Postgraduate medicine
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Postgraduate medicine · Jan 2024
Case ReportsUse of autologous iliac crest graft and free anterolateral femoral skin flap in diabetic foot ulcers: a case report.
Diabetic foot has a great impact on the life of patients. Its treatment involves a multi-disciplinary and multi-direction approach, which requires not only soft tissue repair, but also bone reconstruction and functional repair. ⋯ There is a dearth of reports pertaining to treatment of diabetic foot in patients with midfoot bone and soft tissue loss. In this report, we present an effective method that we used to reconstruct the loss of midfoot in a patient with diabetic foot, illustrating a successful therapeutic strategy for saving limbs in this complex medical condition.
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Postgraduate medicine · Jan 2024
Observational StudyEvaluation of immature granulocyte percentage and count in pediatric nephrotic syndrome.
The importance of immature granulocytes (IGs) in most infectious and inflammatory diseases has been highlighted. This study aimed to determine the clinical usability and importance of changes in the peripheral complete blood count profile, including IG percentage (IG%) and IG count (IG#), during the relapse and remission phases in pediatric nephrotic syndrome (NS) patients. ⋯ It is probable that a high level of immature granulocyte count has a positive correlation for NS relapse in pediatric patients. The IG % and IG# can be used together as biomarkers of inflammation in pediatric NS relapse.
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Postgraduate medicine · Jan 2024
Observational StudyExploring factors related to clinically advanced fibrosis in patients with nonalcoholic fatty liver disease or nonalcoholic steatohepatitis.
To describe the clinical profile of nonalcoholic fatty liver disease (NAFLD) or nonalcoholic steatohepatitis (NASH) patients in a Texas integrated delivery network (IDN) and elucidate the local relationship between patient factors and the risk of advanced fibrosis. ⋯ This study highlights the need for early screening and proactive management of metabolic risk factors for patients with NAFLD/NASH. The findings indicate a notable prevalence of obesity in the study population, a need for specialist referral for those at High-Risk of advanced fibrosis, and the importance of routine labs to evaluate metabolic factors. Primary care providers may be ideal providers to target these interventions and address this care need.
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Postgraduate medicine · Jan 2024
Obstructive sleep apnea increases the risk of herpes zoster and postherpetic neuralgia.
Diseases associated with chronic pain are typically a major source of stress for patients; and have been linked to herpes zoster (HZ) development. Here, we investigated whether obstructive sleep apnea (OSA) is a potential stressor that increases the risk of HZ and postherpetic neuralgia (PHN) in affected individuals. ⋯ OSA increases the risk of not only HZ but also PHN. Therefore, patients with OSA should be aware of the potential effect of the disease on their stress levels, as well as the increased risk of developing HZ and PHN.
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Postgraduate medicine · Jan 2024
Levels and drivers of burnout during the COVID-19 pandemic among a diverse group of resident physicians.
Evidence has shown significant impacts of the COVID-19 pandemic on physicians. We hypothesized that these effects would impact surgical and non-surgical resident education differently, with non-surgical specialties being more heavily impacted by frontline work and surgical specialties losing elective cases. ⋯ Perceived effects of the COVID-19 pandemic upon residents' educational experience was mixed: reduced clinical volume had a negative impact, while increased time for study was perceived favorably. These findings suggest potential strategies and targets to mitigate the stress and burnout of a future crisis, whether large or small, among surgical and non-surgical trainees.