{"title":"Recurrent polychondritis associated with rheumatoid arthritis and ataxia unresponsive to TNF-alpha blockers and JAK inhibitors.","authors":"Josef Finsterer","doi":"10.1016/j.amjmed.2025.08.046","DOIUrl":"10.1016/j.amjmed.2025.08.046","url":null,"abstract":"","PeriodicalId":50807,"journal":{"name":"American Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144977544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Cardiovascular Care in Rural America: Challenges, Insights, and Strategies for Meaningful Improvement.","authors":"Muhammad Ajmal, Ayesha Javed, Michel T Corban","doi":"10.1016/j.amjmed.2025.09.004","DOIUrl":"https://doi.org/10.1016/j.amjmed.2025.09.004","url":null,"abstract":"","PeriodicalId":50807,"journal":{"name":"American Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145182387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Arielle Sabbah, Henri Sasseville, Laurel Walfish, Ivan George Fantus
{"title":"Case Report: Continuous Glucose Monitoring in Insulinoma Diagnosis and Management.","authors":"Arielle Sabbah, Henri Sasseville, Laurel Walfish, Ivan George Fantus","doi":"10.1016/j.amjmed.2025.09.007","DOIUrl":"https://doi.org/10.1016/j.amjmed.2025.09.007","url":null,"abstract":"","PeriodicalId":50807,"journal":{"name":"American Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145182402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tzlil Grinberg, Yaron Aviv, Arthur Shiyovich, Daniella Vronsky, Tsahi T Lerman, Nili Schamroth Pravda, Jenan Awesat, Daniel Monakier, Sara Hoss, Gideon Shafir, Maya Wiessman, Ran Kornowski, Ashraf Hamdan
{"title":"Coronary Artery Disease Characterization and Plaque Morphology in Patients with Hypertrophic Cardiomyopathy.","authors":"Tzlil Grinberg, Yaron Aviv, Arthur Shiyovich, Daniella Vronsky, Tsahi T Lerman, Nili Schamroth Pravda, Jenan Awesat, Daniel Monakier, Sara Hoss, Gideon Shafir, Maya Wiessman, Ran Kornowski, Ashraf Hamdan","doi":"10.1016/j.amjmed.2025.08.047","DOIUrl":"https://doi.org/10.1016/j.amjmed.2025.08.047","url":null,"abstract":"<p><strong>Introduction: </strong>The prevalence of coronary artery disease and plaque characteristics in patients with hypertrophic cardiomyopathy have not been fully evaluated. We aimed to assess the incidence of coronary artery disease, plaque morphology, and plaque burden in patients with hypertrophic cardiomyopathy compared to non-hypertrophic cardiomyopathy subjects.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study involving consecutive patients with hypertrophic cardiomyopathy and controls referred for coronary CTA to evaluate stable chest pain. CTA was assessed using the Coronary Artery Disease Reporting and Data System (CAD-RADS) 2.0, with quantitative plaque analysis performed using dedicated software.</p><p><strong>Results: </strong>A total of 925 patients were included: 137 (15%) with hypertrophic cardiomyopathy and 788 (85%) controls. In multivariable analysis, hypertrophic cardiomyopathy was associated with a 78% lower likelihood of obstructive coronary artery disease (≥50% luminal stenosis) (adjusted OR 0.22, 95% CI 0.11-0.43, P<0.001). After propensity score-matching (n=270), obstructive coronary artery disease remained significantly less prevalent in hypertrophic cardiomyopathy patients compared to matched controls (9.6% vs. 30.4%; P<0.001). High-risk plaque rate was lower among hypertrophic cardiomyopathy patients (10.4% vs. 20%, P=0.003), as was overall plaque burden (CAD-RADS ≥P3) (19.3% vs. 34.1%, P=0.006). At 1-year follow-up, percutaneous coronary intervention rate was lower in hypertrophic cardiomyopathy patients (3% vs. 11.9%, P=0.005), with no differences in death and stroke.</p><p><strong>Conclusion: </strong>Among hypertrophic cardiomyopathy patients undergoing CTA for stable chest pain, a lower incidence of obstructive coronary artery disease and more stable coronary plaque features were observed compared to controls.</p>","PeriodicalId":50807,"journal":{"name":"American Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145182384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Stem Cell Therapy Option For Parkinson's Disease.","authors":"Eli Y Adashi, Daniel P O'Mahony, I Glenn Cohen","doi":"10.1016/j.amjmed.2025.09.012","DOIUrl":"https://doi.org/10.1016/j.amjmed.2025.09.012","url":null,"abstract":"","PeriodicalId":50807,"journal":{"name":"American Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145182422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mushood Ahmed, Jamal S Rana, Raheel Ahmed, Gregg C Fonarow
