The American journal of medicine
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Multicenter Study
Long-Term Functional Limitations and Predictors of Recovery after COVID-19: A Multicenter Prospective Cohort Study.
Limited data exist on post-severe COVID-19 functional trajectory, particularly considering premorbid status. We characterized 1-year functional recovery post-hospitalization for COVID-19, highlighting predictors of long-term recovery. ⋯ Our study provides compelling evidence of the long-term impact of COVID-19 on functional and cognitive status 1-year post-infection.
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Coccidioidomycosis within endemic regions is often undiagnosed because appropriate testing is not performed. A dashboard was developed to provide information about the prevalence of coccidioidomycosis throughout the year. ⋯ Data provided by the coccidioidomycosis dashboard can assist urgent care practitioners in knowing when coccidioidomycosis is prevalent in the community. Patients with exposure to endemic coccidioidomycosis who develop erythema nodosum or pneumonia should routinely be tested for coccidioidomycosis. Data from private health care organizations can augment surveillance of diseases important to public health.
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Altered immune response and cognitive difficulties have been demonstrated in studies of post-COVID syndrome, including differences in immune status and cognitive functioning in the months following infection. This review aimed to examine immune status and cognitive differences in post-COVID Syndrome twelve or more weeks after COVID-19 infection. A further aim of this review was to explore a link between immune response and the cognitive deficits observed in this group. ⋯ This review highlights the frequency of cognitive difficulties months after COVID-19 infection and explores heighted immune response as a predictor of this change. Six studies suggest that immune status is a predictor of cognitive function, examining a marker of immune function and objective cognitive performance at 12 or more weeks following infection. Future studies of cognitive function in Post COVID Syndrome are needed to explore this relationship, and underlying mechanisms leading to changes in cognitive performance.
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Thrombosis in the antiphospholipid syndrome is still frequently treated with vitamin K antagonists with a target international normalized ratio of 2-3. Time in therapeutic range of international normalized ratio of ≥ 70% is considered optimal. Time in therapeutic range among antiphospholipid syndrome patients is not well documented and the clinical consequences of poor international normalized ratio control are uncertain. ⋯ A minority of antiphospholipid syndrome patients treated with vitamin K antagonist s achieve optimal anticoagulation and are at risk for recurrent thrombotic events, particularly arterial. Presence of multiple comorbidities is associated with poor international normalized ratio control. Careful monitoring of this patient population is warranted.
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Few studies have assessed the ability of internal medicine residents to perform a cardiovascular physical examination using real patients. ⋯ Internal medicine interns had variable skills in performing and interpreting the cardiovascular physical exam. Improving cardiovascular exam skills would likely lead to increased identification of relevant cardiovascular findings, inform clinical decision making and improve overall patient care.