Postgraduate medicine
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Postgraduate medicine · Apr 2021
Review Meta AnalysisThe effect of prophylactic thoracic duct ligation during esophagectomy on the incidence of chylothorax and survival of the patients: an updated review.
The role of thoracic duct ligation (TDL) during esophagectomy remains controversial. This review aimed to elucidate the effect of TDL on chylothorax and survival of the patients after esophagectomy for cancer. ⋯ The present review provided updated evidence opposing prophylactic TDL during esophagectomy for lowering chylothorax. Considering the harmful effect of TDL on survival of the patients, further well-designed trials should be considered in selected cases under strict supervision.
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Postgraduate medicine · Apr 2021
Falls, frailty, and metabolic syndrome in urban dwellers aged 55 years and over in the Malaysian elders longitudinal research (MELoR) study - a cross-sectional Study.
While metabolic syndrome, falls, and frailty are common health issues among older adults which are likely to be related, the potential interplay between these three conditions has not previously been investigated. We investigated the relationship between metabolic syndrome with falls, and the role of frailty markers in this potential relationship, among community-dwelling older adults. ⋯ Metabolic syndrome was independently associated with falls among older adults, and this relationship was accounted for by the presence of slow gait speed. Future studies should determine the value of screening for frailty and falls with gait speed in older adults with metabolic syndrome as a potential fall prevention measure.
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Postgraduate medicine · Apr 2021
The impact of delayed heart rate recovery on prevalent hypertension.
Objectives: Delayed heart rate recovery (HRR) is considered an indicator of autonomic nervous dysfunction, which is a primary pathological mechanism of hypertension. The present study aimed to explore the independent association between delayed HRR and prevalent hypertension. Methods: In this cross-sectional study, 314 inpatients were recruited between January 2018 and December 2019. ⋯ Conclusion: Delayed HRR was independently associated with prevalent hypertension. The association was linear and robust over the entire range of HRR. The present study suggested that delayed HRR could be used to optimize hypertension risk stratification.
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Postgraduate medicine · Apr 2021
Similar clinical outcome of AMA immunoblot-M2-negative compared to immunoblot-positive subjects over six years of follow-up.
Background: The detection of anti-mitochondrial antibodies (AMA) is considered a hallmark in diagnosing primary biliary cholangitis (PBC). The most important AMA-subtype is AMA-M2 directed against the E2-subunit of pyruvate dehydrogenase. It is common clinical interpretation that lack of M2 due to immunoblotting (IB) indicates absence of specific auto-reactivity. ⋯ According to the clinical course by the time of FU, subjects were allocated to one of four groups: a) 34 patients had known PBC with n = 16 having an adequate and 18 an inadequate treatment response, b) 1 de novo PBC was detected, c) 13 were AMA-positive without biochemical evidence of PBC and d) 9 subjects were tested AMA-negative at FU. These numbers were comparable to M2-positive subjects with similar long-term clinical outcome. Conclusion: Our data suggest that the clinical value of confirmatory M2 immunoblotting in the diagnostic routine of PBC is overestimated as the clinical course appears not to be related to the test result.
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Postgraduate medicine · Apr 2021
Clinical characteristics of platelets and its possible gender dimorphism in patients with nonalcoholic fatty liver disease (NAFLD).
This study aimed to analyze the characteristics of platelet-associated parameters in nonalcoholic fatty liver disease (NAFLD) patients with varying degrees of disease severity and investigate the sexual dimorphism of platelet features in NAFLD patients. ⋯ The PC showed marked sex-based differences in NAFLD patients and is affected by age and BMI. Regular changes of platelet parameters could be found in patients with varying degrees of NAFLD. These changes might be helpful in assessing the severity of NAFLD.