American Journal of Medicine最新文献

{"title":"Dexterity and Bimanual Coordination, Cognitive Function, Mental and Cognitive Wellbeing in People with Young Onset Dementia: A Case-Control Study.","authors":"Ethan C J Berry, Nilihan E M Sanal-Hayes, Nicholas F Sculthorpe, Sowmya Munishankar, Debbie Tolson, Lawrence D Hayes","doi":"10.1016/j.amjmed.2025.05.034","DOIUrl":"https://doi.org/10.1016/j.amjmed.2025.05.034","url":null,"abstract":"<p><strong>Background: </strong>Dexterity and bimanual coordination, cognitive function, and mental and cognitive wellbeing had not previously been examined in people with young onset dementia. Therefore, this study examined dexterity and bimanual coordination, cognitive function, and mental and cognitive wellbeing in people with young onset dementia (n=16), and age-matched healthy controls (n=17).</p><p><strong>Methods: </strong>Both groups completed the Purdue Pegboard Test (dexterity and bimanual coordination), Addenbrooke's Cognitive Examination III (ACE-III; cognitive function), General Anxiety Disorder-7 (GAD-7; general anxiety), Generic health-related quality of life measures (EQ-5D-3L; overall health), General Self-Efficacy Scale (GSE; self-efficacy), Patient Health Questionnaire (PHQ-9; depression) and The Pittsburgh Sleep Quality Index (PSQI; sleep quality).</p><p><strong>Results: </strong>The main findings of the present investigation were that people with young onset dementia displayed poorer dexterity and bimanual coordination, generic health-related quality of life analogue and generic self-efficacy compared to age-matched healthy controls. However, people with young onset dementia and age-matched healthy controls were comparable for anxiety, depression, generic health-related quality of life index, and sleep quality index.</p><p><strong>Conclusion: </strong>This study highlights differences in dexterity and bimanual coordination, quality of life, and self-efficacy between people with young onset dementia and controls. People with young onset dementia exhibited poorer dexterity, generic health-related quality of life analogue, and self-efficacy. The study highlights the potential impacts of young onset dementia on dexterity, health-related quality of life, and self-efficacy. More longitudinal research is needed to assess the time course of this impact and explore support strategies.</p>","PeriodicalId":50807,"journal":{"name":"American Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235847","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":"Sleep quality and outcomes in preclinical heart failure: a prospective UK Biobank cohort study.","authors":"Fang Zhu, Joseph J Shearer, Jungnam Joo, Rui Miao, Jason Y Y Wong, Gabriel Goodney, Jungeun Lim, Maryam Hashemian, Gretell Henríquez-Santos, Ji-Eun Kim, Sadiya S Khan, Philip Greenland, Véronique L Roger","doi":"10.1016/j.amjmed.2025.05.037","DOIUrl":"https://doi.org/10.1016/j.amjmed.2025.05.037","url":null,"abstract":"<p><strong>Background: </strong>Prevention is crucial in reducing heart failure (HF) morbidity and mortality. The American Heart Association guideline emphasizes the progression from preclinical to clinical HF, yet the association between sleep and outcomes in preclinical HF remains unexplored.</p><p><strong>Objectives: </strong>To examine sleep quality in a large cohort of preclinical HF, and assess its association with clinical HF and mortality risk.</p><p><strong>Methods: </strong>Using UK Biobank data from 2006-2010, we identified individuals with preclinical HF (Stage A/B). We examined self-reported sleep characteristics (duration, chronotype, insomnia, snoring, daytime sleepiness) individually and combined into a sleep quality score. Participants were followed until 2021 for clinical HF (Stage C/D) or death. Cox proportional hazard models assessed the relationship between sleep quality and clinical HF or mortality, accounting for competing risks. Interaction effects between sleep, sex, and deprivation were explored.</p><p><strong>Results: </strong>Among 311,446 preclinical HF participants (mean age 57.5 years, 49% men), sleep quality was categorized as healthy (35%), intermediate (60%), and poor (5%). Over a median 12-year follow-up, 10,780 clinical HF events and 24,996 deaths occurred. Poor sleep quality was associated with a higher risk of clinical HF (HR: 2.03; 95% CI: 1.79-2.31 in women, HR: 1.55; 95% CI: 1.41-1.71 in men). Deprivation was associated with higher HF risk across all sleep categories (P<0.01).