Internal Medicine

24 Jan 2024 22:07

💢 Weight Loss Induced by Anti-obesity Medications and All-Cause Mortality Among Patients With Knee or Hip Osteoarthritis

🗞 Arthritis & Rheumatology. 2023 Nov 8. doi.org/10.1002/art.42754


Weight loss induced by anti-obesity drugs, particularly in a slow-to-moderate range, is linked to lower all-cause mortality in patients with knee or hip osteoarthritis. Fast weight loss did not show a significant difference from stable weight or weight gain.


🩺 Overweight and obesity are significant risk factors for osteoarthritis (OA).

📊 The study analyzed electronic health record data from 6,524 patients with hip or knee OA in the U.K.
💊 Medications studied include orlistat, sibutramine, and rimonabant.

📈 Slow-to-moderate weight loss showed a protective effect against incident hypertension, type 2 diabetes, and venous thromboembolism.

🌐 The research suggests that gradual weight loss, consistent with global guidelines, is beneficial for treating obesity.

🩹 Orlistat, the majority medication in the study, has been available for obesity treatment for two decades and has a good safety profile.

📚 The findings could potentially guide policymaking for the well-being of patients with overweight or obesity and knee or hip OA.

💊 Additional studies with newer anti-obesity medications are needed, especially considering withdrawal of some older drugs due to adverse effects.

🏥 Weight loss medications promoting slow or moderate weight loss, like Qsymia and Contrave, have titration requirements.

⚠️ Rapid weight loss may lead to adverse effects, including loss of lean muscle mass and nutritional deficiencies.

❌ Sibutramine and rimonabant, two medications in the study, have been withdrawn from the market in the U.S. due to adverse effects.

📚 Further studies with newer anti-obesity medications are necessary.


🆔 @Internalmed
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Internal Medicine

22 Jan 2024 09:52

💢 Effect of multivitamin-mineral supplementation versus placebo on cognitive function

🗞 The American Journal of Clinical Nutrition, 2024; DOI: 10.1016/j.ajcnut.2023.12.011

A new report from the COcoa Supplement and Multivitamin Outcomes Study (COSMOS) study indicates statistically significant benefits of a daily multivitamin for memory and global cognition.


🧠 Alarming Projection: By 2060, nearly 25% of Americans will face an elevated risk of cognitive decline and Alzheimer's disease.

🍫 COSMOS Study: Large-scale, nationwide, randomized trial testing cocoa extract and multivitamin supplements on cognitive function.

📱Within COSMOS, two previous studies had tested multivitamin supplementation on cognition using telephone-based cognitive assessments (COSMOS-MIND) and online web-based cognitive assessments (COSMOS-Web).

🌐 COSMOS-Clinic Study: In-person cognitive assessments among 573 participants showed a modest benefit for the multivitamin on global cognition over two years.

🔄 Meta-Analysis Results: A combined analysis of three studies indicates a significant daily multivitamin benefit for both global cognition and episodic memory.

⏳ Cognitive Aging: Daily multivitamin estimated to slow global cognitive aging by two years compared to placebo.

🧑‍⚕️ Trial Leadership: Led by Dr. JoAnn Manson and Dr. Howard Sesso, the COSMOS consortium involves collaboration between Massachusetts General Hospital, Brigham and Women’s Hospital, Columbia University, and Wake Forest University.

🌱 Nutritional Impact: Mechanisms behind the daily multivitamin's protective effect on memory and cognitive decline need further exploration, focusing on nutritional status and aging-related factors.

These findings support the promise of multivitamins as a safe, accessible, and affordable approach to preserving cognitive health in older adults.


🆔 @Internalmed
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Internal Medicine

20 Jan 2024 21:46

💢 Being Active for Just 15 Minutes May Offset Full Day of Sitting at Work


Prolonged sitting at work is associated with an increased risk of death, particularly from cardiovascular disease, according to a large study of half a million people.

However, intermittent sitting and regular exercise can mitigate these risks. The study emphasizes the need to address prolonged occupational sitting to reduce health risks.


Facts
⚠️ Individuals who sit most of the day at work face a substantial increased risk of death, especially from cardiovascular disease.

