The American journal of the medical sciences
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Positive predictive value (PPV) of hemoglobin A1c (HbA1c) for diagnosis of prediabetes in clinical practice has not been well studied. ⋯ PPV of HbA1c for diagnosis of prediabetes in clinical setting is low. Patients with HbA1c of 5.7% to 6.4% should undergo OGTT to confirm diagnosis of dysglycemia.
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Hematologists/Oncologists spend years of training in a fellowship program. At academic centers, patients receiving treatment are often seen by fellows. It has not been established what patients understand about fellowship training, therefore the purpose of this study was to explore their understanding and whether they are content with fellows taking part in their care. ⋯ Patients at academic centers being seen by Hematology/Oncology fellows appear to have a lack of knowledge of a fellow's role and background but have a desire to be educated. Educational initiatives can be introduced to teaching institutions to help patients better understand the role of a fellow.
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Letter Case Reports
Acute myocardial infarction associated with painless thyroiditis.
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Increased kidney absorption of salt and solute-free water resulting in volume overload is frequently observed in cirrhosis, especially with progression of the disease. Although diuretic therapy is able to control volume overload in the early stages of cirrhosis, it fails in a significant proportion of patients in late stages, giving rise to a situation termed "diuretic resistant ascites." This situation represents a state of functional renal failure called hepatorenal syndrome, which is further classified into 2 subgroups based on the severity of renal failure. ⋯ At the same time, an accumulating body of evidence has been pointing toward a direct interaction between the liver and the kidneys that may have an etiologic role for volume overload. Therefore, looking for a new hypothesis for volume overload in cirrhotics is of paramount importance to explain the pathophysiology behind this neat observation and to understand the available options to deal with this morbid complication of cirrhosis.