Postgraduate medicine最新文献

{"title":"Abdominal cancer pain admission in emergency department vs. oncology emergency department.","authors":"Kristina Zaslavsky, Ofir Morag, Menucha Jurkowicz, Galia Pesah, Michelle Nigri Levitan, Itay Goor-Aryeh","doi":"10.1080/00325481.2025.2491296","DOIUrl":"10.1080/00325481.2025.2491296","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the rates of hospitalization, opioid prescription, supportive care, hospice referral, and 30-day all-cause mortality in patients with metastatic cancer and abdominal pain admitted to either the Emergency Department (ED) or the Oncology ED.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of patients with metastatic cancer and abdominal pain admitted to the ED or Oncology ED at a tertiary medical center between June 2020 and May 2022. The MDClone ADAMS Platform, a healthcare data analytics environment, was used for data collection. Inverse probability weighting (IPW) based on propensity scoring was used to balance and compare characteristics of patient groups admitted to both ED settings.</p><p><strong>Results: </strong>Weighted multivariable logistic regression found that metastatic cancer patients with abdominal pain complaints visiting the Oncology ED were 66% less likely to be admitted to the hospital (OR 0.34, 95% CI [0.16, 0.72], p-value = 0.005), and more likely to receive a supportive care consultation (OR 4.67, 95% CI [1.45, 15.05], p-value = 0.010), compared with the ED. Our study found that an Oncology ED, due to its expertise and immediate access to supportive care services due to their physical location within the same facility, enables prompt intervention for symptom management and psychosocial support, besides providing further oncology outpatient clinics follow-up for patients with metastatic cancer.</p><p><strong>Conclusions: </strong>We believe that a developed oncology emergency care with specialized staff has the potential to reduce hospitalization rates.</p>","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":" ","pages":"294-298"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144045280","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":"Administration of COVID-19 vaccination to adult caregivers in pediatric outpatient clinics: a vaccination cocooning project.","authors":"Lauren Rostkowski Jensen, Molly Posa, Stephanie Filipp, Maria Kelly, Jaclyn Otero","doi":"10.1080/00325481.2025.2482513","DOIUrl":"10.1080/00325481.2025.2482513","url":null,"abstract":"<p><strong>Background: </strong>Vaccination against COVID-19 is safe for patients greater than 6 months of age and reduces virus infectivity and severity. One strategy for protecting children unable to be vaccinated is cocooning, a concept that protects at-risk individuals by vaccinating adult caregivers (ACs). This study evaluates AC characteristics of those receiving COVID-19 vaccination in pediatric healthcare clinics.</p><p><strong>Methods: </strong>This study is a retrospective chart review that identified ACs greater than 21 years of age who received a COVID-19 vaccine at one of six UFHealth pediatric offices between March 2021-April 2022. Investigators collected demographic information of the AC and corresponding child.</p><p><strong>Results: </strong>The AC sample was predominantly female (79.8%), parents (75.3% mothers, 19.3% fathers), White (48.2%) or Black/African American (33.7%). Those who completed both primary doses had higher rates of children less than 5 years compared to those who did not (48.2%, 37.2%; p-value: 0.0225). ACs completing both primary doses were also younger compared to their counterparts (37.0, 39.9 years; p-value: 0.0017), with double the rate of government-funded insurance (42.9%, 20.9%; p-value: <0.0001), and significantly different racial/ethnic distribution (p-value 0.0021).</p><p><strong>Conclusions: </strong>ACs who completed both primary doses were younger females and had higher rates of children under 5 years old. We believe these results reflect the convenience of offering AC vaccines at pediatric healthcare clinics because of the high frequency of well-child checks within the first 5 years of life. This cohort also had double the rate of government-funded insurance, attributable to the free administration of COVID-19 vaccines at UF-affiliated pediatric clinics.