Postgraduate medicine
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Postgraduate medicine · Sep 2021
Watermelon and others plant foods that trigger headache in migraine patients.
Background: Food is already recognized as a trigger for migraine, but its mechanism of action has not been fully clarified. There is evidence that they act on the pathogenesis of migraine, interfering with meningeal inflammation, vasodilation and cerebral glucose metabolism. Aim: The aim of this study was to know which plant foods are triggers for migraine and the latency time for the onset of pain. ⋯ Results: There were headaches triggered by plant foods after 90.5 ± 7.9 minutes of ingestion in 40.3% (1,584/3,935) of migraine patients and none with tension-type headache. Headaches triggered by plant foods intake are distributed in the following order of frequency: watermelon (29.5%), passion fruit (3.73%), orange (2.01%), pineapple (1.52%), grape (0.51%), banana (0.46%), cucumber (0.43%), acerola (0.25%) and papaya (0.25%). Conclusions: Many plant foods, especially watermelon, may trigger headache attacks in migraine patients within a few minutes.
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A clinical vignette illustrates a typical presentation of a patient seeking help for acute angioedema. Despite the risks of SARS-CoV-2 (COVID-19) exposure, it is critical to evaluate patients with acute angioedema in person, because there is always the potential for angioedema to progress to the head, neck, or lungs, which can rapidly compromise the airways and require immediate intervention to avoid potential asphyxiation. ⋯ This article provides clinicians essential information for differentiating between these types of angioedema, including an overview of the underlying pathogenies of angioedema, and the subjective and objective findings that are useful in differentiating between angioedema types. The article ends with the appropriate management for each type of acute angioedema, including the medications approved by the FDA for on-demand treatment of an HAE attack.
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Postgraduate medicine · Sep 2021
Determinants of dynamic inspiratory muscle strength in healthy trained elderly.
The S-Index assessed by means of electronic devices is a measure of Inspiratory Muscle Strength (IMS) that highly correlates with the maximal inspiratory pressure (MIP). The variables involved when using regression models for the prediction of IMS/MIP depend on both the sample characteristics and the device or protocol used. In light of the scarce information on the influence of physical activity (PA) on IMS in healthy older adults (OA), together with the incorporation of new assessment devices, the objectives of this research are: 1) to determine which factors influence the IMS in a group of trained OA, using a portable electronic device; and 2) to propose a regression model to improve its assessment and training. ⋯ This is the first study proposing IMS predictive formulas considering spirometry and/or physical fitness results for a Spanish, healthy, and trained OAs population. A predictive formula including also the spirometric variables (mainly the FEV1) might better predict the inspiratory muscle strength. In addition, physical and respiratory functions confirm to be different, so it is necessary for the inspiratory muscles to be trained in a specific way.
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Postgraduate medicine · Sep 2021
Utility of biomarkers in predicting complicated appendicitis: can immature granulocyte percentage and c-reactive protein be used?
Acute appendicitis is the most common reason for abdominal surgery in children. The aim of this study was to evaluate the utility of biomarkers in predicting complicated appendicitis (CA). ⋯ To predict CA, the best AUC values were associated with the IG percentage and the CRP level. Because it is easy, fast to measure, does not require taking extra blood, and does not lead to additional costs, IG percentage may be preferred in the diagnosis of patients with CA.
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Postgraduate medicine · Sep 2021
Physician patient-sharing relationships and healthcare costs and utilization in China: social network analysis based on health insurance data.
Evidence on physician patient-sharing relationships from developing countries is limited. This study aimed to identify patient-sharing networks among physicians in China and explore the effect of attributes of physician networks on healthcare utilization and costs. ⋯ Primary care physicians were located in peripheral positions in China, and the links between primary care facilities and higher-grade hospitals were still weak. Characteristics of physicians' networks and the position of physicians in the network were associated with spending and utilization of services, but not all associations were in the same direction.