Yanjun Sun, Junfeng Gong, Zhuang Li, Lin Han, Dengqun Sun
Gallbladder cancer is a common type of biliary tract tumor. Optimal management for early stage cases typically involves radical excision as the primary treatment modality. Various surgical techniques, including laparoscopic, robotic, and navigational surgery, have demonstrated favorable clinical outcomes in radical gallbladder excision. Unfortunately, most patients are ineligible for surgical intervention because of the advanced stage of the disease upon diagnosis. Consequently, non-surgical interventions, such as chemotherapy, radiotherapy, immunotherapy, and targeted therapy, have become the mainstay of treatment for patients in advanced stages...
April 18, 2024: Postgraduate Medicine
Da Wang, Jingyao Ren, Yuanyuan Wang, Xiaohua Dong, Shuo Liu, Tianyi Liao, Lihui Zhu, Miao Yu, Hui Cai
BACKGROUND: There is an ongoing debate regarding the comparative merits of splenectomy (SP) and splenic preservation in the surgical management of gastric cancer. This systematic review and meta-analysis aims to shed light on potential differences in survival outcomes and postoperative complications associated with these two procedures. METHOD: An exhaustive literature search was conducted across multiple databases, namely PubMed, Embase, Cochrane Library, and Web of Science...
April 3, 2024: Postgraduate Medicine
Chongyang Chen, Yangting Zhao, Xiaoyu Lv, Kai Li, Yawen Wang, Dengrong Ma, Mei Han, Xiaohui Zan, Xinyuan Guo, Jingfang Liu
OBJECTIVE: To investigate the correlation between serum ferritin (SF) and bone turnover markers in type 2 diabetes mellitus (T2DM) patients with non-alcoholic fatty liver disease (NAFLD). METHODS: Seven hundred and forty-two people with T2DM were selected. Serum bone turnover markers: osteocalcin (OC), type I procollagen N-terminal peptide (PINP), β-I type collagen carboxy-terminal peptide (β-CTx), and 25-hydroxyvitamin D3 (25-[OH]-D) levels were detected...
March 25, 2024: Postgraduate Medicine
Yuqing Yan, Yuzhan Jin, Yaoyi Guo, Mingtao Ma, Yue Feng, Yi Zhong, Chen Chen, Chun Ge, Jianjun Zou, Yanna Si
BACKGROUND: The current point-of-care ultrasound (POCUS) assessment of gastric fluid volume primarily relies on the traditional linear approach, which often suffers from moderate accuracy. This study aimed to develop an advanced machine learning (ML) model to estimate gastric fluid volume more accurately. METHODS: We retrospectively analyzed the clinical data and POCUS data (D1: craniocaudal diameter, D2: anteroposterior diameter) of 1386 patients undergoing elective sedated gastrointestinal endoscopy (GIE) at Nanjing First Hospital to predict gastric fluid volume using ML techniques, including six different ML models and a stacking model...
March 22, 2024: Postgraduate Medicine
Carlos Koudouovoh, Robert L Joyner
No abstract text is available yet for this article.
March 20, 2024: Postgraduate Medicine
Trish Elliott, Maria P Merlano, Deborah Morris, Candy Wilson, Julie G Pilitsis
OBJECTIVES: Auricular acupuncture (AA) is becoming increasingly common in primary care clinics, emergency departments and peri-operatively for pain relief. Over the last decade, since the last comprehensive reviews were published, the literature has expanded. In this scoping review, we seek to document the efficacy of AA in treating both acute and chronic pain, describe the mechanism of action of AA in treating pain, and discuss how AA has been integrated into Western medicine to date...
March 19, 2024: Postgraduate Medicine
Davida F Kruger, Diana Isaacs, Lucille Hughes, Eden Miller, Timothy S Bailey
Use of innovative technologies such as continuous glucose monitoring (CGM) and insulin delivery systems have been shown to be safe and effective in helping patients with diabetes achieve significantly improved glycemic outcomes compared to their previous therapies. However, these technologies are underutilized in many primary care practices. This narrative review discusses some of the clinical and economic benefits of tubeless insulin delivery devices and discusses how this technology can overcome the main obstacles inherent to use of conventional insulin delivery devices...
