Postgraduate medicine
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Postgraduate medicine · Apr 2021
Patient initiation and maintenance of GLP-1 RAs for treatment of obesity: Narrative review and practical considerations for primary care providers.
Obesity is a chronic, relapsing metabolic disease, linked to a number of health risks and serious complications. Although highly prevalent in adults in the United States, it is underdiagnosed and untreated. ⋯ In this review, we provide an overview of the clinical data supporting the use of liraglutide 3.0 mg, as well as practical advice for PCPs on the initiation and maintenance of treatment over the long term. This also covers the management of side effects and how to manage patient expectations over time.
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Postgraduate medicine · Apr 2021
The relationship between chronic pain, prehypertension and hypertension. A population-based cross-sectional survey in Al-Kharj, Saudi Arabia.
Background: Chronic pain and hypertension are highly prevalent in both developing and developed countries. Although they may appear to be two separate phenomena, several studies in developed countries have found them associated at the population level. Studies in developing countries are scarce and association between pain with prehypertension are rarely explored. ⋯ I. = 0.879-1.668, P = 0.243]. Conclusion: Results of this survey suggests a statistically significant relationship between hypertension (but not prehypertension) and chronic pain. The temporality of the relationship between hypertension and chronic needs to be explored in future longitudinal studies.
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Postgraduate medicine · Apr 2021
Clinical characteristics of platelets and its possible gender dimorphism in patients with nonalcoholic fatty liver disease (NAFLD).
This study aimed to analyze the characteristics of platelet-associated parameters in nonalcoholic fatty liver disease (NAFLD) patients with varying degrees of disease severity and investigate the sexual dimorphism of platelet features in NAFLD patients. ⋯ The PC showed marked sex-based differences in NAFLD patients and is affected by age and BMI. Regular changes of platelet parameters could be found in patients with varying degrees of NAFLD. These changes might be helpful in assessing the severity of NAFLD.
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Postgraduate medicine · Apr 2021
Review Meta AnalysisThe effect of prophylactic thoracic duct ligation during esophagectomy on the incidence of chylothorax and survival of the patients: an updated review.
The role of thoracic duct ligation (TDL) during esophagectomy remains controversial. This review aimed to elucidate the effect of TDL on chylothorax and survival of the patients after esophagectomy for cancer. ⋯ The present review provided updated evidence opposing prophylactic TDL during esophagectomy for lowering chylothorax. Considering the harmful effect of TDL on survival of the patients, further well-designed trials should be considered in selected cases under strict supervision.
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Postgraduate medicine · Apr 2021
ReviewA brief guide to pustular psoriasis for primary care providers.
Pustular psoriasis refers to a heterogeneous group of chronic inflammatory skin disorders that are clinically, histologically, and genetically distinct from plaque psoriasis. Pustular psoriasis may present as a recurrent systemic illness (generalized pustular psoriasis [GPP]), or as localized disease affecting the palms and/or soles (palmoplantar pustulosis [PPP], also known as palmoplantar pustular psoriasis), or the digits/nail beds (acrodermatitis continua of Hallopeau [ACH]). These conditions are rare, but their possible severity and consequences should not be underestimated. ⋯ PPP is associated with impaired health-related quality of life and psychiatric morbidity, while ACH threatens irreversible nail and/or bone damage. These conditions can be difficult to diagnose; thus, primary care providers should not hesitate to contact a dermatologist for advice and/or patient referral. The role of corticosteroids in triggering and leading to flares of GPP should also be noted, and physicians should avoid the use of systemic corticosteroids in the management of any form of psoriasis.