🏃‍♂️ Active individuals or those practicing intermittent sitting do not exhibit an increased risk of death.

📊 A large retrospective study in Taiwan analyzed data from 1996-2017, categorizing participants based on occupational sitting volume.

🚶‍♀️ The "mostly sitting" group had a 16% increased risk of death and a 34% increased risk of death from cardiovascular disease.

🔄 Intermittent sitters did not show an increased risk of death compared to the most active group.

💪 Engaging in 15-30 minutes of daily exercise offsets health risks associated with prolonged sitting.

🪑 Sedentary behavior, including extended sitting, is linked to various health problems, such as cardiovascular disease, diabetes, and mental health issues.

🌐 The World Health Organization recommends limiting sedentary behavior and incorporating physical activity.

🔄 Cultural and occupational changes are advocated to reduce prolonged occupational sitting, similar to anti-smoking initiatives.

🚶‍♂️ Recommendations to sit less at work include taking regular breaks, incorporating light physical activity, and finding opportunities to be more active.


The study underscores the importance of addressing prolonged sitting at work through lifestyle changes, intermittent sitting, and regular physical activity to reduce associated health risks.


🆔 @Internalmed
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Internal Medicine

18 Jan 2024 11:31

Hypertensive disorders of pregnancy

Internal Medicine

17 Jan 2024 03:42

Nephrotoxic drugs and its site of affection on nephrons

Internal Medicine

15 Jan 2024 13:44

Journal of Neurogastroenterology and Motility. 2024 Jan 30; 30 (1) : 17-28.

Refractory Gastroesophageal Reflux Disease: Diagnosis and Management

Internal Medicine

14 Jan 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🔥🔥


این پست را برای هر کسی که سلامتی‌اش برای شما مهم است ارسال کنید.

#آگاهتر_سالمتر
#عصرانه
#بارش


🌧 بارش، گروهی برای آموزش
@bareshgroup
@bareshgroup

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Internal Medicine

12 Jan 2024 15:04

لینک شرکت در عصرانه
https://meet.google.com/bvn-gqyz-byb

Internal Medicine

11 Jan 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.

———————————————————————————-
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%.

———————————————————————————-
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).


🆔 @Internalmed
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Internal Medicine

11 Jan 2024 18:45

💢 'Just get started moving': Even short walks can improve multiple aspects of patient health

https://www.healio.com/news/primary-care/20240111/just-get-started-moving-even-short-walks-can-improve-multiple-aspects-of-patient-health


🆔 @Internalmed
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Internal Medicine

10 Jan 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

🆔 @GIJournalClub

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Internal Medicine

07 Jan 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.


🆔 @GIJournalClub
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Internal Medicine

06 Jan 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


🆔 @Internalmed
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Internal Medicine

05 Jan 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

.

Internal Medicine

02 Jan 2024 22:37

💢 What Is Myasthenia Gravis?


🆔 @internalmed
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Internal Medicine

24 Jan 2024 08:48

💢 What to know about using non-insulin agents in type 1 diabetes


https://www.healio.com/news/endocrinology/20240111/what-to-know-about-using-noninsulin-agents-in-type-1-diabetes


🆔 @Internalmed
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Internal Medicine

21 Jan 2024 15:47

💢 Why Fruit Juice Without Added Sugar is Still Linked to Weight Gain


📊 A systematic review and meta-analysis found a positive association between 100% fruit juice consumption and weight gain in both children and adults.

🍹 Fruit juice contributes to weight gain due to its high sugar and calorie content, and it lacks the ability to make individuals feel full.

💧 The healthiest beverage alternative for both children and adults is water; if consuming fruit juice, it's recommended to dilute it with water or seltzer.

🤔 The study considered 42 research studies, with 17 focusing on children and 25 on adults, utilizing both prospective cohort studies and randomized controlled trials.

🍭 Excess calories, termed as "empty calories," from sugary beverages like fruit juice can lead to increased energy intake and subsequent weight gain.

🍏 The lack of dietary fiber in fruit juice, compared to whole fruit, results in decreased satiety and potential overconsumption, particularly in children.

