Postgraduate medicine
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Multiple sclerosis (MS) is an inflammatory neurodegenerative disorder manifesting as gradual or progressive loss of neurological functions. Most patients present with relapsing-remitting disease courses. ⋯ The delayed identification of these diseases in late adulthood can lead to severe neurological complications. Herein we discuss genetic diseases that have the potential to mimic multiple sclerosis, with highlights on clinical identification and practicing pearls that may aid physicians in recognizing MS-mimics with genetic background in clinical settings.
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Postgraduate medicine · Sep 2021
Psychosocial impact of the COVID-19 pandemic: A cross-sectional study of online help-seeking Canadian men.
Purpose: The COVID-19 pandemic has had a profound impact on the lives of men. The present study investigated psychosocial impacts of the COVID-19 pandemic on a help-seeking sample of Canadian men, focusing on diverse aspects of their psychosocial well-being. Methods: A cross-sectional, open survey study design was used. ⋯ Nearly a third of respondents who were in a relationship (30.9%; N = 77) reported that they engaged in some type of abuse (primarily verbal abuse, 22.9%; N = 57) toward their intimate partner during COVID-19, and more than a quarter (27.3%; N = 68) reported being abused by their intimate partner (also primarily verbal abuse, 22.5%; N = 56). Just under half (42.2%; N = 183) of the respondents indicated experiencing suicidal ideation. Conclusion: These findings can help inform providers of health services to Canadian men, as well as policies that will be implemented during subsequent waves of COVID-19 or during future infectious outbreaks.
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Postgraduate medicine · Sep 2021
Gastroparesis with cannabis use: a retrospective study from the nationwide inpatient sample.
Background: With increasing utilization of cannabis in the United States (US), clinicians may encounter more cases of Gastroparesis (GP) in coming years. Objective: The primary outcome was inpatient mortality for GP with cannabis use. Secondary outcomes included system-based complications and the burden of the disease on the US healthcare system. ⋯ Furthermore, we noted shorter mean length of stay (LOS) (3.4 vs 4.4 days, aMD: -0.7, 95%CI: -0.9 - [-0.5], p < 0.001), lower mean total hospital charge (THC) ($30,400 vs $38,100, aMD: -5100, 95%CI: -6900 - [-3200], p < 0.001), and lower rates of sepsis (0.11 vs 0.60%, aOR: 0.22, 95% CI: 0.05-0.91, p = 0.036) for GP hospitalizations with cannabis use compared to the non-cannabis use cohort. Conclusion: Inpatient mortality for GP hospitalizations with cannabis use was 0.27%. Additionally, these patients had shorter LOS, lower THC, and lower sepsis rates.
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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
Observational StudyMedication management for complex patients in primary care: application of a remote, asynchronous clinical pharmacist model.
Purpose: Drug therapy problems impact about one-third of US adults, and these issues are likely to continue to worsen as the population of aging Americans increases. The objective of this study is to assess the feasibility of a remotely delivered Comprehensive Medication Management (CMM) for primary practice patients who are polypharmatic and at high risk for drug therapy problems. Methods: Using medical and prescription claims data, a list of Medicare Advantage beneficiaries at high risk for drug therapy problems was identified. ⋯ Seventy-nine percent of all drug therapy problems identified were resolved upon completion of the study. Conclusion: The findings of this study suggest that engagement of a remote clinical pharmacist can contribute to efficient resolution of most drug therapy problems identified in a primary care population. A service model using remote pharmacist services may be an effective means of improving team-based primary care medication management for this population.