Postgraduate medicine
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Postgraduate medicine · Mar 2022
Association of number of primary care physicians with preventable hospitalizations and premature deaths.
Primary care physicians (PCPs) may be the first providers for patients in a healthcare interaction, putting them in a unique position that may determine the health trajectory of a patient. Assessing whether PCPs improve the overall health of a community through reducing preventable hospital stays and premature deaths may provide necessary information towards improving the health outcomes at grassroots. ⋯ Higher number of PCPs in a county was associated with lower hospitalizations for preventable causes and lower premature deaths. Increasing PCPs may be an important metric to improve overall health in a community.
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Postgraduate medicine · Mar 2022
Case ReportsSevere COVID pneumonia and undetectable B cells after vaccination in patients previously treated with rituximab: a case series.
The risk of developing severe COVID-19 illness despite completing vaccination for patients who have previously received immunosuppressive therapy is unclear. ⋯ This case series brings attention to the limited humoral response to vaccines in patients treated with rituximab, highlights existing guidelines and their limitations, and raises future considerations about the potential benefits to testing vaccine responsiveness.
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Postgraduate medicine · Mar 2022
ReviewTherapeutic role of immunomodulators during the COVID-19 pandemic - a narrative review.
The emergency state caused by COVID-19 saw the use of immunomodulators despite the absence of robust research. To date, the results of relatively few randomized controlled trials have been published, and methodological approaches are riddled with bias and heterogeneity. Anti-SARS-CoV-2 antibodies, convalescent plasma and the JAK inhibitor baricitinib have gained Emergency Use Authorizations and tentative recommendations for their use in clinical practice alone or in combination with other therapies. ⋯ Available clinical data also suggest the potential clinical benefit of the early administration of blood-derived products (e.g. convalescent plasma, non-SARS-CoV-2-specific immunoglobins) and the blockade of factors implicated in the hyperinflammatory state of severe COVID-19 (Interleukin 1 and 6; Janus Kinase). Immune therapies seem to have a protective effect and using immunomodulators alone or in combination with viral replication inhibitors and other treatment modalities might prevent progression into severe COVID-19 disease, cytokine storm and death. Future trials should address existing gaps and reshape the landscape of COVID-19 management.
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Postgraduate medicine · Mar 2022
ReviewNeuroinflammation and oxidative stress in schizophrenia: are these opportunities for repurposing?
To summarize the main findings on the subject of neuroinflammation and oxidative stress in patients with Schizophrenia (SCZ). ⋯ This review discusses the various plausible hypotheses, viz., cytokine hypothesis of peripheral inflammation, acute-phase reactants in SCZ, microglial hypothesis of central inflammation, neurogenesis in relation to neuroinflammation, and oxidative stress in SCZ. It also highlights the many opportunities available for repurposing already marketed drugs with anti-inflammatory and antioxidant properties with a view to devising more effective and comprehensive therapies to manage SCZ.