Postgraduate medicine
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Doctors lead, in and out of the clinical environment, from ward to board; their roles will range from dealing with risk and uncertainty, communicating with different audiences and managing crises. At the heart of leadership is the ability to make decisions; which operation to perform or treatment to give or, as during this pandemic, what policy to implement or vaccines to order. ⋯ During this pandemic we have been able to compare different leaders, drawn from across the health, political and other sectors. This article identifies how leaders behaved during this pandemic and importantly what can be learnt from their actions.
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Postgraduate medicine · Sep 2021
Psychosocial impact of the COVID-19 pandemic: A cross-sectional study of online help-seeking Canadian men.
Purpose: The COVID-19 pandemic has had a profound impact on the lives of men. The present study investigated psychosocial impacts of the COVID-19 pandemic on a help-seeking sample of Canadian men, focusing on diverse aspects of their psychosocial well-being. Methods: A cross-sectional, open survey study design was used. ⋯ Nearly a third of respondents who were in a relationship (30.9%; N = 77) reported that they engaged in some type of abuse (primarily verbal abuse, 22.9%; N = 57) toward their intimate partner during COVID-19, and more than a quarter (27.3%; N = 68) reported being abused by their intimate partner (also primarily verbal abuse, 22.5%; N = 56). Just under half (42.2%; N = 183) of the respondents indicated experiencing suicidal ideation. Conclusion: These findings can help inform providers of health services to Canadian men, as well as policies that will be implemented during subsequent waves of COVID-19 or during future infectious outbreaks.
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Postgraduate medicine · Sep 2021
ReviewResidual excessive daytime sleepiness in patients treated for obstructive sleep apnea: guidance for assessment, diagnosis, and management.
Excessive daytime sleepiness (EDS) affects approximately half of patients with obstructive sleep apnea (OSA) and can persist in some despite normalization of breathing, oxygenation, and sleep quality with primary OSA therapy, such as continuous positive airway pressure (CPAP). EDS is often overlooked and under discussed in the primary care setting and in the follow-up of CPAP-treated patients due to difficult assessment of such a multi-dimensional symptom. This review aims to provide suggestions for procedures that can be implemented into routine clinical practice to identify, evaluate, and manage EDS in patients treated for OSA, including how to appropriately use various self-report and objective assessments along the clinical pathway and options for pharmacotherapy. In addition, examples of when it is appropriate to refer a patient to a sleep specialist for evaluation are discussed.
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Postgraduate medicine · Sep 2021
Watermelon and others plant foods that trigger headache in migraine patients.
Background: Food is already recognized as a trigger for migraine, but its mechanism of action has not been fully clarified. There is evidence that they act on the pathogenesis of migraine, interfering with meningeal inflammation, vasodilation and cerebral glucose metabolism. Aim: The aim of this study was to know which plant foods are triggers for migraine and the latency time for the onset of pain. ⋯ Results: There were headaches triggered by plant foods after 90.5 ± 7.9 minutes of ingestion in 40.3% (1,584/3,935) of migraine patients and none with tension-type headache. Headaches triggered by plant foods intake are distributed in the following order of frequency: watermelon (29.5%), passion fruit (3.73%), orange (2.01%), pineapple (1.52%), grape (0.51%), banana (0.46%), cucumber (0.43%), acerola (0.25%) and papaya (0.25%). Conclusions: Many plant foods, especially watermelon, may trigger headache attacks in migraine patients within a few minutes.
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Multiple sclerosis (MS) is an inflammatory neurodegenerative disorder manifesting as gradual or progressive loss of neurological functions. Most patients present with relapsing-remitting disease courses. ⋯ The delayed identification of these diseases in late adulthood can lead to severe neurological complications. Herein we discuss genetic diseases that have the potential to mimic multiple sclerosis, with highlights on clinical identification and practicing pearls that may aid physicians in recognizing MS-mimics with genetic background in clinical settings.