Curēus
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With the introduction of the coronavirus disease 2019 (COVID-19) mRNA vaccines, the incidence of severe infection has significantly decreased. While the vaccines have been shown to be effective and safe, there have been few case reports of acute myocarditis within 3-5 days following the second dose of the vaccine. We report a case of an elderly man who presented with acute-onset chest pain after three months of receiving the second dose of the mRNA vaccine. ⋯ We review the literature and summarize published case reports on COVID-19 vaccine-associated myocarditis. The present case report provides new evidence regarding the possible subacute presentation of myocarditis post-COVID-19 vaccine, and further highlights the favorable outcome in this newly described clinical entity.
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Diabetes mellitus (DM) is associated with dreadful changes in the cardiovascular and renal systems, causing increased morbidity and mortality. Sodium-glucose cotransport-2 (SGLT2) inhibitors belong to the oral hypoglycemic group of drugs believed to reduce these events by various mechanisms in DM. We performed a systematic review to determine the effectiveness of SGLT2 inhibitors in reducing cardiovascular and renal complications and address safety concerns in participants with type 2 diabetes mellitus (T2DM). ⋯ We noticed an initial worsening of the estimated glomerular filtration rate followed by stabilizing and reaching the baseline on long-term treatment, especially in end-stage renal failure patients. The review showed that SGLT2 inhibitors have adverse reactions similar to that of a placebo, with a slight increase in treatable genital mycotic and urinary tract infections but no evidence of diabetic ketoacidosis, fractures, and amputations. According to the available data, SGLT2 inhibitors can significantly prevent or reduce cardiovascular diseases and kidney abnormalities in patients with type 2 diabetes mellitus with tolerable safety outcomes.
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Opioid-induced hyperalgesia (OIH) is characterized by a heightened sensitivity to pain that occurs in patients following opioid use. Prescription of opioids is currently the standard form of pain management for both neuropathic and nociceptive pain, due to the relief that patients typically report following their use. Opioids, which aim to provide analgesic effects, can paradoxically cause increasing degrees of pain among the users. ⋯ This review will analyze the current role and effectiveness of the use of naltrexone in managing OIH in opioid users as described in clinical and non-clinical studies. Additionally, it seeks to characterize the underlying mechanisms that enable opioid antagonist naltrexone to reduce OIH while still allowing opioids to act as an analgesic. The authors find that OIH is a prevalent condition, and in order to effectively combat it, clinicians and patients can benefit from an extended study on how naltrexone can be utilized as a treatment alongside opioids prescribed for pain management.
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Efforts to combat the global pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) range from adequate diagnostic testing and contract tracing to vaccination for the prevention of coronavirus disease 2019 (COVID-19). In the United States alone, three vaccinations have been authorized for emergency use (EUA) or approved to prevent COVID-19. The Ad26. ⋯ Herein, we outline the hospital course of a generally healthy 49-year-old female who experienced an axonal form of GBS nine days after receiving the Ad26. COV2. S vaccine.
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Introduction Diversity and equity in academic medicine are critically important in improving healthcare standards and patient-related outcomes. Gender and racial disparities are some major challenges faced by the health system. This article reviews the gender and racial trends among residents of neurosurgery in the United States (US). ⋯ The representation of Hispanics was 4.3%, Black/African Americans were 4.5%, Native Americans/Alaskans were 0.2%, and others were 8% of the total study population. Conclusion Our study concludes that gender and racial disparity persist within the neurosurgery residency training programs in the US. Concrete efforts at all academic levels are needed to provide greater support for the females and for the careers of underrepresented minority (URM) trainees to ensure their increased representation in neurosurgery.