Postgraduate medicine
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Postgraduate medicine · May 2021
Observational StudySex- related differences in the factors associated with outcomes among patients with strokes of undetermined source: a hospital-based follow-up study.
Objective: Sex-related differences are well established among stroke patients, including the incidence and prevalence of stroke being higher among men than among women. However, the sex-related factors for differences in the outcomes of strokes of undetermined source (SUSs) have not been well described, especially in the Chinese population. We assessed the sex-related differences in the factors associated with outcomes among patients with SUSs in China. ⋯ For male patients, more severe stroke and hyperlipidemia were associated with poor outcomes in SUS. Risk factors for poor outcomes in female patients were stroke severity, age, and TC level. These findings suggest that taking measures to manage blood lipid levels and severe stroke among patients with SUS is important for both male and female patients and is crucial for reducing the burden of stroke in China.
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Postgraduate medicine · May 2021
ReviewDiagnosis and conservative management of great toe pathologies: a review.
Acute great toe (Hallux) pain is a common complaint encountered by the primary care physician. Pathological conditions can vary from acute trauma to acute exacerbation of underlying chronic conditions. ⋯ The acute pathologies discussed in this review are hallux fractures and dislocations, turf toe, sand toe, and sesamoid disorders. The chronic pathologies discussed include hallux rigidus, hallux valgus, and chronic sesamoiditis.
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Postgraduate medicine · May 2021
Randomized Controlled TrialEffect of a change in lasmiditan dose on efficacy and safety in patients with migraine.
Background: Lasmiditan is a selective serotonin (1F) receptor agonist approved for acute treatment of migraine with 3 doses: 50, 100, and 200 mg. Objective: To help provide dosing insights, we assessed the efficacy and safety of lasmiditan in patients who treated two migraine attacks with the same or different lasmiditan doses. Methods: Integrated analyses used data from the migraine attack treated in either of two controlled, Phase 3, single attack studies (SAMURAI/SPARTAN), and after the first attack treated in the open-label GLADIATOR extension study. ⋯ Conclusion: A positive efficacy-TEAE balance exists for patients increasing their lasmiditan dose for treatment of a subsequent migraine attack. These results could be important for optimizing dosing for individual patients. Clinicaltrials.gov: SAMURAI (NCT02439320); SPARTAN (NCT02605174); GLADIATOR (NCT02565186).
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Postgraduate medicine · May 2021
Case ReportsSupraventricular tachycardia with the use of phentermine: case report and review of literature.
Case: A 34-year-old woman with no significant past medical history presented to the hospital with sudden onset of palpitations with associated dyspnea and chest discomfort. She denied any similar previous episodes. ⋯ However, the patient had been taking phentermine for weight loss. Discussion: The exact mechanism is not clear; however, we postulate that the sympathomimetic effects of phentermine likely contribute to SVT induction through enhanced AV nodal conduction or increased atrial ectopy. Conclusions: The only medication she was taking at home was phentermine, and the palpitations did not recur after discontinuation of the drug during follow-up. It is important to collect a thorough medication history when patients present with AV nodal reentrant tachycardia (AVNRT) or other SVT.
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Postgraduate medicine · May 2021
Comparison of pediatric patients with non-infectious idiopathic uveitis and non-infectious uveitis associated with an underlying systemic disease: from a referral center in Turkey.
Aim: The aim of this study was to determine the demographic, clinical, treatment, and outcome features of pediatric noninfectious uveitis patients at a Turkish tertiary center. Materials and methods: This retrospective cohort study included 101 pediatric patients with noninfectious uveitis. Location of uveitis, laterality, age at onset of uveitis, complications of uveitis, duration of follow-up, associated systemic diseases, laboratory findings, medications used, and status of uveitis at the time of data collection were obtained from the patients' files. ⋯ Ocular complications were observed in 22.8% of the patients at presentation or during the follow-up. Conclusion: Herein a large retrospective cohort of noninfectious pediatric uveitis has been described. The findings indicate that noninfectious idiopathic uveitis is characterized by more symptomatic, later onset, and fewer complications than noninfectious uveitis associated with an underlying systemic disease.