Brit J Hosp Med
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This review presents a current perspective on the association between rheumatoid arthritis (RA) and osteoporosis. Many factors contribute to the increased risk of osteoporosis and fracture in RA patients. ⋯ Available anti-osteoporotic treatments, their mechanisms of action, and their potential benefits in managing the interaction between RA and osteoporosis are discussed. We also consider potential advancements, including areas of future development in RA and osteoporosis diagnosis and management.
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In the last decade or so obstetric care has evolved and become more complex. This can be attributed to a combination of factors including rising obesity rates, maternal age and medical treatment advances. Clinicians are caring for more pregnant women with chronic medical disease in addition to any de novo presentations which may occur, emphasising the need for the general medicine body to feel confident and skilled in the management of medical problems before, during and after pregnancy. ⋯ Unfortunately, clinician inertia around the care of pregnant women is a common feature in maternal mortality reviews. The most recent maternal mortality report discusses common themes around cardiovascular disease in pregnancy, alongside management of acute and acute-on-chronic presentations in the context of common endocrine, gastrointestinal and neurological disease in pregnancy. This article discusses some of these themes and the management of common medical problems in pregnancy.
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Aims/Background Rheumatoid arthritis (RA) is an inflammatory autoimmune disease and N-acetylcysteine (NAC) is considered a potential therapeutic agent for RA due to strong antioxidant and anti-inflammatory properties. Therefore, this systematic review and meta-analysis aimed to evaluate the efficacy of NAC as an adjuvant therapy for RA. Methods A systematic search was conducted across five databases from inception to 1 August 2024, including CINAHL, Cochrane Library, EMBASE, PubMed, and Web of Science. ⋯ Additionally, NAC reduced inflammatory markers (erythrocyte sedimentation rate (ESR): MD = 3.00). However, the beneficial effects of NAC on oxidative stress in RA patients were not observed. Conclusion This meta-analysis demonstrated the efficacy of NAC in reducing inflammatory markers, improving joint tenderness, and swelling in patients with RA.
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Aims/Background During the coronavirus disease 2019 (COVID-19) pandemic, the COVID-19 surveillance staff members experienced an increased risk for musculoskeletal disorders. Thus, it is necessary to further investigate the causal factors stemming from COVID-19 surveillance work, especially nucleic acid testing, and establish their relationship with work-related musculoskeletal disorders (WMSDs) by building upon the previous research. This study aimed to determine the prevalence of WMSDs and the major risks faced by the COVID-19 surveillance staff members. ⋯ The top three coping strategies for lowering the risk of WMSDs included adjusting the plinth/bed height (49.6%), utilizing different parts of the body at work (47.3%), and taking short breaks when required (33.6%). Conclusion Prolonged large-scale nucleic acid detection can aggravate the musculoskeletal injuries of the neck, shoulder, upper back, and wrist in COVID-19 surveillance staff members. Prevention measures for musculoskeletal injuries factors must be in place to deter such incidence at work.
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Randomized Controlled Trial
Impact of Propofol Administered before Extubation on Respiratory Adverse Events in Pediatric Patients Undergoing Tonsillectomy and Adenoidectomy: A Randomized Controlled Trial.
Aims/Background Perioperative respiratory adverse events (PRAEs) are common in pediatric anesthesia, especially in otolaryngology procedures. In this randomized controlled trial, we investigated the impact of administering propofol before extubation on PRAEs in pediatric patients undergoing tonsillectomy and adenoidectomy. Methods We enrolled children aged 3 to 8 years old, of American Society of Anesthesiologists (ASA) classes I to III, scheduled for tonsillectomy, and randomly divided them into propofol and control groups. ⋯ Conclusion This trial demonstrated that while administering repeated small doses of propofol before extubation does not significantly reduce respiratory adverse events in children undergoing tonsillectomy and adenoidectomy, it does significantly reduce the incidence of severe coughing, improving postoperative recovery and clinical outcomes. Moreover, propofol helps reduce postoperative agitation, enhancing the safety and effectiveness of postoperative care, and maintaining its valuable clinical role in postoperative management. Clinical Trial Registration ClinicalTrials.gov (NCT05769842).