Postgraduate medicine
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Postgraduate medicine · Aug 2020
Determinants of carotid intima-media thickness in asymptomatic elders: a population-based cross-sectional study in rural China.
Objective: To examine the mean carotid intima-media thickness (CIMT) and potentially relevant determinants of increased CIMT in elders. Method: Stroke-free and cardiovascular disease-free residents aged ≥65 years were recruited in a low-income population in China. B-mode ultrasonography was performed to measure CIMT. ⋯ However, high triglyceride level was negatively associated with mean CIMT only among individuals without metabolic syndrome (P = 0.036). Discussion: These findings suggest that there is an urgent need to delay atherosclerosis progression and reduce the stroke burden by managing hypertension, especially for men. Moreover, to decrease the stroke burden in rural China, caution is advised regarding lipid-lowering treatment in elderly patients without metabolic syndrome.
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Postgraduate medicine · Aug 2020
The association between serum uric acid levels and ischemic stroke in essential hypertension patients.
Objectives: The association between serum uric acid (SUA) and ischemic stroke is still inconsistent across population. This study aimed to examine the association between SUA and ischemic stroke in essential hypertension patients. Methods: This retrospective study recruited participants from September 2011 to December 2012, in the Liao-bu community, Guangdong Province, China, and followed them until 31 December 2016. ⋯ Gender subgroup analysis showed SUA was an independent risk of ischemic stroke in female (HR = 1.35, 95%CI: 1.11, 1.81, P = 0.002) and male (HR = 1.53, 95%CI: 1.14, 1.92, P < 0.001). ROC curve demonstrated that SUA yielded an AUC of 0.7476 (95%CI: 0.7098, 0.7855, P < 0.001) for predictive of ischemic stroke. Conclusions: SUA was an independent risk factor for ischemic stroke, and also have a good predictive value ischemic stroke among hypertensive patients in Chinese community.
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Postgraduate medicine · Aug 2020
Review Case ReportsInvasive Group A streptococcal postpartum endometritis associated with multi-organ infarctions: an uncommon case presentation and literature review.
Background: Streptococcal Toxic Shock Syndrome (STSS) is a serious condition that can arise from streptococcal postpartum endometritis. It is associated with a substantial increase in mortality rate and can rarely result in multiorgan infarction. Early recognition plays a vital role in patients' outcome. ⋯ Thirteen out of 15 cases of postpartum endometritis occurred after uncomplicated vaginal delivery. Conclusion: STSS is a serious and possibly fatal medical condition that requires early diagnosis and treatment to prevent poor patient outcomes and death. Careful consideration to the patient's postpartum clinical presentation with the implementation of an intradisciplinary approach should be utilized.
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Objectives: To evaluate the risk of periodontal disease (PD) in gout patients. Methods: This retrospective cohort study was conducted using data from the Longitudinal Health Insurance Database 2000. The gout cohort included 31,759 patients newly diagnosed with gout from 2000 to 2012, and the comparison (nongout) cohort included 63,517 patients. ⋯ Only patients using colchicine had a significantly lower risk of PD (aHR = 0.85, 95% CI = 0.79-0.91). Conclusion: In our study, patients with gout showed an increased risk of PD, and treatment with colchicine could decrease the risk. Abbreviations: PD: periodontal disease; LHID: Longitudinal Health Insurance Research Database; NHIRD, National Health Insurance Research Database; ICD-9-CM: International Classification of Diseases, Ninth Revision, Clinical Modification; CI: confidence interval; HR: hazard ratio.
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Postgraduate medicine · Aug 2020
Evaluation of internal medicine physicians' attitudes toward the treatment of dyslipidemia.
Objectives: Dyslipidemia is one of the risk factors for atherosclerotic cardiovascular disease. Cardiovascular events decrease with decreasing LDL-C levels and all guidelines emphasize the importance of LDL-C lowering. However, implementation in real life is suboptimal. ⋯ Conclusion: Despite overwhelming evidence, some physicians did not use guidelines and some physicians doubted the necessity of dyslipidemia treatment. A significant proportion of physicians were affected by the patient's reluctance. There is a clear need to educate physicians about the importance of guidelines.