Postgraduate medicine最新文献

{"title":"Diabetes and skin health: a statewide survey on Ohio healthcare providers' knowledge.","authors":"Sarah C Beach, Amber M Healy, Allyson S Hughes","doi":"10.1080/00325481.2026.2740273","DOIUrl":"https://doi.org/10.1080/00325481.2026.2740273","url":null,"abstract":"<p><strong>Objectives: </strong>With increasing rates of diabetes, there is an increased incidence of diabetes skin conditions, yet the extent to which healthcare professionals are aware of these skin conditions is unclear. The purpose of this study was to assess Ohio healthcare providers' (HCPs) understanding of diabetes dermatological manifestations, which can serve as early indicators of diabetes and impact diabetes management.</p><p><strong>Methods: </strong>An online survey was distributed from February 2025 to March 2025 to collect data on demographics, frequency of dermatological issues in practice, screening practices, self-efficacy, knowledge of diabetes-related skin conditions, and preferences for further education, with 167 Ohio HCPs surveyed. Survey distribution included mass e-mails sent through the Clinical and Translational Research Unit (CTRU) by University Communications and Marketing (UCM) at Ohio University, individual e-mails to Ohio professional societies for physician assistants and nurse practitioners, and posts on social media.</p><p><strong>Results: </strong>Importantly, 66.5% of participants were early career HCPs with 10 years or less of experience. Participants were nurse practitioners (28.7%), physician assistants (15.6%), resident physicians (26.3%), and attending physicians (29.3%). Regarding diabetes technology, 61.1% of the sample stated they rarely encountered patients with skin reactions from diabetes technology. Notably, over half of respondents (56.3%) received a score of 50% or less on the dermatology and diabetes knowledge test and only 41.9% of respondents reported moderate confidence in diagnosing diabetes dermatologic manifestations.</p><p><strong>Conclusion: </strong>These findings suggest potential knowledge gaps on the topic, which warrants further evaluation of the quality of diabetes care and patient outcomes. These results may help inform educational efforts for HCPs to enhance overall knowledge of dermatologic manifestations of diabetes. Further studies should assess knowledge and practice patterns among primary care healthcare professionals.</p>","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":" ","pages":"1-7"},"PeriodicalIF":2.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149121264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reported anti-TNF-induced vasculitis: clarifying incidence, causality, confounding by indication.","authors":"Shahzaib Ali, Vishaka Khana, Muzzamil Qureshi","doi":"10.1080/00325481.2026.2740378","DOIUrl":"https://doi.org/10.1080/00325481.2026.2740378","url":null,"abstract":"","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":" ","pages":"1-2"},"PeriodicalIF":2.8,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149083562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Plain language review: non-invasive screening for metabolic dysfunction-associated steatotic liver disease (MASLD) and metabolic dysfunction-associated steatohepatitis (MASH) in primary care.","authors":"Marcelo Kugelmas, Ariana M Chao","doi":"10.1080/00325481.2026.2724170","DOIUrl":"10.1080/00325481.2026.2724170","url":null,"abstract":"","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":" ","pages":"1-14"},"PeriodicalIF":2.8,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148993298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association between atorvastatin use and prothrombin time, apolipoprotein A-I levels, and apolipoprotein B levels in patients with type 2 diabetes mellitus and no history of atherosclerotic cardiovascular diseases: a cross-sectional study.","authors":"Taima'a Kefah Al-Mohammad, Linda Tahaineh, Shoroq M Altawalbeh","doi":"10.1080/00325481.2026.2726596","DOIUrl":"https://doi.org/10.1080/00325481.2026.2726596","url":null,"abstract":"<p><strong>Background and objectives: </strong>Recent observational studies have demonstrated an association between apolipoproteins and vitamin K-dependent coagulation factors. Further research investigating this association is required. This study aimed to assess the association between atorvastatin use and prothrombin time (PT), apolipoprotein A-I (ApoA-I) levels, and apolipoprotein B (ApoB) levels in type 2 diabetes mellitus (T2DM) patients without established atherosclerotic cardiovascular disease and to investigate the association between PT and these apolipoproteins.</p><p><strong>Methods and results: </strong>A cross-sectional study recruited 147 T2DM patients attending Family Medicine clinics at King Abdullah University Hospital and Jordan University of Science and Technology Health Care Center, 72 patients started receiving atorvastatin at least 6 months before the recruitment date (case group), and 75 patients were not on statins (control group). PT showed an inverse association with ApoB in both groups (case group: β = -0.09, 95% CI: -0.17 to -0.02, <i>p</i> = 0.017; and control group: β = -0.08, 95% CI: -0.15 to -0.02, <i>p</i> = 0.015). No significant association was observed between PT and ApoA-I.</p><p><strong>Conclusion: </strong>The inverse association between PT and ApoB may suggest a potential link between the reduction in ApoB levels, through atorvastatin use, and the modulation of coagulation pathways relevant to venous thrombosis, although this requires confirmation in future prospective studies.