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Neratinib as extended adjuvant therapy in patients with copositive early breast cancer: German health technology assessment-driven analyses from the ExteNET study.

Eur J Cancer 2021 May 7;150:268-277. Epub 2021 May 7.

LMU University Hospital, Breast Center, Dept. OB&GYN, Marchioninistr. 15, Munich, 81377, Germany. Electronic address:

Background: Neratinib is approved in the European Union for extended adjuvant treatment of human epidermal growth factor receptor 2-positive/hormone receptor-positive (copositive) early breast cancer ≤1 year of completion of prior trastuzumab-based therapy. Here, we report analyses of the hormone receptor-positive subgroup (N = 1631) from the ExteNET trial performed for the German health technology assessment (HTA).

Results: With 2 years of median follow-up, HTA analyses revealed a significant advantage in disease-free survival (DFS) for neratinib vs. Read More

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Chondrosarcoma of the Spine: A Narrative Review.

Spine J 2021 May 7. Epub 2021 May 7.

Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD USA 21287. Electronic address:

Chondrosarcoma is an uncommon primary bone tumor with an estimated incidence of 0.5 per 100,000 patient-years. Primary chondrosarcoma of the mobile spine and sacrum cumulatively account for less than 20% of all cases, most commonly causing patients to present with focal pain with or without radiculopathy or myelopathy secondary to neural element compression. Read More

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Computational phenotyping of brain-behavior dynamics underlying approach-avoidance conflict in major depressive disorder.

PLoS Comput Biol 2021 May 10;17(5):e1008955. Epub 2021 May 10.

Department of Cognitive, Linguistic & Psychological Sciences, Brown University, Providence, Rhode Island, United States of America.

Adaptive behavior requires balancing approach and avoidance based on the rewarding and aversive consequences of actions. Imbalances in this evaluation are thought to characterize mood disorders such as major depressive disorder (MDD). We present a novel application of the drift diffusion model (DDM) suited to quantify how offers of reward and aversiveness, and neural correlates thereof, are dynamically integrated to form decisions, and how such processes are altered in MDD. Read More

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Reward anticipation buffers neuroendocrine and cardiovascular responses to acute psychosocial stress in healthy young adults.

Authors:
Weiyu Hu Juan Yang

Stress 2021 May 10:1-9. Epub 2021 May 10.

Faculty of Psychology, Southwest University, Chongqing, China.

Research over the last 10 years suggests that the brain's reward system plays a crucial role in stress resilience. Notably, reward processing includes both an anticipatory (cue-triggered "wanting") phase and a consummatory ("liking") phase. However, previous studies manipulated rewards via direct reward administration, which makes it difficult to isolate the buffering effect of anticipating the reward stimulus. Read More

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Using heterogeneity in disease to understand the relationship between health and personality.

Psychol Health Med 2021 May 10:1-14. Epub 2021 May 10.

School of Psychology, University of Nottingham, Nottingham, UK.

The aim of this study was to compare the relationship between two health outcomes (pain and self-reported health) and personality while accounting for heterogeneity in arthritic disease. Traditionally health research has treated patients' disease experiences as homogeneous but stratified medicine suggests that doing so might over-generalise findings and miss important effects. We present a longitudinal analysis over 14 years, on a subsample of 443 arthritic respondents from the English Longitudinal Study of Ageing (ELSA). Read More

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Grit and successful aging in older adults.

Aging Ment Health 2021 May 10:1-8. Epub 2021 May 10.

Department of Psychology, Temple University, Philadelphia, PA, USA.

Objectives: Grit is a noncognitive trait that has been shown to increase monotonically throughout adulthood and predict late-life cognitive performance. Less is known about the relation between grit and successful aging in older adults.

Method: Participants over 55-years-old ( = 185) completed a series of self-report surveys assessing demographics, grit (Short Grit Scale; Grit-S), physical and emotional functioning (Medical Outcomes Study Short Form Health Survey; SF-36), and changes in cognitive functioning (Everyday Cognition; ECog). Read More

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Spinal Pseudoaneurysms Mimicking an Osteogenic Tumor: A Case Report.

J Am Acad Orthop Surg Glob Res Rev 2020 May;4(5):e1900156

From the National Guard Health Affairs, King Abdulaziz Medical City, Riyadh, Saudi Arabia.