</p>","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":" ","pages":"1-7"},"PeriodicalIF":0.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143712636","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":"<i>Moraxella catarrhalis</i> bacteremia in adult with cardiogenic pulmonary edema.","authors":"Naoto Ishimaru, Motohiro Shingu, Jun Ohnishi, Shimpei Mizuki, Yohei Kanzawa, Takahiro Nakajima, Saori Kinami","doi":"10.1080/00325481.2025.2463877","DOIUrl":"10.1080/00325481.2025.2463877","url":null,"abstract":"<p><p>Bacteremia due to <i>Moraxella Catarrhalis</i> is rare. An 85-year-old Japanese woman had productive cough, dyspnea, and fever. She had type 2 diabetes mellitus and chronic heart failure. Infiltration shown on chest radiography could be explained by heart failure or pneumonia. Initial blood culture yielded Gram-negative cocci, identified as <i>M. catarrhalis</i>. We therefore diagnosed cardiogenic pulmonary edema and <i>M. catarrhalis</i> pneumonia. <i>M. catarrhalis</i> has a high prevalence of β-lactamase production, so treatment comprised ampicillin/sulbactam. The clinical outcomes were favorable. Our case shows the importance of consideration of <i>M. catarrhalis</i> when patients with heart failure have pneumonia and the importance of blood culture for such patients.</p>","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":" ","pages":"121-125"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191702","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":"A review of venous thromboembolism for the hospitalist.","authors":"Kelly Szymanski, Carly Weber, Kaitlin Daugherty, David A Cohen","doi":"10.1080/00325481.2025.2452155","DOIUrl":"10.1080/00325481.2025.2452155","url":null,"abstract":"<p><p>Venous thromboembolism (VTE), consisting of both deep vein thrombosis (DVT) and pulmonary embolism (PE), is an extremely common condition both in the United States and worldwide. Not only is the diagnosis associated with significant morbidity and mortality for patients but it also imposes a deleterious financial burden on the US healthcare system. Diagnosis may be challenging due to variability in clinical presentation and requires a sequential workup including assessment of clinical pretest probability for VTE, D-dimer testing, and imaging. Following diagnosis, proper risk stratification is necessary to determine the appropriate treatment as well as the need for inpatient care. Elucidation of underlying major or minor risk factors at the time of diagnosis is essential as the presence of which may influence the duration of therapy. First-line treatment for most patients is anticoagulation with a direct oral anticoagulant (DOAC) for a minimum of 3-6 months. In multiple clinical trials, DOACs have proven to be non-inferior to vitamin K antagonists for the treatment of VTE with a lower risk of bleeding. Special consideration should be taken in the choice of agent and duration of treatment for patients who have underlying thrombophilias or malignancy and who are pregnant.</p>","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":" ","pages":"131-138"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142981083","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":"Surgical intervention for patients with fibrinopurulent pleural empyema and acute respiratory failure: a case report.","authors":"Hang Guo, Wenmao Zhuang, Yan Zhang, Xiao Qi, Baofeng Li, Jingcheng Wang, Chunguang Wang","doi":"10.1080/00325481.2024.2446009","DOIUrl":"10.1080/00325481.2024.2446009","url":null,"abstract":"<p><strong>Background: </strong>Fibrinopurulent thorax is a rare condition that can lead to respiratory failure. Fibroblastic decortication surgery has been shown to be an effective treatment for chronic empyema in previous studies. However, there is limited evidence supporting surgical intervention for fibrinopurulent thorax in cases of respiratory failure.</p><p><strong>Case description: </strong>We report a case of a male patient with a fibrinopurulent thorax and acute respiratory failure. The patient required invasive mechanical ventilation but showed no improvement, necessitating surgical intervention for empyema drainage. DNA gene sequencing technology was employed to diagnose the infection etiology, which facilitated the adjustment of antibiotics. This approach ultimately led to the patient's improvement and liberation from the ventilator.