{"title":"Oral anticoagulant monotherapy in patients with chronic coronary disease: An updated meta-analysis.","authors":"Mushood Ahmed, Jamal S Rana, Raheel Ahmed, Gregg C Fonarow","doi":"10.1016/j.amjmed.2025.09.019","DOIUrl":"https://doi.org/10.1016/j.amjmed.2025.09.019","url":null,"abstract":"<p><strong>Background: </strong>The optimal antithrombotic strategy for patients with chronic coronary disease requiring long-term anticoagulation remains uncertain. While dual therapy with oral anticoagulants (OACs) and antiplatelet agents is common, it significantly increases bleeding risk. This meta-analysis was conducted to compare the efficacy and safety of OAC monotherapy against combination therapy.</p><p><strong>Methods: </strong>We searched PubMed, Embase, ClinicalTrials.gov, and Cochrane library through August 2025 to identify randomized controlled trials (RCTs) comparing OAC monotherapy to dual therapy (OAC plus a single antiplatelet agent) in patients with chronic coronary disease. The primary outcome was a composite of cardiovascular death, stroke, myocardial infarction, and major bleeding.</p><p><strong>Results: </strong>Five RCTs with 4964 participants were included. OAC monotherapy was associated with a significantly lower risk of the primary composite outcome (RR: 0.68, 95% CI: 0.53-0.85). The risks of all-cause death, cardiovascular death, myocardial infarction, stroke, and systemic embolism were comparable between the two groups. OAC monotherapy significantly reduced the risk of major bleeding (RR: 0.49, 95% CI: 0.31-0.77) and major or clinically relevant non-major bleeding (RR: 0.51, 95% CI: 0.38-0.68).</p><p><strong>Conclusions: </strong>In patients with chronic coronary disease requiring long-term anticoagulation, OAC monotherapy reduces bleeding complications without increasing the risk of ischemic events compared to dual therapy. These findings support the use of a simplified antithrombotic strategy without antiplatelet therapy in this patient population.</p>","PeriodicalId":50807,"journal":{"name":"American Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145182413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kimiya R Aframian, Arash Pour Mohammad, Alina S Feng, Gordon H Bae
{"title":"Multiple Dermal Nodules and Progressive Neurological Symptoms in an Immunocompetent Patient.","authors":"Kimiya R Aframian, Arash Pour Mohammad, Alina S Feng, Gordon H Bae","doi":"10.1016/j.amjmed.2025.09.010","DOIUrl":"https://doi.org/10.1016/j.amjmed.2025.09.010","url":null,"abstract":"","PeriodicalId":50807,"journal":{"name":"American Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145180238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cole G Chapman, Philip M Polgreen, Manish Suneja, Barry L Carter, Linnea A Polgreen
{"title":"Association of Documented High Blood Pressure Measurements with Time to Hypertension Diagnosis.","authors":"Cole G Chapman, Philip M Polgreen, Manish Suneja, Barry L Carter, Linnea A Polgreen","doi":"10.1016/j.amjmed.2025.09.024","DOIUrl":"10.1016/j.amjmed.2025.09.024","url":null,"abstract":"<p><strong>Introduction: </strong>Diagnostic delays contribute to uncontrolled hypertension, leading to increased morbidity, mortality and costs. The goal of this study was to estimate the duration of delays in the diagnosis of hypertension that contribute to uncontrolled hypertension in the US.</p><p><strong>Methods: </strong>We collected data from the electronic health record for University of Iowa Healthcare from 2016-2022 for all patients with any BP record of 130/80 mmHg or greater but without an initial hypertension diagnosis. We used a Cox Proportional Hazards Model to determine the length of diagnostic delay as well as risk factors for delay. We specifically examined the presence of provider notes discussing BP or hypertension.</p><p><strong>Results: </strong>Only 5% of our cohort with BP readings of 130/80 mm Hg or greater were diagnosed with hypertension at the first visit. At one month, 7.4% were diagnosed, 10% within 3 months, increasing to 14% at 12 months. Most patients remained undiagnosed after at 12 months and 75% remained undiagnosed at 5 years. Shorter delays were associated with higher BP values, prior diagnoses of \"high BP, not hypertension\" and prior clinical notes discussing BP or hypertension. Shorter delays were also associated with other cardiovascular diagnoses, primary-care visits and inpatient stays.</p><p><strong>Conclusions: </strong>Our findings highlight the large number of missed opportunities to diagnose hypertension and demonstrate compelling reasons for improving clinical documentation related to high BP readings and increasing primary-care visits.</p>","PeriodicalId":50807,"journal":{"name":"American Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145180225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}