Postgraduate medicine
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Postgraduate medicine · May 2022
ReviewThe impact of physical activity on well-being, lifestyle and health promotion in an era of COVID-19 and SARS-CoV-2 variant.
We must recognize the limitations of the current situation and vaccines where SARS-CoV-2 variants continue to transform and spread and need to build strategies to maintain and promote health in adherence to the suggested recommended action of the WHO. The purpose of this review is to examine the literature and latest research on the effects of physical activity (PA) on health in preparation for the SARS-CoV-2 strain and future infectious diseases era. In addition, it provides some general guidelines for actionable PA. ⋯ As a result, PA suggests opportunities to not only maintain and promote health by strengthening the immune system in an era where the COVID-19 variant is a crisis but also implement opportunities for well-being (WB), healthy lifestyles, and long-term health improvement. In particular, maintaining a regular PA routine outdoors or at home could be an important means to lower infection rates and maintain health during the potential impact of the current COVID-19 crisis and future pandemics (i.e. dramatic moments). The clinical relevance of the present review is crucial to understanding the impact of PA on WB, lifestyle, physical and mental health, maintaining regular PA, and important preventive factor to better prepare for the era of COVID-19 variants and similar pandemics in the future as it is emphasized as a prevention strategy and key strategy for continuous health promotion.
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Postgraduate medicine · May 2022
ReviewAbuse of immediate-release opioids and current approaches to reduce misuse, abuse and diversion.
Deaths from opioid overdoses have increased dramatically over the past few years. Given that immediate-release (IR) opioids account for most of the U. S. market share, and that abusers generally prefer IR opioids over extended-release (ER) opioids, it is not surprising that rates of abuse are higher for IR than ER opioids. ⋯ Food and Drug Administration regulations, state legislation, insurance company policies, the use of multimodal analgesic therapy, patient risk assessment and monitoring, limiting access to opioids by reducing IR opioid prescription quantity and length, prescription drug monitoring programs, patient education on proper disposal of unused medication and risks of diversion, as well as abuse-deterrent formulations. Albeit, most abuse-deterrent formulations have focused on ways to prevent the circumvention of ER characteristics rather than placing obstacles to abuse of IR opioid formulations. Reducing opioid abuse requires the combined efforts of multiple stakeholders, including prescribing clinicians, patients, pharmacists, nurses, insurance companies, government agencies, and pharmaceutical companies.
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Postgraduate medicine · May 2022
Potential public health impact of a Neisseria meningitidis A, B, C, W, and Y pentavalent vaccine in the United States.
Globally, 5 serogroups (A, B, C, W, and Y) cause the majority of invasive meningococcal disease (IMD). Vaccines targeting these serogroups are currently part of the US adolescent immunization platform, which includes 1 + 1 dosing of a MenACWY vaccine routinely at ages 11 and 16 years and 2 doses of a MenB vaccine at age 16-23 years under shared clinical decision-making between the patient and healthcare provider. In 2018, MenACWY vaccination coverage was 86.6% for ≥1 dose and 50.8% for ≥2 doses, whereas MenB vaccination coverage was 17.2% for ≥1 dose and <50% for completion of the multidose series. A pentavalent MenABCWY vaccine could simplify immunization schedules and improve vaccination coverage. We estimated the public health impact of a pentavalent MenABCWY vaccine using a model that considers meningococcal carriage and vaccination coverage. ⋯ Replacing one or more MenACWY/MenB vaccine doses with MenABCWY could reduce IMD caused by all 5 meningococcal serogroups among the US adolescent population, while also reducing the number of injections required.
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Postgraduate medicine · May 2022
Syncope in patients with transthyretin amyloid cardiomyopathy: clinical features and outcomes.
We aimed to describe the clinical characteristics, underlying causes and outcomes of syncope in patients with transthyretin amyloid cardiomyopathy (ATTR-CM). ⋯ Syncope is frequent in patients with ATTR-CM. This study could not demonstrate an independent association between syncope and mortality in those individuals.Abbreviations: ATTR-CM: Transthyretin amyloid cardiomyopathy; CI: Confidence Interval; HF: Heart Failure; HR: Hazard Ratio; IQR: Interquartile rank; LVEF: Left Ventricular Ejection Fraction; NTproBNP: N-terminal pro-brain natriuretic peptide; SD: Standard Deviation; 99mTc-DPD: technetium-99m-labeled 3,3-diphosphono-1,2-propanodicarboxylic acid.
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Postgraduate medicine · May 2022
Is it all about age? Clinical characteristics of Kawasaki disease in the extremely young: PeRA research group experience.
In the evaluation of children with Kawasaki disease (KD), the age of onset is important and complications may occur if the distinctive features are not assessed accordingly. The objective of the study is to define the clinical and laboratory presentations and treatment outcomes of KD in infants ≤6 months of age compared to those >6 months multicentrically. ⋯ Since clinical presentations and laboratory features of KD may vary with age, and the frequency of atypical and incomplete presentations is high, awareness of KD in young children should be raised among pediatricians.