Postgraduate medicine
-
Postgraduate medicine · Jan 2014
Randomized Controlled TrialRaisins compared with other snack effects on glycemia and blood pressure: a randomized, controlled trial.
To compare effects of raisin snacks with conventional snacks on glycemia and cardiovascular risk factors. ⋯ Regular consumption of raisins may reduce glycemia and cardiovascular risk factors, including BP rate.
-
Postgraduate medicine · Jan 2014
The AWAKEN survey: knowledge of narcolepsy among physicians and the general population.
Narcolepsy can be a debilitating sleep disorder resulting from the dysregulation of pathways that control the sleep and wake states of patients. Although overall knowledge of narcolepsy has increased, no previous studies characterize awareness and perceptions of this condition in the general population or among physicians. Our survey evaluated the understanding and perceptions of narcolepsy among individuals from the general population and from a sample of physicians, including sleep specialists. ⋯ Sixty-three percent of sleep specialists and 39% of PCPs recognized both of the most prominent narcolepsy symptoms, which are excessive daytime sleepiness and cataplexy. Substantial gaps exist in understanding narcolepsy and its symptoms, even among sleep medicine specialists. Our findings suggest a need for educational initiatives for physicians to improve recognition of narcolepsy symptoms.
-
Postgraduate medicine · Nov 2013
ReviewNeutrophil gelatinase associated lipocalin in acute kidney injury.
Neutrophil gelatinase-associated lipocalin (NGAL) is a member of the lipocalin family of proteins. Usually, NGAL is produced and secreted by kidney tubule cells at low levels, but the amount produced and secreted into the urine and serum increases dramatically after ischemic, septic, or nephrotoxic injury of the kidneys. The purpose of our review article is to summarize the role of NGAL in acute kidney injury (AKI), emergent, and intensive care. ⋯ Based on the evidence reviewed, it is clear that patient NGAL level is an appropriate, sensitive, and specific early biomarker of AKI caused by a variety of different etiologies. It is advised that a multidisciplinary group of experts come together to make recommendations and propose a consensus of clinical procedures to advance the most efficacious NGAL monitoring protocol for early detection and treatment of patients with AKI.
-
Postgraduate medicine · Sep 2013
Comparative StudyImpact of an electronic medical record system on emergency department discharge instructions for patients with hypertension.
Uncontrolled hypertension is associated with significant patient morbidity and health care costs. Many patients evaluated in the emergency department (ED) do not regularly consult health care providers and have socioeconomic barriers to receiving primary care. Hypertension screening and counseling has been advocated as a routine part of ED care. Previous work has shown poor referral rates and education for ED patients presenting with elevated blood pressure (BP). We sought to determine whether implementation of an electronic medical record (EMR) would improve these rates. ⋯ Overall, the initiation of EMR led to a decrease in outpatient referrals and acknowledgment of elevated BP rates in discharge instructions. The provision of more complete lifestyle modifications improved in the post-EMR phase.
-
Postgraduate medicine · Sep 2013
Randomized Controlled Trial Multicenter StudyLower-dose diclofenac submicron particle capsules provide early and sustained acute patient pain relief in a phase 3 study.
Non-steroidal anti-inflammatory drugs are prescribed for the treatment of patients with acute pain but use of such analgesics is associated with dose-dependent adverse events (AEs). Diclofenac submicron particle capsules have been developed using SoluMatrix technology to provide analgesia at lower doses than available solid oral dosing forms. Our study evaluated the analgesic efficacy and safety of lower-dose diclofenac submicron particle capsules in patients with acute pain following elective surgery. ⋯ Lower-dose diclofenac submicron particle capsules provided effective analgesia in this phase 3 clinical study in patients with acute pain and are a potentially promising option for the treatment of patients with acute pain.