Postgraduate medicine
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Postgraduate medicine · Jun 2020
ReviewThe effect of early oral feeding after esophagectomy on the incidence of anastomotic leakage: an updated review.
Early oral feeding (EOF) is considered to be an important component of enhanced recovery after surgery (ERAS), but raises the concern of increased risk of anastomotic leakage (AL) in patients receiving esophagectomy. This review aimed to elucidate the correlation of EOF and the incidence of AL after esophageal resection. ⋯ EOF after esophagectomy probably does not increase the incidence of AL, and it is a promising strategy in line with the essence of ERAS. However, more and better evidence from high-quality RCTs are still needed.
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Atherosclerotic cardiovascular disease (ASCVD) is the main cause of morbidity and mortality in the US. ASCVD is caused by elevated levels of ApoB lipoproteins, which over many years penetrate the arterial subendothelial space leading to plaque growth and eventually rupture causing clinical symptoms. ApoB lipoprotein levels are approximated in clinical practice by LDL-C measurement. ⋯ However, for a variety of reasons, many patients do not achieve their recommended LDL-C levels using currently available therapies. This has prompted the development of new LDL-C lowering drugs in the hope to reduce cardiovascular risk, such as bempedoic acid, inclisiran, gemcabene, and evinacumab. Drugs targeting other lipids (triglycerides, HDL-C, lipoprotein (a)), intravascular inflammation or acting by other mechanisms also have a role in atherosclerosis prevention, however, they will not be covered in this review.
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Postgraduate medicine · Jun 2020
Improving statin prescription through the involvement of nurses in the provision of ASCVD score: a quality improvement initiative in primary care.
This study compares two methods of providing CVD risk score on the percentage of appropriate statin therapy for primary prevention of CVD in family medicine clinics, according to the American Heart Association guidelines. ⋯ The provision of the CVD risk score alone as clinical decision support is not enough to improve statin initiation for primary prevention. The nurse collaboration can improve guideline-concordant statin initiation.
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Postgraduate medicine · Jun 2020
Reduced antibiotic use after initial treatment of acute respiratory infections with phytopharmaceuticals- a retrospective cohort study.
We examined the relationship between the initial treatment of acute lower and upper tract respiratory infections with phytopharmaceuticals and the duration of the disease as well as between the initial treatment and the use of antibiotics in the further course of the disease. ⋯ The use of selected phytopharmaceuticals for acute respiratory infections is associated with a significantly reduced need for antibiotic prescriptions in the further course of the disease, as well as significantly shorter sick leaves.