🚸 Children under 12 months should avoid fruit juice, and for older children and adults, moderation and limited serving sizes are recommended.

🥤 While 100% fruit juice provides some vitamins and minerals, it's advised to choose whole fruit when possible for a more balanced nutritional intake.

🚱 Water is emphasized as the best choice for both children and adults, with occasional fruit juice consumption considered a sweet treat rather than a health necessity.

🔄 When selecting fruit juice, opt for 100% juice and be cautious of added sugars; diluting juice with water, seltzer, or incorporating whole fruit into the drink are suggested alternatives.


🆔 @Internalmed
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Internal Medicine

18 Jan 2024 20:40

💢 Idiopathic Intracranial Hypertension

A 25-year-old woman with severe obesity presented to the emergency department with a 1-week history of blurred vision, transient visual obscurations, daily headaches, and intermittent whooshing sounds. Her body-mass index (the weight in kilograms divided by the square of the height in meters) was 57.

On neurologic examination, optic-disk swelling and retinal hemorrhages were present by in both eyes (Panel A, left eye). The results of visual-field and cranial-nerve testing were normal.

Magnetic resonance imaging and venography of the head revealed flattened posterior globes with marked elevation of the optic-nerve heads (Panel B, arrows), an empty sella (Panel C, asterisk), and stenoses of the transverse sinuses without obstruction or thromboses — all of which were suggestive of elevated cerebrospinal fluid pressure.

A lumbar puncture was notable for an elevated opening pressure of 55 cm of water (reference range, 10 to 20); the results of the cerebrospinal fluid analysis were normal.

A diagnosis of idiopathic intracranial hypertension was made. Idiopathic intracranial hypertension is a disorder associated with obesity that manifests with symptoms resulting from increased intracranial pressure, including headaches, diplopia, visual field defects, and pulsatile tinnitus.

Treatment with high-dose acetazolamide was started, and counseling on weight loss was provided. At a 1-month follow-up visit, the patient’s papilledema had decreased, and treatment with acetazolamide had been continued.

🔅 Jauregui R, Busis NA. Idiopathic Intracranial Hypertension. New England Journal of Medicine. 2023 Dec 28;389(26):2467.


🆔 @Internalmed
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Internal Medicine

17 Jan 2024 13:35

📍عصرانه این هفته:
      تغذیه در دیابت

📍با حضور:
      دکتر آسیه منصور
متخصص تغذیه بالینی
      هیات علمی دانشگاه علوم پزشکی تهران

🗓 جمعه بیست و نهم دی ماه
⏰ ساعت پنج و نیم عصر

دیابت، بیماری شایع و با عوارضی خطرناک و کُشنده است که خوشبختانه، در صورت تشخیص و اقدام صحیح و به موقع، تا حد زیادی قابل کنترل می‌باشد. این هفته دانش خود در مورد تغذیه در دیابت را به روز خواهیم کرد.

🔗 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

.

Internal Medicine

16 Jan 2024 07:03

💢 Nonstatin therapy to reduce low-density lipoprotein cholesterol and improve cardiovascular outcomes

🔅 Cleveland Clinic Journal of Medicine. 2024 Jan 2;91(1):53-63.


🆔 @Internalmed
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Internal Medicine

15 Jan 2024 10:19

💢 Necrobiosis Lipoidica

A 43-year-old woman presented to the dermatology clinic with an 8-year history of yellow-brown spots on her shins. The lesions had been asymptomatic, and she had not sought care for them until they had grown in size.

She had no history of diabetes mellitus, hypertension, or thyroid disease. On physical examination, atrophic yellow-brown plaques with telangiectasias and irregular violaceous borders were observed on both shins (Panel A and inset).

A skin biopsy of the right shin was performed. Histopathological analysis showed several layers of necrobiosis within the dermis, perivascular inflammatory-cell infiltrates, collagen degeneration, and findings consistent with granulomatous dermatitis. A diagnosis of necrobiosis lipoidica was made.

Necrobiosis lipoidica is a chronic granulomatous skin disorder that is frequently associated with diabetes and may precede the development of impaired glucose control. However, the condition is also seen in persons without diabetes, as occurred in this patient, who had normal results on glycemic testing.

