Bmc Med
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Pain is a major challenge for patients with rheumatoid arthritis (RA), with many people suffering chronic pain. Current RA management guidelines focus on assessing and reducing disease activity using disease-modifying anti-rheumatic drugs (DMARDs). Consequently, pain care is often suboptimal, with growing evidence that analgesics are widely prescribed to patients with RA, despite potential toxicities and limited evidence for efficacy. Our review provides an overview of pharmacological treatments for pain in patients with RA, summarising their efficacy and use. ⋯ In patients with active RA, DMARDs have efficacy at reducing pain, supporting the role of treat-to-target strategies. Despite limited evidence that analgesics improve pain in patients with RA, these medicines are widely prescribed. The reasons for this are unclear. We consider that closing this evidence-to-practice gap requires qualitative research exploring the drivers of this practice, high-quality trials of analgesic efficacy in contemporary RA populations, alongside an increased focus on pain management (including pharmacological and non-pharmacological options) within RA guidelines.
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Randomized Controlled Trial Comparative Study
Initial treatment with a single capsule containing half-dose quadruple therapy vs standard-dose dual therapy in hypertensive patients (QUADUAL): a randomized, blinded, crossover trial.
Guidelines recognized dual combination in initial antihypertensive therapy. Studies found that low-dose quadruple combination were superior to monotherapy. However, whether low-dose quadruple therapy is better than dual combination is unknown. ⋯ Initiating treatment with half-dose quadruple combination therapy was more effective in lowering blood pressure than standard-dose dual therapy. The safety of half-dose quadruple therapy was comparable.
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India's large youth population presents a significant opportunity to harness the demographic dividend. The disease burden in adolescents could be a hindrance for the future economy if not appropriately addressed. ⋯ Strengthening the Indian Adolescent Health Strategy to address the diseases/ conditions contributing most to the total economic loss is needed to facilitate substantial avoidance of the high economic losses attributable to adolescent premature deaths and morbidity in India.
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Multicenter Study
Virtual biopsy for non-invasive identification of follicular lymphoma histologic transformation using radiomics-based imaging biomarker from PET/CT.
This study aimed to construct a radiomics-based imaging biomarker for the non-invasive identification of transformed follicular lymphoma (t-FL) using PET/CT images. ⋯ This study offers a promising approach for identifying t-FL non-invasively by radiomics analysis on PET/CT images. The developed t-FL scoring system provides a valuable tool for clinical decision-making, potentially improving patient management and outcomes.
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Many studies have found more severe COVID-19 outcomes in migrants and ethnic minorities throughout the COVID-19 pandemic, while recent evidence also suggests higher risk of longer-term consequences. We studied the risk of a long COVID diagnosis among adult residents in Sweden, dependent on country of birth and accounting for known risk factors for long COVID. ⋯ The greater exposure and impact of the COVID-19 virus among migrants also affected longer-term consequences. Disease severity was the most important risk factor for long COVID in migrants. The findings emphasize the need for targeted health interventions for migrant communities during an infectious disease pandemic, such as strategic vaccination campaigns and extending social insurance schemes, focusing on reducing disease severity to mitigate the longer-term health consequences of an infection.