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Postgraduate Medical Journal

Imran M Paruk, Yasmeen Ganie, Sureka Maharaj, Fraser J Pirie, Vasudevan G Naidoo, Ntombifikile M Nkwanyana, Hilary L Dinnematin, Pratistadevi K Ramdial, Ayesha A Motala
OBJECTIVE: Data on the prevalence of autoimmune thyroid disease (AITD) and gastric autoimmunity in type 1 diabetes mellitus (T1DM) in Africa are limited. The aim of this study was to assess the prevalence of antithyroid peroxidase (TPO-A) and antiparietal cell antibody (PCA) in patients with T1DM at a tertiary diabetes clinic in Durban, South Africa. RESEARCH DESIGN AND METHODS: This was a cross-sectional observational study among subjects attending the adult T1DM clinic at Inkosi Albert Luthuli Hospital...
October 14, 2016: Postgraduate Medical Journal
Ju-Sing Fan, Yen-Chia Chen, Hsien-Hao Huang, David Hung-Tsang Yen, Chorng-Kuang How, Mu-Shuan Huang
OBJECTIVE: To explore the incidence and risk factors for interhospital transfer neurological deterioration (IHTND) in patients with spontaneous intracerebral haemorrhage (SICH). METHODS: Consecutive adult patients with first-ever SICH referred to our emergency department (ED) and transported by ambulance from July 2011 through June 2015 were eligible for this prospective observational study. Enrolled patients had SICH with elapsed time <12 hours and a nearly normal Glasgow Coma Scale (GCS) score (≥13) at presentation...
October 12, 2016: Postgraduate Medical Journal
Grigoriy E Gurvits, Gloria Lan, Amy Tan, Arlene Weissman
BACKGROUND: Increasing prevalence of inflammatory bowel disease (IBD) poses significant challenges to medical community. Preventive medicine, including vaccination against opportunistic infections, is important in decreasing morbidity and mortality in patients with IBD. We conduct first study to evaluate general awareness and adherence to immunisation guidelines by primary care physicians in the USA. METHODS: We administered an electronic questionnaire to the research panel of the American College of Physicians (ACP) assessing current vaccination practices, barriers to vaccination and provider responsibility for administering vaccinations and compared responses with the European Crohn's and Colitis Organization consensus guidelines and expert opinion from the USA...
October 12, 2016: Postgraduate Medical Journal
George Goodchild, Ian Gooding, Tina Goodey
No abstract text is available yet for this article.
October 11, 2016: Postgraduate Medical Journal
Yubao Lv, Linuo Zhou, Zihui Tang, Jingcheng Dong
BACKGROUND: This study assessed the extent to which diabetes mellitus (DM) and SCN10A (rs7375036) and their interaction impact on cardiovascular autonomic neuropathy (CAN) susceptibility in a Chinese Han sample. METHOD: We performed a study in a cross-sectional dataset that included 419 patients with DM and 1557 controls who were genotyped for the presence of the SCN10A rs7375036 polymorphisms. Genotyping was performed by iPLEX technology. The associations of rs7375036 and DM with CAN was assessed by using univariate and multivariate logistic regression controlling for confounders...
October 11, 2016: Postgraduate Medical Journal
Lauren Elizabeth Thomson, Nicola Fry, Richard Jackson
Trauma is one of the leading causes of death worldwide, with road traffic accidents being the leading cause of death in the age group of 15-29 years However, with modern advances in management and the introduction of specialised trauma centres, more and more are surviving severe and life-threatening trauma. The ideal timing of fracture fixation has been the subject of debate for a number of decades. There is evidence to suggest that fracture fixation in the patient with polytrauma is best achieved early on to reduce the incidence of morbidity and mortality, with damage control surgery in the more appropriate option in those patients who are haemodynamically unstable...
October 11, 2016: Postgraduate Medical Journal
Kuei-Feng Lin, Fu-Zong Wu
No abstract text is available yet for this article.
October 5, 2016: Postgraduate Medical Journal
Tim Blake, Andrew Whallett
Medical registrars have been described as the 'workhorses' of National Health Service hospitals, being at the interface of acute and chronic health services. They are expected to demonstrate effective leadership skills. There are concerns from the Royal College of Physicians that medical registrars are being overwhelmed and unsupported by organisations, and are struggling in their ability to provide safe, high-quality patient care. Junior colleagues are also being deterred by general medical specialties by the prospect of becoming the 'Med Reg'...
October 5, 2016: Postgraduate Medical Journal
Satyam Veean, Nancy Thakkar, Supriya Gupta, Jayanth Keshavamurthy
No abstract text is available yet for this article.
October 5, 2016: Postgraduate Medical Journal
Leah Raj, Bhavin Adhyaru
An estimated 5.1 million Americans have chronic heart failure and this is expected to increase 25% by 2030. Heart failure is a clinical syndrome that evolves from either functional or structural changes to the ventricles that lead to filling or ejection abnormalities. Thus far, pharmacotherapy has been show to be beneficial in patients only with reduced ejection fraction; however, new therapies have been developed in hopes of reducing the burden of heart failure. In this review, we will discuss current pharmacotherapies recommended in American College of Cardiology/American Heart Association guidelines, the evidence behind these recommendations as well as new and emerging therapies that have been developed...
