Postgraduate medicine
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Postgraduate medicine · Jan 2025
ReviewPreoperative intravenous versus oral iron supplementation for elective surgery: evidence based on 12 randomized trials.
This study aims to clarify hematological parameters, transfusion requirements, and adverse events of preoperative intravenous (IVIS) versus oral iron supplementation (OIS) in elective surgery patients. ⋯ PROSPERO CRD42023483284.
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Venous thromboembolism (VTE), consisting of both deep vein thrombosis (DVT) and pulmonary embolism (PE), is an extremely common condition both in the United States and worldwide. Not only is the diagnosis associated with significant morbidity and mortality for patients but it also imposes a deleterious financial burden on the US healthcare system. Diagnosis may be challenging due to variability in clinical presentation and requires a sequential workup including assessment of clinical pretest probability for VTE, D-dimer testing, and imaging. ⋯ First-line treatment for most patients is anticoagulation with a direct oral anticoagulant (DOAC) for a minimum of 3-6 months. In multiple clinical trials, DOACs have proven to be non-inferior to vitamin K antagonists for the treatment of VTE with a lower risk of bleeding. Special consideration should be taken in the choice of agent and duration of treatment for patients who have underlying thrombophilias or malignancy and who are pregnant.
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Postgraduate medicine · Jan 2025
ReviewQuality of guidelines for hyperthyroidism: systematic quality assessment using the AGREE II tool.
The aim of this study was to systematically assess the quality of different guidelines for the management of patients with hyperthyroidism and to explore and analyze the recommendations and key evidence in different guidelines. ⋯ The quality of hyperthyroidism treatment guidelines is variable, and treatment recommendations vary greatly from guideline between guidelines. Analyzing and improving the causes of inconsistencies in recommendations for patients with hyperthyroidism could be a reasonable and effective way for developers to improve the quality of guidelines for the management of hyperthyroidism.
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Postgraduate medicine · Jan 2025
ReviewDetermining the outcome measures and clinical relevance of respiratory muscle training with multiple sclerosis patients: a systematic review.
The following systematic review aimed to gather information on the effectiveness of Respiratory Muscle Training (RMT) with Multiple Sclerosis (MS) patients. The method followed the ENTREQ and PRISMA protocol. MEDLINE, Cochrane, and Science Direct databases were used to source relevant literature. ⋯ Although muscle strength increased, increases in FVC had moderate effects on functional ability, which were negligible, and patient-reported fatigue. Findings suggest that muscle strength increases were predominantly in inspiratory muscles, and expiratory results were combined. However, the review shows a lack of research concerning the use of RMT and its prescription for MS patients.
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Postgraduate medicine · Jan 2025
ReviewDetermining the outcome measures and clinical relevance of respiratory muscle training with multiple sclerosis patients: a systematic review.
The following systematic review aimed to gather information on the effectiveness of Respiratory Muscle Training (RMT) with Multiple Sclerosis (MS) patients. The method followed the ENTREQ and PRISMA protocol. MEDLINE, Cochrane, and Science Direct databases were used to source relevant literature. ⋯ Although muscle strength increased, increases in FVC had moderate effects on functional ability, which were negligible, and patient-reported fatigue. Findings suggest that muscle strength increases were predominantly in inspiratory muscles, and expiratory results were combined. However, the review shows a lack of research concerning the use of RMT and its prescription for MS patients.