</p><p><strong>Conclusion: </strong>This case demonstrates the efficacy of surgical treatment for fibrinopurulent thorax with respiratory failure, a scenario not previously documented in literature. Successful treatments for pneumonia and chronic empyema in the context of respiratory failure have provided both inspiration and validation for this approach. The findings of this case highlight the potential of surgical intervention as a new treatment option for clinical practice. However, as this is a single case report, further research is necessary to validate the efficacy and safety of this treatment method.</p>","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":" ","pages":"126-130"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142916360","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":"Impact of low-dose aspirin on the prevalence of anemia in elderly patients: a systematic review and meta-analysis.","authors":"Vitória Martins Prizão, Mariana de Moura de Souza, Beatriz Austregésilo de Athayde De Hollanda Morais, Beatriz Ximenes Mendes, Otávio Cosendey Martins, Maria Luiza Rodrigues Defante, Juliana Queiroz Vasconcelos Muniz, Bruno Francisco Buzetti Spinelli","doi":"10.1080/00325481.2024.2446010","DOIUrl":"10.1080/00325481.2024.2446010","url":null,"abstract":"<p><strong>Background: </strong>Aspirin is largely used for cardiovascular prevention. While its adverse effect on bleeding is well-documented, the prevalence of anemia remains uncertain. We conducted a meta-analysis on how low-dose aspirin affects hemoglobin and other hematologic parameters in the elderly.</p><p><strong>Methods: </strong>We systematically searched PubMed, Embase, and Cochrane for studies comparing the hematological parameters and the prevalence of anemia between low-dose aspirin (≤325 mg) and non-aspirin users in individuals aged older than 60 years. We pooled mean differences (MD) for continuous outcomes and odds ratio (OR) for binary outcomes, with 95% confidence intervals (CI), under a random-effects model for both.</p><p><strong>Results: </strong>Seven studies were included, including three randomized controlled trials (RCTs), totaling 19,792 participants. Among them, 9,771 (49.3%) were treated with aspirin; 55.4% were women and 44% had a history of smoking. There was no significant difference in anemia prevalence (OR 0.85; 95% CI 0.52-1.38; <i>p</i> = 0.50). Mean Corpuscular Hemoglobin (MD 0.06 pg; 95% CI -0.37 to 0.49; <i>p</i> = 0.79), Mean Corpuscular Volume (MD -0.31 fl; 95% CI -1.17 to 0.56; <i>p</i> = 0.49), and hemoglobin concentration (MD -0.02 g/dL; 95% CI -0.26 to 0.21; <i>p</i> = 0.85) between the two groups. However, hemoglobin decline from baseline was higher in aspirin users (MD -0.11 g/dL; 95% CI -0.17 to -0.05; <i>p</i> = 0.0002; I² = 0%).</p><p><strong>Discussion: </strong>Our study employs rigorous methodology and a substantial patient cohort, marking the first quantitative meta-analysis in the past decade. Limitations include diverse study designs, short follow-up durations, gender-specific anemia criteria, and insufficient ferritin and iron levels data. Nonetheless, our findings suggest that while low-dose aspirin does not increase anemia prevalence, it is associated with declining hemoglobin levels over time.</p>","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":" ","pages":"148-154"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142878380","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":"Metabolic, hormonal profiles and comorbidities in pituitary Cushing's syndrome, adrenal Cushing's syndrome and mild autonomous cortisol secretion: a comparative study.","authors":"Belma Özlem Tural Balsak, Narin NasiroglU Imga, Şefika Burçak Polat, Cevdet Aydin, Oya Topaloğlu, Reyhan Ersoy, Bekir Çakir","doi":"10.1080/00325481.2025.2455373","DOIUrl":"10.1080/00325481.2025.2455373","url":null,"abstract":"<p><strong>Purpose: </strong>Our study aimed to discern disparities in metabolic, hormonal profiles, and comorbidities among patients with pituitary Cushing (PC), adrenal Cushing (AC), and Mild autonomous cortisol secretion (MACS).</p><p><strong>Methods: </strong>We conducted a retrospective analysis involving 76 patients diagnosed with PC (<i>n</i> = 26), AC (<i>n</i> = 21), and MACS (<i>n</i> = 29) at our clinic. We compared the groups' demographic data, clinical characteristics, biochemical profiles, hormonal analyses, and surgical interventions.