</p>","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":" ","pages":"1-11"},"PeriodicalIF":2.8,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148946549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utility and practical application of at-home daily urine hormone monitoring to support health, nutrition, and exercise: illustrative case-based perspectives across the female lifespan.","authors":"Katie R Hirsch, Melanie Sulaver, Christina H Saldanha","doi":"10.1080/00325481.2026.2727795","DOIUrl":"https://doi.org/10.1080/00325481.2026.2727795","url":null,"abstract":"<p><p>Delayed diagnosis and fragmented care remain persistent challenges across women's health, due in part to limitations in evaluating the dynamic female hormone profile. Current clinical approaches to hormonal assessment often rely on single timepoint assessments that fail to capture hormonal variability, leading to incomplete or misleading insight into hormonal health. Recent technological advancements now allow for quantitative measurement of key reproductive hormones in urine using smartphone-compatible, at-home devices, making daily hormone monitoring across the menstrual cycle and reproductive lifespan feasible. The purpose of this illustrative, case-based perspective is to provide insight into: 1) when and why comprehensive at-home, daily hormone monitoring could be implemented; 2) how comprehensive hormone monitoring gives insight into the health state of women at different reproductive stages; and 3) how such information can inform lifestyle or medical recommendations. Illustrative case-based examples are given to demonstrate the potential applications of comprehensive at-home, daily hormone monitoring across the reproductive lifespan, including low energy availability (LEA), postpartum return to exercise, polyendocrine metabolic ovarian syndrome (PMOS), and perimenopause. Across cases, daily monitoring of reproductive hormones revealed hormone patterns that were not identifiable using traditional methods. In many cases, clinically meaningful patterns of ovulatory function, luteal phase quality, or reproductive stage were identified within one to two cycles, allowing more individualized lifestyle or medical interventions to be implemented. Collectively, these illustrative cases demonstrate that, when integrated with comprehensive clinical assessment and practitioner expertise, daily hormone monitoring can provide actionable insight into female physiology, support earlier identification of hormonal dysregulation, and inform personalized medicine and lifestyle changes across the reproductive lifespan.</p>","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":" ","pages":"1-19"},"PeriodicalIF":2.8,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148908511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronic urticaria in primary health care: how aware are family physicians?","authors":"Tuğba Tehçi, Musa Şahin, Merthan Tunay, Merve Çiçek Şahin, Merve Erkoç Karaduman","doi":"10.1080/00325481.2026.2727794","DOIUrl":"https://doi.org/10.1080/00325481.2026.2727794","url":null,"abstract":"<p><strong>Objectives: </strong>Chronic urticaria (CU) is a common dermatologic condition that significantly affects quality of life and is frequently first managed in primary care. This study aimed to evaluate the awareness, knowledge, and clinical practices of primary care physicians (PCPs) regarding CU management.</p><p><strong>Methods: </strong>This cross-sectional study was conducted among PCPs working across Turkey. Data were collected through an online questionnaire distributed nationwide. The questionnaire assessed demographic characteristics, knowledge of CU diagnosis and treatment, and clinical attitudes and practices. Total knowledge scores (TKS) were calculated according to correct responses.</p><p><strong>Results: </strong>A total of 274 physicians participated in the study; 55.1% were female, and the mean age was 38.2 ± 9.2 years. Most participants reported recognizing urticarial lesions (82.5%) and correctly identified antihistamines as first-line treatment (90.1%). However, only 42.3% correctly distinguished acute from chronic and identified dose escalation of second-generation antihistamines as the recommended next treatment step in unresponsive cases. Awareness and use of omalizumab were limited (33.2%). Routine skin prick testing and pseudoallergen-restricted diets were still commonly recommended. Specialists had significantly higher TKS scores than general practitioners and resident physicians (<i>p</i> = 0.005). Professional experience was negatively associated with TKS (β = -0.175, <i>p</i> = 0.005). Although most physicians supported lifestyle modification and psychiatric referral when necessary, 65.0% reported feeling inadequate in the follow-up of CU patients.</p><p><strong>Conclusion: </strong>Primary care physicians demonstrated a basic level of knowledge regarding CU; however, important gaps remain, particularly in treatment escalation, follow-up strategies, and appropriate use of diagnostic tests. These findings highlight the need for targeted educational interventions and guideline-based training to improve CU management in primary care.</p>","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":" ","pages":"1-7"},"PeriodicalIF":2.8,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148883125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Waist circumference provides improved cardiometabolic discrimination compared with body mass index in psoriatic disease: discrimination and reclassification analyses.","authors":"Rubén Queiro, Estefanía Pardo, Marta Loredo, Stefanie Burger, Ignacio Braña, Paula Alvarez","doi":"10.1080/00325481.2026.2727239","DOIUrl":"https://doi.org/10.1080/00325481.2026.2727239","url":null,"abstract":"<p><strong>Background: </strong>Patients with psoriatic disease present a distinctive metabolic phenotype, yet the optimal anthropometric marker to capture cardiometabolic risk remains unclear. We evaluated whether waist circumference provides superior cardiometabolic discrimination and reclassification compared with BMI in psoriatic disease.