There are no evidence-based guidelines for treatment, and the lesions often abate on their own. In this case, topical glucocorticoids were administered, but the patient discontinued treatment after 1 month owing to minimal improvement and concerns about side effects.

At follow-up performed 13 years after the patient’s initial visit, the plaques had resolved (Panel B) and her glycemic control remained normal.

🔅 Liu MJ, Li J. Necrobiosis Lipoidica. New England Journal of Medicine. 2024 Jan 4;390(1):70.


🆔 @Internalmed
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Internal Medicine

12 Jan 2024 16:50

💢 Ozempic Plateau: What to Do When Weight Loss Drugs Stop Working

https://www.healthline.com/health-news/ozempic-plateau-what-to-do-when-weight-loss-drugs-stop-working


🆔 @Internalmed
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Internal Medicine

12 Jan 2024 09:58

💢 When Are Rheumatology Lab Tests Indicated?

👇
https://podcasts.apple.com/us/podcast/mayo-clinic-talks/id1183061010?i=1000641291976


🆔 @Internalmed
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Internal Medicine

11 Jan 2024 19:49

💢 Semaglutide linked to lower suicidal ideation risk than other obesity, diabetes drugs

👇
https://www.healio.com/news/endocrinology/20240111/semaglutide-linked-to-lower-suicidal-ideation-risk-than-other-obesity-diabetes-drugs


🆔 @Internalmed
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Internal Medicine

11 Jan 2024 12:26

💢 ترفندی برای صرفه جویی در تزریق خون


برای آزمایش‌های روزانه در بیماران بستری، در مجموع حجم قابل توجهی خون از بیماران گرفته می‌شود که بخش مهمی از آن لازم نیست. 4 تا 6 میلی‌لیتر خون گرفته شده در هر لولۀ استاندارد، یک میراث قدیمی‌ است: دستگاه های مدرن آزمایشگاهی نیاز به کمتر از نیم میلی‌لیتر خون در هر نمونه دارند و بقیه دور ریخته می‌شوند. گاهی معادل یک واحد خون کامل در هفته از هر بیمار بستری در ICU هدر می‌رود.

برآورد یک مطالعه نشان می‌دهد که به همین منوال، سالانه 25 میلیون لیتر خون دور ریخته می‌شود؛ این مقدار خون، معادل حجمی است که 700 واگن حمل سوخت در خود جای می‌دهند؛ یا حدود 4 برابر نیاز سالانه بیماران ایالات متحده به تزریق خون است.

امروزه در بسیاری نقاط دنیا لوله‌های جمع‌آوری خون با حجم کوچک‌تر به طور گسترده‌ و با هزینه مناسب در دسترس هستند که با تجهیزات آزمایشگاهی نیز سازگارند. این لوله‌ها خلأ با قدرت کمتر دارند و تقریباً به اندازه نصف لوله‌های مرسوم از بیمار خون می‌گیرند. اما تعداد بسیار کمی از مراکز از آنها استفاده می‌کنند.

در یک کارآزمایی، این فرضیه مورد آزمون قرار گرفت: آیا گرفتن خون کمتر می‌تواند منجر به باقی ماندن خون بیشتر در بدن بیماران شود و بدین‌ترتیب نیاز آنها به دریافت خون را کاهش دهد؟

طی بازه زمانی 2019 تا 2021، بیست و پنج ICU در کانادا در زمان‌های تصادفی شده از لوله‌های جمع‌آوری خون با حجم کوچک استفاده کردند. بیش از 21،000 بیمار مورد بررسی و تجزیه و تحلیل قرار گرفتند.

با استفاده از لوله‌های کم‌حجم‌تر در مقایسه با لوله‌های با حجم استاندارد، نیاز بیماران به تزریق خون، به ازای هر 100 بیمار، 9.84 واحد RBC کمتر شد، که از نظر آماری معنادار بود.