</p><p><strong>Results: </strong>No significant differences were noted in age, height, body mass index, or gender distribution among the groups, although a higher proportion of females was observed across all three groups. However, PC patients exhibited markedly elevated 24-hour urinary cortisol levels compared to AC and MACS patients. Furthermore, alanine aminotransferase, triglycerides, very low-density lipoprotein, insulin, and basal cortisol levels were significantly elevated in PC and AC cases compared to MACS cases. Interestingly, no significant differences were observed in terms of comorbidities among the groups.</p><p><strong>Conclusion: </strong>Our findings suggest that urinary cortisol levels were significantly higher in the PC group than in the AC and MACS groups, potentially indicating that high-amplitude adrenocorticotropic hormone stimulation may lead to increased cortisol secretion in PC patients. The increased utilization of imaging methods has facilitated the earlier detection of adrenal incidentalomas, enabling the diagnosis of adrenal Cushing's cases with milder cortisol elevations. Additionally, the severity of disease symptoms worsens with increasing cortisol levels.Notably, moderate increases in cortisol are associated with heightened comorbidities, underscoring the importance of vigilant management in Cushing's syndrome patients. Despite a lower degree of hypercortisolism in MACS, there were no differences in comorbidities, suggesting that even mild cortisol secretion abnormalities are sufficient to establish the presence of comorbidities. Even moderate increases in cortisol levels can impact bone metabolism.</p>","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":" ","pages":"182-188"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143019097","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":"Factors associated with renal involvement in adult immunoglobulin a vasculitis: what is it?","authors":"Özlem Kılıç, Duygu Tecer, Mehmet Nur Kaya, Merve Sungur Özgünen, Muhammet Çınar, Sedat Yılmaz","doi":"10.1080/00325481.2025.2454216","DOIUrl":"10.1080/00325481.2025.2454216","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study is to examine the potential of specific parameters in determining renal involvement in adult patients diagnosed with Immunoglobulin A vasculitis (IgAV).</p><p><strong>Methods: </strong>The patients' records with IgAV meeting the EULAR/PRINTO/PRES classification criteria who were diagnosed between January 2017 and January 2022 were retrospectively reviewed. The Birmingham Vasculitis Activity Score (BVAS) version 3 was used to assess initial disease activity. A comparison was conducted between the data of patients with and without renal involvement. To investigate factors associated with renal involvement, the significant parameters were used to develop a forward stepwise multivariate regression model. Receiver Operating Characteristic (ROC) curve analysis was used to evaluate the predictive ability of significant parameters for renal involvement.</p><p><strong>Results: </strong>The study included 85 patients, of whom 22 (25.9%) had renal involvement. Patients with renal involvement had a median age of 60.5 years and a median follow-up of 56.3 months. The median BVAS and ferritin/albumin ratio (FAR) values were significantly higher in patients with renal involvement (<i>p</i> < 0.001). Multivariate regression analysis identified initial BVAS and FAR values as factors associated with renal involvement. ROC analysis demonstrated that the initial BVAS and FAR values were associated with renal involvement, with AUCs of 0.882 and 0.817, respectively (<i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>The initial BVAS above 7.5, and baseline FAR above 24.97 are factors associated with renal involvement. The results of this study may provide the basis for identifying individuals at high risk for renal involvement and, consequently, for more rigorous monitoring.