</p><p><strong>Methods: </strong>In this cross-sectional study, we assessed consecutive patients with psoriasis and/or psoriatic arthritis (<i>n</i> = 572). The primary outcome was clustered cardiometabolic burden (≥2 predefined cardiometabolic abnormalities). Waist circumference and BMI were compared using principal component analysis (PCA), ROC curves, Youden-derived sex-specific thresholds, and both categorical and continuous reclassification metrics (NRI and IDI), overall and stratified by sex. Additional sensitivity analyses used standard metabolic cutoffs (ATP III/IDF).</p><p><strong>Results: </strong>Waist circumference and BMI showed the highest loadings on the first principal component representing the cardiometabolic axis, with a slightly higher contribution from waist circumference (loading 0.864 vs 0.826). Waist circumference showed modest but statistically significant improvement in discrimination compared with BMI for clustered cardiometabolic abnormalities (AUC 0.78 vs 0.73 for ≥2 factors, DeLong <i>p</i> = 0.003; AUC 0.78 vs 0.71 for ≥3 factors, DeLong <i>p</i> < 0.001). Waist circumference-derived thresholds provided incremental risk stratification beyond BMI, with consistent improvements in reclassification metrics across cardiometabolic burden definitions. Youden-derived thresholds (100 cm in men and 99 cm in women) showed better balance between sensitivity and specificity than ATP III and IDF criteria, while maintaining clinically relevant likelihood ratios. Sensitivity analyses incorporating waist-to-height ratio showed similar findings without additional benefit over waist circumference alone.</p><p><strong>Conclusion: </strong>Waist circumference provided consistently better overall cardiometabolic discrimination than BMI and may represent a more informative anthropometric marker for cardiometabolic risk assessment in psoriatic disease.</p>","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":" ","pages":"1-10"},"PeriodicalIF":2.8,"publicationDate":"2026-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148860691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic performance of APUA, APUA-RO₂, and CURB-65 scores in patients with critical pneumonia.","authors":"Serdar Özdemir, İbrahim Altunok, Merve Osoydan Satıcı","doi":"10.1080/00325481.2026.2726610","DOIUrl":"https://doi.org/10.1080/00325481.2026.2726610","url":null,"abstract":"<p><strong>Background: </strong>Severe pneumonia requiring intensive care unit (ICU) admission is associated with high short-term mortality. Early risk stratification in emergency settings is essential to guide clinical decisions. The APUA and APUA-RO₂ scores have been proposed as simplified prognostic tools, but their performance in critically ill pneumonia patients remains unclear.</p><p><strong>Objective: </strong>To compare the prognostic performance of APUA, APUA-RO₂, and CURB-65 scores in emergency department patients with pneumonia and ICU indications.</p><p><strong>Methods: </strong>This retrospective, single-center study included adult patients with community-acquired pneumonia who were evaluated for ICU admission in the emergency department between 1 September 2024, and 1 September 2025. Demographic, clinical, and laboratory data were extracted from electronic medical records. APUA, APUA-RO₂, and CURB-65 scores were calculated at presentation. The primary outcome was 30-day in-hospital mortality. Discriminative ability was assessed using receiver operating characteristic curves and area under the curve (AUC) analysis. Multivariable logistic regression was performed to identify independent predictors of mortality.</p><p><strong>Results: </strong>Among 191 patients, 121 (63.4%) died within 30 days. Non-survivors had higher respiratory rates, CRP, LDH, creatinine, and pneumonia severity scores (APUA, APUA-RO₂, CURB-65; all <i>p</i> < .001). All three scores demonstrated moderate discriminative performance, with AUCs of 0.732 for APUA, 0.765 for APUA-RO₂, and 0.697 for CURB-65. Model performance was highest for APUA-RO₂ (AUC 0.825, sensitivity 87.6%, specificity 55%). Pairwise AUC comparisons did not reach statistical significance, although APUA-RO₂ showed a trend toward better performance. Multivariable analysis confirmed that malignancy and higher pneumonia severity scores were independent predictors of mortality.</p><p><strong>Conclusions: </strong>All three severity scores demonstrated moderate discriminative ability for predicting 30-day mortality in critically ill pneumonia patients. Among them, APUA-RO₂ showed the highest prognostic performance, although its overall discrimination remained moderate. Therefore, these scores may assist, but should not replace, clinical judgment when assessing critically ill patients. Prospective multicenter validation is warranted.</p>","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":" ","pages":"1-8"},"PeriodicalIF":2.8,"publicationDate":"2026-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148857997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oral semaglutide for obesity: clarifying comparative evidence and real-world applicability.","authors":"Yi Zou","doi":"10.1080/00325481.2026.2721720","DOIUrl":"https://doi.org/10.1080/00325481.2026.2721720","url":null,"abstract":"","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":" ","pages":"1-2"},"PeriodicalIF":2.8,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148804131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction.","authors":"","doi":"10.1080/00325481.2026.2717478","DOIUrl":"https://doi.org/10.1080/00325481.2026.2717478","url":null,"abstract":"","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":" ","pages":"1"},"PeriodicalIF":2.8,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148715102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}