Postgraduate medicine
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Postgraduate medicine · Jan 2025
The triglyceride-glucose index as an indicator of latent atherogenicity of the plasma lipid profile in healthy men with normolipidaemia.
The triglyceride-glucose (TyG) index is a novel diagnostic marker for various metabolic and cardiovascular diseases. However, little is known about the association of the TyG index with plasma atherogenicity, especially with its latent forms. The aim of this study was to assess the potential of the use of the TyG index as a marker of atherogenic risk. ⋯ Thus, the TyG index can be a valuable additional marker for assessing latent atherogenic risk; it can provide useful information for the diagnosis and treatment of early atherosclerosis.
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Postgraduate medicine · Jan 2025
Must we remain blind to the need for clinical ethics support services in Africa? Eyes on Nigeria.
Hospitals and healthcare workers in Africa, and Nigeria specifically, are increasingly being confronted by complex situations, in which decision-making becomes more troublesome in the presence of conflicting goals, values, and preferences among the respective stakeholders. Given that all healthcare decision-making requires ethical considerations, and there is a noted absence or paucity of documentation of institutionalized mechanisms for addressing any associated concern or dilemma in Nigeria, it is thus unclear how most hospitals, healthcare workers, and the public handle the ethical dimensions of patients' care and hospital practice, while also generating possibilities for improvement in care quality. ⋯ Based on the identified bioethics manpower capacity and societal utilization of the existing telecommunication infrastructure in Nigeria, we propose the establishment of a homegrown and socially responsive pilot initiative in which, on-site hospital ethics support services, as well as a web/portal-based or online component will be accessible to all interested healthcare professionals/students, patients, bioethicists, and members of the public. Though the evidence for the effectiveness and impact of CESS and related services on the quality and outcome of care has remained relatively weak and there is no single existing CESS model that has been comprehensively proven to be beneficial to healthcare practice in all settings, we argue that the establishment of formal and homegrown CESS should be of top priority in Nigeria, and Africa generally.
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Postgraduate medicine · Jan 2025
Case ReportsDelayed diagnosis of adult onset Still's disease in 2 cases: diagnostic dilemma in positive antinuclear antibody and tuberculosis endemic areas.
Adult-onset Still's disease (AoSD) is a rare systemic autoinflammatory disorder of unknown etiology that affects young adults. Here, we report two cases of delayed AoSD diagnosis, which was initially diagnosed as tuberculous arthritis and systemic lupus erythematosus (SLE) before referral. ⋯ After further evaluation, the clinical and laboratory features were found to be appropriate for the diagnosis of AoSD. Both patients had anemia, fever, arthritis, and high ferritin levels and were treated with high-dose methylprednisolone followed by methotrexate; clinical improvement was observed, and the ferritin levels reduced.
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Postgraduate medicine · Jan 2025
Analysis of influencing factors of exercise systolic blood pressure response in nonalcoholic fatty liver disease aged 40-60 years.
This study investigated the influencing factors of exercise systolic blood pressure response (ESBPR) by cardiopulmonary exercise test (CPX) in nonalcoholic fatty liver disease (NAFLD) in people aged 40-60 years. ⋯ Our findings indicate that ESBPR is associated with an increased risk of NAFLD in individuals aged 40-60 years. Furthermore, in NAFLD subjects, VE/VCO2 and VO2/WR were found to be correlated with a decreased risk of ESBPR, whereas resting SBP was linked to an elevated risk of ESBPR. This will provide a research basis for the NAFLD subjects who have ESBPR at risk of adverse events during exercise.
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Postgraduate medicine · Jan 2025
The impact of metabolic health on fibromyalgia: insights from insulin resistance and related indexes.
To assess the association between fibromyalgia (FM) and insulin resistance (IR) using multiple IR indices in FM patients and to investigate how these indices vary with the severity of FM. ⋯ This study observed a significant association between FM and IR, as evidenced by metabolic indices in FM patients compared to controls. IR levels tended to increase with FM severity and duration. These findings suggest that IR could play a role in FM pathogenesis. Non-invasive and practical methods, such as METS-IR, may provide advantages for metabolic screening in FM patients; however, further studies are needed to establish their clinical utility.