Postgraduate medical journal
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Multicenter Study
Temporal relationship between sarcoidosis and malignancies in a nationwide cohort of 1942 patients.
To investigate the phenotype of sarcoidosis according to the time when a malignancy is diagnosed (preexisting to the diagnosis of sarcoidosis, concomitant, or sequential) and to identify prognostic factors associated with malignancies in a large cohort of patients with sarcoidosis. ⋯ It is essential to consider the synchronous or metachronous timing of the diagnosis of malignancies in people with sarcoidosis. We found that half of the malignancies were diagnosed after a diagnosis of sarcoidosis, with spleen and bone marrow involvement associated with a four to eight times higher risk of developing hematological malignancies. Key messages What is already known on this topic Malignancies are one of the comorbidities more frequently encountered in people with sarcoidosis What this study adds Malignancies occur in 12% of patients with sarcoidosis Malignancy may precede, coincide with, or follow the diagnosis of sarcoidosis One-third were identified before sarcoidosis, and half were diagnosed after Spleen and bone marrow involvement are risk factors for developing hematological malignancies How this study might affect research, practice or policy Patients with sarcoidosis should be regularly monitored for neoplasms, informed of the increased risk, and educated on early detection. Those with spleen or bone marrow involvement must be closely followed.
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Randomized Controlled Trial Multicenter Study Comparative Study
Comparison of diclofenac with tramadol, tizanidine or placebo in the treatment of acute low back pain and sciatica: multi-center randomized controlled trial.
Low back pain (LBP) is a leading cause of disability worldwide and has posed numerous health and socioeconomic challenges. This study compared whether nonsteroidal anti-inflammatory drugs (NSAIDs) in combination with tramadol, tizanidine or placebo would be the best treatment regime to improve the Roland Morris Disability Questionnaire (RMDQ) scores at 1 week. ⋯ Among patients with acute LBP and sciatica presenting to the ED, adding tramadol or tizanidine to diclofenac did not improve functional recovery.
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The evaluation of patients with fatty liver as defined by metabolic dysfunction-associated fatty liver disease (MAFLD) in the real world remains poorly researched. This study aimed to analyse the clinical and histological features of patients with MAFLD and nonalcoholic fatty liver disease (NAFLD) and to characterize each metabolic subgroup of MAFLD. ⋯ Patients with MAFLD have a higher degree of liver fibrosis than NAFLD patients. In addition, diabetic patients should be screened for fatty liver and liver fibrosis degree.
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Randomized Controlled Trial Multicenter Study
Intensive blood pressure control in older patients with hypertension-a STEP in the right direction?
In November 2022, the Clinical Practice Guidelines for the Management of Hypertension in China were updated; the definition of hypertension and the target of treatment was changed from 140/90 mm Hg to 130/80 mm Hg. This was prompted by the results of the Strategy of Blood Pressure Intervention in the Elderly Hypertensive Patients (STEP) study, a large multicenter randomized controlled trial conducted in China. ⋯ It is also reassuring to know that treating adults aged 60 years or older to achieve a systolic blood pressure of <130 mm Hg is safe, while reducing cardiovascular events, stroke and all-cause mortality. Nevertheless, further studies are needed to delineate the risks and benefits in subgroups, such as the elderly with diabetes or a history of stroke.
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Multicenter Study Observational Study
Influence of medical trainee sleep pattern (chronotype) on burn-out and satisfaction with work schedules: a multicentre observational study.
Medical trainees' work schedule is designed to cover duties without consideration of differences in circadian rhythms during a 24-hour period (chronotype). ⋯ Burn-out is prevalent among medical trainees. Improving alignment between trainee preferences may improve performance, reduce human errors and burn-out.