Postgraduate medicine
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Postgraduate medicine · Mar 2022
Characteristics of tuberculosis-related deaths and risk factors: a retrospective cohort study in Samsun province of Turkey.
Tuberculosis (TB) remains one of the top ten leading causes of death worldwide despite effective therapy. The present study aims to examine the characteristics of TB-related deaths in Samsun Province and to determine the risk factors. ⋯ The majority of deaths in our cohort occurred within the first two months after starting the treatment. Advanced age, male sex, a new diagnosis of TB, pulmonary TB, MDR-TB, and a treatment delay of more than ten days after diagnosis increased the risk for mortality during antituberculosis treatment.
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Postgraduate medicine · Mar 2022
EditorialWhat should a family physician know about nutrition and physical exercise rehabilitation' advices to communicate to "long-term COVID-19" patients?
In real practice, there is a paradox in the management of patients with 'long-term Covid-19.' Indeed, Family physicians (FPs) are on the front line in the management process of these patients. For 'long-term Covid-19' patients, and according to the World Health Organization guideline, the cardiopulmonary rehabilitation (CPR) should be provided not only at tertiary- or secondary care but mainly at primary care with a real implication of FPs. However, specific guidelines/recommendations were addressed for FPs. ⋯ Thus, this paper aimed to report the CPR 'minimal advice' that should be provided by FPs managing 'long-term Covid-19' patients with incapacity (i.e.; alteration of the cardiorespiratory and muscular chain). According to the authors, FPs should be more cautious in the prescription of exercise and nutrition program and informed about the minimal advices related to nutritional and physical exercise rehabilitation guidelines when taking care of 'long-term Covid-19' patients, and how these guidelines can relieve the mental and physical problems, improve immunity, and accelerate the recovery process of the patients. With the occurrence of new variants of the severe acute respiratory syndrome coronavirus 2, the nutritional and exercise rehabilitation guidelines implemented by FPs become indispensable to promote the recovery of Covid-19 patients and support a return to normal life.
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Postgraduate medicine · Mar 2022
Transmission of SARS-CoV-2 infection and risk factors in a cohort of close contacts.
Many factors might affect SARS-CoV-2 transmission, but their relevance is not well established. The objectives were to assess the secondary attack rate (SAR) and the risk factors for SARS-CoV-2 transmission from confirmed index cases to their close contacts in household and non-household settings. ⋯ The risk of SARS-CoV-2 infection was considerable among close contacts of infected persons. The higher risk associated with household contacts, immigrants, older index cases, close contacts with lower income level and comorbidities should be considered to address preventive interventions.
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Postgraduate medicine · Mar 2022
Patient preferences for mitral valve regurgitation treatment: a discrete choice experiment.
This study aimed to quantify patients' preferences for benefits and risks associated with treating degenerative mitral regurgitation (DMR) via open heart surgical repair versus a beating heart surgical approach. ⋯ This study of US adults with DMR provides quantitative measures of risk tolerance for tradeoffs related to repair by a beating heart approach relative to conventional open-heart surgery (standard of care). These results may inform DMR treatment choices from regulatory agencies, payers, clinicians, and patients considering a beating heart repair or treatments with similar attributes as potential new alternatives to conventional surgery.
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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.