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Trending Papers in internal medicine

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233
From Paper: Associations Between Systolic Interarm Differences in Blood Pressure and Cardiovascular Disease Outcomes and Mortality
Published: Feb 2021
From Paper: Associations Between Systolic Interarm Differences in Blood Pressure and Cardiovascular Disease Outcomes and Mortality
Published: Feb 2021
  • This study undertook individual participant data meta-analyses to (1) quantify independent associations of systolic interarm difference with mortality and cardiovascular events; (2) develop and validate prognostic models incorporating interarm difference, and (3) determine whether interarm difference remains associated with risk after adjustment for common cardiovascular risk scores
  • Hazard ratios for all-cause mortality increased with interarm difference magnitude from a ≥5 mm Hg threshold
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Patrick Joyce
1
Authors: Alboraie, Mohamed, et al
Published: Sep 2020
Authors: Alboraie, Mohamed, et al
Published: Sep 2020
Background & study aimsCorona virus disease-19 (COVID-19) pandemic has markedly impacted routine medical services including gastrointestinal (GI) endoscopy. We aim to report the real-life performance in high volume GI endoscopy units during the pandemic.Patients and methodsA web-based survey covering all aspects of daily performance in GI endoscopy units was sent to endoscopy units worldwide. Responses were collected and data were analyzed to reveal the effect of COVID-19 pandemic on endoscopy practice.ResultsParticipants from 48 countries (n = 163) responded to the survey with response rate of 67.35%. The majority (85%) decreased procedure volume by over 50%, and four endoscopy units (2.45%) completely stopped. The top three indications for procedures included upper GI bleeding (89.6%), lower GI bleeding (65.6%) and cholangitis (62.6%). The majority (93.9%) triaged patients for COVID-19 prior to procedure. N95 masks were used in (57.1%), isolation gowns in (74.2%) and head covers in (78.5%). Most centers (65%) did not extend use of N95 masks, however 50.9% of centers reused N95 masks. Almost all (91.4%) centers used standard endoscopic decontamination and most (69%) had no negative pressure rooms. Forty-two centers (25.8%) reported positive cases of SARS-CoV-2 infection among patients and 50 (30.7%) centers reported positive cases of SARS-CoV-2 infection among their healthcare workers.ConclusionsMost GI endoscopy centers had a significant reduction in their volume and most procedures performed were urgent. Most centers used the recommended personal protective equipment (PPE) by GI societies however there is still a possibility of transmission of SARS-CoV-2 infection in GI endoscopy units.
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Colin Moser
1
Authors: Ng, Jia H., et al
Published: Sep 2020
Authors: Ng, Jia H., et al
Published: Sep 2020
Rationale & ObjectiveOutcomes of patients hospitalized with coronavirus disease 2019 (COVID-19) and acute kidney injury (AKI) are not well understood. The goal of this study was to investigate the survival and kidney outcomes of these patients.Study DesignRetrospective cohort study.Setting & ParticipantsPatients (aged≥18 years) hospitalized with COVID-19 at 13 hospitals in metropolitan New York between March 1, 2020, and April 27, 2020, followed up until hospital discharge.ExposureAKI.OutcomesPrimary outcome: in-hospital death. Secondary outcomes: requiring dialysis at discharge, recovery of kidney function.Analytical ApproachUnivariable and multivariable time-to-event analysis and logistic regression.ResultsAmong 9,657 patients admitted with COVID-19, the AKI incidence rate was 38.4/1,000 patient-days. Incidence rates of in-hospital death among patients without AKI, with AKI not requiring dialysis (AKI stages 1-3), and with AKI receiving dialysis (AKI 3D) were 10.8, 31.1, and 37.5/1,000 patient-days, respectively. Taking those without AKI as the reference group, we observed greater risks for in-hospital death for patients with AKI 1-3 and AKI 3D (HRs of 5.6 [95% CI, 5.0-6.3] and 11.3 [95% CI, 9.6-13.1], respectively). After adjusting for demographics, comorbid conditions, and illness severity, the risk for death remained higher among those with AKI 1-3 (adjusted HR, 3.4 [95% CI, 3.0-3.9]) and AKI 3D (adjusted HR, 6.4 [95% CI, 5.5-7.6]) compared with those without AKI. Among patients with AKI 1-3 who survived, 74.1% achieved kidney recovery by the time of discharge. Among those with AKI 3D who survived, 30.6% remained on dialysis at discharge, and prehospitalization chronic kidney disease was the only independent risk factor associated with needing dialysis at discharge (adjusted OR, 9.3 [95% CI, 2.3-37.8]).LimitationsObservational retrospective study, limited to the NY metropolitan area during the peak of the COVID-19 pandemic.ConclusionsAKI in hospitalized patients with COVID-19 was associated with significant risk for death.
