MYCPDŸ ARTICLES
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Medical
Explore concise and informative medical articles covering a wide range of topics. Stay up-to-date with the latest research, treatments, and breakthroughs in healthcare.
Examples of clinical articles available once registered
Nociceptive Views â Ed 20
Every August, South Africa marks Womenâs Month â a time to honour the countless contributions of women across our society, to reflect on the continuing struggles against inequality, and to recommit ourselves to the pursuit of justice and equity. As healthcare professionals, we are uniquely placed to translate this national ethos into something more than symbolism. We must use this month not only to celebrate women, but also to interrogate how health systems â including our own clinical practices â continue to overlook, misunderstand, or under-treat the pain that disproportionately affects women.
CLINICAL: 2 POINTS
Major depression and the biological hallmarks of aging
Major depressive disorder (MDD) is characterized by psychological and physiological manifestations contributing to the disease severity and outcome. In recent years, several lines of evidence have suggested that individuals with MDD have an elevated risk of age-related adverse outcomes across the lifespan. This review provided evidence of a significant overlap between the biological abnormalities in MDD and biological changes commonly observed during the aging process (i.e., hallmarks of biological aging). Based on such evidence, we formulate a mechanistic model showing how abnormalities in the hallmarks of biological aging can be a common denominator and mediate the elevated risk of age-related health outcomes commonly observed in MDD. Finally, we proposed a roadmap for novel studies to investigate the intersection between the biology of aging and MDD, including the use of geroscience-guided interventions, such as senolytics, to delay or improve major depression by targeting biological aging.
CLINICAL: 2 POINTS
Menopause and the workplace: consensus recommendations from The Menopause Society
Menopause is a natural life transition experienced by half the worldâs population. Women aged 50 years and older are the fastest growing demographic group in many countries, making essential contributions to the workforce. Although menopause is a universal and natural life transition, the symptom experience is highly variable among women. Some women may experience few or no symptoms, whereas others may be bothered by moderate to severe symptoms for a decade or longer, which can adversely affect quality of life, relationships, job satisfaction, and career advancement.
CLINICAL: 2 POINTS
Metaflammation in obesity and its therapeutic targeting
Obesity-associated inflammation is a systemic process that affects all metabolic organs. Prominent among these is adipose tissue, where cells of the innate and adaptive immune system are markedly changed in obesity, implicating these cells in a range of processes linking immune memory to metabolic regulation. Furthermore, weight loss and weight cycling have unexpected effects on adipose tissue immune populations. Here, we review the current literature on the roles of various immune cells in lean and obese adipose tissue. Within this context, we discuss pharmacological and nonpharmacological approaches to obesity treatment and their impact on systemic inflammation.
CLINICAL: 2 POINTS
Mitochondria in skin health, ageing, and disease
The skin is a high turnover organ, and its constant renewal depends on the rapid proliferation of its progenitor cells. The energy requirement for these metabolically active cells is met by mitochondrial respiration, an ATP generating process driven by a series of protein complexes collectively known as the electron transport chain (ETC) that is located on the inner membrane of the mitochondria. However, reactive oxygen species (ROS) like superoxide, singlet oxygen, peroxides are inevitably produced during respiration and disrupt macromolecular and cellular structures if not quenched by the antioxidant system.
CLINICAL: 2 POINTS
Social Robots for the Care of Persons with Dementia: A Systematic Review
Intelligent assistive robots can enhance the quality of life of people with dementia and their caregivers. They can increase the independence of older adults, reduce tensions between a person with dementia and their caregiver, and increase social engagement. This article provides a review of assistive robots designed for and evaluated by persons with dementia. Assistive robots that only increased mobility or brain-computer interfaces were excluded.
CLINICAL: 2 POINTS
Photoprotection for Skin of Color
Photoprotection behaviors can mitigate skin damage caused by ultraviolet radiation, and common methods include seeking shade, avoiding sun exposure during peak daylight hours, wearing sun-protective clothing, applying sunscreen, and using sunglasses. While the role of sun protection in preventing sunburns, photoaging, and skin cancer is well established in fair-skinned populations, individuals with skin of color (SOC) are presumed to suffer fewer negative effects from solar radiation.
CLINICAL: 2 POINTS
CHOLERA OUTBREAK IN SOUTH AFRICA
Since the last update on 28 February 2023, four new cholera cases have been reported. All new cases were detected in Gauteng Province over the last week, and have been classified as indigenous cases; none reported recent travel (international or local) and there was no evidence of a direct link to imported cases. Three of the new cases are in the City of Johannesburg and are adults who participated in the same traditional healing ritual. One case is in Ekhurhuleni: a 10-year-old child with no history of travel and no apparent links to other cases. All new cases are recovering.
CLINICAL: 2 POINTS
The Role of Glucagon-Like Peptide-1 Receptor Agonists (GLP-1 RA) in Diabetes-Related Neurodegenerative Diseases
Recent clinical guidelines have emphasized the importance of screening for cognitive impairment in older adults with diabetes, however, there is still a lack of understanding about the drug therapy. Glucagon-like peptide 1 receptor agonists (GLP-1 RAs) are widely used in the treatment of type 2 diabetes and potential applications may include the treatment of obesity as well as the adjunctive treatment of type 1 diabetes mellitus in combination with insulin.
