American Journal of Medicine最新文献

{"title":"Unraveling Tuberculosis: An Atypical Tuberculous Presentation.","authors":"Genevieve My Tan, Ying Na Ho, Glenn Kw Yong","doi":"10.1016/j.amjmed.2024.10.014","DOIUrl":"https://doi.org/10.1016/j.amjmed.2024.10.014","url":null,"abstract":"","PeriodicalId":50807,"journal":{"name":"American Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479979","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":"Rethinking Our Roots: The Ground-Up Approach to Heart Health & Planetary Sustainability.","authors":"Ali Saad, Eric J Brandt, Kamil F Faridi, Jeremy W Paster, Sohum Sheth, Andrew M Freeman, Verity Ramirez, Monica Aggarwal","doi":"10.1016/j.amjmed.2024.09.028","DOIUrl":"https://doi.org/10.1016/j.amjmed.2024.09.028","url":null,"abstract":"<p><p>Cardiovascular disease is the leading cause of death in the United States. Poor dietary habits are not only a major modifiable risk factor for cardiovascular disease and other chronic illnesses, but they also harm planetary health. Our food system is complex, shaped by agricultural practices and human behaviors. To change it, we need to understand why current agricultural practices exist and address nutrition education, food insecurity, and nutritional security. There are effective ways to make our food system healthier, more equitable, and more sustainable. The best available evidence points to plant-forward diets as the keystone to this complex issue. This manuscript reviews how human and planetary health are connected through our food system and suggests solutions for diets that prevent and treat cardiovascular disease while promoting planetary health.</p>","PeriodicalId":50807,"journal":{"name":"American Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142394999","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 Four Ts of Mentoring Minorities.","authors":"Smita Pakhale","doi":"10.1016/j.amjmed.2024.10.001","DOIUrl":"10.1016/j.amjmed.2024.10.001","url":null,"abstract":"","PeriodicalId":50807,"journal":{"name":"American Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142395000","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":"Increased Risk of Chronic Respiratory Disease among Individuals with Inflammatory Bowel Disease in a Prospective Cohort Study.","authors":"Lintao Dan, Ying Xie, Tian Fu, Yuhao Sun, Xuejie Chen, Xiaoyan Wang, Chenkai Wu, Jie Chen, Xue Li","doi":"10.1016/j.amjmed.2024.09.001","DOIUrl":"10.1016/j.amjmed.2024.09.001","url":null,"abstract":"<p><strong>Background: </strong>Cross-sectional evidence suggests a higher burden of chronic respiratory diseases in people with inflammatory bowel disease, but there is a lack of prospective evidence to clarify the direction of their associations. We aimed to investigate the association of inflammatory bowel disease with the risk of 2 major chronic respiratory diseases, chronic obstructive pulmonary disease, and asthma.</p><p><strong>Methods: </strong>We included 430,414 participants from UK Biobank and followed them from recruitment (2006-2010) to 2021. Chronic obstructive pulmonary disease and asthma cases were obtained from inpatient data and death register. Using Cox proportional hazards models, we estimated the multivariable-adjusted hazard ratios (HR) of developing chronic obstructive pulmonary disease and asthma in participants with inflammatory bowel disease compared with inflammatory bowel disease-free groups. We also investigated the association among Crohn's disease and ulcerative colitis with the risk of chronic obstructive pulmonary disease and asthma.</p><p><strong>Results: </strong>Over a median follow-up of 11.9 years, there were 11,196 incidents of chronic obstructive pulmonary disease and 9831 asthma cases. The adjusted HRs of developing chronic obstructive pulmonary disease (HR 1.54; 95% confidence interval [CI], 1.33-1.79) and asthma (HR 1.52; 95% CI, 1.29-1.79) were higher for those with inflammatory bowel disease when compared with inflammatory bowel disease-free participants. Participants with Crohn's disease and ulcerative colitis were also found to have a higher risk of chronic obstructive pulmonary disease (Crohn's disease: HR 1.71; 95% CI, 1.36-2.15; ulcerative colitis: HR 1.45; 95% CI, 1.20-1.75) and asthma (Crohn's disease: HR 1.73; 95% CI, 1.33-2.25; ulcerative colitis: HR 1.41; 95% CI, 1.15-1.73) when compared with those free of inflammatory bowel disease.</p><p><strong>Conclusions: </strong>This study suggested that individuals with inflammatory bowel disease have a higher risk of developing chronic obstructive pulmonary disease and asthma, highlighting the importance of preventing chronic respiratory diseases among inflammatory bowel disease patients.