Internal Medicine
15 January 2024 13:44
Journal of Neurogastroenterology and Motility. 2024 Jan 30; 30 (1) : 17-28.
Refractory Gastroesophageal Reflux Disease: Diagnosis and Management
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Internal Medicine
14 January 2024 05:49
پنجمین اپیزود از پادکست عصرانه منتشر شد
👈 کبدچرب - با حضور دکتر امیرعلی سهراب پور
👈 پاسخ به پرسشهای رایج شنوندگان
🔥🔥در پادکست عصرانه صوت عصرانه های قبلی را گوش کنید🔥🔥
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#آگاهتر_سالمتر
#عصرانه
#بارش
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Internal Medicine
12 January 2024 15:04
لینک شرکت در عصرانه
https://meet.google.com/bvn-gqyz-byb
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Internal Medicine
11 January 2024 20:19
💢 Pharmacotherapy of Obesity
A 46-year-old woman with obesity (body mass index 34 kg/m2), prediabetes, and hypertension presents to clinic for follow-up. She takes olmesartan 20 mg daily for hypertension. She has made several unsuccessful attempts to lose weight with changes in diet and exercise. What additional pharmacotherapy might you recommend next?
Obesity is a global epidemic. Its prevalence has been increasing worldwide for several decades, and it is associated with poor health outcomes including cardiovascular disease, diabetes mellitus, malignancy, and musculoskeletal diseases.
For people who are obese, losing as little as 5% to 10% of body weight helps to improve cardiovascular risk factors, and losing more has even greater benefit. Major guidelines continue to recommend low-calorie diets, exercise, and comprehensive lifestyle management plans as cornerstones of obesity management.
However, the human body seems to have a set point for weight, with metabolic and homeostatic adaptations that make it difficult to lose weight or maintain weight loss. Therefore, many patients regain weight after participating in lifestyle modification programs.
As a result, pharmacotherapy is an important consideration for achieving weight-loss goals. Newer drugs such as semaglutide have shown promising outcomes for weight loss and maintenance.
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Tirzepatide once weekly promotes weight loss in patients without diabetes
In a double-blind, industry-sponsored, randomized clinical trial conducted in 19 countries, participants were randomized in a 1:1:1:1 ratio to receive tirzepatide 5 mg, 10 mg, or 15 mg or placebo injections for 72 weeks. All groups received dietary and physical activity intervention.
Participants were age 18 and older, had a body mass index of at least 30 kg/m2, or had a body mass index of at least 27 kg/m2 with at least 1 weight-related complication, defined as hypertension, hyperlipidemia, obstructive sleep apnea, or cardiovascular disease.
Exclusion criteria included diabetes, treatment with other weight-loss medications within 90 days before screening, and planned weight-loss surgery. The coprimary outcomes were change in body weight from baseline to week 72 and weight reduction of at least 5%.
A total of 2,539 participants were randomized, of whom 68% were women, 71% were White, and 48% were Hispanic or Latino. All of the active-treatment groups lost a significant amount of weight, and the higher the dose the more they lost: The mean change in body weight was –15% with tirzepatide 5 mg, –19.5% with tirzepatide 10 mg, –20.9% with tirzepatide 15 mg, and –3.1% with placebo.
More than 85% of participants in the tirzepatide groups lost more than 5% of their body weight, compared with 35% of those in the placebo group.
Nausea, vomiting, and diarrhea were more common in patients receiving tirzepatide than in patients receiving placebo, but these adverse effects infrequently led to drug discontinuation and were clustered around drug initiation or dose increases.
A higher risk of cholecystitis was seen in patients receiving tirzepatide, but the incidence was less than 0.6%.
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Should we prescribe tirzepatide for our 46-year-old patient without diabetes?
In addition to ongoing diet, exercise, and lifestyle counseling, consideration of pharmacotherapy is a reasonable option. Both tirzepatide and semaglutide are approved by the US Food and Drug Administration for weight loss, but the high cost and varying insurance coverage for each of these medications render them unobtainable for many patients.
Before patients start weight-loss therapy, clinicians and patients should discuss its possible benefits, risks, cost, availability, and duration (which is unknown at this point but may need to be lifelong to prevent weight regain).
