Postgraduate medicine
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Postgraduate medicine · Nov 2024
ReviewThe masters athlete and use of antihypertensive medications.
Hypertension is the most common cardiovascular condition in recreational athletes, especially older (masters) athletes. The interacting effects of hypertension, cardiac adaptation to endurance training, and antihypertensive medications on exercise performance are complex and of relevance to athletes, trainers, and health care providers. ⋯ This review summarizes the influence of antihypertensive medications on exercise performance, which can include both hemodynamic and metabolic effects, and includes practical considerations in choice of antihypertensive agent for the masters endurance athlete. Whereas the overriding priority for choice of antihypertensive is control of hypertension and improving clinical outcomes, other considerations regarding effects on exercise performance may also influence the choice of agent.
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Postgraduate medicine · Nov 2024
ReviewCalcific aortic valve disease and cardiometabolic triggers: an explanation behind progression of aortic valvular disease and failure of medical therapy interventions.
Calcific aortic valve disease (CAVD), a nonrheumatic stenosis of the trileaflet aortic valve, is a complex, multifaceted cardiovascular condition involving a widespread inflammatory process and an analogous atheromatous process affecting the arteries. It is currently the most encountered valvular abnormality in cardiology. ⋯ Furthermore, we suggest CAVD as a cardio metabolic disorder. New perspectives as well as which pathways we believe are critically involved and ideas for early intervention are discussed.
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Postgraduate medicine · Nov 2024
Juvenile idiopathic arthritis management: insights into the utilization of intra-articular corticosteroid injections.
Juvenile idiopathic arthritis (JIA) is a common chronic rheumatic disease in children, requiring careful management to reduce both short- and long-term morbidity. In this study, our objective was to assess the clinical features of patients diagnosed with JIA who received intra-articular corticosteroid injections (IACI). ⋯ Notably, the high percentage of arthritis remission achieved with intra-articular corticosteroid injections (IACI) on a joint-specific basis highlights its efficacy and favorable safety profile. A lymphocyte count exceeding 5000/mm3 at the time of diagnosis may serve as an early indicator for considering intra-articular steroid administration. These findings emphasize the need for nuanced and individualized treatment strategies in JIA management to optimize outcomes for affected children.
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Postgraduate medicine · Nov 2024
Comparative StudyExploring the potential of artificial intelligence models for triage in the emergency department.
To perform a comparative analysis of the three-level triage protocol conducted by triage nurses and emergency medicine doctors with the use of ChatGPT, Gemini, and Pi, which are recognized artificial intelligence (AI) models widely used in the daily life. ⋯ The undertriage rates observed in AI models were considerably high. Hence, it does not yet seem appropriate to solely rely on the specified AI models for triage purposes in the emergency department.
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Postgraduate medicine · Nov 2024
Giant cell arteritis (GCA) as a risk factor for seizures: a cohort study.
The objective of this study was to assess the risk of seizures in Giant Cell Arteritis (GCA) patients in a large cohort of Israeli subjects, in comparison to matched controls. ⋯ According to this study, individuals with GCA are at a higher risk of developing seizures when compared to the general population. This increased risk is independent of their predisposition for stroke. One proposed mechanism is that the GCA pro-inflammatory state may decrease the neuronal threshold for depolarization.