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Pediatric reference intervals for endocrine markers and fertility hormones in healthy children and adolescents on the Siemens Healthineers Atellica immunoassay system.

Clin Chem Lab Med 2021 May 6. Epub 2021 May 6.

CALIPER Program, Department of Pediatric Laboratory Medicine, Hospital for Sick Children, Toronto, ON, Canada.

Objectives: Rapid development in childhood and adolescence combined with lack of immunoassay standardization necessitates the establishment of age-, sex-, and assay-specific reference intervals for immunochemical markers. This study established reference intervals for 11 immunoassays on the new Siemens Healthineers Atellica® IM Analyzer in the healthy CALIPER cohort.

Methods: A total of 600 healthy participants (birth to 18 years) were recruited from the community, and serum samples were collected with informed consent. Read More

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Outcomes of the First Pregnancy After Fertility-Sparing Surgery for Early-Stage Ovarian Cancer.

Obstet Gynecol 2021 May 6. Epub 2021 May 6.

Department of Gynecologic Oncology and Reproductive Medicine, the Department of Health Services Research, Division of Cancer Prevention and Population Sciences, and the Department of Breast Medical Oncology, the University of Texas MD Anderson Cancer Center, Houston, Texas; the Department of Obstetrics and Gynecology, Massachusetts General Hospital, and Harvard Medical School, Boston, Massachusetts; the Department of Obstetrics and Gynecology, the University of Texas Medical Branch at Galveston, Galveston, Texas; and the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Columbia University Vagelos College of Physicians and Surgeons, and the Division of Reproductive Endocrinology, Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York, New York.

Objective: To evaluate the outcomes of the first pregnancy after fertility-sparing surgery in patients treated for early-stage ovarian cancer.

Methods: We performed a retrospective study of women aged 18-45 years with a history of stage IA or IC ovarian cancer reported to the California Cancer Registry for the years 2000-2012. These data were linked to the 2000-2012 California Office of Statewide Health Planning and Development birth and discharge data sets to ascertain oncologic characteristics and obstetric outcomes. Read More

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Prevalence of Medically Resistant Epilepsy in Saudi Arabia.

Neuroepidemiology 2021 May 6:1-7. Epub 2021 May 6.

King Fahad University Hospital, Alkhobar, Saudi Arabia.

Objectives: The objective of this study was to evaluate the prevalence of medically resistant epilepsy (MRE) in our hospital and to compare the prevalence with that in other populations.

Methods: We retrospectively analyzed the data of patients who visited the epilepsy clinics at King Fahd University Hospital, Al-Khobar, Saudi Arabia between January 2017 and December 2018. This study included patients aged ≥14 years who had at least 2 unprovoked seizures 24 h apart. Read More

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Urachal Pathology: Review of Cases.

Urol Int 2021 May 6:1-4. Epub 2021 May 6.

Department of Urology, Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Spain.

Introduction: The urachus is an embryologic remnant which is formed from the obliteration of the allantois. Urachal abnormalities are caused when defective obliteration of the urachus happens. They are an infrequent condition. Read More

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Dog Ownership in Early Life Increased the Risk of Nonatopic Asthma in Children.

Int Arch Allergy Immunol 2021 May 6:1-9. Epub 2021 May 6.

Department of Pediatrics, Childhood Asthma Atopy Center, Humidifier Disinfectant Health Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.

Background: It is still debatable whether dog ownership during early childhood is a risk factor for the development of allergic diseases.

Objective: We investigated the association of dog ownership in early life with sensitization and asthma in childhood.

Methods: Data from the Cohort for Childhood Origin of Asthma and Allergic diseases were used to investigate the association between dog ownership at any time from pregnancy to 1 year of age and sensitization to aeroallergens at 3 and 7 years old, bronchial hyperresponsiveness (BHR), and asthma at 7 years old. Read More

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The Effects of Aerobic Exercise in Patients with Early-Onset Dementia: A Scoping Review.

Dement Geriatr Cogn Disord 2021 May 6:1-8. Epub 2021 May 6.

Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.

