Postgraduate medicine
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Atherosclerotic cardiovascular disease (ASCVD) is the main cause of morbidity and mortality in the US. ASCVD is caused by elevated levels of ApoB lipoproteins, which over many years penetrate the arterial subendothelial space leading to plaque growth and eventually rupture causing clinical symptoms. ApoB lipoprotein levels are approximated in clinical practice by LDL-C measurement. ⋯ However, for a variety of reasons, many patients do not achieve their recommended LDL-C levels using currently available therapies. This has prompted the development of new LDL-C lowering drugs in the hope to reduce cardiovascular risk, such as bempedoic acid, inclisiran, gemcabene, and evinacumab. Drugs targeting other lipids (triglycerides, HDL-C, lipoprotein (a)), intravascular inflammation or acting by other mechanisms also have a role in atherosclerosis prevention, however, they will not be covered in this review.
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Postgraduate medicine · Jun 2020
ReviewHealth benefits of Lactobacillus rhamnosus GG and Bifidobacterium animalis subspecies lactis BB-12 in children.
While the literature indicates that probiotics are effective for the treatment or prevention of several conditions, data in children specifically focusing on individual probiotic strains are still limited. ⋯ We propose that LGG can be safely administered to toddlers and older children to manage the symptoms of AGE and prevent AAD. These findings should be considered for incorporation into clinical practice guidelines and should help to focus the efforts of the probiotic industry.
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Postgraduate medicine · Jun 2020
Association between regular aerobic exercise and hyperhomocysteine in hypertensive patients.
The relationship between total plasma homocysteine (tHcy) and exercise remains controversial. This study aimed to investigate the association between regular aerobic exercise and hyperhomocysteine (hHcy) in patients with hypertension. ⋯ Regular aerobic exercise has a negative association with hHcy in this cross-sectional study. That suggests a hypothesis that doing aerobic exercise might decrease the risk of hHcy in hypertensive patients.
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Postgraduate medicine · Jun 2020
Improving statin prescription through the involvement of nurses in the provision of ASCVD score: a quality improvement initiative in primary care.
This study compares two methods of providing CVD risk score on the percentage of appropriate statin therapy for primary prevention of CVD in family medicine clinics, according to the American Heart Association guidelines. ⋯ The provision of the CVD risk score alone as clinical decision support is not enough to improve statin initiation for primary prevention. The nurse collaboration can improve guideline-concordant statin initiation.
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Postgraduate medicine · Jun 2020
ReviewThe effect of early oral feeding after esophagectomy on the incidence of anastomotic leakage: an updated review.
Early oral feeding (EOF) is considered to be an important component of enhanced recovery after surgery (ERAS), but raises the concern of increased risk of anastomotic leakage (AL) in patients receiving esophagectomy. This review aimed to elucidate the correlation of EOF and the incidence of AL after esophageal resection. ⋯ EOF after esophagectomy probably does not increase the incidence of AL, and it is a promising strategy in line with the essence of ERAS. However, more and better evidence from high-quality RCTs are still needed.