March 18, 2024: Postgraduate Medicine
Susan Renda, Jeffrey Freeman
Since its first use just over a century ago, insulin treatment has evolved dramatically, such that the molecules are physiologic in nature, and treatment can now closely resemble the natural hormone response over 24 hours. Newer, longer-acting basal insulin analogs have provided insulin therapies with improved characteristics and, therefore, ease of use, and can readily be incorporated as part of routine treatment for type 2 diabetes (T2D), but evidence suggests that insulin remains underused in people with T2D...
March 11, 2024: Postgraduate Medicine
Alina M Allen, Michael Charlton, Kenneth Cusi, Stephen A Harrison, Kris V Kowdley, Mazen Noureddin, Jay H Shubrook
BACKGROUND: The prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD) is increasing worldwide. Primary care providers play a critical role in the screening, diagnosis, and management of MASLD and/or metabolic dysfunction-associated steatohepatitis (MASH), though they can face challenges in this setting, particularly where healthcare resources are limited and barriers to care exist. To address these challenges, several guidelines have been developed to provide evidence-based recommendations for the clinical assessment and management of patients with MASLD/MASH...
March 11, 2024: Postgraduate Medicine
Artemis Kyriakidou, Angeliki V Kyriazou, Theocharis Koufakis, Yiannis Vasilopoulos, Iakovos Avramidis, Stefanos Baltagiannis, Dimitrios G Goulis, Kalliopi Kotsa
OBJECTIVES: The factors determining the response to treatment with glucagon-like peptide-1 receptor agonists (GLP-1- RAs) have not been clarified. The present study investigated the association between polymorphisms in TCF7L2 , CTRB1/2 , and GLP-1 R genes and response to GLP-1 RAs regarding glycemic control and weight loss among Greek patients with type 2 diabetes mellitus (T2DM). METHODS: Patients ( n  = 191) treated with GLP-1 RAs for at least 6 months were included...
March 11, 2024: Postgraduate Medicine
Faruk Tas, Akın Ozturk, Kayhan Erturk
BACKGROUND: Body mass index (BMI) and serum albumin (ALB) level are long-established markers that reflect the nutritional status and eventually the prognosis of cancer patients. The objective of the study was to determine the clinical significance of these factors and specify their roles in outcomes compared with performance status (PS) and weight loss (WL), which are considered the most significant patient-related prognostic factors in small cell lung cancer (SCLC) treated with platinum-etoposide-based chemotherapy...
March 8, 2024: Postgraduate Medicine
Carol M Antequera, Kimberly Orleck, Rinu Jacob, Amy Kenneally, Wendy L Wright
Gastroesophageal reflux disease (GERD) and Helicobacter pylori (H. pylori) infection are different disease states that are united by the core role of acid suppression in their management. In GERD, proton pump inhibitors (PPIs) have long been standard therapy based on abundant positive clinical trial data supporting their efficacy and safety. In H. pylori , PPIs are also a critical element of therapy in combination with 1 or more antibiotics to achieve and maintain a pH that maximizes the efficacy of therapy...
March 6, 2024: Postgraduate Medicine
Uğur Topçu, Nihal Sahin, Özlem Kayabey, Kadir Babaoğlu
OBJECTIVES: Kawasaki disease (KD), which is a medium vessel vasculitis, is common in Asian countries and is the most common cause of childhood-acquired heart diseases in developed countries. However, disease course and epidemiological data are limited in non-Asian developing countries like ours. We aimed to evaluate the clinical features and prognosis of patients with KD in our country and ethnicity, one of the referee centers of our country. METHODS: Patients with KD in our center for the last 20 years in the pre-COVID-19 pandemic era were included in the study...
February 29, 2024: Postgraduate Medicine
Anji Xiong, Shifeng Zhou, Can Liu, Ziyi Hu, Chuanmei Xie, Xiaoli Zheng, Xiongyan Luo
PURPOSE: This meta-analysis aimed to explore correlations between vitamin D and idiopathic inflammatory myopathy (IIM). METHODS: A comprehensive database search was conducted on 13 October 2020. Mean differences (MDs) and aggregated risk ratios (RR) with 95% confidence intervals (CIs) were used to determine the correlation between vitamin D deficiency (VDD) and IIM. Statistical analysis was performed with RevMan 5.4 and Stata15, statistical significance was set at p  < 0...
