14,608 results match your criteria worsening health

US Trends in Opioid Access Among Patients With Poor Prognosis Cancer Near the End-of-Life.

J Clin Oncol 2021 Jul 22:JCO2100476. Epub 2021 Jul 22.

Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA.

Purpose: Heightened regulations have decreased opioid prescribing across the United States, yet little is known about trends in opioid access among patients dying of cancer.

Methods: Among 270,632 Medicare fee-for-service decedents with poor prognosis cancers, we used part D data to examine trends from 2007 to 2017 in opioid prescription fills and opioid potency (morphine milligram equivalents per day [MMED]) near the end-of-life (EOL), defined as the 30 days before death or hospice enrollment. We used administrative claims to evaluate trends in pain-related emergency department (ED) visits near EOL. Read More

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Longitudinal Assessment of Quality of Life Following Molecular Testing for Indeterminate Thyroid Nodules.

Ann Surg Oncol 2021 Jul 22. Epub 2021 Jul 22.

Section of Endocrine Surgery, Department of Surgery, University of California Los Angeles David Geffen School of Medicine, 10833 Le Conte Ave. 72-227 CHS, Los Angeles, CA, 90095, USA.

Background: Molecular testing can refine the risk of malignancy in cytologically indeterminate thyroid nodules and can reduce the need for diagnostic thyroidectomy. However, quality of life (QOL) in patients mananged with molecular testing is not well studied.

Objective: We aimed to assess the QOL of patients undergoing surveillance after a benign molecular test result, or thyroidectomy after a suspicious molecular test result. Read More

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Comparative Analysis of Health Domains for Neuropathic Pain Patients.

Clin Nurs Res 2021 Jul 22:10547738211030640. Epub 2021 Jul 22.

University of Pennsylvania School of Nursing, Philadelphia, USA.

Active duty military members have significant service-related risks for developing pain from injury. Although estimates for neuropathic pain (NP) are available for civilian populations, the incidence and prevalence for NP in military members is less clear. Understanding correlates of pain in military members is vital to improving their physical, mental, and social health. Read More

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Vortioxetine Improved Depressive State In Parkinson's Disease.

Cureus 2021 Jun 18;13(6):e15750. Epub 2021 Jun 18.

Psychiatry, University of Occupational and Environmental Health, Kitakyushu, JPN.

We report the case of a 67-year-old Japanese Parkinson's disease (PD) patient with depression who was successfully treated with vortioxetine. The patient's PD was being treated with levodopa (100 mg/day). As improvement was noted in PD symptoms, levodopa was continued. Read More

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Exercise and Worsening of Extrapyramidal Symptoms during Treatment with Long-Acting Injectable Antipsychotics.

Pharmacy (Basel) 2021 Jul 3;9(3). Epub 2021 Jul 3.

British Columbia Mental Health & Substance Use Services Research Institute, Vancouver, BC V5Z 3L7, Canada.

Second-generation antipsychotic medications are used to treat schizophrenia and a range of other psychotic disorders, although adverse effects, including cardiovascular and metabolic abnormalities and extrapyramidal symptoms, are often inevitable. Studies have shown that exercise, as an adjunct therapy, can be effective in reducing the core symptoms of schizophrenia as well as ameliorating intrinsic and antipsychotic-induced cardiometabolic abnormalities. However, it is noteworthy that exercise may need to be implemented with caution in some individuals receiving certain antipsychotic treatment regimens. Read More

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Clinical Efficacy of Corticosteroids in the Early Stages of Deterioration in COVID-19 Pneumonia.

Infect Drug Resist 2021 12;14:2667-2674. Epub 2021 Jul 12.

Department of Respiratory Medicine, The Petroleum Clinical Medical College of Hebei Medical University, Langfang, Hebei, 065000, People's Republic of China.

Background: The World Health Organization (WHO) strongly suggests using corticosteroids in patients with severe coronavirus disease 2019 (COVID-19). Similarly, a large randomized controlled clinical trial (RCT) in the UK found that dexamethasone effectively reduced the mortality rate in severe COVID-19 patients. However, the safety profile of corticosteroids has been a controversial area of study. Read More

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Pediatric PTSD is characterized by age- and sex-related abnormalities in structural connectivity.

Neuropsychopharmacology 2021 Jul 20. Epub 2021 Jul 20.

Department of Psychiatry, University of Wisconsin School of Medicine & Public Health, Madison, USA.