CLINICAL: 2 POINTS
The effect of vitamin D supplementation on depressive symptoms in adults: A systematic review and metaâanalysis of randomized controlled trials
Neurosteroid and immunological actions of vitamin D may regulate depression-linked physiology. Metaâanalyses investigating the effect of vitamin D on depression have been inconsistent. This meta-analysis investigated the efficacy of vitamin D in reducing depressive symptoms among adults in randomized placebo-controlled trials (RCT). General and clinical populations, and studies of ill individuals with systemic diseases were included. Light therapy, co-supplementation (except calcium) and bipolar disorder were exclusionary.
CLINICAL: 2 POINTS
Existential Suffering in Palliative Care: An Existential Positive Psychology Perspective
The COVID-19 pandemic has exposed the inadequacies of the current healthcare system and needs a paradigm change to one that is holistic and community based, illustrated by the healing wheel. The present paper proposes that existential positive psychology (PP 2.0) represents a promising approach to meet the rising needs in palliative care. This framework has a twofold emphasis on (a) how to transcend and transform suffering as the foundation for wellbeing and (b) how to cultivate our spiritual and existential capabilities to achieve personal growth and flourishing.
CLINICAL: 2 POINTS
Effects and safety of the combination of platelet-rich plasma (PRP) and hyaluronic acid (HA) in the treatment of knee osteoarthritis: a systematic review and meta-analysis
Studies have shown that the combined application of hyaluronic acid (HA) and platelet-rich plasma (PRP) can repair degenerated cartilage and delay the progression of knee osteoarthritis (KOA). The purpose of this study was to explore the efficacy and safety of the intra-articular injection of PRP combined with HA compared with the intra-articular injection of PRP or HA alone in the treatment of KOA
CLINICAL: 2 POINTS
New Therapeutic Horizons for Gravesâ Hyperthyroidism
Gravesâ hyperthyroidism is characterized by the presence of autoantibodies that stimulate the thyâ roid-stimulating hormone receptor (TSHR), resulting in uncontrolled secretion of excessive thyâ roid hormone. Conventional treatments, including antithyroid medication, radioiodine, or surgeryhave remained largely unchanged for the past 70 years and either lack efficacy for many patients,or result in lifelong thyroid hormone replacement therapy, in the case of the latter 2 options.
CLINICAL: 2 POINTS
Light therapy for preventing seasonal active disorder (Review)
Seasonal a+ective disorder (SAD) is a seasonal pattern of recurrent major depressive episodes that most commonly occurs during autumn or winter and remits in spring. The prevalence of SAD ranges from 1.5% to 9%, depending on latitude. The predictable seasonal aspect of SAD provides a promising opportunity for prevention. This review â one of four reviews on e+icacy and safety of interventions to prevent SAD â focuses on light therapy as a preventive intervention.
CLINICAL: 2 POINTS
Health effects of voluntary exposure to cold water â a continuing subject of debate
This review is based on a multiple database survey on published literature to determine the effects on health following voluntary exposure to cold-water immersion (CWI) in humans. After a filtering process 104 studies were regarded relevant. Many studies demonstrated significant effects of CWI on various physiological and biochemical parameters.
ETHICS: 2 POINTS
Multiple sclerosis
Multiple sclerosis (MS) is one of the most common neurological disorders. It has the potential to disable the brain and spinal cord, meaning the central nervous system. MS affects almost 2.1 million people worldwide.
ETHICS: 1 POINTS
Supplemental parenteral nutrition in cancer care: why, who, when
Malnutrition is an often-overlooked challenge for patients with cancer. It is associated with muscle mass reduction, poor compliance and response to cancer treatments, decreased quality of life, and reduced survival time. The nutritional assessment and intervention should be a vital part of any comprehensive cancer treatment plan.
CLINICAL: 3 POINTS
Parenteral nutrition with fish oil-based lipid emulsion reduces the risk of cholestasis in preterm infants
Preterm infants receive long-term parenteral nutrition (PN) for gastrointestinal immaturity. This study aimed to determine if mixed lipid emulsions containing fish oil decrease the incidence of PN-associated cholestasis by reducing oxidative stress and providing an anti-inflammatory effect.
CLINICAL: 3 POINTS
Growth and Clinical Outcome in Very Low-Birth-Weight Infants After the Introduction of a Multicomponent Intravenous Lipid Emulsion
Very low-birth-weight (VLBW; birth weight<1500 g) infants are often dependent on intravenous nutrition after birth. Conventional soy-based intravenous lipid emulsions (Soy LE) are associated with inflammatory and metabolic complications that may be harmful to preterm infants. Evidence to support any clinical benefit associated with newer multicomponent emulsions (Mixed LE), remains inconsistent and unsubstantiated in appropriate studies. This retrospective study aimed to determine whether growth and clinical outcomes differed between VLBW infants given Mixed LE vs Soy LE at Auckland City Hospital. CLINICAL: 3 POINTS
Association between early postoperative nutritional supplement utilisation and length of stay in malnourished hip fracture patients
Malnutrition in older hip fracture patients is associated with increased complication rates and mortality. As postoperative nutrition delivery is essential to surgical recovery, postoperative nutritional supplements, including oral nutritional supplements or tube feeding formulas, can improve postoperative outcomes in malnourished hip/femur fracture patients. The association between early postoperative nutritional supplements utilisation and hospital length of stay was assessed in malnourished hip/femur fracture patients.