</p>","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":" ","pages":"174-181"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143019131","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":"Risk of rhabdomyolysis in patients with mental disorders.","authors":"Ya-Wen Lu, Jong-Yi Wang, Tzu-Ju Hsu, Wei-Sheng Chung","doi":"10.1080/00325481.2025.2466411","DOIUrl":"10.1080/00325481.2025.2466411","url":null,"abstract":"<p><strong>Objectives: </strong>Rhabdomyolysis is caused by rapid muscle breakdown. Although patients with mental disorders are more susceptible to rhabdomyolysis, its incidence in this group is poorly established. Therefore, we conducted a population-based cohort study to investigate its incidence and risk in this group.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of 120,094 patients with mental disorders and 120,094 control patients from the Taiwan National Health Insurance Research Database. We excluded patients with rhabdomyolysis diagnosed before the index date, which was defined as the date of the first diagnosis of the mental disorder and beginning of antipsychotic medication. We matched the case cohort 1:1 with a control cohort by a propensity score method.</p><p><strong>Results: </strong>The overall incidence of rhabdomyolysis were 3.21 per 1000 person-years in the patients with mental disorders and 1.16 per 1000 person-years in the patients without mental disorders. After controlling for potential covariates, the patients with mental disorders showed an adjusted hazard ratio (aHR) of 2.77 (95% Cl: 2.62-2.92) compared with the controls. Men exhibited a risk of rhabdomyolysis 1.29-fold that exhibited by women (95% CI: 1.22-1.35). Alcoholic liver disease (aHR, 2.35) and generalized convulsive epilepsy (aHR, 2.06) were independent risk factors for rhabdomyolysis. Phenothiazines with aliphatic side-chains (aHR, 1.43), or piperidine structures (aHR, 1.54); butyrophenone derivatives (aHR, 1.24); lithium (aHR, 1.18) were independent risk factors for rhabdomyolysis after adjustment for covariates.</p><p><strong>Conclusions: </strong>The risk of rhabdomyolysis is significantly higher for patients with mental disorders than that for patients without mental disorders.</p>","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":" ","pages":"201-208"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442795","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":"Trends of primary health care practitioners toward bleeding management in Saudi Arabia: a cross-sectional analysis.","authors":"Abdulaziz Mohammad Al-Sharydah, Faisal Ahmad Katbi, Razan Essam AlHarbi, Faisal Al-Ghamdi, Saleh AlShreadah, Bander Fuhaid AlDhafery","doi":"10.1080/00325481.2025.2452146","DOIUrl":"10.1080/00325481.2025.2452146","url":null,"abstract":"<p><strong>Objectives: </strong>High rates of morbidity and mortality are a result of trauma being a significant health burden in Saudi Arabia. We evaluated the current trends of primary healthcare (PHC) physicians in Saudi Arabia toward patients with bleeding and their referral awareness for percutaneous endovascular arterial embolization (EAE).</p><p><strong>Methods: </strong>We formulated a 13-question survey to assess PHC physicians' knowledge regarding decision-making and appropriate approaches to manage patients with traumatic and non-traumatic abdominopelvic and lower limb bleeding. We conducted in-person surveys with various specialists with varying levels of clinical experience in Saudi Arabia.</p><p><strong>Results: </strong>Overall, 112 PHC physicians were assessed. Of them, 43.75% had ≥ 5 years of independent practice experience, and 72.3% and 27.7% encountered bleeding patients rarely and routinely, respectively. General practitioners scored lower across all questions than other PHC physicians. Physicians with > 10 years of practice had higher median scores in decision-making questions (<i>p</i> = 0.159). Internists and gynecologists (<i>p</i> = 0.046) and physicians (<i>p</i> = 0.050) in tertiary-care settings had significantly higher median scores on decision-making questions. Pediatricians (<i>p</i> = 0.091) and PHC physicians (<i>p</i> = 0.440) at private institutions had higher median scores on approach appropriateness questions.</p><p><strong>Conclusions: </strong>PHC physicians in Saudi Arabia require a better understanding of the indications of EAE to avoid referral and triage errors, inefficient use of healthcare resources, and suboptimal patient outcomes.</p>","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":" ","pages":"189-200"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142960655","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}