Aim: This study presents a rare case of pseudoaneurysm mimicking a tumor on the back, with no history of fever, trauma, or surgical intervention. In which no identifiable symptoms or warning signs were present. This pseudoaneurysm arises from intercostal arteries and segmental arteries. Read More

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Integration of Patient-reported Outcomes in a Total Joint Arthroplasty Program at a High-volume Academic Medical Center.

J Am Acad Orthop Surg Glob Res Rev 2020 May;4(5):e2000034

From the Department of Orthopaedic Surgery (Ms. Bhatt, Dr. Manning, Dr. Peabody), Northwestern University Feinberg School of Medicine; the Northwestern Memorial HealthCare (Ms. Davis, Dr. Barnard), Northwestern University Center for Healthcare Studies; the Department of Medical Social Sciences (Dr. Rothrock), Northwestern University Feinberg School of Medicine; and the Department of Surgery (Dr. Barnard), Feinberg School of Medicine, Northwestern University, Chicago, IL.

Introduction: Despite widely appreciated barriers to successful clinical implementation, the literature regarding how to operationalize electronic health record-integrated patient-reported outcomes (PROs) remains sparse. We offer a detailed summary of the implementation of PROs into the standard of care at a major tertiary academic medical center.

Methods: Collection of four Patient-Reported Outcomes Measurement Information System computer adaptive tests was piloted in a large academic orthopaedic surgery ambulatory clinic starting in October 2016. Read More

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Late Effects of Clubfoot Deformity in Adolescent and Young Adult Patients Whose Initial Treatment Was an Extensive Soft-tissue Release: Topic Review and Clinical Case Series.

J Am Acad Orthop Surg Glob Res Rev 2020 May;4(5):e1900126

From the Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, MO (Dr. Johnson, Dr. Klein, Dr. McCormick, Dr. Dobbs, Dr. Gordon, Dr. Schoenecker); the Department of Orthopaedic Surgery, Dartmouth-Hitchcock School of Medicine, New Hampshire, NH (Dr. Fortney); and the Congress Orthopaedic Associates, Arcadia, CA (Dr. Luk).

Children with congenital clubfoot often have residual deformity, pain, and limited function in adolescence and young adulthood. These patients represent a heterogeneous group that often requires an individualized management strategy. This article reviews the available literature on this topic while proposing a descriptive classification system based on a review of patients at our institution who underwent surgery for problems related to previous clubfoot deformity during the period between January 1999 and January 2012. Read More

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Developing a real-world evidence base for prescribed cannabis in the United Kingdom: preliminary findings from Project Twenty21.

Psychopharmacology (Berl) 2021 May 10. Epub 2021 May 10.

Imperial College London, Burlington Danes Building, Hammersmith Hospital, Du Cane Rd, White City, London, W12 0NN, UK.

The therapeutic potential of medical cannabis to treat a variety of conditions is becoming increasingly recognised. Globally, a large number of countries have now legalised cannabis for medical uses and a substantial number of patients are able to access their medications. Yet in the UK, where medical cannabis was legalised in November 2018, only a handful of NHS prescriptions have been written, meaning that most patients are unable to access the medicine. Read More

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The Comparability of Perceived Physical and Mental Health Measures Across Immigrants and Natives in the United States.

Demography 2021 May 10. Epub 2021 May 10.

University of Cologne, Faculty of Management, Economics and Social Sciences, Institute of Sociology and Social Psychology, Cologne, Germany.

The comparative study of perceived physical and mental health in general-and the comparative study of health between the native-born and immigrants, in particular-requires that the groups understand survey questions inquiring about their health in the same way and display similar response patterns. After all, observed differences in perceived health may not reflect true differences but rather cultural bias in the health measures. Research on cross-country measurement equivalence between immigrants and natives on self-reported health measures has received very limited attention to date, resulting in a growing demand for the validation of existing perceived health measures using samples of natives and immigrants and establishing measurement equivalence of health-related assessment tools. Read More

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'This won't hurt a bit!' - A descriptive review of health care professionals' pharmacological management of pain in minor trauma.

S Afr Fam Pract (2004) 2021 Apr 22;63(1):e1-e8. Epub 2021 Apr 22.

Division of Emergency Medicine, Nelson Rolihlahla Mandela School of Medicine, University of KwaZulu-Natal, Durban.

