Postgraduate medicine
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Postgraduate medicine · Jan 2022
ReviewCardiometabolic risk factors efficacy of semaglutide in the STEP program.
People with overweight or obesity often suffer from associated cardiometabolic diseases and comorbidities. Current therapies for obesity include lifestyle intervention, bariatric surgery, and pharmacotherapy. The magnitude of weight loss achieved with these therapies can determine the level of improvement in various comorbidities. ⋯ In STEP 4, all participants had a 20-week run-in period on semaglutide before either continuing on semaglutide or switching to placebo at week 20 in a 2:1 ratio for 48 weeks. At week 68, continued semaglutide led to further reductions from week 20 in HbA1c, improvements in lipid profile, and stabilization of SBP. Overall, across the STEP trials, treatment with semaglutide 2.4 mg versus placebo improved cardiometabolic risk factors associated with obesity, illustrating an effective treatment option for people with overweight (and associated comorbidities) or obesity.
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Postgraduate medicine · Jan 2022
Twenty years on - has patient-centered care been equally well integrated among medical specialties?
The concept of 'patient-centered care' was touted as a pillar of good clinical practice and endorsed by the US Institute of Medicine in a seminal 2001 publication. We explore the extent to which differing medical specialties have engaged with the concept over the last 20 years and how and why this attention has varied among a sample of medical specialties since 2001. ⋯ Uptake, attention, and applicability of the principles of patient-centered care have varied over the last 20 years. Differences among specialties appear to reflect true differences in patient centricities in the disciplines, with higher uptake in specialties that are person-oriented rather than technique-oriented. Greater engagement with patient-centered care correlates strongly with the number of female physicians in each field.
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Postgraduate medicine · Jan 2022
The Effect of Whole Blood Viscosity on Contrast Induced Nephropathy Development in Patients Undergoing Percutaneous Coronary Intervention.
In our study, we aimed to investigate how whole blood viscosity (WBV) affects the development of contrast-induced nephropathy (CIN) in patients undergoing percutaneous coronary intervention (PCI). ⋯ We found that low WBV was an independent predictor of CIN in patients undergoing elective PCI(NCT04703049).
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Postgraduate medicine · Jan 2022
Perceptions and knowledge gaps on CHA2DS2-VASc score components: a joint survey of Chinese clinicians and clinical pharmacists.
The CHA2DS2-VASc score is a guideline-recommended stroke risk stratification scheme for patients with atrial fibrillation (AF). Accurately calculating the CHA2DS2-VASc score and recognizing the stroke risk in AF patients is the foundation of optimal anticoagulation therapy. This survey aims to obtain a comprehensive understanding of perceptions and knowledge gaps on CHA2DS2-VASc scores among Chinese medical professionals for future education programs. ⋯ Chinese medical professionals, especially EPs and GPs, revealed a lack of knowledge and insufficient skills for CHA2DS2-VASc scores and their components. Improvements in the awareness of the CHA2DS2-VASc score and its detailed scoring criteria are urgently needed for Chinese medical professionals. Therefore, education programs concerning the introduction of stroke risk evaluation for AF patients and the development of referencing scoring tools are necessary.
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Postgraduate medicine · Jan 2022
An overlooked nerve ın neuropathies associated with ıntragluteal ınjections: the posterior femoral cutaneous nerve.
The aim of this study was to investigate the frequency of posterior femoral cutaneous nerve (PFCN) lesions in patients referred to the electrophysiology laboratory with an initial diagnosis of sciatic nerve lesion following injection, and to create awareness that PFCN lesions can occur following intramuscular injections administered to the gluteal region. ⋯ As correct diagnosis is the priority starting point for successful treatment, clinicians should plan examinations taking into consideration the fact that PFCN lesions can occur following gluteal region injection.