Postgraduate medicine
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Postgraduate medicine · Apr 2024
Review Meta Analysis Comparative StudySplenectomy versus splenic preservation in total gastrectomy for gastric cancer: a systematic review and meta-analysis comparing survival benefits and short-term complications.
There is an ongoing debate regarding the comparative merits of splenectomy (SP) and splenic preservation in the surgical management of gastric cancer. This systematic review and meta-analysis aims to shed light on potential differences in survival outcomes and postoperative complications associated with these two procedures. ⋯ Despite the lack of significant differences in certain individual complications and postoperative mortality, the broader pattern of our data suggests that SP is associated with a greater overall frequency of postoperative complications, without providing additional survival benefits compared to splenic preservation. Thus, the routine implementation of SP is not advocated.
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Postgraduate medicine · Apr 2024
ReviewGuideline-based management of metabolic dysfunction-associated steatotic liver disease in the primary care setting.
The prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD) is increasing worldwide. Primary care providers play a critical role in the screening, diagnosis, and management of MASLD and/or metabolic dysfunction-associated steatohepatitis (MASH), though they can face challenges in this setting, particularly where healthcare resources are limited and barriers to care exist. To address these challenges, several guidelines have been developed to provide evidence-based recommendations for the clinical assessment and management of patients with MASLD/MASH. ⋯ Primary care providers are ideally placed to identify at-risk individuals, implement evidence-based interventions to prevent the development of fibrosis and cirrhosis, and effectively manage comorbidities. Equipping primary care providers with the necessary knowledge and tools to effectively manage MASLD/MASH may help to improve patient outcomes and reduce the burden of liver disease.
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Postgraduate medicine · Apr 2024
A machine learning stacking model accurately estimating gastric fluid volume in patients undergoing elective sedated gastrointestinal endoscopy.
The current point-of-care ultrasound (POCUS) assessment of gastric fluid volume primarily relies on the traditional linear approach, which often suffers from moderate accuracy. This study aimed to develop an advanced machine learning (ML) model to estimate gastric fluid volume more accurately. ⋯ The stacking model and its web calculator can serve as practical tools for accurately estimating gastric fluid volume in patients undergoing elective sedated GIE. It is recommended that anesthesiologists measure D1 and D2 in the patient's RLD position.
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Postgraduate medicine · Apr 2024
Association between serum ferritin and bone turnover marker levels in type 2 diabetes mellitus patients with nonalcoholic fatty liver disease.
To investigate the correlation between serum ferritin (SF) and bone turnover markers in type 2 diabetes mellitus (T2DM) patients with non-alcoholic fatty liver disease (NAFLD). ⋯ SF level was positively correlated with β-CTx in T2DM patients with NAFLD, which may promote bone resorption and increase the risk of bone loss.
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Postgraduate medicine · Apr 2024
Impact of on-call shifts on working memory and the role of burnout, sleep, and mental well-being in trainee physicians.
Optimal cognitive functions, including working memory (WM), are crucial to enable trainee physicians to perform and excel in their clinical practice. Several risk factors, including on-call shifts, poor mental health, burnout, and sleep problems, can impair clinical practice in trainee physicians, potentially through cognitive impairment; however, these associations have not been fully explored. ⋯ Working more on-call shifts is associated with compromised WM. Trainee physicians who experienced more depressive symptoms and burnout had worse WM.