ETHICS: 3 POINTS
Glutamine for Amelioration of Radiation and Chemotherapy Associated Mucositis during Cancer Therapy
Health promotion is an effective tool for public health. It goes beyond preventing the spread of diseases and reducing the disease burden. It includes interventions encompassing the creation of supportive environments, building public health policy, developing personal skills, reorienting health services and strengthening multisectoral community actions.
CLINICAL: 3 POINTS
Effect of Early vs Late Supplemental Parenteral Nutrition in Patients Undergoing Abdominal Surgery
The effect of and optimal timing for initiating supplemental parenteral nutrition (SPN) remain unclear after major abdominal surgery for patients in whom energy targets cannot be met by enteral nutrition (EN) alone.
CLINICAL: 3 POINTS
Effects of glutamine supplementation on critically ill patients: Focus on efficacy and safety. An overview of systematic reviews
The aim of this overview of systematic reviews was to synthesise, appraise, and present all systematic review (SR) evidence on the clinical efficacy of glutamine administration to severely ill patients. Medline, Scopus, the Cochrane Library, and Prospero were searched up to March 2020. Systematic reviews and meta-analyses of randomised controlled trials published in English, comparing immunomodulating dietsâcontaining exclusively glutamineâwith standard diets for critically ill adult patients were selected.
ETHICS: 3 POINTS
Examples of ethics articles available once registered
The POPI Act and the laboratory
The POPI Act is essentially an act which protects people from harm by protecting their personal information. The act regulates the flow of information and sets out a code of conduct pertaining to how personal information is collected, handled, distributed and stored and eventually discarded. The POPI Act sets out the minimum standards regarding accessing and âprocessingâ of any personal information belonging to another. The Act defines âprocessingâ as collecting, receiving, recording, organising, retrieving, the use, distribution or sharing of any such information.
ETHICS: 2 POINTS
Video versus Direct Laryngoscopy for Tracheal Intubation of Critically Ill Adults
Whether video laryngoscopy as compared with direct laryngoscopy increases the likelihood of successful tracheal intubation on the first attempt among critically ill adults is uncertain.
ETHICS: 2 POINTS
What We Have Learned from Two Decades of Epidemics and Pandemics: A Systematic Review and Meta-Analysis of the Psychological Burden of Frontline Healthcare Workers
In light of the current coronavirus disease 2019 (COVID-19) pandemic and potential future infectious disease outbreaks, a comprehensive understanding of the negative effects of epidemics and pandemics on healthcare workersâ mental health could inform appropriate support interventions. Thus, we aimed to synthesize and quantify the psychological and psychosomatic symptoms among frontline medical staff.
ETHICS: 2 POINTS
Prevalence of Discrimination, Abuse, and Harassment in Emergency Medicine Residency Training in the US
The prevalence of workplace mistreatment and its association with the well-being of emergency medicine (EM) residents is unclear. More information about the sources of mistreatment might encourage residency leadership to develop and implement more effective strategies to improve professional well-being not only during residency but also throughout the physicianâs career. To examine the prevalence, types, and sources of perceived workplace mistreatment during training among EM residents in the US and the association between mistreatment and suicidal ideation.
ETHICS: 2 POINTS
Gender Differences in Experiences of Leadership Emergence Among Emergency Medicine Department Chairs
The number of women entering medicine continues to increase, but women remain underrepresented at all tiers of academic rank and chair leadership in EM. The proportion of female chairs in EM has not exceeded 12% in 2 decades.
ETHICS: 2 POINTS
Burnout, Drop Out, Suicide: Physician Loss in Emergency Medicine, Part I
Each year more than 400 physicians take their lives, likely related to increasing depression and burnout. Burnoutâa psychological syndrome featuring emotional exhaustion, depersonalization, and a reduced sense of personal accomplishmentâis a disturbingly and increasingly prevalent phenomenon
in healthcare, and emergency medicine (EM) in particular.
ETHICS: 2 POINTS
Ethical considerations at the end-of-life care
The goal of end-of-life care for dying patients is to prevent or relieve suffering as much as possible while respecting the patientsâ desires. However, physicians face many ethical challenges in end-of-life care. Since the decisions to be made may concern patientsâ family members and society as well as the patients, it is important to protect the rights, dignity, and vigor of all parties involved in the clinical ethical decision-making process. Understanding the principles underlying biomedical ethics is important for physicians to solve the problems they face in end-of-life care.
ETHICS: 3 POINTS
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