and disability among women in Rwanda and Democratic Republic of Congo living with fistula and identify characteristics associated with higher disability scores.

Methods: Women presenting for fistula care were recruited. Eligible participants underwent a physical examination to classify fistula type and completed WHODAS 2. Read More

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Neglected sexual dysfunction symptoms amongst chronic patients during routine consultations in rural clinics in the North West province.

Afr J Prim Health Care Fam Med 2021 Apr 28;13(1):e1-e7. Epub 2021 Apr 28.

Division of Family Medicine, School of Clinical Medicine, University of the Witwatersrand, Johannesburg.

Background: Sexual dysfunction contributes to personal feelings of loss and despair and being a cause of exacerbated interpersonal conflict. Erectile dysfunction is also an early biomarker of cardiovascular disease. As doctors hardly ever ask about this problem, it is unknown how many patients presenting for routine consultations in primary care suffer from symptoms of sexual dysfunction. Read More

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School and work absenteeism due to menstruation in three West African countries: findings from PMA2020 surveys.

Sex Reprod Health Matters 2021 Dec;29(1):1915940

Professor, The Water Institute, Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.

Reports of school and work absences due to unmet menstrual needs have prompted increased attention to menstruation in policy and practice. However, there appear to be few quantitative studies reported in published literature capturing the prevalence of this hypothesised absenteeism. This study undertook secondary analysis of nationally representative Performance Monitoring and Accountability 2020 (PMA2020) data from Burkina Faso and Nigeria, and city-representative data from Niamey, Niger to determine the extent of women's and girls' self-reported absence from school and work due to menstruation. Read More

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December 2021

Cost-effectiveness of mifepristone and misoprostol versus misoprostol alone for the management of missed miscarriage: an economic evaluation based on the MifeMiso Trial.

BJOG 2021 May 10. Epub 2021 May 10.

NHS Greater Glasgow and Clyde, Glasgow, UK.

Objective: To assess the cost-effectiveness of mifepristone and misoprostol (MifeMiso) compared with misoprostol only for the medical management of a missed miscarriage.

Design: Within-trial economic evaluation and model-based analysis to set the findings in the context of the wider economic evidence for a range of comparators. Incremental costs and outcomes were calculated using non-parametric bootstrapping and reported using cost-effectiveness acceptability curves. Read More

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Emergency department visits among people with cancer: Frequency, symptoms, and characteristics.

J Am Coll Emerg Physicians Open 2021 Jun 1;2(3):e12438. Epub 2021 May 1.

Division of Cancer Prevention and Control National Center for Chronic Disease Prevention and Health Promotion Centers for Disease Control and Prevention Atlanta Georgia USA.

Objective: People with cancer are increasingly more likely to visit an emergency department for acute care than the general population. They often have long wait times and more exposure to infection and receive treatment from staff less experienced with cancer-related problems. Our objective was to examine emergency department (ED) visits among people with cancer to understand how often and why they seek care. Read More

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Higher Physical Activity Levels May Help Buffer the Negative Psychological Consequences of Coronavirus Disease 2019 Pandemic.

Front Psychol 2021 22;12:672811. Epub 2021 Apr 22.

CIEQV - Life Quality Research Centre, Polytechnic of Leiria, Leiria, Portugal.

This study explored the associations between physical activity (PA) anxiety levels, and the perception of satisfaction of basic psychological needs (BPN), during Coronavirus Disease 2019 (COVID-19) lockdown. Thus, 1,404 participants (977 women, 426 men, and one respondent preferred not to answer) ranging from 18 to 89 years old (36.4 ± 11. Read More

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Fetal akinesia: The need for clinical vigilance in first trimester with decreased fetal movements.

Taiwan J Obstet Gynecol 2021 May;60(3):559-562

Prenatal Diagnostic Center, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, China. Electronic address:

Objective: We present two cases of fetal akinesia detected by first trimester ultrasound with noticing reduced fetal movements.

Case Report: Both of the two cases presented with reduced fetal movements. Fetal microarray results were normal. Read More

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Visual field-based grading of disease severity in newly diagnosed primary open angle glaucoma patients presenting to a tertiary eye care centre in India.

Int Ophthalmol 2021 May 9. Epub 2021 May 9.

Aravind Eye Hospital, Madurai, Tamil Nadu, India.

Purpose: To evaluate the severity of primary open angle glaucoma (POAG) at presentation using visual field analysis and its relationship to demographic and ocular factors in patients presenting to a tertiary eye care centre.

Design: Cross-sectional study.

Methods: Newly diagnosed POAG patients were classified as early, moderate, or severe stage in the worse eye based on the Humphrey visual field testing using Hodapp-Parrish-Andersons criteria. Read More

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Our experience with the laparoscopic surgery of hiatal hernias

Orv Hetil 2021 05 9;162(19):754-759. Epub 2021 May 9.

1 Markusovszky Egyetemi Oktatókórház, Szombathely.

Összefoglaló. Bevezetés: A hiatus hernia egy anatómiai betegség; gyakoribb előfordulása idősebbeknél jelezheti, hogy a betegség idővel előrehalad, súlyosbodik. Elhanyagolt esetben szövődmények alakulhatnak ki, melyek növelhetik a perioperatív mortalitást. Read More

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Changes in Sexual Fantasy and Solitary Sexual Practice During Social Lockdown Among Young Adults in the UK.

Sex Med 2021 May 5;9(3):100342. Epub 2021 May 5.

