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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
{"title":"Determining professional identity formation ideas for clerkship year curricula at a single institution: Students' and directors' viewpoints","authors":"","doi":"10.1016/j.amjms.2024.04.014","DOIUrl":"10.1016/j.amjms.2024.04.014","url":null,"abstract":"","PeriodicalId":55526,"journal":{"name":"American Journal of the Medical Sciences","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140758901","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
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":null,"pages":null},"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
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
{"title":"Metastatic calcification from secondary hyperparathyroidism","authors":"","doi":"10.1016/j.amjms.2024.03.007","DOIUrl":"10.1016/j.amjms.2024.03.007","url":null,"abstract":"","PeriodicalId":55526,"journal":{"name":"American Journal of the Medical Sciences","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140069046","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
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
{"title":"Autoimmune polyglandular syndrome with shock and high anion gap metabolic acidosis","authors":"","doi":"10.1016/j.amjms.2024.05.019","DOIUrl":"10.1016/j.amjms.2024.05.019","url":null,"abstract":"<div><p>Autoimmune polyglandular syndrome (APS) is a rare group of immune-mediated disorders, which are typically, but not exclusively, related to the presence of endocrine abnormalities. APS type 2 is the most common subtype of the syndrome, more often observed in adulthood, with a characteristic clinical triad, which includes adrenal insufficiency, autoimmune thyroiditis and diabetes mellitus type 1. Adrenal insufficiency is an essential and necessary clinical manifestation of the syndrome, as it is observed in 100 % of the cases, while it can be accompanied by hyperchloremic metabolic acidosis. Herein, we present a 23 years-old patient with adrenal insufficiency in the context of autoimmune polyglandular syndrome type 2 with coexisting autoimmune thyroiditis and metabolic acidosis with an increased anion gap attributed to prolonged malnutrition. Additionally, we analyze the main clinical features of adrenal insufficiency, which is a central component of autoimmune polyglandular syndrome; highlight characteristics that differentiate the major APS subtypes.</p></div>","PeriodicalId":55526,"journal":{"name":"American Journal of the Medical Sciences","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141158454","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 &gt; 120.1 mg/dL) than for delta urea (Cutoff &gt; 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":null,"pages":null},"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
{"title":"Recognizing the roles of fever in host survival and in medical intervention in infectious diseases","authors":"","doi":"10.1016/j.amjms.2024.05.013","DOIUrl":"10.1016/j.amjms.2024.05.013","url":null,"abstract":"<div><p>Fever has roles both in host defense against infectious challenges and in guidance of medical intervention. These roles remain insufficiently acknowledged and considered by both health care providers and patients and their families. This review cites reports in support of both roles and provides recommendations regarding the clinician's approach to fever, as well as points relevant for education of patients and their families.</p></div>","PeriodicalId":55526,"journal":{"name":"American Journal of the Medical Sciences","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141136184","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
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
{"title":"Malignant melanoma of the thymus","authors":"","doi":"10.1016/j.amjms.2024.03.006","DOIUrl":"10.1016/j.amjms.2024.03.006","url":null,"abstract":"","PeriodicalId":55526,"journal":{"name":"American Journal of the Medical Sciences","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140069045","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
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
{"title":"Perils of reduced dose apixaban in atrial fibrillation/flutter – A case report with a brief literature review","authors":"","doi":"10.1016/j.amjms.2024.04.018","DOIUrl":"10.1016/j.amjms.2024.04.018","url":null,"abstract":"<div><p>Patients with atrial fibrillation/atrial flutter (AF) are notoriously predisposed to thromboembolic events secondary to the development of thrombi within the left atrium of the heart. AF accompanied by a fairly decent CHA2DS2-VASc score is a known indication for full anticoagulation, frequently with direct oral anticoagulants (DOACs), such as apixaban. Following extensive studies weighing the benefits of anticoagulation versus risks of major bleeding, patients meeting two or more of the dose-reduction criteria (age ≥80 years, weight ≤60 kg, and/or creatinine ≥ 1.5 mg/dL) require appropriate step-down to a reduced dose of apixaban. However, with rising concern for bleeding complications, many physicians are found to have been reducing the dose of apixaban despite the patient not completely meeting the defined criteria. Our study particularly emphasizes the risk of significantly increased thromboembolic complications in the setting of sub-therapeutic anticoagulation, in patients with both appropriately and inappropriately reduced doses of apixaban.</p></div>","PeriodicalId":55526,"journal":{"name":"American Journal of the Medical Sciences","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140869842","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
Pancreatic metastatic malignant melanoma 胰腺转移性恶性黑色素瘤。
IF 2.3 4区 医学
American Journal of the Medical Sciences Pub Date : 2024-08-01 DOI: 10.1016/j.amjms.2024.03.008
{"title":"Pancreatic metastatic malignant melanoma","authors":"","doi":"10.1016/j.amjms.2024.03.008","DOIUrl":"10.1016/j.amjms.2024.03.008","url":null,"abstract":"","PeriodicalId":55526,"journal":{"name":"American Journal of the Medical Sciences","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140069047","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
Salary equity in academic medicine physicians 学术医学医生的薪酬公平。
IF 2.3 4区 医学
American Journal of the Medical Sciences Pub Date : 2024-08-01 DOI: 10.1016/j.amjms.2024.05.009
{"title":"Salary equity in academic medicine physicians","authors":"","doi":"10.1016/j.amjms.2024.05.009","DOIUrl":"10.1016/j.amjms.2024.05.009","url":null,"abstract":"","PeriodicalId":55526,"journal":{"name":"American Journal of the Medical Sciences","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141077019","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
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