Postgraduate medicine
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Postgraduate medicine · Jan 2025
ReviewPreoperative intravenous versus oral iron supplementation for elective surgery: evidence based on 12 randomized trials.
This study aims to clarify hematological parameters, transfusion requirements, and adverse events of preoperative intravenous (IVIS) versus oral iron supplementation (OIS) in elective surgery patients. ⋯ PROSPERO CRD42023483284.
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Venous thromboembolism (VTE), consisting of both deep vein thrombosis (DVT) and pulmonary embolism (PE), is an extremely common condition both in the United States and worldwide. Not only is the diagnosis associated with significant morbidity and mortality for patients but it also imposes a deleterious financial burden on the US healthcare system. Diagnosis may be challenging due to variability in clinical presentation and requires a sequential workup including assessment of clinical pretest probability for VTE, D-dimer testing, and imaging. ⋯ First-line treatment for most patients is anticoagulation with a direct oral anticoagulant (DOAC) for a minimum of 3-6 months. In multiple clinical trials, DOACs have proven to be non-inferior to vitamin K antagonists for the treatment of VTE with a lower risk of bleeding. Special consideration should be taken in the choice of agent and duration of treatment for patients who have underlying thrombophilias or malignancy and who are pregnant.
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Postgraduate medicine · Jan 2025
ReviewQuality of guidelines for hyperthyroidism: systematic quality assessment using the AGREE II tool.
The aim of this study was to systematically assess the quality of different guidelines for the management of patients with hyperthyroidism and to explore and analyze the recommendations and key evidence in different guidelines. ⋯ The quality of hyperthyroidism treatment guidelines is variable, and treatment recommendations vary greatly from guideline between guidelines. Analyzing and improving the causes of inconsistencies in recommendations for patients with hyperthyroidism could be a reasonable and effective way for developers to improve the quality of guidelines for the management of hyperthyroidism.
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Postgraduate medicine · Jan 2025
Trends of primary health care practitioners toward bleeding management in Saudi Arabia: a cross-sectional analysis.
High rates of morbidity and mortality are a result of trauma being a significant health burden in Saudi Arabia. We evaluated the current trends of primary healthcare (PHC) physicians in Saudi Arabia toward patients with bleeding and their referral awareness for percutaneous endovascular arterial embolization (EAE). ⋯ PHC physicians in Saudi Arabia require a better understanding of the indications of EAE to avoid referral and triage errors, inefficient use of healthcare resources, and suboptimal patient outcomes.
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Postgraduate medicine · Jan 2025
Surgical intervention for patients with fibrinopurulent pleural empyema and acute respiratory failure: a case report.
Fibrinopurulent thorax is a rare condition that can lead to respiratory failure. Fibroblastic decortication surgery has been shown to be an effective treatment for chronic empyema in previous studies. However, there is limited evidence supporting surgical intervention for fibrinopurulent thorax in cases of respiratory failure. ⋯ This case demonstrates the efficacy of surgical treatment for fibrinopurulent thorax with respiratory failure, a scenario not previously documented in literature. Successful treatments for pneumonia and chronic empyema in the context of respiratory failure have provided both inspiration and validation for this approach. The findings of this case highlight the potential of surgical intervention as a new treatment option for clinical practice. However, as this is a single case report, further research is necessary to validate the efficacy and safety of this treatment method.