Bournemouth University, Poole, England, UK. Electronic address:

Introduction: Pandemic-related social lockdown limited many sexual behaviors, but to date, no study has examined the perceived impact of social lockdown due to COVID-19 on sexual fantasy and solitary sexual behavior.

Aims: The present study sought to examine the perceived impact of social lockdown on sexual fantasy and solitary sexual behavior among UK young adults in various living situations.

Methods: A convenience sample of 565 adults aged 18-32 and living in the UK completed anonymous, web-based, study-specific questionnaires between May 14 and 18, 2020, 7 weeks after social lockdown was initiated. Read More

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Am J Med Sci 2021 May 4. Epub 2021 May 4.

Division of Cardiology, University of Florida College of Medicine, Jacksonville, FL. Electronic address:

Background: This study aimed to assess sex and racial differences related to high-density lipoprotein cholesterol (HDL-C) levels in those presenting with acute coronary syndromes (ACS) .

Methods: Records from patients with ACS presenting to the Emergency Department of University of Florida Hospital Jacksonville from 2009-2012, were reviewed. Detailed medical history was obtained. Read More

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Losses Associated With Childhood Sexual Abuse in Women Survivors: A Scoping Review.

Trauma Violence Abuse 2021 May 7:15248380211013137. Epub 2021 May 7.

56405North West University, Vanderbijlpark, Gauteng, South Africa.

Method: This article reports the findings of a scoping review designed to identify research exploring the losses associated with childhood sexual abuse in women survivors. A systematic search of databases for articles published between 1983 and 2019 were conducted using keywords related to loss and women survivors of childhood sexual abuse.

Findings: Twenty studies were selected for review using predefined inclusion criteria: studies that include adult women survivors of childhood sexual abuse, studies that include child/childhood sexual abuse, studies that include stigmatized loss, studies that indicate stigmatized loss in adult women survivors of childhood sexual abuse. Read More

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Fungal Melanonychia as a Solitary Black Linear Vertical Nail Plate Streak: Case Report and Literature Review of Candida-Associated Longitudinal Melanonychia Striata.

Cureus 2021 Apr 1;13(4):e14248. Epub 2021 Apr 1.

Pain Management/Palliative Care, Scripps Memorial Hospital, La Jolla, USA.

Longitudinal melanonychia striata, presenting as a black linear vertical band of the nail plate, can be caused by pigmented lesions and non-pigmented etiologies. A fungal infection of the nail plate, also referred to as onychomycosis or tinea unguim, can result from dermatophytes, non-dermatophyte molds, and . Albeit rare, -associated fungal melanonychia can present as a longitudinal black nail plate streak. Read More

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Quantifying procedural pain associated with office gynecologic tract sampling methods.

Gynecol Oncol 2021 May 3. Epub 2021 May 3.

Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, MN, United States of America. Electronic address:

Objective: Emerging technologies may enable detection of endometrial cancer with methods that are less invasive than standard biopsy methods. This study compares patient pain scores among 3 office gynecologic tract sampling methods and explores their potential determinants.

Methods: A prospective study including 3 sampling methods (tampon, Tao brush (TB), endometrial biopsy (EB)) was conducted between December 2015 and August 2017 and included women ≥45 years of age presenting with abnormal uterine bleeding, postmenopausal bleeding, or thickened endometrial stripe. Read More

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ACR Appropriateness Criteria® Postmenopausal Acute Pelvic Pain.

J Am Coll Radiol 2021 May;18(5S):S119-S125

Specialty Chair, University of Toronto and Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.

Acute pelvic pain is a common presenting complaint in both the emergency room and outpatient settings. Pelvic pain of gynecologic origin in postmenopausal women occurs less frequently than in premenopausal women; however, it has important differences in etiology. The most common causes of postmenopausal pelvic pain from gynecologic origin are ovarian cysts, uterine fibroids, pelvic inflammatory disease, and ovarian neoplasm. Read More

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The precordial R'-wave: a novel discriminator between cardiac sarcoidosis and arrhythmogenic right ventricular cardiomyopathy in patients presenting with ventricular tachycardia.

Heart Rhythm 2021 May 3. Epub 2021 May 3.

Department of Cardiology, Willem Einthoven Center of Arrhythmia research and Management, Leiden University Medical Center, The Netherlands. Electronic address:

Background: Cardiac sarcoidosis (CS) with right ventricular (RV) involvement can mimic arrhythmogenic right ventricular cardiomyopathy (ARVC). Histopathological differences may result in disease-specific RV activation patterns, detectable on the 12-lead electrocardiogram (ECG). Dominant subepicardial scar in ARVC leads to delayed activation of areas with reduced voltages, translating into terminal activation delay and occasionally (epsilon) waves with small amplitude. Read More

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Are Newborn Outcomes Different for Term Babies Who Were Exposed to Antenatal Corticosteroids?

Am J Obstet Gynecol 2021 May 3. Epub 2021 May 3.

Indiana University School of Medicine Department of Obstetrics and Gynecology. Electronic address:

Background: Antenatal corticosteroids improve newborn outcomes for preterm infants. However, predicting which women presenting for threatened preterm labor will have preterm infants is inaccurate and many women receive antenatal corticosteroids but then go on to deliver at term.

Objective: The purpose of this study was to compare the short-term outcomes of infants born at term to women who received betamethasone (BMZ) for threatened preterm labor to infants who were not exposed to BMZ in utero. Read More

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