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Internal Medicine
10 January 2024 14:01
💢 شواهد درباره فراورده های میکروبی اندک است
میکروبیوم دستگاه گوارش بسیار غنی است و احتمالا مداخله در آن، در پیشگیری و درمان بیماریهای مختلف می تواند نقش داشته باشد.
اما واقعیت آن است که شواهد علمی قوی برای بسیاری از فراورده های موجود در بازار (هم ایران و هم تمام دنیا) وجود ندارد.
در این مقاله مروری مهم که در ژورنال معتبر AJG منتشر شده، آخرین شواهد گردآوری شده اند.
این نشان می دهد که هنوز راه بسیار درازی برای اثبات اثربخشی انواع این فراورده های رنگارنگ در پیش است.
👈 لینک مقاله
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Internal Medicine
07 January 2024 16:02
💢 Ozempic, Mounjaro and Similar Drugs Don't Increase Risk of Pancreatic Cancer
People with type 2 diabetes who take an anti-diabetes medication such as semaglutide don’t have a higher risk of developing pancreatic cancer, a new study found.
These drugs called glucagon-like peptide-1 (GLP-1) receptor agonists have skyrocketed in popularity sold under the brand names Ozempic, Wegovy and Mounjaro among others.
“This is a very important study, because it’s a large population-based study with a very good follow-up,” said Dr. Anton Bilchik, surgical oncologist, chief of medicine and director of the Gastrointestinal and Hepatobiliary Program at Saint John’s Cancer Institute in Santa Monica, Calif., who was not involved in the new research.
In general, pancreatic cancer hasn’t been a big concern among people taking these types of medications, said Dr. Mir Ali, bariatric surgeon and medical director of MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center in Fountain Valley, Calif.
“… this study is reassuring, in that if you prescribe these drugs to patients long-term, it’s not increasing their risk for pancreatic cancer,” said Ali, who was not involved in the new research.
The new study was published Jan. 4 in JAMA Network Open.
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Internal Medicine
06 January 2024 16:26
💢 تأثیر داروهای GLP1A بر سیر طبیعی آرتروز زانو
سالهاست که محققان در پی کشف دارویی برای تغییر سر طبیعی آرتروز هستند. بعید نیست داروهای جدید چاقی کلید حل این معما باشند!
👇
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10423473/pdf/ard-2023-223845.pdf
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Internal Medicine
05 January 2024 09:04
📍عصرانه این هفته:
انتقال فرآوردههای خونی
📍با حضور:
دکتر سعید محمدی
دانشیار دانشگاه علوم پزشکی تهران
دکترای تخصصی هماتولوژی آزمایشگاهی و بانک خون
فلوشیپ علوم آزمایشگاهی بالینی
معاون فنی و فن آوریهای نوین سازمان انتقال خون ایران
🗓 جمعه پانزدهم دی ماه
⏰ ساعت پنج و نیم عصر
تزریق خون و فرآوردههای آن از زمان ابداع تا کنون، جان بسیاری از افراد را نجات داده است. با این وجود، خطرات خاص خود را نیز بر بیماران تحمیل میکند که بعضاً حتی میتوانند کشنده باشند. در این عصرانه میخواهیم با نحوه درخواست صحیح خون و فرآوردههای آن آشنا شویم نا از میزان این عوارض بکاهیم.
🔗 لینک برنامه عصرانه
👈 در تقویم گوگل ثبت کنید
برنامه به صورت لایو در اینستاگرام هم پخش خواهد شد،
اما توصیه ما فعلا شرکت از طریق Google meet است.
شرکت برای عموم آزاد است.
🔥🔥در پادکست عصرانه صوت عصرانه های قبلی را گوش کنید🔥🔥
این پست را برای هر کسی که سلامتیاش برای شما مهم است ارسال کنید.
#آگاهتر_سالمتر
#عصرانه
#بارش
🌧 بارش، گروهی برای آموزش
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Internal Medicine
02 January 2024 22:37
💢 What Is Myasthenia Gravis?
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Internal Medicine
02 January 2024 21:09
💢 Debunking the 3,500-Calorie-per-Pound Rule
https://nutritionfacts.org/blog/debunking-the-3500-calorie-per-pound-rule/
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