</p><p><strong>Conclusions: </strong>Low-quality sleep was prevalent and associated with a higher risk of clinical HF and death, especially in women. Deprivation was linked to worse outcomes in both sexes. These findings highlight an opportunity to improve preclinical HF outcomes by addressing sleep quality.</p>","PeriodicalId":50807,"journal":{"name":"American Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144227484","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":"Association of cancer and anti-synthetase syndrome: a retrospective multicentre study.","authors":"Laura Bucy, Hervé Devilliers, Paul Decker, Florian Manneville, Bernard Bonnotte, Bruno Ribeiro Baptista, Anne Guillaumot, Philippe Bonniaud, Jean Francis Maillefert, Alain Meyer, Amelie Servettaz, Julien Campagne, Nadine Magy-Bertrand, Roland Jaussaud, Thomas Moulinet","doi":"10.1016/j.amjmed.2025.05.042","DOIUrl":"https://doi.org/10.1016/j.amjmed.2025.05.042","url":null,"abstract":"<p><strong>Objectives: </strong>We aimed to assess the incidence of cancer associated myositis among patients with anti-synthetase syndrome, identify factors associated with cancer associated myositis, and its impact on prognosis.</p><p><strong>Methods: </strong>We conducted a retrospective multicentre study, including adult patients with anti-synthetase syndrome. Factors associated with cancer were assessed using a multivariable logistic regression model. Unsupervised analysis was used to identify a cluster of patients associated with cancer. Cox proportional hazard ratio model was used to assess impact of cancer associated myositis on mortality.</p><p><strong>Results: </strong>Among the 122 patients included, 14 (11.4%) met cancer associated myositis criteria. Standardised incidence ratio was 5.4 (5.14 to 5.65, p < 0.0001). Patients with cancer associated myositis were older, had more often a history of cancer, had lower creatine kinase (CK) level and less muscular weakness. They had a significantly worse overall survival compared to those without (log-rank test χ² = 16.2, p < 0.0001)). Age and history of cancer were independently associated with cancer associated myositis. Patients with cancer associated myositis segregated within a cluster characterized by an older age, a milder muscular involvement, and less Jo-1 antibodies. Finally, cancer associated myositis was an independent predictor of death.</p><p><strong>Conclusion: </strong>Cancer associated myositis is not rare in anti-synthetase syndrome with higher incidence compared to general population. Due to its higher mortality, cancer should be carefully screened, especially in older patients with history of cancer.</p>","PeriodicalId":50807,"journal":{"name":"American Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217465","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":"Skin Deep: A Narrative Case Series and Review of Cutaneous Vasculitis and Possible Doppelgängers.","authors":"Gabriel Kirsch, Cristine Arcilla, Maya Khasho, Gurjit S Kaeley","doi":"10.1016/j.amjmed.2025.05.043","DOIUrl":"https://doi.org/10.1016/j.amjmed.2025.05.043","url":null,"abstract":"<p><p>Cutaneous vasculitis presents with a wide variety of lesions. These may occur in systemic vasculitis, represent isolated cutaneous vasculitis, or signal mimickers arising from non-rheumatologic etiologies, highlighting the importance of a broad differential diagnosis. The consumption of recreational drugs and various adulterants has been increasingly recognized for their cutaneous manifestations that may mimic a vasculitic lesion. This combination review and case series highlights the vascular anatomy of the skin and a suggested clinical approach when evaluating vasculitic-appearing lesions through four vignettes.