Gout, the most common inflammatory arthritis in developed countries, can lead to deformities and disabilities, significantly affecting quality of life. Primary care physicians (PCPs) play a crucial role in its management and must adhere to recent guidelines. This study assessed PCPs’ knowledge and adherence to gout treatment recommendations in Saudi Arabia using a questionnaire survey. A total of 367 PCPs completed the survey, with 86.4% practicing in Saudi Arabia. The respondents included general physicians (53.1%) and family physicians (49.9%), with a nearly equal gender distribution. For acute gout management, 25.34% recommended nonsteroidal anti-inflammatory drugs combined with corticosteroids. Colchicine was considered safe by 69.8% of participants. Knowledge of urate-lowering therapy was suboptimal, with only 7.9% correctly identifying the appropriate initiation timing and 43.1% recognizing the target serum uric acid (SUA) level. While 74.1% recommended modifying therapy if the SUA target was unmet, only 32% advocated for long-term urate-lowering therapy. Additionally, 18% correctly identified the proper time to measure SUA levels. Lifestyle modifications were acknowledged by 57.2%, and 55% recognized the cardiovascular risks associated with gout. Overall, PCPs demonstrated poor compliance with gout management guidelines. Strategies to improve adherence include continuing medical education, disease-management websites, and smartphone apps. Rheumatologists should serve as key resources for PCPs, providing education through consultations, formal training, and conference presentations.
Background/Objectives: Migraine and chronic obstructive pulmonary disease (COPD) are both common chronic conditions that may share underlying pathophysiological mechanisms despite presenting with distinct clinical features. Understanding the association between these two conditions could enhance treatment strategies and improve patient outcomes. This review aims to evaluate the relationship between COPD and migraine, highlighting shared risk factors and identifying gaps in the existing literature. Methods: A search was conducted across four electronic databases (PubMed, Ovid Medline, ScienceDirect, and Web of Science) following PRISMA guidelines up to January 2024. The search identified 85 studies, of which five met the inclusion criteria: observational studies, cohort studies, case–control studies, and randomized controlled trials examining the association between migraine and COPD. Studies not published in English and irrelevant study designs were excluded. The risk of bias was assessed using the JBI Critical Appraisal Tool, which evaluated aspects such as study design, participant selection, measurement methods, and the handling of confounding factors. Results: The review included five studies comprising 184,817 patients. All studies identified a significant association between COPD and migraine, with varying methodologies for diagnosing the conditions. Notably, COPD patients had an increased risk of migraine compared to controls, and migraine patients also demonstrated a higher risk of developing COPD. However, the evidence was marked by high heterogeneity and potential confounding factors. Conclusions: The findings suggest a significant association between COPD and migraine, potentially driven by shared mechanisms such as systemic inflammation. However, the predominance of cross-sectional studies limits causal inference. Future research should prioritize longitudinal studies to clarify the directionality and causality of the relationship between COPD and migraine while thoroughly addressing potential confounding factors.
Background/Objectives: Upper extremity deep vein thrombosis (UEDVT) is a harmful complication of elective upper limb surgeries. Different strategies are employed to prevent this condition. The aim of the review is to quantify the effectiveness of various preventive interventions and investigate correlated factors that affect the incidence of UEDVT (upper extremity deep vein thrombosis). Methods: We performed a systematic search using the PubMed, EBSCO, Ovid, EMBASE, Cochrane, and Google Scholar databases. Randomized controlled trials (RCTs), prospective or retrospective cohort studies, or case–control studies were examined. We included adult patients over 18 years old undergoing elective upper limb surgery and receiving Prophylactic measures for Upper Extremity Deep Venous Thrombosis. Results: After a literature search and quality assessment, 6 studies were included. All the studies were of good quality but significantly heterogeneous in terms of sample size, population size, treatment modalities, and baseline characteristics. In these studies, the reported incidence of symptomatic venous thromboembolism (VTE) varied widely, ranging from 0.41% to 13%. However, thromboprophylaxis did not have a significant impact on the rates of deep vein thrombosis (DVT). Certain factors such as older age and trauma as the cause of surgery were identified as notable risk factors for symptomatic VTE. Conclusions: This systematic review highlights the complexity of preventing upper extremity deep vein thrombosis (UEDVT) following elective upper limb surgeries. The reported incidence of symptomatic VTE varies considerably across studies, and thromboprophylaxis was not associated with a significant reduction in its rates. The evidence is characterized by substantial heterogeneity in patient populations and surgical contexts. More research is needed to better understand the role of thromboprophylaxis in preventing DVT.