</p>","PeriodicalId":50807,"journal":{"name":"American Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142382245","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":"Misconceptions and Facts About Orthostatic Hypotension.","authors":"Chayakrit Krittanawong, Affan Rizwan, Aryan Rezvani, Muzamil Khawaja, Mario Rodriguez, John M Flack, Roland D Thijs, Stephen P Juraschek","doi":"10.1016/j.amjmed.2024.09.032","DOIUrl":"10.1016/j.amjmed.2024.09.032","url":null,"abstract":"<p><p>Orthostatic hypotension is a highly prevalent medical condition that is an independent risk factor for falls and mortality. It reflects a condition in which autonomic reflexes are impaired or intravascular volume is depleted, causing a significant reduction in blood pressure upon standing. This disorder is frequently unrecognized until later in its clinical course. Symptoms like orthostatic dizziness do not reliably identify patients with orthostatic hypotension, who are often asymptomatic, leading further to the difficulty of this diagnosis. We summarize seven clinically important misconceptions about orthostatic hypotension.</p>","PeriodicalId":50807,"journal":{"name":"American Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142382247","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":"Low-Risk Chest Pain Patients: Exploring the Impact of Socioeconomy on Emergency Department Revisits.","authors":"Erik Kadesjö, Love Cyon, Gustaf Edgren, Andreas Roos","doi":"10.1016/j.amjmed.2024.09.033","DOIUrl":"https://doi.org/10.1016/j.amjmed.2024.09.033","url":null,"abstract":"<p><strong>Background: </strong>Patients with chest pain and undetectable high-sensitivity cardiac troponin T (hs-cTnT) in the emergency department (ED) have a low short-term risk of cardiovascular events, but the frequency of ED revisits in this group is unknown. This study investigated the associations between disposable income and risk of ED revisits in patients with chest pain and undetectable hs-cTnT.</p><p><strong>Methods: </strong>All first visits to 7 EDs in Sweden from 2010 to 2017 by patients with chest pain and hs-cTnT <5 ng/l were included. Incidence rate ratios (IRR) were calculated to estimate the ED revisit risk in relation to disposable income according to data obtained from Swedish government agencies (Statistics Sweden).</p><p><strong>Results: </strong>Altogether, 61,539 patients with a first ED visit were included, in whom 126,650 revisits occurred. The adjusted 30-day risk of a revisit was 1.3- (IRR 1.32, 95% CI: 1.23-1.42) and 1.5-fold (IRR 1.50, 95% CI: 1.40-1.60), and for any revisit during the follow-up 1.6- (IRR 1.63, 95% CI: 1.59-1.66) and 1.8-fold (IRR 1.78, 95% CI 1.72-1.79), in patients with middle-low and low versus high income, respectively. During a median follow-up of 6.8 years, 1714 (2.8%) deaths occurred, and the adjusted cumulative incidence of major adverse cardiovascular events at 1 and 5 years was only 0.3% (95% CI: 0.2-0.4%) and 1.1% (95% CI: 0.8-1.4%) higher in patients with the lowest versus highest income levels.</p><p><strong>Conclusions: </strong>Disposable income level is inversely associated with the risk of ED revisits among patients presenting with chest pain and undetectable hs-cTnT, in whom cardiovascular risks are low.</p>","PeriodicalId":50807,"journal":{"name":"American Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142382246","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":"A Practical Guide to Smoking Cessation.","authors":"Pamela M Ling, Edward J Goetzl","doi":"10.1016/j.amjmed.2024.09.031","DOIUrl":"https://doi.org/10.1016/j.amjmed.2024.09.031","url":null,"abstract":"","PeriodicalId":50807,"journal":{"name":"American Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142382244","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":"Asymptomatic Eosinophilia in Travelers: Perseverance is Key!","authors":"Oula Itani, Lucie Kuhmel, Nicolas Etienne, Paul Henri Consigny","doi":"10.1016/j.amjmed.2024.09.029","DOIUrl":"10.1016/j.amjmed.2024.09.029","url":null,"abstract":"","PeriodicalId":50807,"journal":{"name":"American Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142378549","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":"Immune response and cognitive impairment in Post-COVID Syndrome: A systematic review.","authors":"Jessica Holland, Diarmuid Sheehan, Sinead Brown, Susan O'Flanagan, Stefano Savenelli, Fiadhnait O'Keeffe, Jessica Bramham","doi":"10.1016/j.amjmed.2024.09.022","DOIUrl":"https://doi.org/10.1016/j.amjmed.2024.09.022","url":null,"abstract":"<p><strong>Background: </strong>Altered immune response and cognitive difficulties have been demonstrated in studies of post-COVID syndrome, including differences in immune status and cognitive functioning in the months following infection. This review aimed to examine immune status and cognitive differences in post-COVID Syndrome twelve or more weeks after COVID-19 infection. A further aim of this review was to explore a link between immune response and the cognitive deficits observed in this group.