Postgraduate medicine
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Postgraduate medicine · Aug 2022
The utility of neutrophil-to-lymphocyte ratio determined at initial diagnosis in predicting disease stage and discriminating between active and stable disease in patients with sarcoidosis: cross-sectional study.
To evaluate the utility of neutrophil-lymphocyte ratio (NLR) determined at initial diagnosis in predicting advanced disease stage and discriminating between active and stable disease in sarcoidosis. ⋯ Our findings indicate the potential utility of on-admission NLR values to predict the risk of advanced disease stage and to discriminate between active and stable disease in sarcoidosis. Measured via a simple, readily available, and low-cost test, NLR seems to be a valuable marker for monitoring disease activity and progression.
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Postgraduate medicine · Aug 2022
How use of continuous glucose monitoring can address therapeutic inertia in primary care.
A significant proportion of individuals with diabetes have suboptimal glycemic management. Studies have shown that persistent hyperglycemia significantly increases the risks for both acute and long-term microvascular and macrovascular complications of diabetes. A key contributor to suboptimal glycemic management is therapeutic inertia in which clinicians delay intensifying therapy when patients are not meeting their glycemic goals. ⋯ As demonstrated in numerous clinical trials and real-world observational studies, use of CGM improves glycated hemoglobin (HbA1c) and reduces the occurrence and severity of hypoglycemia. However, for primary care clinicians who are unfamiliar with using CGM, integrating this technology into clinical practice can be daunting. In this article, we discuss the benefits and rationale for using CGM compared with traditional blood glucose monitoring (BGM), review the evidence supporting the clinical value of CGM in patients with T1D and T2D, and describe how use of CGM in primary care can facilitate appropriate and more timely therapy adjustments.
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The anatomic site of primary melanoma is significantly associated with patient survival, e.g. trunk melanomas have poorer prognosis than limb melanomas. The aim of this study was to evaluate the clinicopathological factors and survival outcomes of trunk melanoma patients and to identify the differences between anatomical areas of the trunk. ⋯ Trunk melanomas may be associated with aggressive pathological and poor clinical features, such as thickness, mitotic rate, ulceration, and advanced clinical stages; therefore, they predict unfavorable survival rates regardless of anatomical sites.
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Postgraduate medicine · Aug 2022
Randomized Controlled TrialA randomized controlled trial concerning the implementation of the postural Mézières treatment in elite athletes with low back pain.
This study aimed to evaluate the impact of adding the Mézières Method (MM) to the standard rehabilitation protocol for the elite athletes with low back pain (LBP) in reducing lumbar pain rather than only using the traditional rehabilitation protocol treatment. The disciplines considered in this study were soccer, rhythmic gymnastics, and basketball. ⋯ The MM approach can also be applied to established conventional protocols to alleviate pain and functionality. The obtained results include improving the quality of life of the athletes and their physical and emotional states.
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Postgraduate medicine · Aug 2022
ReviewThe role of osteoanabolic agents in the management of patients with osteoporosis.
Reducing fracture risk is the objective of osteoporosis treatment. Bone-forming osteoporosis drugs increase bone mass, restore bone microarchitecture, and reduce fracture risk more effectively than oral bisphosphonates, providing strong justification for the use of these agents as the initial therapy or after anti-remodeling agents in patients at very high risk of fracture. At the end of a 12-to-24-month course of osteoanabolic therapy, transitioning to a potent anti-remodeling agent maintains and enhances the treatment benefit. This review describes the clinical applications of osteoanabolic therapy for osteoporosis.