October 5, 2016: Postgraduate Medical Journal
Eloy Viso
No abstract text is available yet for this article.
October 5, 2016: Postgraduate Medical Journal
Fidan Yousuf
No abstract text is available yet for this article.
October 3, 2016: Postgraduate Medical Journal
Eric Egnot, Kim Jordan, John O Elliott
BACKGROUND: Use of the electronic cigarette for nicotine delivery has increased dramatically in recent years. Information continues to emerge on its role as a smoking cessation aid, but little is known about resident physician use of the device in clinical practice. METHODS: In 2015, an electronic survey was administered to resident physicians in one healthcare system in Columbus, Ohio. The survey included questions about personal smoking exposure, knowledge, beliefs, attitudes about electronic cigarettes and early adoption of electronic cigarettes with patients...
October 3, 2016: Postgraduate Medical Journal
Christopher Orsborne, Parminder S Chaggar, Steven M Shaw, Simon G Williams
Heart failure is one of the major public health challenges facing the Western world. Its prevalence is increasing as the population ages and modern techniques are implemented to manage cardiac disease. In response, there has been a sustained effort to develop novel strategies to address the high levels of associated morbidity and mortality. Indeed, agents that target the renin-angiotensin-aldosterone system (RAAS) have transformed the way in which we manage heart failure. Despite this, mortality in heart failure is poorer than in many malignancies and a large burden of morbidity and recurrent hospitalisation remains...
September 26, 2016: Postgraduate Medical Journal
Xingshun Qi, Han Deng, Xiaozhong Guo
A faked peer review is a novel cause for retraction. We reviewed the characteristics of papers retracted due to a faked peer review. All papers retracted due to faked peer reviews were identified by searching the Retraction Watch website and by conducting a manual search. All identified papers were confirmed in published journals. The information of retracted papers was collected, which primarily included publisher, journal, journal impact factor, country, as well as publication and retraction year. Overall, 250 retracted papers were identified...
September 23, 2016: Postgraduate Medical Journal
Maya Vijayaraghavan, Steven A Schroeder, Margot Kushel
Despite population-wide efforts to reduce tobacco use, low-income populations in the USA have much higher rates of tobacco use compared with the general population. The principal components of tobacco control policies in the USA include cigarette taxes, clean indoor air laws and comprehensive interventions to increase access to tobacco cessation services. In this review, we describe the effectiveness of these policies and interventions in reducing tobacco use among vulnerable populations, focusing on persons with mental health disorders and substance use disorders, persons who have experienced incarceration or homelessness, and low-income tenants of public housing...
September 22, 2016: Postgraduate Medical Journal
Jesse Bittman, Penny Tam, Chris Little, Nadia Khan
BACKGROUND: Handover of patients between care providers is a critical event in patient care. There is, however, little evidence to guide the handover process, including determining which patients to handover. AIM: Compare the ability of gestalt-based handover with two structured scores, the modified early warning score (MEWS) and our novel iHAND clinical decision support system, to predict which patients will be assessed by a physician overnight. METHODS: This case-control study included 90 inpatients, comprising 32 patients assessed overnight (cases) and 58 patients not assessed overnight (controls) at a teaching hospital in British Columbia, Canada (May 2012)...
September 21, 2016: Postgraduate Medical Journal
Morteza Abdar Esfahani, Fariborz Mokarian, Mohammad Karimipanah
BACKGROUND: Anthracycline-induced cardiotoxicity can reach an irreversible phase; therefore great efforts are made to diagnose it early. As the right ventricle (RV) is smaller than the left, the right side of the heart is probably influenced by anthracycline to a greater extent and in a shorter time. The purpose of the present study was to investigate the early effects of chemotherapy on the right side of the heart. METHODS: This cross-sectional study was performed in Isfahan University hospitals from August 2014 to December 2015...
September 20, 2016: Postgraduate Medical Journal
Jessica Hookham, Peter Truran, Amit Allahabadia, Sabapathy P Balasubramanian
BACKGROUND: Patients' perceptions and preferences influence the choice of radioiodine ablation (RIA) or surgery in the definitive management of Graves' disease. This study aimed to evaluate their concerns, experiences and satisfaction following definitive treatment. METHODS: A postal survey of patients who had treatment with surgery or RIA between January 2011 and June 2013 for Graves' disease was conducted. RESULTS: Of 214 patients, 136 (64%) responded...
September 20, 2016: Postgraduate Medical Journal
Koddus Ali, Jon Raphael, Salim Khan, Mourad Labib, Rui Duarte
Opioids commonly used for pain relief may lead to hypogonadism, which is characterised by suppression of production of the gonadotropin-releasing hormone (GnRH) resulting in inadequate production of sex hormones. The aim of this narrative review was to highlight the effects of opioids on the endocrine system and the development of hypogonadism. MEDLINE, EMBASE and Cochrane Library were searched for relevant articles investigating hypogonadism in patients undertaking opioid therapy by using a combination of both indexing and free-text terms...
September 19, 2016: Postgraduate Medical Journal
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