Background: Emergency Centres (ECs) have a prominent trauma burden requiring effective pain management. This study aimed to review analgesia-prescribing habits in minor trauma, reviewing the patient demographics and diagnoses, analgesia-prescribing habits of health care professionals (HCPs) managing these cases, and differences in prescribing noted by patients' age group, gender and triage code.

Methods: A prospective, cross-sectional, descriptive study was conducted in a regional EC in KwaZulu-Natal. Read More

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Emergency Department Health Care Utilization and Opioid Administration Among Pediatric Patients With Sickle Cell Vasoocclusive Pain Crisis and Coexisting Mental Health Illness.

Pediatr Emerg Care 2020 Dec 14. Epub 2020 Dec 14.

From the *Department of Emergency Medicine †Children's Minnesota Research Institute ‡Department of Hematology and Oncology, Children's Minnesota, Minneapolis, MN.

Objectives: To determine whether patients with sickle cell disease (SCD) who present to the emergency department (ED) with vasoocclusive pain crises (VOC), and have coexisting mental health (MH) diagnoses, are more likely to have increased health care utilization and more frequent opioid administration compared with those without coexisting MH conditions.

Methods: This is a retrospective study of patients aged 5 to 18 years with SCD who presented to a tertiary care ED with a primary complaint of VOC between January 1, 2013, and December 31, 2017. We excluded patients with sickle cell trait and without a pain management plan in the electronic medical record. Read More

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December 2020

Outcomes of Total Hip Arthroplasty in Patients With Acetabular Protrusio.

J Am Acad Orthop Surg Glob Res Rev 2020 Jul;4(7):e2000121

From the Department of Orthopaedic Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA (Dr. Greig, Dr. Hsiue, Mr. Chen, Dr. Trikha, and Dr. Stavrakis), and the Division of Orthopaedic Surgery, University of Toronto, Toronto, Ontario (Dr. Khoshbin), Canada.

Background: Acetabular protrusio (AP) is associated with distorted anatomic landmarks and insufficient bone stock that increases complexity of total hip arthroplasty (THA). This study used a large national database to compare outcomes after THA in patients with and without AP.

Methods: The Nationwide Readmissions Database was used to identify patients with and without AP who underwent THA from 2010 to 2014. Read More

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Patient satisfaction with root canal treatment and outcomes in the Swedish public dental health service. A prospective cohort study.

Int Endod J 2021 May 10. Epub 2021 May 10.

Department of Endodontology, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.

Aim: To document satisfaction with root canal treatment procedures and outcomes among patients treated at Swedish public dental clinics.

Method: The original material comprised 243 patients who began root canal treatment (RCT) at 20 public dental clinics in the county of Västra Götaland, Sweden. One to three years later, 236 (97. 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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False negative point-of-care urine pregnancy tests in an urban academic emergency department: a retrospective cohort study.

J Am Coll Emerg Physicians Open 2021 Jun 1;2(3):e12427. Epub 2021 May 1.

Department of Emergency Medicine Boston Medical Center Boston University School of Medicine Boston Massachusetts USA.

Study Objective: To determine the prevalence of false negative point-of-care (POC) urine pregnancy tests among emergency department (ED) patients and among those with abdominal pain or vaginal bleeding.

Methods: We identified all female patients, ages 14-50 years without prior hysterectomy who had a negative POC urine pregnancy test (beta subunit of human chorionic gonadotropin [β-hCG]) performed by trained clinical staff in the ED between September 1, 2017 and December 31, 2018, as well as a subgroup we defined a priori as "high risk" for early pregnancy complications based on a triage chief complaint (text) of abdominal pain or vaginal bleeding. We identified those with a positive urine β-hCG, serum β-hCG >5 mIU/mL, or a diagnosis of pregnancy within 3 months of the initial ED visit (index visit). Read More

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Surgical microdiscectomy versus transforaminal epidural steroid injection in patients with sciatica secondary to herniated lumbar disc (NERVES): a phase 3, multicentre, open-label, randomised controlled trial and economic evaluation.

Lancet Rheumatol 2021 May 18;3(5):e347-e356. Epub 2021 Mar 18.

Liverpool Clinical Trials Centre, University of Liverpool, Liverpool, UK.