Background: Early-onset dementia (EOD) defines all dementia related conditions with an onset before the age of 65 years. EOD places a large and distressing psychological, emotional and financial burden on the individuals themselves and their caregivers. For various reasons, diagnostic and treatment strategies for EOD are very challenging. Read More

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Impact of Sleep Duration on Mortality and Quality of Life in Chronic Kidney Disease: Results from the 2007-2015 KNHANES.

Am J Nephrol 2021 May 6:1-8. Epub 2021 May 6.

Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea.

Introduction: In the general population, short and long sleep durations have been associated with adverse health outcomes. However, this association remains unclear in patients with chronic kidney disease (CKD). We examined the relationship of sleep duration to mortality and health-related quality of life (HRQOL) in individuals with CKD. Read More

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QT interval prolongation and the rate of malignant ventricular dysrhythmia and cardiac arrest in adult poisoned patients.

Am J Emerg Med 2021 Apr 29;46:156-159. Epub 2021 Apr 29.

Division of Medical Toxicology, Department of Emergency Medicine, University of Virginia School of Medicine, Charlottesville, VA 22903, United States of America.

Introduction: Prolongation of QTc interval, a common electrocardiographic (ECG) abnormality encountered in the toxicology patient, is reportedly associated with an increased risk of malignant ventricular dysrhythmias (MVD), such as ventricular tachycardia (VT, with and without a pulse), ventricular fibrillation (VF), and/or cardiac arrest. Quantifiable cardiac arrest risk in relation to specific QTc interval length is not known in this population.

Methods: We conducted a retrospective, observational study to assess the rate of cardiac arrest and its association with degree of QTc prolongation in a cohort of patients requiring toxicology consultation. Read More

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Medial displacement calcaneal osteotomy versus lateral column lengthening to treat stage II tibialis posterior tendon dysfunction, a prospective randomized controlled study.

Foot (Edinb) 2021 Apr 7;47:101798. Epub 2021 Apr 7.

Orthopedic Department, Assiut University Hospital, Assiut, Egypt. Electronic address:

Purpose: Adult-acquired flatfoot deformity (AAFD) requires optimum planning that often requires several procedures for deformity correction. The objective of this study was to detect the difference between MDCO versus LCL in the management of AAFD with stage II tibialis posterior tendon dysfunction regarding functional, radiographic outcomes, efficacy in correction maintenance, and the incidence of complications.

Patient And Methods: 42 Patients (21 males and 21 females) with a mean age of 49. Read More

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Clinical outcome of a conservative approach to giant cell tumor of ankle and foot bones.

Foot (Edinb) 2021 Jan 11;47:101766. Epub 2021 Jan 11.

Musculoskeletal Oncology, Max Institute of Cancer Care, Saket, New Delhi, India.

Giant cell tumor of the bone (GCTB) affecting foot and ankle is rare, and the literature available on their clinical behavior and reconstructive options is scarce. Many authors consider these sites a special subset with high rates of local recurrence. Eighteen patients with GCTB of foot and ankle were treated from (March 2014 to February 2020). Read More

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January 2021

Causes of delayed diagnosis of posterior ankle impingement in the pediatric and adolescent population.

Foot (Edinb) 2021 Apr 7;47:101799. Epub 2021 Apr 7.

Texas Children's Hospital, 6701 Fannin St, Houston, TX 77030, USA.

Purpose: The purpose of this study was to identify and characterize various causes of delay in the diagnosis of posterior ankle impingement syndrome (PAIS) in pediatric patients.

Methods: IRB approved prospective study of patients under 18 years who underwent arthroscopic surgery for the diagnosis of posterior ankle impingement after failed conservative treatment at a tertiary children's hospital. Radiographic findings were compared with an age-matched control group. Read More

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The Covid 19 outbreak: Maternal Mental Health and Associated Factors.

Midwifery 2021 Apr 15;99:103013. Epub 2021 Apr 15.

Department of Maternity and Gynecology Nursing, Balıkesir University. Electronic address:

Objective: Evaluation of the mental health of pregnant women during the early and peak stages of the Covid-19 outbreak DESIGN: Online survey PARTICIPANTS: Pregnant women over the age of 18 years with no mental disorder during the pre-pregnancy period (N = 729).

