American Journal of the Medical Sciences最新文献

Epidural block with lidocaine ameliorates kidney function deterioration and fibrosis of chronic kidney disease in rats 利多卡因硬膜外阻滞可改善慢性肾功能衰竭大鼠的肾功能恶化和纤维化。

IF 2.3 4区医学

American Journal of the Medical Sciences Pub Date : 2024-08-17 DOI: 10.1016/j.amjms.2024.08.020

Xin Xu MS , Buwei Yu MD , Youwen Lv MS , Qing Cai MS , Mengya Li MS , Guifeng Li MS , Shunjie Chen MD , Qifang Li MD

{"title":"Epidural block with lidocaine ameliorates kidney function deterioration and fibrosis of chronic kidney disease in rats","authors":"Xin Xu MS , Buwei Yu MD , Youwen Lv MS , Qing Cai MS , Mengya Li MS , Guifeng Li MS , Shunjie Chen MD , Qifang Li MD","doi":"10.1016/j.amjms.2024.08.020","DOIUrl":"10.1016/j.amjms.2024.08.020","url":null,"abstract":"<div><h3>Background</h3><div>According to evidences from clinical practices and experiments, renal denervation achieved by removing both the afferent and sympathetic nerves has therapeutic impacts on poor renal function and hypertension in chronic kidney disease (CKD). Epidural anesthesia is presumed to function on the target spine segments with a complete sympathetic block. Based on this perspective, we hypothesized that epidural block with lidocaine could ameliorate renal injury in CKD rats.</div></div><div><h3>Method and Results</h3><div>Male Sprague-Dawley rats weighing 250–300 g were randomized into four groups: control, CKD, CKD + sham, and CKD + epidural block with lidocaine groups. CKD was induced by resection of the lower and upper thirds of the left kidney followed by right nephrectomy one week later. Significant differences in renal function, sympathetic activation as well as renal fibrosis parameters were observed between CKD and control rats. These parameters corresponded with typical phenotypes of CKD rats. Epidural block with lidocaine improved renal function as well as renal fibrosis, and reversed the abnormalities of the renal function and cardiovascular parameters either fully or partially.</div></div><div><h3>Conclusion</h3><div>Epidural block with lidocaine confers renal protection, which is presumably mediated by decreasing sympathetic nerve activities in the renal region and other target organs in CKD.</div></div>","PeriodicalId":55526,"journal":{"name":"American Journal of the Medical Sciences","volume":"368 6","pages":"Pages 660-667"},"PeriodicalIF":2.3,"publicationDate":"2024-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142006233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Contemporary awareness of nonalcoholic fatty liver disease and viral hepatitis based on the stage 基于阶段的非酒精性脂肪肝和病毒性肝炎的当代认识。

IF 2.3 4区医学

American Journal of the Medical Sciences Pub Date : 2024-08-17 DOI: 10.1016/j.amjms.2024.08.014

Donghee Kim MD, PhD , Richie Manikat MD , Karn Wijarnpreecha MD, MPH , George Cholankeril MD, MSECR , Aijaz Ahmed MD

引用次数: 0

Metastatic calcification from secondary hyperparathyroidism 继发性甲状旁腺功能亢进症转移性钙化

IF 2.3 4区医学

American Journal of the Medical Sciences Pub Date : 2024-08-01 DOI: 10.1016/j.amjms.2024.03.007

引用次数: 0

Determining professional identity formation ideas for clerkship year curricula at a single institution: Students' and directors' viewpoints 确定单一机构实习年课程的专业身份形成思路：学生和主任的观点。

IF 2.3 4区医学

American Journal of the Medical Sciences Pub Date : 2024-08-01 DOI: 10.1016/j.amjms.2024.04.014

引用次数: 0

Metformin as adjuvant treatment in hepatitis C virus infections and associated complications 二甲双胍作为丙型肝炎病毒感染及相关并发症的辅助治疗药物。

IF 2.3 4区医学

American Journal of the Medical Sciences Pub Date : 2024-08-01 DOI: 10.1016/j.amjms.2024.04.019