Background: The optimal invasive treatment for sciatica secondary to herniated lumbar disc remains controversial, with a paucity of evidence for use of non-surgical treatments such as transforaminal epidural steroid injection (TFESI) over surgical microdiscectomy. We aimed to investigate the clinical and cost-effectiveness of these options for management of radicular pain secondary to herniated lumbar disc.

Methods: We did a pragmatic, multicentre, phase 3, open-label, randomised controlled trial at 11 spinal units across the UK. Read More

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Intracardiac, pulmonary cement embolism in a 67-year-old female after cement-augmented pedicle screw instrumentation: A case report and review of literature.

World J Clin Cases 2021 May;9(13):3120-3129

Department of Orthopedics, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou 510289, Guangdong Province, China.

Background: We report a case of Intracardiac, pulmonary, and intravenous cement embolism after cement-augmented pedicle screw instrumentation in treating spondylolisthesis underlying osteoporotic bone, which was successfully managed by conservative treatment. We describe the treatment and outcome of the patient, hoping to shed light on the management of bone cement embolism.

Case Summary: A 67-year-old female suffered from progressive low back pain and numbness in lower extremities for 30 years. Read More

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Pulmonary arterial hypertension in a patient with hereditary hemorrhagic telangiectasia and family gene analysis: A case report.

World J Clin Cases 2021 May;9(13):3079-3089

Department of Pulmonary and Critical Care Medicine, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China.

Background: Hereditary hemorrhagic telangiectasia (HHT) is a rare autosomal dominant genetic disease. Very few patients suffering from HHT present with associated pulmonary arterial hypertension (PAH), which may result in a poor prognosis. Here, we report a case of HHT with PAH. Read More

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The Psychological Impact of COVID-19 Among Pakistani Adults in Lahore.

Front Public Health 2021 21;9:578366. Epub 2021 Apr 21.

Department of Psychology, Forman Christian College: A Chartered University, Lahore, Pakistan.

In the wake of the worldwide spread of the novel coronavirus and the resultant restrictive measures, mental health has become a crucial issue. Physical health is not the only aspect of humans that is at risk. Globally, the rates and severity of mental illness are being significantly impacted by this pandemic. Read More

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Can we still consider thyroid hyperfunction a protective condition for the onset of thyroid cancer?

Gland Surg 2021 Apr;10(4):1359-1367

General Surgery Unit, Department of Medicine and Surgery, Parma University Hospital, Parma, Italy.

Background: Thyroid cancer is the ninth most commonly diagnosed cancer in the world, and the most common endocrine carcinoma. It was originally believed to be a rare event in patients with thyroid hyperfunction and it was reported that hyperthyroidism had a protective role against thyroid neoplasms. However, in recent years, several studies have hypothesized that differentiated thyroid carcinomas and hyperthyroidism may coexist. Read More

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Surgical management of incomplete duplex kidney with both upper and lower moieties ureteropelvic junction obstruction: a case report with modified reconstructive method.

Transl Androl Urol 2021 Apr;10(4):1792-1796

Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Center, Beijing, China.

An incomplete duplex kidney combined with ureteropelvic junction obstruction is a rare entity, and the surgical management strategy is highly individualized according to the anatomic variability. Currently, there is no literature report of the specific reconstructive method for the condition when obstruction occurs in both the upper and lower units of the duplex kidney. In this case report, a 60-year-old female with a right solitary kidney was admitted to our hospital. Read More

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Quality of life in patients with Marfan syndrome: a cross-sectional study of 102 adult patients.

Cardiovasc Diagn Ther 2021 Apr;11(2):602-610

Department of Sport and Health Sciences, Chair of Sport Psychology, Technical University Munich, Munich, Germany.

Background: Marfan syndrome (MFS) is a genetically determined multiorgan disease that leads to severe physiological and psychological impairments in adult life. Little consensus exists regarding quality of life (QOL) in individuals with MFS. The present study sought to investigate QOL in a representative cohort of adults with MFS. Read More

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Acute Pancreatitis in Children: The Clinical Profile at a Tertiary Hospital.

Cureus 2021 May 6;13(5):e14871. Epub 2021 May 6.

Medicine, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, BHR.