تأثیر این مداخله در سطح هر فرد بیمار بسیار کم بود: لوله‌های با حجم کوچک‌تر، از کاهش هموگلوبین هر بیمار تنها به میزان 0.1 g/dL جلوگیری کردند. اما اگرچه تأثیر این مداخله در سطح هر فرد اندک بود، مجموع این مقادیر اندک، چشمگیر بود.


🆔 @Internalmed
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Internal Medicine

07 Jan 2024 16:20

📍عصرانه این هفته:
      درمان‌ دارویی دیابت

📍با حضور:
      دکتر محبوبه ابراهیم پور
فوق تخصص بیماری‌های غدد و متابولیسم
      دانشیار دانشگاه علوم پزشکی تهران
🗓 جمعه بیست و دوم دی ماه
⏰ ساعت پنج و نیم عصر

دیابت، بیماری شایع و با عوارضی خطرناک و کشنده است که خوشبختانه، در صورت تشخیص و اقدام صحیح و به موقع، تا حد زیادی قابل کنترل می‌باشد. این هفته دانش خود در مورد درمان‌های دارویی دیابت را به روز خواهیم کرد.

🔗 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

06 Jan 2024 21:46

💢 Pulmonary hypertension


🆔 @Internalmed
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Internal Medicine

06 Jan 2024 15:13

💢 Navigating and Communicating about Serious Illness and End of Life

👇
nej.md/3GMhwml


🆔 @internalmed
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Internal Medicine

03 Jan 2024 10:01

💢 Nonprescription Medications for Adults With Allergic Rhinitis


🆔 @internalmed
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Internal Medicine

02 Jan 2024 22:10

‏💢 ارتباط بین مصرف نوشابه های رژیمی و کبدچرب


در سال‌های اخیر، نوشابه‌های رژیمی که بر "بدون قند و بدون کالری" بودن تاکید دارند، به دلیل نگرانی مصرف‌کنندگان از مصرف قند، مورد توجه قرار گرفته‌اند. در این نوع نوشابه‌ها، از شیرین‌کننده‌های مصنوعی نظیر آسپارتام استفاده می‌شود.

چندین مطالعه نشان داده‌اند که مصرف نوشابه‌های رژیمی با افزایش شاخص توده بدنی (BMI) و درصد چربی بدن در ‌‏نوجوانان همراه است‌‏.‌‏ به عبارت دیگر، نوشابه‌های رژیمی که بر کالری صفر تاکید دارند لزوما از افزایش وزن جلوگیری نمی‌کنند و مصرف بیش از حد آنها ممکن است حتی منجر به چاقی شود. از آنجا که چاقی مجموعه‌ای از مشکلات متابولیک را به دنبال دارد، بعید نیست که مصرف نوشابه‌های رژیمی خطر ابتلا به سندرم متابولیک را هم افزایش دهد.

تجزیه و تحلیل داده‌های مطالعه Northern Manhattan Study نشان داد که مصرف روزانه نوشابه رژیمی با افزایش خطر ابتلا به حوادث عروقی همراه است. علاوه بر این، مطالعات قبلی نشان داده‌اند که مصرف نوشابه رژیمی با افزایش فشارخون در نوجوانان همراه ‌‏است و مصرف‌‏ بیش از حد شیرین کننده های مصنوعی خطر ابتلا به دیابت نوع ‌‏۲ را افزایش‌‏ می‌دهد. با این حال، ارتباط بین نوشابه های رژیمی و کبدچرب مشخص نیست.

‏در این مطالعه با استفاده از داده‌های سرشماری ملی بهداشت و تغذیه (NHANES)، ارتباط بین مصرف نوشابه های رژیمی و کبدچرب مورد بررسی قرار گرفت.

‏در مجموع 2,378 شرکت کننده در این مطالعه شرکت کردند که از این میان 1,089 نفر یعنی 43.64% آنها کبدچرب داشتند. پس از تعدیل متغیرهای مربوط به جمعیت شناسی، شیوه زندگی و سندرم متابولیک، مصرف بیش از حد نوشابه های رژیمی خطر ابتلا به کبدچرب را حدوداً دو برابر می کند (OR = 1.98, 95%CI = 1.36–2.89, P = 0.003).


🆔 @hr1ghadam
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