Notes

Twelve months involving COVID-19 in Italia: are generally containment plans enough to condition your pandemic structure?
Taking quizzes using the "Exam" feature was the highest rated use of AnatomyShare, and students cited that the application exposed them to anatomical variation and motivated them to correctly identify structures during dissection. While steps need to be taken to combat low-quality learner-generated content and to enhance meaningful student interaction and collaboration, AnatomyShare was a feasible and highly rated supplement to dissection that provided valuable assessment opportunities for students. Future research will examine the impact of use on course grades and engagement in gross anatomy dissection.
To examine the association between age at menarche and risk of vasomotor menopausal symptoms (VMS) and whether midlife body mass index (BMI) modified the association.

A pooled analysis of six cohort studies.

The International collaboration on the Life course Approach to reproductive health and Chronic disease Events (InterLACE).

18555 women from the UK, USA and Australia.

VMS frequency data (never, rarely, sometimes and often) were harmonised from two studies (n=13602); severity data (never, mild, moderate and severe) from the other four studies (n=4953). Multinominal logistic regression models were used to estimate relative risk ratios (RRRs) and 95%CIs adjusted for confounders and incorporated study as random effects.

Hot flushes and night sweats.

Frequency data showed that early menarche ≤11years was associated with an increased risk of 'often' hot flushes (RRR 1.48, 95% CI 1.24-1.76) and night sweats (RRR 1.59, 95% CI 1.49-1.70) compared with menarche at ≥14years. Severity data showed similar results, but appeared less conclusive, with RRRs of 1.16 (95% CI 0.94-1.42) and 1.27 (95% CI 1.01-1.58) for 'severe' hot flushes and night sweats, respectively. BMI significantly modified the association as the risk associated with early menarche and 'often' VMS was stronger among women who were overweight or obese than those of normal weight, while this gradient across BMI categories was not as strong with the risk of 'severe' VMS.

Early age at menarche is a risk factor for VMS, particularly for frequent VMS, but midlife BMI may play an important role in modifying this risk.

Overweight and obesity exacerbate the risk of vasomotor symptoms associated with early menarche.
Overweight and obesity exacerbate the risk of vasomotor symptoms associated with early menarche.
Immunotherapy has revolutionised the treatment of many malignancies. Along with their success, there have been inflammatory and immune-related adverse events (irAE). There is a paucity of literature describing the Australian experience of rheumatic irAE.

To describe and characterise the Royal North Shore Hospital and Westmead Hospital cohort with rheumatic irAE.

This case series reports on seventeen patients with advanced cancer treated at two sites in Sydney, Australia who were referred for rheumatological evaluation from 2013 to 2016. Data was collected retrospectively and inspected for clinical signs, duration of immunotherapy prior to onset of symptoms, management strategies and cancer outcomes.

Patients presented with arthralgias, myalgias, periarticular and systemic symptoms. Onset of rheumatological symptoms was variable, with a median of 4 months (range 0.2- 24) for monotherapy and 5.05 months (range 0.2- 6.9) for combination. The predominant findings were of tenosynovitis (23%) and large joinay be associated with tumour response. However, there is still limited experience in rheumatic irAEs management and outcomes. This article is protected by copyright. All rights reserved.Published radiotherapy results for suspected heart-based tumours in dogs are limited. In this retrospective longitudinal study (3/2014-2019), eight dogs with either clinical signs attributable to a heart-base mass (6), or asymptomatic with a progressively larger mass on echocardiogram (2), received conventional fractionated radiotherapy (CFRT) or stereotactic body radiotherapy (SBRT). Clinical findings in symptomatic cases included one or more of the following retching/coughing (4), exercise intolerance (2), collapse (1), pericardial effusion (2), rare ventricular premature contractions (2), abdominal effusion (1), or respiratory distress due to chylothorax (1). CFRT cases received 50 Gray (Gy) in 20 fractions and SBRT cases received 30 Gy in 5 or 24 Gy in three fractions. Two dogs received chemotherapy post-radiation. At analysis, 7/8 dogs were deceased and one was alive 684 days post-treatment. The estimated median overall survival (MOS) from first treatment was 785 days (95% CI 114-868 days, [range 114-1492 days]). Five dogs received CFRT (MOS 817 days; (95% CI 155 days-not reached [range 155-1492 days])). Three dogs received SBRT with one alive at analysis (MOS 414 days, (95% CI, 114 days-not reached [range 114-414 days])). No statistically significant difference was found between survival for CFRT and SBRT. Of the symptomatic patients, 5/6 showed improvement. Mass size reduced in 4/5 cases receiving follow-up ultrasounds. Possible complications included asymptomatic radiation pneumonitis (4), atrial tachycardia/premature beats (4) and pericardial effusion with heart failure coincident with tumour progression (1). This study provides preliminary evidence that radiotherapy may impact clinically relevant or progressively enlarging heart-base masses.
The coronavirus disease 2019 (COVID-19) pandemic has led to changes in health care utilization for different acute cardiovascular diseases. Whether hospitalization rates and in-hospital mortality were affected by the pandemic in patients with acute symptomatic heart failure (HF) was investigated in this study.

Administrative data provided by 67 German Helios hospitals were examined for patients with a main discharge diagnosis of HF using ICD codes. Urgent hospital admissions per day were compared for a study period (13 March-21 May 2020) with control intervals in 2020 (1 January-12 March) and 2019 (13 March-21 May), resulting in a total of 13 484 patients excluding all patients with laboratory-proven COVID-19 infection. Incidence rate ratios (IRR) were calculated using Poisson regression. Generalized linear mixed models were used for univariable and multivariable analysis to identify predictors of in-hospital mortality. learn more The number of admissions per day was lower in the study period compared to the same year [IRR 0.
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