{"title":"Metformin as adjuvant treatment in hepatitis C virus infections and associated complications","authors":"","doi":"10.1016/j.amjms.2024.04.019","DOIUrl":"10.1016/j.amjms.2024.04.019","url":null,"abstract":"<div><p>Hepatitis C virus is an important global cause of hepatitis and subsequently cirrhosis and hepatocellular carcinoma. These infections may also cause extrahepatic manifestations, including insulin resistance and type 2 diabetes mellitus. These two complications can potentially reduce sustained virologic responses (SVR) in some drug regimens for this infection. Metformin has important biochemical effects that can limit viral replication in cellular cultures and can improve the response to antiviral drug therapy based on ribavirin and interferon. Clinical studies comparing treatment regimens with interferon, ribavirin, metformin with these regimens without metformin have demonstrated that metformin increases viral clearance, establishes higher rates of SVRs, and increases insulin sensitivity. Metformin also reduces the frequency of hepatocellular carcinoma in patients who have had SVRs. Larger treatment trials are needed to determine metformin's short-term and long-term treatment effects in patients with diabetes using newer antiviral drugs. In particular, if metformin reduces the frequency of cirrhosis and hepatocellular carcinoma, this would significantly reduce the morbidity and mortality associated with this infection.</p></div>","PeriodicalId":55526,"journal":{"name":"American Journal of the Medical Sciences","volume":"368 2","pages":"Pages 90-98"},"PeriodicalIF":2.3,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140868531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Serum urea increase during hospital stay is associated with worse outcomes after in-hospital cardiac arrest 住院期间血清尿素升高与院内心脏骤停后的不良预后有关

IF 2.3 4区医学

American Journal of the Medical Sciences Pub Date : 2024-08-01 DOI: 10.1016/j.amjms.2024.04.016

{"title":"Serum urea increase during hospital stay is associated with worse outcomes after in-hospital cardiac arrest","authors":"","doi":"10.1016/j.amjms.2024.04.016","DOIUrl":"10.1016/j.amjms.2024.04.016","url":null,"abstract":"<div><h3>Background</h3><p>Evaluate the association between serum urea at admission and during hospital stay with return of spontaneous circulation (ROSC) and in-hospital mortality in patients with in-hospital cardiac arrest (IHCA).</p></div><div><h3>Methods</h3><p>This retrospective study included patients over 18 years with IHCA attended from May 2018 to December 2022. The exclusion criteria were the absence of exams to calculate delta urea and the express order of “do-not-resuscitate”. Data were collected from the electronic medical records. Serum admission urea and urea 24 hours before IHCA were also collected and used to calculate delta urea.</p></div><div><h3>Results</h3><p>A total of 504 patients were evaluated; 125 patients were excluded due to the absence of variables to calculate delta urea and 5 due to “do-not-resuscitate” order. Thus, we included 374 patients in the analysis. The mean age was 65.0 ± 14.5 years, 48.9% were male, 45.5% had ROSC, and in-hospital mortality was 91.7%. In logistic regression models, ROSC was associated with lower urea levels 24 hours before IHCA (OR: 0.996; CI95%: 0.992-1.000; p: 0.032). In addition, increased levels of urea 24 hours before IHCA (OR: 1.020; CI95%: 1.008-1.033; p: 0.002) and of delta urea (OR: 1.001; CI95%: 1.001-1.019; p: 0.023) were associated with in-hospital mortality. ROC curve analysis showed that the area under the ROC curve for mortality prediction was higher for urea 24 hours before IHCA (Cutoff > 120.1 mg/dL) than for delta urea (Cutoff > 34.83 mg/dL).</p></div><div><h3>Conclusions</h3><p>In conclusion, increased serum urea levels during hospital stay were associated with worse prognosis in IHCA.</p></div>","PeriodicalId":55526,"journal":{"name":"American Journal of the Medical Sciences","volume":"368 2","pages":"Pages 153-158"},"PeriodicalIF":2.3,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140828898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Recognizing the roles of fever in host survival and in medical intervention in infectious diseases 认识发热在宿主生存和传染病医疗干预中的作用

IF 2.3 4区医学

American Journal of the Medical Sciences Pub Date : 2024-08-01 DOI: 10.1016/j.amjms.2024.05.013

引用次数: 0

Autoimmune polyglandular syndrome with shock and high anion gap metabolic acidosis 伴有休克和高阴离子间隙代谢性酸中毒的自身免疫性多腺综合征。

IF 2.3 4区医学

American Journal of the Medical Sciences Pub Date : 2024-08-01 DOI: 10.1016/j.amjms.2024.05.019

引用次数: 0

Malignant melanoma of the thymus 胸腺恶性黑色素瘤

IF 2.3 4区医学

American Journal of the Medical Sciences Pub Date : 2024-08-01 DOI: 10.1016/j.amjms.2024.03.006

引用次数: 0

Perils of reduced dose apixaban in atrial fibrillation/flutter – A case report with a brief literature review 减量阿哌沙班治疗心房颤动/扑动的危险--一份病例报告及简要文献综述。

IF 2.3 4区医学

American Journal of the Medical Sciences Pub Date : 2024-08-01 DOI: 10.1016/j.amjms.2024.04.018

引用次数: 0