Pediatric post-traumatic stress disorder (pPTSD) is a prevalent and pervasive form of mental illness comprising a disparate constellation of psychiatric symptoms. Emerging evidence suggests that pPTSD may be characterized by alterations in functional networks traversing the brain. Yet, little is known about pathological changes in the structural tracts underlying functional connectivity. Read More

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COVID-19 social distancing: negative effects on people with Parkinson disease and their associations with confidence for self-management.

BMC Neurol 2021 Jul 20;21(1):284. Epub 2021 Jul 20.

Department of Physical Therapy, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel.

Background: The purpose of this study was to describe the effects of COVID-19 social distancing on the function, health, and well-being of people with Parkinson disease (PD), and test the association of these effects with patients' activation levels, i.e., their skills and confidence in managing their health. Read More

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Changes in Health-Related Quality of Life After Transient Ischemic Attack.

JAMA Netw Open 2021 Jul 1;4(7):e2117403. Epub 2021 Jul 1.

Neurological Institute, Cleveland Clinic, Cleveland, Ohio.

Importance: Numerous studies have found that patients diagnosed with TIA have decreased health-related quality of life, which has been interpreted as suggesting that patients with TIA have residual symptoms after the event. Studies assessing health status in the same patients before and after an event are lacking but may allow a direct determination of the association of TIA with postevent health status.

Objective: To examine patient-reported health before transient ischemic attack (TIA) among individuals diagnosed with this event and evaluate change in patient-reported health after the event overall and by TIA characterization subgroups. Read More

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L5 Radiculopathy After Formal Reduction of High-Grade SDSG Type 5 and 6 L5-S1 Isthmic Spondylolisthesis with 2-Year Follow-Up.

Int J Spine Surg 2021 Jul 19. Epub 2021 Jul 19.

Post-Graduate Program in Health Science, Biomechanics and Musculoskeletal Rehabilitation Laboratory, University Santo Amaro, São Paulo, Brazil.

Background: Surgery is the main treatment for patients with high-grade L5-S1 isthmic spondylolisthesis, which can result in neurologic complications, but little is known about its clinical course. The present study evaluated the presence of L5 radiculopathy in high-grade L5-S1 spondylolisthesis in adults in pre- and postoperative periods and after a 2-year follow-up.

Methods: A series of 16 patients who underwent reduction and instrumented fusion for high-grade 5 and 6 spondylolisthesis between 2018 and 2019 were retrospectively evaluated in the pre- and postoperative periods as well as after 6 weeks, 3 months, 6 months, and 1 and 2 years of follow-up. Read More

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Dehydration and loss of appetite: Key nutrition features in older people receiving home health care.

Nutrition 2021 Jun 6;91-92:111385. Epub 2021 Jun 6.

Department of Surgery, School of Medical Sciences, Örebro University, Örebro, Sweden.

Objectives: The aim was to describe a population of older people in home health care based on what is probably a novel theoretical model, previously published, and to analyze longitudinal changes in different dimensions of nutritional status.

Methods: This explorative and longitudinal study examines nutritional status based on four domains in the novel theoretical model: health and somatic disorders; cognitive, affective, and sensory function; physical function and capacity; and food and nutrition. Inclusion criteria were age ≥65 y and need of home health care for more than three months. Read More

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Intergenerational upward mobility and racial differences in mortality among young adults: Evidence from county-level analyses.

Health Place 2021 Jul 17;70:102628. Epub 2021 Jul 17.

Institution for Social and Policy Studies, Yale University, New Haven, CT, USA.

Inspired by the influential "deaths of despair" narrative, which emphasizes the role of worsening economic opportunity in driving the increasing mortality for non-Hispanic Whites in the recent decades, a rising number of studies have provided suggestive evidence that upward mobility levels across counties may partly explain variations in mortality rates. A gap in the literature is the lack of life-course studies examining the relationship between early-life upward mobility and later-life mortality across counties. Another gap is the lack of studies on how the relationship between upward mobility and mortality across counties varies across diverse sociodemographic populations. Read More

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Plastic and its consequences during the COVID-19 pandemic.

Environ Sci Pollut Res Int 2021 Jul 19. Epub 2021 Jul 19.

Technology Development Center, Universidade Federal de Pelotas, Rua Gomes Carneiro, 1, Pelotas, RS, 96010-610, Brazil.