</p><p><strong>Methods: </strong>A systematic review was carried out of PubMed, PsychInfo, EMBASE and Web of Science electronic databases of observational studies 12+ weeks after COVID-19 infection, with assessment of immune status and cognitive function in post-COVID Syndrome samples. This review protocol was recorded on PROSPERO with registration number CRD42022366920.</p><p><strong>Results: </strong>Following eligibility screening, eleven studies met inclusion criteria and were selected for our review. Six of eight studies which examined between group differences in specific domains suggested impaired cognition in the Post COVID Syndrome population, with the domains of executive function particularly affected. Of the eleven studies with immune data, nine studies reported increased markers of inflammation in the Post COVID Syndrome group, when compared to an age and gender matched \"healthy control\" sample, or population norms. Finally, when immune function and cognition are examined together, six studies presented results indicating a significant association between elevated immune response and cognitive function.</p><p><strong>Conclusion: </strong>This review highlights the frequency of cognitive difficulties months after COVID-19 infection and explores heighted immune response as a predictor of this change. Six studies suggest that immune status is a predictor of cognitive function, examining a marker of immune function and objective cognitive performance at 12 or more weeks following infection. Future studies of cognitive function in Post COVID Syndrome are needed to explore this relationship, and underlying mechanisms leading to changes in cognitive performance.</p>","PeriodicalId":50807,"journal":{"name":"American Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142373493","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":"Vitamin K Antagonist Anticoagulation in Antiphospholipid Syndrome: Time in Therapeutic Range and Clinical Outcomes.","authors":"Keren Meir, Stanley Niznik, Orly Avnery, Adi Zoref-Lorenz, Nancy Agmon-Levin, Martin H Ellis","doi":"10.1016/j.amjmed.2024.09.019","DOIUrl":"10.1016/j.amjmed.2024.09.019","url":null,"abstract":"<p><strong>Background: </strong>Thrombosis in antiphospholipid syndrome is still frequently treated with vitamin K antagonists, with a target international normalized ratio of 2-3. Time in therapeutic range of international normalized ratio of ≥ 70% is considered optimal. Time in therapeutic range among antiphospholipid syndrome patients is not well documented and the clinical consequences of poor international normalized ratio control are uncertain. This study aimed to determine the proportion of vitamin K antagonist-treated antiphospholipid syndrome patients achieving time in therapeutic range ≥ 70%, to define the features associated with poor control and to determine its association with thrombotic and bleeding events.</p><p><strong>Methods: </strong>This medical records review included antiphospholipid syndrome patients treated with vitamin K antagonists, between 2012-2023. The proportion of patients achieving a time in therapeutic range ≥ 70% was determined, and thrombotic and bleeding events were compared between patients with time in therapeutic range ​​≥ 70% vs < 70%.</p><p><strong>Results: </strong>Sixty seven antiphospholipid syndrome patients were studied. It was observed that 29.9% achieved time in therapeutic range ≥ 70% and 9.1% of patients with 3 or more comorbidities achieved time in therapeutic range values ≥ 70% compared with 40% of patients with less than 3 comorbidities. Fewer recurrent arterial and overall thrombotic events occurred with time in therapeutic range ​​≥ 70%.</p><p><strong>Conclusions: </strong>A minority of antiphospholipid syndrome patients treated with vitamin K antagonists achieve optimal anticoagulation and are at risk for recurrent thrombotic events, particularly arterial. Presence of multiple comorbidities is associated with poor international normalized ratio control. Careful monitoring of this patient population is warranted.</p>","PeriodicalId":50807,"journal":{"name":"American Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142373494","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}