Postgraduate medicine
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Postgraduate medicine · May 2023
ReviewTrends and recent developments in pharmacotherapy of acute pancreatitis.
Acute pancreatitis (AP), a complex inflammatory disease of the pancreas, is associated with increased morbidity and mortality. Currently, no specific therapies are approved for its treatment, and management is primarily based on supportive care. Despite enhanced understanding of AP pathogenesis, patients remain at significant risk owing to a lack of targeted drug treatments. ⋯ Alternative treatment options using stem cells and nanoparticles are also being explored and may hold promise for AP therapy. However, challenges for exploring targeted treatment approaches include disease complexity, timing of therapeutic intervention, and establishing appropriate clinical endpoints. Understanding the role of specific biomarkers may help in identifying appropriate targets for drug discovery and facilitate determining relevant clinical study endpoints to monitor disease severity and progression, thereby aiding in design of more precise therapies with improved clinical outcomes.
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Postgraduate medicine · May 2023
Multicenter StudyThe prevalence and treatment patterns of familial hypercholesterolemia among Thai patients with premature coronary artery disease.
Familial hypercholesterolemia (FH) is an autosomal dominant genetic disorder that is characterized by severe hypercholesterolemia. The prevalence of FH in Thailand has not been reported. Therefore, this study aimed to investigate the prevalence of FH and treatment patterns among Thai patients with premature coronary artery disease (pCAD). ⋯ The prevalence of definite/probable FH, particularly possible FH, was high among pCAD patients in this study. The early diagnosis of FH among Thai pCAD patients should be performed for the early treatment and prevention of CAD.
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Postgraduate medicine · May 2023
Observational StudyEffectiveness of hepatitis C antiviral treatment and feasibility of hepatitis C elimination goal.
Second-generation direct-acting antivirals (DAAs) have shown high efficacy in the treatment of chronic hepatitis C virus (HCV) infections in clinical trials. This study aimed to estimate the effectiveness in real-life conditions and their capacity to eliminate HCV infection in the general population. ⋯ With DAAs, SVR was achieved in all patients with active HCV infection who completed follow-up, and a second course of treatment was only necessary in a small proportion of patients. Adherence to treatment is essential for HCV infection elimination.
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This study was conducted to reveal the characteristics of pediatric emergency revisits of children with COVID-19 and the factors associated with clinical worsening and hospitalization at the revisit. ⋯ Children with a diagnosis of COVID-19 can revisit the emergency without evident clinical worsening. Since revisits cause increase in frequency of laboratory and radiological testing, preventing unnecessary revisits of children with COVID-19 can reduce the workload and cost of health care services. We may consider changing our perspective on revisit patients to make decisions based on clinical findings instead of obtaining for more laboratory tests.
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Postgraduate medicine · May 2023
The association between bedtime at night and hypertension in adults.
This research was conducted to explore the association between bedtime at night and the prevalence of hypertension in adults. ⋯ With the delay in bedtime, the association between bedtime and hypertension showed a significantly U-shaped relationship. Falling asleep at 23:00 has the lowest risk of developing hypertension.