Postgraduate medicine
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Postgraduate medicine · Sep 2021
Impact of monocyte to high-density lipoprotein ratio on the identification of prevalent coronary heart disease: insights from a general population.
Recent studies have identified monocyte to high-density lipoprotein ratio (MHR) as a simple, practical surrogate of atherosclerosis. Considering atherosclerosis is a major mechanism of coronary heart disease (CHD). The present study aims to evaluate the association between MHR and the prevalence of CHD. ⋯ Our work suggests the robust and linear relationship between MHR and the prevalent CHD in a general population, providing epidemiological evidence for laboratory studies. More importantly, the findings implicate the efficacy of MHR to be a potential indicator to identify the prevalent CHD.
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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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A clinical vignette illustrates a typical presentation of a patient seeking help for acute angioedema. Despite the risks of SARS-CoV-2 (COVID-19) exposure, it is critical to evaluate patients with acute angioedema in person, because there is always the potential for angioedema to progress to the head, neck, or lungs, which can rapidly compromise the airways and require immediate intervention to avoid potential asphyxiation. ⋯ This article provides clinicians essential information for differentiating between these types of angioedema, including an overview of the underlying pathogenies of angioedema, and the subjective and objective findings that are useful in differentiating between angioedema types. The article ends with the appropriate management for each type of acute angioedema, including the medications approved by the FDA for on-demand treatment of an HAE attack.
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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
Utility of biomarkers in predicting complicated appendicitis: can immature granulocyte percentage and c-reactive protein be used?
Acute appendicitis is the most common reason for abdominal surgery in children. The aim of this study was to evaluate the utility of biomarkers in predicting complicated appendicitis (CA). ⋯ To predict CA, the best AUC values were associated with the IG percentage and the CRP level. Because it is easy, fast to measure, does not require taking extra blood, and does not lead to additional costs, IG percentage may be preferred in the diagnosis of patients with CA.