Annals of medicine
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Despite abundant evidence linking dyslipidaemia to an increased risk of hyperuricaemia, the exact association between each component of dyslipidaemia and hyperuricaemia remains controversial. Thus, the objective of this research was to examine the correlation between dyslipidaemia and its components, as well as hyperuricaemia in Chinese people over the age of 60. ⋯ Dyslipidaemia and its two distinct types, high TG and low HDL-C, increased hyperuricaemia incidence in this prospective cohort. Further research should be undertaken to investigate the possible reverse causality between different components of dyslipidaemia and hyperuricaemia.
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The global burden of hypertension remains an unsolved problem, especially in low- and middle-income countries (LMICs). For this reason, clinical practice guidelines containing the latest evidence-based recommendations are crucial in the management of hypertension. It is noteworthy that guidelines simply translated from those of high-income countries (HICs) are not the solution to the problem of hypertension in LMICs. ⋯ The lack of customised guidelines for LMICs cannot be solved simply by adopting guidelines from high-income countries. The World Health Organisation (WHO) recently published a clinical guideline for the pharmacological management of hypertension in LMICs. We compare select recommendations from the guidelines to those published by the International Society of Hypertension.
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Multicenter Study Observational Study
The role of prognostic stratification on prescription of anticoagulants in older patients with atrial fibrillation: a multicenter, observational, prospective European study (EUROSAF).
Literature suggests that different risks of mortality could influence physicians in prescribing or not anticoagulants in older patients with atrial fibrillation (AF). The Multidimensional Prognostic Index (MPI) can be considered a tool for the detection of multidimensional frailty. The aim of this cross-sectional study was to evaluate whether prescription patterns of oral anticoagulants exist, based on MPI values. ⋯ The EURopean study of Older Subjects with Atrial Fibrillation (EUROSAF) suggested that almost half of the older persons with AF do not receive anticoagulants and that MPI is an important determinant in prescribing or not anticoagulants. Trial Registration: https://clinicaltrials.gov/ct2/show/NCT02973984KEY POINTSAtrial fibrillation is a common condition in older people. The data regarding the use of anticoagulants is mainly derived from randomised controlled trials that do not include a sufficient number of older frail people.Our study suggests that a consistent part of older people affected by atrial fibrillation was not treated with anticoagulants, in particular, older frail patients; however, it is unclear if this choice is supported or not by evidence.The prognostic evaluation through the multidimensional prognostic index could be useful information for the choice in the prescription of anticoagulants in older people affected by atrial fibrillation.
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The COVID-19 pandemic led to many changes in healthcare including graduate medical education (GME). Residency and fellowship programs halted in-person recruitment and pivoted to virtual models. Residency selection and recruitment were practices ripe for redesign, as they relied on in-person interviewing as the major point of contact prior to match list creation. In this commentary, we review the state of virtual interviewing and propose a future state where virtual interactions are commonplace and integrated into a comprehensive recruitment process. ⋯ The GME community was able to adopt technology for the recruitment interview rapidly due to the pandemic. As more opportunities for technology-based interactions grow, the opportunity exists to reimagine recruitment beyond the interview. While resources are constrained, some of the efficiencies gained by adopting virtual interviewing can be leveraged to expand the interactions between programs and applicants. Incorporation of in-person interaction may still be needed. Models will need to be developed to build upon the best characteristics of the virtual and in-person environments to optimize GME recruitment.KEY MESSAGES:Virtual communication methods have substantially changed residency recruitment during the COVID -19 pandemic.COVID -19 related changes in residency recruitment, including wide adoption of virtual methods, should be maintained and strengthened.Efforts should be made to advance the gains in residency recruitment strategy during the pandemic by use of technologies that expand virtual interactions beyond the interview.
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Postural stability and gait are affected by an individual's emotional state. Physical therapy practice does not usually include an explicit assessment of the individual's emotional status. In contrast, complementary movement therapies often include the assessment of "grounding quality", which refers to the individual's physical and emotional stabilities. This study examined the correlation between conventional physical stability measures and grounding quality. ⋯ Although grounding quality and sway measures are somewhat correlated, they focus on different aspects of movement stability. A comprehensive assessment and holistic intervention strategies require incorporating multiple approaches to stability assessment. Further research is necessary to determine the contribution of combining these approaches among individuals with balance impairments.KEY MESSAGESGait stability measures were not correlated to "grounding quality" (a measure of emotional regulation and emotional awareness).Postural sway measures were found to be correlated to "grounding quality" items in the more demanding stance conditions.A comprehensive evaluation of an individual's stability may facilitate reliable and valid objective measurement instruments for both physical and emotional aspects of the movement.