Objectives The clinical course and progression of acute pancreatitis are poorly understood to date, necessitating more studies of clinical profiles during the disease. Moreover, understanding the etiologies and clinical presentations of acute pancreatitis (AP) in children can contribute to early diagnosis and, hence, earlier interventions. Therefore, this article aims to study the clinical profiles of children with acute pancreatitis (AP) in relation to complications and other variables. Read More

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A Comparison of Diagnostic Accuracy of a Rapid Antigen Detection Test in Screening for Group A Streptococcal Throat Infection Between 3- to 10-Year-Old (Children and Preadolescents) and 11- to 21-Year-Old (Adolescents).

Cureus 2021 May 4;13(5):e14840. Epub 2021 May 4.

Pediatric Emergency Medicine, Loma Linda University Medical Center, Loma Linda, USA.

Introduction Pharyngitis is one of the most common childhood diseases worldwide. We intended to compare the performance of one such rapid antigen detection test (RADT) using lateral flow immunoassay technique, between 3- to 10-year-old (children and preadolescent) and 11- to 21-year-old (adolescents). Methods Children and adolescents attending the pediatric ED with complaints of throat pain and signs of pharyngeal and tonsillar inflammation were tested by both the RADT and throat culture (TC) directed towards group A streptococcal (GAS) between April and June of 2016. Read More

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Efficacy and Safety of Orally Administered Acotiamide Extended-Release Tablets Among Functional Dyspepsia-Postprandial Distress Syndrome Patients: A Randomized, Double-Blind, Multicenter Study.

Cureus 2021 Apr 8;13(4):e14361. Epub 2021 Apr 8.

Clinical Development and Medical Affairs, Hetero Labs Limited, Hyderabad, IND.

Background: Acotiamide, is the world's first-in-class, prokinetic drug and world's first approved treatment for postprandial distress syndrome (PDS) symptoms of functional dyspepsia (FD). An extended-release (ER) formulation of this drug product, developed first-time in the world has been evaluated in phase 3, a comparative trial to explore the efficacy and safety in patients with FD-PDS.

Methods: In this study, 219 patients with FD-PDS aged 18-65 years were randomized (1:1) to receive either acotiamide ER 300 mg once daily or acotiamide 100 mg three times daily for four weeks. Read More

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Motor Control and Ergonomic Intervention Home-Based Program: A Pilot Trial Performed in the Framework of the Motor Control Home Ergonomics Elderlies' Prevention of Falls (McHeELP) Project.

Cureus 2021 Apr 7;13(4):e14336. Epub 2021 Apr 7.

Physiotherapy, Physiotherapy Department, Faculty of Health and Care Sciences, University of West Attica (UNIWA), Athens, GRC.

Objectives Falls are a serious problem that can reduce living autonomy and health-related quality of life of older adults. A decrease in the muscular strength of the lower limbs and the deterioration of balance or motor performance deficits may lead to falls. "Motor Control Home Ergonomics Elderlies' Prevention of Falls" (McHeELP) is a novel motor control exercise program combined with ergonomic arrangements of the home environment. Read More

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Initial Experience With a Full Endoscopic Facet Fusion in Combination With Endoscopic Interbody Fusion.

Cureus 2021 Apr 6;13(4):e14327. Epub 2021 Apr 6.

Neurological Surgery, Mount Sinai Health System, New York, USA.

Background Facet fusion has been described in open and minimally invasive approaches to promote fusion. Our objective is to describe the technique of an endoscopic facet decortication and allograft placement as an adjunct to an interbody fusion. Methodology This was a descriptive analysis of patients who underwent endoscopic interbody fusion combined with facet fusion and percutaneous screw placement. Read More

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Renal Cell Carcinoma in Fistulizing Crohn's Disease Patient Who Received Anti-TNF Therapy.

Case Rep Gastrointest Med 2021 21;2021:5593067. Epub 2021 Apr 21.

Radiology Department, Armed Forces Hospital Southern Region, Khamis Mushayt, Saudi Arabia.

Inflammatory bowel diseases are chronic inflammatory diseases affecting the gastrointestinal tract with different clinical presentations. These chronic inflammatory diseases are associated with an increased risk for both intestinal and different types of extra-intestinal malignancies. In this case report, we describe the condition of a 29-year-old Saudi male diagnosed with fistulizing ileal Crohn's disease 7 years ago. Read More

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