Measurements And Findings: Mental disorders were assessed using the "Depression Anxiety Stress Scale" and social support was determined using the "Multidimensional Perceived Social Support Scale." Pregnant women had moderate levels of anxiety and depression and mild levels of stress. Read More

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Prenatal exposure to propylparaben at human-relevant doses accelerates ovarian aging in adult mice.

Environ Pollut 2021 Apr 28;285:117254. Epub 2021 Apr 28.

Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Ave, Wuhan, 430030, Hubei, China. Electronic address:

Embryonic exposure to environmental chemicals may result in specific chronic diseases in adulthood. Parabens, a type of environmental endocrine disruptors widely used in pharmaceuticals and cosmetics, have been shown to cause a decline in women's reproductive function. However, whether exposure to parabens during pregnancy also negatively affect the ovarian function of the female offspring in adulthood remains unclear. Read More

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Determination of START triage skill and knowledge levels of Prehospital Emergency Medical Staff: A cross sectional study.

Int Emerg Nurs 2021 May 3;56:101004. Epub 2021 May 3.

Department of Healthc Management, Faculty of Health Sciences, Ordu University, Ordu, Turkey.

Background: Emergency medical staff working in pre-hospital (PH-staff) may encounter mass casualty incident (MCI) events. In these events these medical personnel should perform triage. The objective of this study is to determine the skill and knowledge levels of PH-staff about Simple Triage and Rapid Treatment (START) triage. Read More

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First-line liposomal irinotecan with oxaliplatin, 5-fluorouracil and leucovorin (NALIRIFOX) in pancreatic ductal adenocarcinoma: A phase I/II study.

Eur J Cancer 2021 May 3;151:14-24. Epub 2021 May 3.

St John of God Subiaco Hospital, Subiaco, WA, Australia.

Background: This open-label, phase I/II study evaluated safety and efficacy for first-line liposomal irinotecan + oxaliplatin + 5-fluorouracil + leucovorin (NALIRIFOX).

Methods: Patients (aged ≥18 years) had locally advanced/metastatic pancreatic ductal adenocarcinoma (mPDAC), with an Eastern Cooperative Oncology Group performance status score of 0/1 and adequate organ function. Primary objectives were to determine the maximum tolerated dose (MTD) and to evaluate safety and tolerability. Read More

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The predictors of COVID-19 mortality in a nationwide cohort of Turkish patients.

Respir Med 2021 Apr 28;183:106433. Epub 2021 Apr 28.

Department of Pulmonary Medicine, Kestel State Hospital, Bursa, Turkey. Electronic address:

The COVID-19-related death rate varies between countries and is affected by various risk factors. This multicenter registry study was designed to evaluate the mortality rate and the related risk factors in Turkey. We retrospectively evaluated 1500 adults with COVID-19 from 26 centers who were hospitalized between March 11 and July 31, 2020. Read More

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Coil assisted glue embolization to improve safety and accuracy in endovascular management of Vein of Galen patients.

Clin Neurol Neurosurg 2021 Apr 21;205:106652. Epub 2021 Apr 21.

Army Hospital (Referral & Research), Delhi Cantt, New Delhi 110010, India. Electronic address:

Background: Vein of Galen malformation (VOGM) patients present in neonatal age with cardiac failure or significant neurologic consequences. The most established method of treatment has been transarterial embolization with high concentration glue (N-Butyl Cyano Acrylate) which may be difficult to control due to very high flow rates and may migrate to the venous side with undesirable consequences. We describe our experience in four patients in whom initial coil placement in prominent feeding arteries helped inflow reduction thereby facilitating controlled glue injection with a good result and no incidence of non-target embolization. Read More

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A phase 2 trial of single low doses of rasburicase for treatment of hyperuricemia in adult patients with acute leukemia.

Leuk Res 2021 Apr 24;107:106588. Epub 2021 Apr 24.

Section of Leukemia, Department of Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA.