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Colin Moser
1
From Paper: Increasing Heroin, Cocaine, and Buprenorphine Arrests Reported to the Maine Diversion Alert Program
Authors: Simpson, Kevin J, et al
Published: Aug 2019
From Paper: Increasing Heroin, Cocaine, and Buprenorphine Arrests Reported to the Maine Diversion Alert Program
Authors: Simpson, Kevin J, et al
Published: Aug 2019
  • The Diversion Alert Program (DAP) was developed to combat illicit drug use and prescription drug diversion by facilitating communication between law enforcement and healthcare providers with the goal of limiting drug-related harms and criminal behaviors. Our objectives in this report were to analyze 2014-2017 DAP for: 1) trends in drug arrests and, 2) differences in arrests by offense, demographics (sex and age) and by region.
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Kolawole Solomon
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Kolawole Solomon
107
Published: Oct 2020
Published: Oct 2020
  • Technique combining mass transport theory with statistical pattern recognition, discovering sensitive cartilage phenotypes that predict future osteoarthritis progression with high accuracy is available
  • osteoarthritis detection in healthy individuals may be possible 3 y prior to symptoms or bone damage.
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Emeka A. Ezewudo
52
Authors: Kgosidialwa, Oratile, et al
Published: Dec 2020
Authors: Kgosidialwa, Oratile, et al
Published: Dec 2020
  • Pregestational diabetes mellitus (PGDM) is associated with adverse pregnancy outcomes including increased rates of caesarean section birth, macrosomia, congenital malformation, prematurity, admission to the neonatal intensive care unit and stillbirth.
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Emeka A. Ezewudo
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Emeka A. Ezewudo
45
Authors: Adam B Levin, Christine M Ball, Peter J Featherstone
Published: Nov 2020
Authors: Adam B Levin, Christine M Ball, Peter J Featherstone
Published: Nov 2020
  • Cholera, a deadly diarrhoeal illness caused by the bacteria Vibrio cholerae, has been responsible for seven pandemics since the 19th century. Collectively, the pandemics have caused millions of deaths.
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Emeka A. Ezewudo
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Emeka A. Ezewudo
9
From Paper: A novel technological approach towards the early diagnosis of neurodevelopmental disorders
Published: Aug 2008
From Paper: A novel technological approach towards the early diagnosis of neurodevelopmental disorders
Published: Aug 2008
  • Neuro-Developmental Engineering (NDE) is a new and emerging interdisciplinary research area at the intersection of developmental neuroscience and bioengineering aiming at providing new methods and tools for: i) understanding neuro-biological mechanisms of human brain development; ii) quantitative analysis and modeling of human behavior during neuro-development; iii) assessment of neuro-developmental milestones achieved by humans from birth onwards.
  • This technology is expected to be also useful in the long term for developing new tools, e.g. toys, which can sustain, in ecological scenarios, the regular development of motor and cognitive abilities of the child, based on a rigorous scientific approach.
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Emeka A. Ezewudo
4
From Paper: Avoidance of sun exposure is a risk factor for all-cause mortality: results from the Melanoma in Southern Sweden cohort
From Paper: Avoidance of sun exposure is a risk factor for all-cause mortality: results from the Melanoma in Southern Sweden cohort
Background Sunlight exposure and fair skin are major determinants of human vitamin D production, but they are also risk factors for cutaneous malignant melanoma (MM). There is epidemiological evidence that all-cause mortality is related to low vitamin D levels. Methods We assessed the avoidance of sun exposure as a risk factor for all-cause mortality for 29 518 Swedish women in a prospective 20-year follow-up of the Melanoma in Southern Sweden (MISS) cohort. Women were recruited from 1990 to 1992 and were aged 25 to 64 years at the start of the study. We obtained detailed information at baseline on their sun exposure habits and potential confounders. Multivariable flexible parametric survival analysis was applied to the data. Results There were 2545 deaths amongst the 29 518 women who responded to the initial questionnaire. We found that all-cause mortality was inversely related to sun exposure habits. The mortality rate amongst avoiders of sun exposure was approximately twofold higher compared with the highest sun exposure group, resulting in excess mortality with a population attributable risk of 3%. Conclusion The results of this study provide observational evidence that avoiding sun exposure is a risk factor for all-cause mortality. Following sun exposure advice that is very restrictive in countries with low solar intensity might in fact be harmful to women's health.
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Daniel Horowitz
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Daniel Horowitz