During the pandemic outbreak of COVID-19, the important role of plastic becomes evident since vital equipment such as respirators have plastic parts, as well as personal protective equipment (PPE), which avoids the transmission of the SARS-CoV-2 virus, is made of plastic. So, plastic during a pandemic is considered a life savior in the struggle against the virus. However, the same material that is a protector becomes a polluter when inadequately disposed of in the environment, generating or worsening socio-environmental problems, such as pollution of water bodies by plastic. Read More

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Juvenile cystic adenomyoma, a rare diagnostic challenge: Case Reports and literature review.

F S Rep 2021 Jun 10;2(2):166-171. Epub 2021 Feb 10.

Department of Obstetrics and Gynecology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma.

Objective: To report 2 very rare cases of young women who presented with severe dysmenorrhea and a large cystic lesion in the myometrium, which presented a diagnostic dilemma because they were confused with a Müllerian anomaly.

Design: Case reports and a literature review.

Setting: A university-based reproductive endocrinology and infertility clinic in the United States. Read More

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Inflammatory Biomarkers Are Associated With a Decline in Functional Status at Discharge in Children With Acute Respiratory Failure: An Exploratory Analysis.

Crit Care Explor 2021 Jul 13;3(7):e0467. Epub 2021 Jul 13.

Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Michigan, Ann Arbor, MI.

To evaluate the link between early acute respiratory failure and functional morbidity in survivors using the plasma biomarkers interleukin-8, interleukin-1 receptor antagonist, thrombomodulin, and plasminogen activator inhibitor-1. We hypothesized that children with acute respiratory failure with higher levels of inflammation would have worse functional outcomes at discharge, as measured by Pediatric Overall Performance Category.

Design: Secondary analysis of the Genetic Variation and Biomarkers in Children with Acute Lung Injury (R01HL095410) study. Read More

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Improvements of Fibrosis and Disease Activity Are Associated With Improvement of Patient-Reported Outcomes in Patients With Advanced Fibrosis Due to Nonalcoholic Steatohepatitis.

Hepatol Commun 2021 Jul 12;5(7):1201-1211. Epub 2021 May 12.

NAFLD Research Center University of California at San Diego La Jolla CA USA.

Patient-reported outcomes (PROs) are important endpoints for clinical trials. The impact of investigational drugs on PROs of patients with advanced nonalcoholic steatohepatitis (NASH) was investigated. Patients with NASH with bridging fibrosis or compensated cirrhosis were enrolled in a phase 2, randomized, placebo-controlled study of selonsertib, firsocostat, or cilofexor, alone or in two-drug combinations (NCT03449446). Read More

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Right Ventricular Function and Its Coupling With Pulmonary Circulation in Precapillary Pulmonary Hypertension: A Three-Dimensional Echocardiographic Study.

Front Cardiovasc Med 2021 2;8:690606. Epub 2021 Jul 2.

Department of Echocardiography, Heart Center, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.

To assess right ventricular (RV) function and RV-pulmonary arterial (PA) coupling by three-dimensions echocardiography and investigate the ability of RV-PA coupling to predict adverse clinical outcomes in patients with precapillary pulmonary hypertension (PH). We retrospectively collected a longitudinal cohort of 203 consecutive precapillary PH patients. RV volume, RV ejection fraction (RVEF), and RV longitudinal strain (RVLS) were quantitatively determined offline by 3D echocardiography. Read More

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Antimicrobial Resistance & Migrants in Sweden: Poor Living Conditions Enforced by Migration Control Policies as a Risk Factor for Optimal Public Health Management.

Front Public Health 2021 1;9:642983. Epub 2021 Jul 1.

Malmö Institute for Studies of Migration, Diversity and Welfare (MIM), Malmö University, Malmö, Sweden.

Infectious diseases exacerbated by Antimicrobial Resistance (AMR) are of increasing concern in Sweden, with multi-drug resistant strains associated with new resistance mechanisms that are emerging and spreading worldwide. Existing research has identified that sub-optimal living conditions and poor access to healthcare are significant factors in the spread and incubation of AMR strains. The article considers this linkage and the effort to control the spread of AMR in relation to migrants, highlighting deficiencies in public policy where such individuals are often increasingly exposed to those conditions that exacerbate AMR. Read More

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The Effectiveness of Electroconvulsive Therapy on Catatonia in a Case of Anti-N-Methyl-D-Aspartate (Anti-NMDA) Receptor Encephalitis.