</p>","PeriodicalId":50807,"journal":{"name":"American Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144210148","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":"Malignant pleural effusion as a presentation of recurrent penile squamous cell carcinoma.","authors":"Eamon P McCarron, Joanne Jooste, Aisling Fegan, Jenson Daniel, Darren Brady, Jason Wieboldt","doi":"10.1016/j.amjmed.2025.05.041","DOIUrl":"https://doi.org/10.1016/j.amjmed.2025.05.041","url":null,"abstract":"","PeriodicalId":50807,"journal":{"name":"American Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200753","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":"Isolated diabetic third cranial palsy with MRI enhancement.","authors":"Amlan Kusum Datta, Anirban Majhi","doi":"10.1016/j.amjmed.2025.05.040","DOIUrl":"https://doi.org/10.1016/j.amjmed.2025.05.040","url":null,"abstract":"","PeriodicalId":50807,"journal":{"name":"American Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200752","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":"Unilateral Parotid Swelling and Multiple Lymphadenopathy.","authors":"Xinyi Liu, Yanchun Zhou, Weiwei Bian","doi":"10.1016/j.amjmed.2025.05.036","DOIUrl":"https://doi.org/10.1016/j.amjmed.2025.05.036","url":null,"abstract":"","PeriodicalId":50807,"journal":{"name":"American Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144192468","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":"Patient Simulation-Based Primary Care Training to Increase Evidence-Based COPD Care and Value-Based Success: Real-World Cost and Quality Impact Analysis.","authors":"Bruce Muma, Courtland Keteyian, David Kolde, Sean Drake, Diane George, Michael Foust, Steven Fried, Jodie Elsberg, Sharon Thomas, Lily Johnston, Alan Kulawczyk, David Paculdo, Isabella Cooney, John Peabody, Trever Burgon","doi":"10.1016/j.amjmed.2025.05.032","DOIUrl":"https://doi.org/10.1016/j.amjmed.2025.05.032","url":null,"abstract":"","PeriodicalId":50807,"journal":{"name":"American Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144188455","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":"Higher Risk of Kidney Failure Associated with Angiotensin Receptor Blockers Versus ACE Inhibitors in Patients with Heart Failure.","authors":"Hans J Moore, Wen-Chih Wu, Paul A Heidenreich, Patrick Rossignol, Samir S Patel, Frederick Lu, Phillip H Lam, Amiya A Ahmed, Charles Faselis, Javed Butler, Carlos E Palant, Bertram Pitt, Matthew R Weir, Prakash Deedwania, David Atkins, Venkatesh K Raman, Janani Rangaswami, Jose D Vargas, Sijian Zhang, Charity J Morgan, Helen M Sheriff, Qing Zeng-Treitler, Gregg C Fonarow, Ali Ahmed","doi":"10.1016/j.amjmed.2025.05.024","DOIUrl":"https://doi.org/10.1016/j.amjmed.2025.05.024","url":null,"abstract":"<p><strong>Background: </strong>Renin-angiotensin system (RAS) inhibition with angiotensin-covering enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) is associated with a lower risk of kidney failure in patients with heart failure. We examined whether this association varies between ACEIs and ARBs.</p><p><strong>Methods: </strong>From 300,361 Veterans with heart failure without kidney failure initiated on ACEIs (n=256,224) or ARBs (n=44,137), we assembled a propensity score-matched cohort of 88,178 patients while remaining blinded to study outcomes. Hazard ratio (95% CI) for 5-year kidney failure in patients in the ARB group was estimated. Kidney failure was defined as receipt of kidney replacement therapy or persistent drop in baseline estimated glomerular filtration rate (eGFR) to <15 mL/min/1.73m².</p><p><strong>Results: </strong>Matched patients had mean age 71 years, ejection fraction 44%, eGFR 70 mL/min/1.73m², 97% were male, 18% African American, 23% received ACEIs or ARBs in high doses, and were balanced on 76 baseline characteristics. Kidney failure occurred in 4.4% (1961/44,089) and 5.4% (2389/44,089) of the patients in the ACEI and ARB groups, respectively. When accounted for the competing risk of death, patients in the ARB group had a 20% (95% CI, 13-28%) higher risk of kidney failure, which was similar in low-dose and high-dose subgroups. The associated risk of death was 5% (95% CI, 3-7%) lower in the ARB group, which was only significant in the low-dose group (7% vs 0%; interaction p, 0.007).</p><p><strong>Conclusion: </strong>In patients with heart failure, ARBs (vs. ACEIs) are associated with a higher risk of incident kidney failure. These findings need to be confirmed in future clinical trials.</p>","PeriodicalId":50807,"journal":{"name":"American Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152826","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":"Leveraging Medical Licensure for Safer Artificial Intelligence Use in Health Care.","authors":"D Douglas Miller, M Vinayak Kamath, John Albers, David C Hess","doi":"10.1016/j.amjmed.2025.05.012","DOIUrl":"https://doi.org/10.1016/j.amjmed.2025.05.012","url":null,"abstract":"","PeriodicalId":50807,"journal":{"name":"American Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152827","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}