Irish journal of medical science
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Patients presenting with chest pain may or may not be experiencing a panic attack. Is chest pain caused by a panic attack or myocardial infarction with non-obstructive coronary arteries (MINOCA) syndrome? ⋯ Clinicians should pay attention to the patient's age, gender, number of attacks per week, HEART score, and which symptoms (palpitations, shortness of breath, and fear of death) are present in patients who meet the panic attack diagnostic criteria. Clinicians should be alert to the MINOCA syndrome in panic attack patients.
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Surgical masks have become an important accessory of physical activity in daily life due to the COVID-19 pandemic. ⋯ The surgical mask use affected the maximal exercise capacity of middle-aged participants more than young participants. Although males performed better than females in tests without masks, the decrease in exercise capacity with mask use was greater than in females. Advanced age and male gender may be factors that need more attention during exercise with mask use.
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The SARS-CoV-2 pandemic caused severe disruption to scheduled surgery in Ireland but its impact on emergency abdominal surgery (EAS) is unknown. ⋯ Significant improvements in patient flow following admission for EAS during the pandemic were observed. These changes were not associated with greater mortality nor increased readmission rates and offer important insights into optimal delivery of EAS services.
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Burnout is a syndrome resulting from chronic workplace stress that has not been successfully managed. Healthcare professionals are particularly susceptible to this occupational phenomenon. There is limited literature currently published addressing burnout in the context of the Irish frontline workers during the COVID-19 pandemic. ⋯ The COVID-19 pandemic may be contributing to the long-established problem of health care burnout. The trajectory of this disease is still unclear. Consistent, progressive measures to address staff well-being, and support frontline workers, are imperative going forward.
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Dietary supplement use has continued to rise. In addition to supplement-drug interactions, it is prudent to consider how dietary supplements may interact with a patient's specific pharmacogenetics. Variations in genes associated with CYP 450 enzymes have evidence of impacting drug metabolism and adverse effects. ⋯ CYP P450 activity is an important consideration for any patient but becomes increasingly critical if patients have certain CYP P450 phenotypes that impact metabolism. These popular supplements have the potential for changes in supplement exposure, and adverse effects based on pharmacogenetic profiles. Furthermore, these sites of metabolism are shared with many medications, setting the stage for possibly more profound interactions between medications and supplements. This paper highlights the mechanisms in which dietary supplements may constitute a risk for patients with certain CYP P450 phenotypes. Further research is needed in the area of dietary supplements and their pharmacogenomic implications.