Cureus 2021 Jun 17;13(6):e15706. Epub 2021 Jun 17.

Psychiatry, Drexel University College of Medicine, Philadelphia, USA.

Catatonia is a symptom seen in a variety of neuropsychiatric conditions, including anti-N-Methyl D-aspartate receptor (NMDAR) encephalitis. When associated with anti-NMDAR encephalitis, catatonia is resistant to standard therapy. However, electroconvulsive therapy (ECT) has shown promising success in management. Read More

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Outcomes of stereotactic radiosurgery for large vestibular schwannomas: a systematic review and meta-analysis.

Neurooncol Pract 2021 Aug 18;8(4):405-416. Epub 2021 Feb 18.

Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA.

Background: Large vestibular schwannomas (VS) pose a treatment challenge for both microsurgery (MS) and stereotactic radiosurgery (SRS). Technical developments have allowed for safer irradiation of large tumors. It remains unclear if SRS can achieve appropriate tumor control and acceptable cranial nerve toxicities. Read More

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Instrumental and Hedonic Motives for Emotion Regulation in Musical Practice.

Front Psychol 2021 30;12:643974. Epub 2021 Jun 30.

Institute of Musicians' Medicine, University of Music Carl Maria von Weber, Dresden, Germany.

Emotion regulation literature often emphasizes that individuals regulate their emotions for hedonic reasons. However, there is increasing support for an instrumental approach to emotion regulation. This approach suggests that emotions are regulated if they are believed to be beneficial to the pursuit of personally relevant goals. Read More

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Indeterminate Cell Histiocytosis of the Spine: A Case Report.

Pediatr Neurosurg 2021 Jul 16:1-6. Epub 2021 Jul 16.

Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA.

Introduction: Indeterminate cell histiocytosis is a rare neoplastic disease characterized by proliferation of dendritic cells that share morphologic and immunophenotypic features of Langerhans cells and non-Langerhans histiocytes. ICH lesions are typically restricted to the skin; however, there have been rare reports of extracutaneous and systemic involvement.

Case Presentation: We describe a case of a 13-year-old female presenting with complaints of worsening lower back pain for 1 year. Read More

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Impact of the COVID-19 pandemic on adults with current and prior depression: initial findings from the longitudinal Texas RAD study.

J Affect Disord 2021 Jul 2;294:103-108. Epub 2021 Jul 2.

Center for Depression Research and Clinical Care, Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX, United States. Electronic address:

Background: Emerging work has suggested worsening mental health in the general population during the COVID-19 pandemic, but there is minimal data on individuals with a prior history of depression.

Methods: Data regarding depression, anxiety and quality of life in adult participants with a history of a depressive disorder (n = 308) were collected before and during the COVID-19 pandemic. Mixed effects regression models were fit for these outcomes over the period May - August 2020, controlling for pre-pandemic depressive groups (none, mild, moderate-to-severe), demographic characteristics, and early COVID-19 related experiences (such as disruptions in routines, mental health treatment, and social supports). Read More

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Obeticholic Acid Impact on Quality of Life in Patients With Nonalcoholic Steatohepatitis: REGENERATE 18-Month Interim Analysis.

Clin Gastroenterol Hepatol 2021 Jul 15. Epub 2021 Jul 15.

Feinberg School of Medicine, Northwestern University, Chicago, IL, United States.

BACKGROUND & AIMS: Nonalcoholic steatohepatitis (NASH) affects patients' health-related quality of life (HRQoL). Patient-reported outcomes (PROs) evaluating HRQoL were assessed in the REGENERATE study, which demonstrated that obeticholic acid (OCA) significantly improved fibrosis in patients with NASH.

Methods: Noncirrhotic NASH patients in a phase 3, double-blind, randomized, placebo-controlled, multicenter, international study of OCA. Read More

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Darolutamide and health-related quality of life in patients with non-metastatic castration-resistant prostate cancer: An analysis of the phase III ARAMIS trial.

Eur J Cancer 2021 Jul 14;154:138-146. Epub 2021 Jul 14.

Institut Gustave Roussy, Université Paris-Saclay, Villejuif, France.

Background: In the ARAMIS trial, darolutamide plus androgen deprivation therapy (ADT) versus placebo plus ADT significantly improved metastasis-free survival (MFS), overall survival (OS) and time to pain progression in patients with non-metastatic castration-resistant prostate cancer (nmCRPC). Herein, we present analyses of patient-reported health-related quality of life (HRQoL) outcomes.