Background: Rasburicase can markedly and rapidly decrease uric acid (UA) levels, thereby preventing and treating tumor lysis syndrome. However, rasburicase is expensive, especially when used as per the manufacturer's recommended dosage of 0.2 mg/kg/day for up to 5 days. Read More

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Impact of coronary risk scores on disposition decision in emergency patients with chest pain.

Am J Emerg Med 2021 Apr 14;48:165-169. Epub 2021 Apr 14.

Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan; Department of Computer Science and Engineering, National Sun Yat-sen University, Kaohsiung, Taiwan. Electronic address:

Background: Coronary risk scores (CRS) including History, Electrocardiogram, Age, Risk Factors, Troponin (HEART) score and Emergency Department Assessment of Chest pain Score (EDACS) can help identify patients at low risk of major adverse cardiac events. In the emergency department (ED), there are wide variations in hospital admission rates among patients with chest pain.

Objective: This study aimed to evaluate the impact of CRS on the disposition of patients with symptoms suggestive of acute coronary syndrome in the ED. Read More

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Children's spatial-numerical associations on horizontal, vertical, and sagittal axes.

J Exp Child Psychol 2021 May 3;209:105169. Epub 2021 May 3.

School of Psychology and Institute of Neuroscience, Trinity College Dublin, College Green, Dublin 2, Ireland.

There is substantial evidence linking numerical magnitude to the physical properties of space. The most influential support for this connection comes from the SNARC effect (spatial-numerical association of response codes), in which responses to small/large numbers are faster on the left/right side of space, respectively. The SNARC effect has been extensively replicated, and is understood as horizontal mapping of numerical magnitude. Read More

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Reconstruction in Women with T4 Breast Cancer after Neoadjuvant Chemotherapy: When Is It Safe?

J Am Coll Surg 2021 Apr 24. Epub 2021 Apr 24.

Breast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY. Electronic address:

Background: Despite limited evidence regarding its safety, immediate reconstruction (IR) is increasingly offered to women with T4 breast cancer. We compared outcomes following IR, delayed reconstruction (DR), and no reconstruction (NR) in patients treated with neoadjuvant chemotherapy (NAC) and postmastectomy radiation therapy (PMRT) for T4 disease.

Study Design: We retrospectively identified consecutive women with T4 tumors treated with trimodality therapy from 1/2007-12/2019. Read More

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Association Between Trimester and Outcomes after Cholecystectomy During Pregnancy.

J Am Coll Surg 2021 Apr 9. Epub 2021 Apr 9.

Division of Upper GI and General Surgery, Department of Surgery, University of Southern California, Los Angeles, CA.

Background: Conventional philosophy promotes the second trimester as the ideal time during pregnancy for cholecystectomy. However, literature supporting this belief is sparse. The purpose of the present study is to examine the association of trimester and clinical outcomes following cholecystectomy during pregnancy. Read More

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Implementation of a palliative hospital-centered spiritual and psychological telehealth system during COVID-19 pandemic.

J Pain Symptom Manage 2021 May 3. Epub 2021 May 3.

Geriatric Section, Department of Internal Medicine, Faculty of Medicine. Universidad de Chile, Santiago, Chile.

Background: The severity of the COVID-19 pandemic has resulted in limited provision of palliative care and hospital teams have had to rise to the challenge of how to deliver care safely to people with palliative needs. Telehealth interventions have been seen as a useful resource with potential to improve clinical effectiveness.

Objective: To describe the implementation of a spiritual and psychological palliative telehealth system during the pandemic. Read More

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Echocardiographic Indicators Associated with Adverse Clinical Course and Cardiac Sequelae in Multisystem Inflammatory Syndrome in Children with COVID-19.

J Am Soc Echocardiogr 2021 May 3. Epub 2021 May 3.

Department of Pediatrics, Division of Pediatric Cardiology, Central Michigan University College of Medicine, Children's Hospital of Michigan, 3901 Beaubien Street, Detroit, Michigan, USA. Electronic address:

Background: Multisystem inflammatory syndrome in children associated with COVID-19 (MIS-C) causes significant cardiovascular involvement, which can be a determinant of clinical course and outcome. We aimed to investigate whether echocardiographic measures of ventricular function were independently associated with adverse clinical course and cardiac sequaele in MIS-C.