February 29, 2024: Postgraduate Medicine
Merve Cansu Polat, Saniye Mertek, Zeynep Birsin Özçakar, Elif Çelikel, Fatma Aydın, Zahide Ekici Tekin, Atilla Halil Elhan, Banu Çelikel Acar, Nilgün Çakar
OBJECTIVES: To evaluate adverse events (AEs) in pediatric patients with rheumatologic diseases being treated with approved or off-label biologic agents (BAs). METHODS: This observational, retrospective, multicenter study was conducted from 2010 to 2022 in patients under 18 years of age with rheumatic diseases who were receiving interleukin-1 antibodies (Anti-IL1), interleukin-6 antibodies (Anti-IL6), and tumor necrosis factor alpha inhibitors (anti-TNF). Efficacy, AEs, and timing of AEs were collected from electronic medical records...
February 28, 2024: Postgraduate Medicine
Michael A Benson, Deborah Tolich, Jeannie L Callum, Moises Auron
Plasma is overused as a blood product worldwide; however, data supporting appropriate use of plasma is scant. Its most common utilization is for treatment of coagulopathy in actively bleeding patients; it is also used for coagulation optimization prior to procedures with specific coagulation profile targets. A baseline literature review in PUBMED and Google Scholar was done (1 January 2000 to 1 June 2023), utilizing the following search terms: plasma, fresh frozen plasma, lyophilized plasma, indications, massive transfusion protocol, liver disease, warfarin reversal, cardiothoracic surgery, INR < 2...
February 16, 2024: Postgraduate Medicine
Javier Morales, Biff F Palmer
Chronic kidney disease (CKD) is a prevalent complication of Type II diabetes (T2D). The coexistence of CKD with T2D is comparable to cardiovascular disease (CVD) when the estimated glomerular filtration rate declines below 60 ml/min/1.73 m2 . Screening and early detection of people with high risk for CKD would be beneficial in managing CKD progress and the associated complications such as CV complications. Renin-angiotensin-aldosterone system inhibitors (RAASi) have demonstrated beneficial effects in delaying CKD progression, but they carry the risk of hyperkalemia...
February 16, 2024: Postgraduate Medicine
Lorena Morschek, Jobst-Hendrik Schultz, Ricarda Wigbels, Nadja Gebhardt, Cassandra Derreza-Greeven, Hans-Christoph Friederich, Alexandra Noll, Inga Unger, Christoph Nikendei, Till Johannes Bugaj
OBJECTIVES: Against the backdrop of poor discharge communication in hospitals, this study explores the purpose of discharge interviews from the physicians' perspective and the challenges they are confronted with. Discharge interviews are legally required in Germany as part of the discharge management. Led by the ward physician, the discharge interview should summarize relevant information about the hospital stay, medication, lifestyle interventions and follow-up treatment. METHODS: Semi-structured interviews with n  = 12 physicians were conducted at Heidelberg University Hospital between February and April 2020...
February 15, 2024: Postgraduate Medicine
Kenan Toprak, İbrahim Halil Toprak, Osman Acar, Mehmet Fatih Ermiş
OBJECTIVE: ST-elevation myocardial infarction (STEMI) is a medical emergency demanding immediate intervention, and primary percutaneous coronary intervention (pPCI) is the standard of care for this condition. While PCI has proven highly effective, a subset of patients experience the devastating no-reflow phenomenon, and some face increased short-term mortality. The Hemoglobin, Albumin, Lymphocyte, and Platelet (HALP) score, a novel biomarker-based tool, has recently surfaced as an innovative predictor of these adverse outcomes...
February 14, 2024: Postgraduate Medicine
Zuhat Urakçı, Senar Ebinç, Zeynep Oruc, Ziya Kalkan, Muhammet Ali Kaplan, Mehmet Küçüköner, Abdurrahman Işıkdoğan
OBJECTIVES: In this study, we aimed to investigate the causes of liver test abnormalities in newly diagnosed patients naive to anti-tumoral therapy. METHOD: This study included a total of 490 patients with ALT levels > 5X ULN on liver function tests at the initial presentation to our clinic. Data from 247 (50.4%) patients diagnosed with cancer (cohort A) and 243 (49.6%) patients without cancer (cohort B) were compared with regard to the etiology of liver test abnormalities and the risk factors...
February 8, 2024: Postgraduate Medicine
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