Patients And Methods: This double-blind, placebo-controlled, phase III trial randomised patients with nmCRPC and prostate-specific antigen doubling time ≤10 months to darolutamide 600 mg (n = 955) twice daily or matched placebo (n = 554) while continuing ADT. Read More

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Impact of the COVID-19 pandemic on inflammatory bowel disease: The role of emotional stress and social isolation.

Stress Health 2021 Jul 17. Epub 2021 Jul 17.

Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands.

Inflammatory bowel disease (IBD) is a chronic health condition exacerbated by negative emotional stress experiences. In the current study, we examined whether the outbreak of the COVID-19 pandemic coincided with an increase in stress experiences and accordingly an aggravation of disease activity in IBD patients. Sixty-three IBD patients (30 Crohn's disease or CD, 33 ulcerative colitis) completed an online survey during the COVID-19-related lockdown, assessing clinical disease activity, disease-related quality of life, presence of functional gastrointestinal symptoms, social isolation and stress experiences. Read More

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Utilisation of machine learning to predict surgical candidates for the treatment of childhood upper airway obstruction.

Sleep Breath 2021 Jul 17. Epub 2021 Jul 17.

School of Electrical and Electronic Engineering, The University of Adelaide, Adelaide, SA, 5005, Australia.

Objective: To investigate the effect of adenotonsillectomy on OSAS symptoms based on a data-driven approach and thereby identify criteria that may help avoid unnecessary surgery in children with OSAS.

Methods: In 323 children enrolled in the Childhood Adenotonsillectomy Trial, randomised to undergo either early adenotonsillectomy (eAT; N = 165) or a strategy of watchful waiting with supportive care (WWSC; N = 158), the apnea-hypopnea index, heart period pattern dynamics, and thoraco-abdominal asynchrony measurements from overnight polysomnography (PSG) were measured. Using machine learning, all children were classified into one of two different clusters based on those features. Read More

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Characterizing the features and course of psychiatric symptoms in children and adolescents with autoimmune encephalitis.

Eur Arch Psychiatry Clin Neurosci 2021 Jul 17. Epub 2021 Jul 17.

Division of Psychiatry, Imperial College, London, UK.

Autoimmune encephalitis (AE) can present like a psychiatric disorder. We aimed to illustrate the psychiatric manifestations, course and management of AE in a paediatric cohort. Neuropsychiatric symptoms, investigations and treatment were retrospectively retrieved in 16 patients (mean age 11. Read More

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Efficacy of dapagliflozin in heart failure with reduced ejection fraction according to body mass index.

Eur J Heart Fail 2021 Jul 16. Epub 2021 Jul 16.

BHF Cardiovascular Research Centre, University of Glasgow, Glasgow, United Kingdom.

Background: In heart failure with reduced ejection fraction (HFrEF), there is an "obesity paradox", where survival is better in patients with a higher body mass index (BMI) and weight loss is associated with worse outcomes. We examined the effect of a SGLT2 inhibitor according to baseline BMI in the Dapagliflozin And Prevention of Adverse-outcomes in Heart Failure trial (DAPA-HF).

Methods And Results: BMI was examined using standard categories i. Read More

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Flexible vs. standard subthalamic stimulation in Parkinson disease: A double-blind proof-of-concept cross-over trial.

Parkinsonism Relat Disord 2021 Jul 8;89:93-97. Epub 2021 Jul 8.

Edmond J. Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Centre, Toronto Western Hospital, UHN, Toronto, Canada; Krembil Brain Institute, Toronto, Canada; The Center for Advancing Neurotechnological Innovation to Application (CRANIA), Toronto, ON, Canada. Electronic address:

Background: Deep brain stimulation (DBS) of the subthalamus (STN) is effective for the treatment of cardinal motor signs of Parkinson disease (PD). Structures around the STN can suppress dyskinesia and tremor (zona incerta) and improve gait and balance (substantia nigra pars reticulata).

Objective: Is the newer 8-contact linear lead connected to a 'flexible' DBS system superior to standard 4-contact stimulation in PD patients receiving STN DBS?

Methods: After 3 months of open label programming, 10 patients were randomized to standard or flexible stimulation before crossing over to the other arm (3 months each period). Read More

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