Methods: In a longitudinal observational study of 54 MIS-C patients (mean age 6. Read More

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Percutaneous gastrostomy compared with esophageal stenting for the treatment of esophageal cancer with dysphagia.

J Vasc Interv Radiol 2021 May 3. Epub 2021 May 3.

Minimally Invasive and Interventional Department, Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou 450008, Henan, China. Electronic address:

Purpose: To compare the outcomes of self-expandable metal stent and percutaneous gastrostomy (PG) for treatment of patients with esophageal cancer (EC) and dysphagia.

Materials And Methods: This retrospective observational study consisted of 113 patients with EC and dysphagia who underwent either stent insertion (n = 47) or PG (n = 66) at a single center between June 2014 and June 2018.

Results: There were 63 men and 50 women with the mean age of 76. Read More

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Anatomic feasibility of off-the-shelf thoracic single side-branched endograft in patients with blunt traumatic thoracic aortic injury.

J Vasc Surg 2021 May 3. Epub 2021 May 3.

Department of Surgery, Division of Vascular Surgery, University of California-Davis Medical Center, Sacramento, CA.

Objectives: The advent of thoracic single side-branched endograft (TSSBE) provides a treatment option to obviate the need for open cervical debranching of the left subclavian artery (LSA), thereby enabling total endovascular incorporation of the LSA during thoracic endovascular aortic repair (TEVAR). In a previous study in patients with type B aortic dissection who required zone 2 TEVAR, anatomic feasibility of this device has been demonstrated to range between 28% and 35%, suggesting limited applicability of currently available designs. The objective of this study was twofold: (1) to evaluate the anatomic feasibility of TSSBE in blunt traumatic thoracic aortic injury (BTAI) patients who would require LSA revascularization; and (2) to describe the anatomical characteristics of the supra-aortic arch branches that can be used to improve future device design. Read More

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Low dose radiation therapy for severe COVID-19 pneumonia: a randomized double-blind study.

Int J Radiat Oncol Biol Phys 2021 May 3. Epub 2021 May 3.

Clinic of Intensive Care Medicine, University Hospital Basel, Basel, Switzerland.

Purpose: The morbidity and mortality of patients requiring mechanical ventilation for coronavirus disease 2019 (COVID-19) pneumonia is considerable. We studied the use of whole-lung low dose radiation therapy (LDRT) in this patient cohort.

Methods And Materials: Patients admitted to the intensive care unit (ICU) and requiring mechanical ventilation for COVID-19 pneumonia were included in this randomized double-blind study. Read More

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Superior capsular reconstruction with autologous fascia lata using single lateral row technique is an effective option in massive irreparable rotator cuff tears. Minimum two-year follow-up.

Arthroscopy 2021 May 3. Epub 2021 May 3.

Hospital Puerto Montt, Los Aromos 65, Puerto Montt, Chile.

Purpose: The purpose of this study is to evaluate clinical and radiological outcomes of arthroscopic superior capsular reconstruction (ASCR) with fascia lata autograft in patients with irreparable rotator cuff tears (IRCT) performed with a single lateral row fixation technique.

Methods: Retrospective case series of patients with large or massive IRCTs for ASCR with fascia lata autograft. Clinical outcomes were evaluated with visual analog scale (VAS) and Constant Score. Read More

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The Everted Acetabular Labrum: Patho-anatomy, Magnetic Resonance Imaging, and Arthroscopic Findings of a Native Variant.

Arthroscopy 2021 May 3. Epub 2021 May 3.

University of Colorado School of Medicine, Department of Orthopedics, Aurora CO 80045. Electronic address:

Purpose: The purpose of this study was to introduce a native labral variant, the everted acetabular labrum, and describe the patho-anatomy, magnetic resonance imaging/arthrogram (MRI/MRA) characteristics, and arthroscopic findings of this condition.

Methods: All primary hip arthroscopy procedures performed by the senior author between June 2013 and January 2020 were retrospectively reviewed. An everted acetabular labrum was identified as a segment of labrum that lacked apposition to the femoral head with the hip off traction. Read More

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